Chapter 04: Creating a New School of Allied Health Professions

Title

Chapter 04: Creating a New School of Allied Health Professions

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Description

In this chapter, Dr. Ahearn speaks about the creation of the degree-granting School of Health Professions from the loosely structured, certificate-based training programs then in existence. The School was formed in reaction to the (national) shortages of allied health professionals at that time and it continues to address that problem. He explains problems that arose from the fact that MD Anderson was not a degree granting institution despite the fact that it offered many training programs. He describes the advantages that degree-granting status would offer MD Anderson.

Identifier

Ahearn,MJ_01_20110802_S04

Publication Date

8-2-2011

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - The Administrator; The Administrator; The Educator; The Leader; MD Anderson History; The History of Health Care, Patient Care; Evolution of Career; Professional Practice; The Professional at Work; Education; Institutional Processes; The Business of MD Anderson; The MD Anderson Brand, Reputation

Disciplines

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

Transcript

Tacey Ann Rosolowski, PhD

-- very small group, yeah. I guess I wanted -- maybe we could change, shift gears now and talk about some of your roles in developing the institution, because your interest because to bifurcate, I guess I would say, between the interest in the ultrastructural pathology, and then you became interested in really developing MD Anderson as an educational institution. And the major role, of course, that leaps to my mind is the creation of the School of Health Professions, and I’m wondering if you -- that took place in 1987, as I understand, it was formally created. Would you tell me what that process was like? When did someone decide, and who decided that this was needed?

Michael Ahearn, PhD

Well, we had had training at the Institution for many, many years -- in fact, from almost the inception of the $$ WHY CAPS? Institution. They had training programs because they needed to be able to train technologists to be able to meet attrition needs within the Institution. But there were programs -- I think at the time I remember only two basic programs; one was in histotechnology, which supported the pathology service, and the other was in what we call medical technology; it’s now clinical laboratory sciences. But in those days it was medical technology that supported the diagnostic clinical laboratory, and these were programs that were in the departments. They had accreditation from professional organizations, but they were very loosely structured and did not have any academic base whatsoever. And in 1987, Jim Bowen, who was the Vice President for Academic Affairs, approached me and asked me if I would be willing to work in developing those programs and bringing them into the Office of Academic Affairs. Now, they were certificate based programs because Anderson could not award degrees, because in the initial formative legislation it actually said MD Anderson could not award degrees. And as I understand, it was a town and gown decision when Anderson, the formative legislation was done, in which some of the institutions -- I think particularly maybe Rice -- was concerned that maybe Austin UT was metastasizing to Houston, and so they thought to allay those fears they would simply say that Anderson was not to award degrees. They could do clinical training but not be degree training. So we brought them together as a collection of certificate programs, and by that time we had also radiation therapy, which had been a new area that Anderson had been very in the forefront of radiation therapy development with Dr. Fletcher here, and the development of the Cobalt 60 unit at Anderson. And so we brought those programs together as certificate programs, but with an academic structure in the Department or in the Office of Academic Programs. And then it became obvious that we really needed to be able to award degrees, and as we kept adding programs, by the time we became degree granting in 2000 we had some five academic programs. We had added cytogenetic technology to that, and also cytology.

Tacey Ann Rosolowski, PhD

Can I interrupt you just for a sec? Because one of the things I haven’t really understood about the climate or context in which this is taking place -- so today, and actually for the past, I don’t know, 10, 15 years, I think the general public is very aware that there’s a lack of doctors and of nurses, but I guess I hadn’t been aware that there was such difficulty in finding this kind of support staff, and were the reasons for the lack the same in 1987 as they are now, and...?

Michael Ahearn, PhD

Yes.

Tacey Ann Rosolowski, PhD

And what are those reasons?

Michael Ahearn, PhD

Well, allied health is some 200 different professions, and you hear a lot about the need for nursing and the shortages of nursing. Nursing is one profession, and it is well lobbied, and you hear a lot about the needs for nurses and physicians. You do not hear a lot about the allied health fields because each one is a separate field and they are not as well organized to make their presence known. A lot of the allied health training was taking place in hospital-based programs, and when third party payers came along hospitals found that they could no longer support the education efforts in their institution. In the mid 1970s, just as an example, we had over 700 programs in medical technology. Today we have some 248, and the number of graduates has been precipitously dropping, along with those program closures. And the Bureau of Labor Statistics in the clinical laboratory sciences is saying by the year 2015 that we’re going to need some 86,000 new people in the clinical laboratory sciences to take the place of individuals that are retiring for attrition need, and another 68,000 for all individuals that would be new opportunities, new employment opportunities. We’re not producing nearly enough graduates to meet those needs. I mean, the total number of laboratory science graduates is about 4,700 annually in the US, so you can see there’s no way we are going to meet those goals. It’s going to be a limiting factor in the delivery of patient care. You don’t hear a lot about it, but certainly individuals that are aware of the situation know what’s coming, and that’s the reason that most of us are trying to help the fields of allied health increase the number of students in order to be able to meet the needs of these people there. Many of them are hidden. They’re behind the walls. You don’t know who’s doing all the testing on your specimens, laboratory specimens, who are delivering the radiation therapy, who are doing the diagnostic imaging. All of these areas are not really at the forefront. They’re not touching the patient.

Tacey Ann Rosolowski, PhD

So tell me more about -- you were telling the story of how the school came into existence and then I interrupted you with that question more about the lack of allied health professionals, so tell me more about that, the story of setting up the school. You said that Jim Bowen wanted to have a conversation about doing this, and how did it work? What was the process of actually getting the school instituted?

