Chapter 20: The Value of Committee Work; Changes in MD Anderson Culture and the Need for Mentoring

Title

Chapter 20: The Value of Committee Work; Changes in MD Anderson Culture and the Need for Mentoring

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In this chapter, Dr. Alexanian explains that committee work is not "a waste of time" as so many faculty believe. He notes that committee discussions with conflict can be very helpful in bringing important issue to the foregrounds for resolution. In the final minutes of this chapter, Dr. Alexanian notes changes in MD Anderson culture: Department heads no longer mentor as actively nor do they foster as much exchange among faculty. He explains what is needed in a good mentoring relationship.

Identifier

Alexanian_R_20140605_S20

Publication Date

6-5-2014

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Critical Evaluation; Critical Evaluation; Institutional Processes; MD Anderson Culture; Education; Growth and/or Change; Critical Perspectives

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey Ann Rosolowski, PhD

Any other observations you want to make on committees at this point?

Raymond Alexanian, MD

I think one thing that it’s important for committees to do is to—first of all, most of the faculty doesn’t want to do committees. They feel it’s a waste of their time. And that’s unfortunate, because they can learn a lot on committees. On the face of it, it may seem uninteresting, and hours can be spent on boring things, but I think that committees have a useful purpose, especially when there’s a clash of divergent views. And the stronger the clash, the better it is and the better the outcome, because if there’s a clash, there’s something important that someone’s clashing about, and if you can resolve it in a way that satisfies both parties, then only good can come from it. So I like to see clashes. I participate in clashes if I can.

I think that too much of our work is pro forma work. Fortunately, the committees are now more streamlined, so that I think—I’m not sure—that many times certain modest amendments or adjustments on a protocol can be just cleared by the chairman without going through a committee, and I think that’s good. In the old days, everything would have to go through the committee. And committee work should be streamlined. Unfortunately, as I mentioned, too much of our internal review board committees are meant to protect the hospital rather than to expedite research.

Tacey Ann Rosolowski, PhD

It seems to be a common view.

Raymond Alexanian, MD

Also, there are even, I’m told—I don’t know if it’s true—that even some departments don’t have—well, that’s not true. They probably do have. Do you know, for example, do all departments now have departmental meetings of their staff?

Tacey Ann Rosolowski, PhD

I believe so, yeah. I think that’s pretty much standard process.

Raymond Alexanian, MD

Is that standard process?

Tacey Ann Rosolowski, PhD

Yeah, pretty much standard practice, yeah. I think a lot of those kind of things have evolved as the institution has become larger and more complicated, because I think when it was smaller, you could rely on people having face-to-face contact in situations and passing information, but now the institution is so large that you have to have a formal meeting in order to get basic communication done.

Raymond Alexanian, MD

How many of those meetings do you suppose people present their research work to each other?

Tacey Ann Rosolowski, PhD

Well, that’s a different issue. That’s a completely different issue.

Raymond Alexanian, MD

See, in those days, in the old—we used to expect that—

Tacey Ann Rosolowski, PhD

Wow.

Raymond Alexanian, MD

—for each meeting, have a short presentation of some something interesting. Could be an interesting patient or an interesting idea or a result of your own work, just for ten minutes. I have a feeling none of that is done.

Tacey Ann Rosolowski, PhD

Right. I think other venues have to be created to do that, because people do talk a lot about how the institution has changed. And actually, that’s a question I wanted to ask you, because you left, you retired in 2004, so you were here during the huge expansion.

Raymond Alexanian, MD

Yeah. Well, who knows more about a particular department’s research? Don’t you think other people in the department would be more familiar, should be more familiar?

Tacey Ann Rosolowski, PhD

Mm-hmm.

Raymond Alexanian, MD

Well, I think that work is being done in departments that are not even known about by other department members. They don’t even know about it.

Tacey Ann Rosolowski, PhD

When did you start seeing that happening in the history of the institution?

Raymond Alexanian, MD

Oh, I think I can’t—it’s hard to pinpoint it. Maybe twenty years ago. Some departments do make a point of having—because all of the doctors are included on a project, for example. They’re all colleagues. But somebody may be working on a project, say, in his laboratory or on a few patients on his own protocol that other people in the department aren’t aware of. Then what’s even more is that after a year of progress, the person is working, no one knows where he is in the project. Maybe it’s successful and no one knows about it, and he’s published. The world knows about it. The people in the department don’t know about it. Can you imagine that?

Tacey Ann Rosolowski, PhD

Yeah, I can. I can, actually. I can. [unclear]. (laughter)

Raymond Alexanian, MD

So I say, why is that?

Tacey Ann Rosolowski, PhD

Well, that’s really a measure of growth, you know, and just how large the institution has become.

Raymond Alexanian, MD

Well, I mean, all right, that’s an excuse, and I think—

Tacey Ann Rosolowski, PhD

Oh, really? So what’s your view?

Raymond Alexanian, MD

I think it’s the department head is so busy, probably with personnel and other things or his own work, that he doesn’t clash heads or inform, have this exchange, and doesn’t many times look after the progress of the younger staff or the new fellows, say, “What are you working on? Tell me about your work.”

You know, in the old days in medical schools, I would be in some departments when, let’s say, the student and the department head would ask you to come to his office, and, of course, we knew it would be our turn. And the student would meet with the department head. These are busy department heads, and these are students, medical students, third-year students. And he would meet with you for ten or fifteen minutes and ask you, “What did you see that was interesting in my department, and what did you learn from it? Tell me what you read about it,” one-on-one with the department head to a medical student. It’s probably not that anymore.

Tacey Ann Rosolowski, PhD

Yeah. I mean, those days are long gone.

Raymond Alexanian, MD

And I know that it’s not done very much here, but I think that it doesn’t take that much time to require each member of a department, let’s say, every three to four months to make a presentation for ten minutes, fifteen minutes. I don’t think that’s hard. Then it’s amazing how many new things, things that can be done to—why don’t you do it this way? Why don’t you ask such-and-such to do it? [unclear].

Tacey Ann Rosolowski, PhD

Mm-hmm, fostering that collegiality and [unclear].

Raymond Alexanian, MD

Yeah. And look, if you [unclear], maybe I’m happy to—“If you’re having trouble writing, well, send me a draft, I’ll just edit it and don’t give me any credit. I’ll be happy to work it over for you.” We don’t hear that.

Tacey Ann Rosolowski, PhD

Have there been some other big cultural changes that you’ve noticed that concerned you and are concerning you?

Raymond Alexanian, MD

Well, not anymore since I’m retired. (laughs)

Tacey Ann Rosolowski, PhD

You’re retired. Right.

Raymond Alexanian, MD

In my final years, I would comment on many of these things. I said, “Look, why don’t you do this or do that.”

Of course, no one pays any attention, and then say, “Well, that’s the old-fashioned way. We don’t do that anymore.”

Chapter 20: The Value of Committee Work; Changes in MD Anderson Culture and the Need for Mentoring

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