Michael Ahearn, PhD

Well, for years we developed new programs -- as I said, they were all certificate based programs -- but even with certificate based programs you had to get passed through the Texas Higher Education Coordinating Board, so it was a process each time we developed a new program of being able to get approval from the Coordinating Board and then from the Professional Accrediting Body. But in order to sit for the Registry as these fields developed, they were requiring the baccalaureate degree, and what we had to do is we had to depend upon affiliations with other institutions that could award degrees. We provided the clinical training here at this institution, but their actual degree came from another institution, and that became a very awkward and limiting factor, not being able to control the degree part of this training, and so it was very obvious, particularly when Dr. Mendelsohn came on board, and he was supportive of the fact that if we were doing the actual training in the field that we ought to have our name associated with that. And so it required us going back and redoing the formative legislation, and it was House Bill 1314, which Representative Hochberg from the Houston area sponsored. But it took a lot of -- it was about a three year process, because any time you go back and undo some kind of legislation you have to explain to people why, because there’s a natural tendency to “What’s going on here?”, you know, and “It’s been in existence all these years; what is the need for the change, and what are the fiscal implications going to be to the State in doing this?” And so it was an educational process that required many, many trips out to Austin with our Government Affairs Office, and certainly with the support of Dr. Mendelsohn, that was very heavily involved and having to take his time to go and appear before the Higher Education Committees in the House and the Senate in order to lend support to this. And then a lot of dealings with the legislative staff people, which -- the legislatures have a great deal on their plate, and they depend upon their staff to apprise them of what needs to be done and to listen to a lot of people like us that are coming with requests. And so it meant that we met with a staff of almost all the people in the House and the Senate, answering their questions and making their case. So it was a long process before we actually got the vote to be able to change the legislation to award degrees.

Tacey Ann Rosolowski, PhD

And how did you make your case? I mean, what were the points that you made?

Michael Ahearn, PhD

Showing the need for -- certainly, even back in those days we were seeing that we were not meeting the goals of what the professions were going to require for the general populace, and then the fact that we were doing the critical part of the training but were not being recognized for the effort that we were putting forth, because we were not able to have any sort of tuition. We could not charge for tuition and we could not get formula funding, so we were doing this training without any support from the State at all, and it was a burden on the institution as these programs grew, which they needed to do to meet the workforce demand, but we were having to do it out of just the revenues from the institution without having any State support at all.

Tacey Ann Rosolowski, PhD

So you received no revenues from the degree granting institution for providing the--?

Michael Ahearn, PhD

No.

Tacey Ann Rosolowski, PhD

Wow.

Michael Ahearn, PhD

None. None.

Tacey Ann Rosolowski, PhD

That’s pretty amazing! (laughter)

Michael Ahearn, PhD

Yeah, they collected the formula funding for the students. We did not get anything.

Tacey Ann Rosolowski, PhD

Was -- a question occurred to me a little earlier as you were describing the scenario; I’m wondering if -- was the education compromised at all, you know, having the students sort of institutionally based elsewhere and then having their experience at MD Anderson?

Michael Ahearn, PhD

They determined the prerequisite courses at the institution. We did not have any control over that. We could just control the curriculum that we provided here, and we certainly knew what we needed insofar as prerequisites, but many times the students that they sent us, we were not privy to say “This is not satisfactory,” because it met their degree requirements and they were the ones awarding the degree. We were just providing 90 hours -- I mean 30 hours or 60 hours of clinical training.

Tacey Ann Rosolowski, PhD

I read -- I mean, on a slightly different subject, but related -- I read that John Mendelsohn wanted MD Anderson to be, the phrased used was a “full service academic center,” and from your perspective, what did it mean really to the identify of MD Anderson to be able to grant degrees?

Michael Ahearn, PhD

I think up until that time MD Anderson was recognized as a cancer center, as a hospital, but had no academic basis whatsoever. I remember early on when we contacted the Southern Association of Colleges and Schools for regional accreditation, which you have to have in order to have transferable credit, and also to qualify for all Title 4 programs within the federal government, and so every academic institution has a regional accreditation in the United States. And when we first applied for that, we had a call from the representative from SACS that was assigned to MD Anderson saying, “You all have a real problem, because they said this morning when we had our staff meeting here in Atlanta, we were going around the table talking about the applicant schools that each one of the staff was assigned to, and when it came to MD Anderson and I said that, you know, MD Anderson is applying, and they said unanimously around the room, they said, ‘That is not an academic institution.’” So she said, “You’re going to have a double burden, because you have got to convince these people that you are an academic institution.” And I think that was the general feeling at that time, and I think Dr. Mendelsohn realized that, and it was going to be a little bit of an uphill battle, but it was one that in order to be an academic institution we needed to overcome. And it was the same thing with the graduate students. Anderson faculty were mentoring and supervising about half of the graduate students, and yet the degrees were being awarded by UT Health Science Center in cooperation with MD Anderson, but it was not an equal partner. And yet, our faculty was making up half of the faculty or more in the graduate school faculty, but we were not recognized for the effort. And I think, to Dr. Mendelsohn’s credit, he recognized that this had to be changed.

Tacey Ann Rosolowski, PhD

Did not being recognized as an academic center put into question at all the quality of research or the quality of care? I mean, how -- I’m wondering if there was sort of an aura that academic lends --

Michael Ahearn, PhD

No, I don’t think so, but I think we were training a great many people and providing, perhaps, some of the finest training there could be in the United States, but nobody was recognizing that because we were not recognized as an academic institution.

Tacey Ann Rosolowski, PhD

Just didn’t have a, didn’t have a label, basically.

Chapter 04: Creating a New School of Allied Health Professions

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