By Ricardo Azziz | December 27, 2012
Recently, after wide-spread vetting, we published guidelines for the structure and vocabulary of interdisciplinary and transdisciplinary units at GHSU (and eventually GRU) and the GHS Health System. And so I thought it would be an opportune time to review why we need these kinds of units and what are the principles underlying their structures and scope of authority.
The departmental structure of academic institutions today follows the 19th century model of the European research university, driven by an emphasis on specialization and disciplinarity. In the US the organizational structure of universities and colleges can be traced to 1825 when George Ticknor, recognized academic and Hispanist, upon returning from Europe convinced the Harvard Board of Overseers that American colleges should follow the model of the German research university and be organized by departments. Hearing of this, in that same year the University of Virginia opened with seven departments (called colleges).
And the departmental structure has continued to proliferate, helping to create profound knowledge by focusing research and training in particular disciplines, reducing the dispersion of attention and effort of faculty and students, and helping to drive the American research university to its preeminence today.
Paradoxically, then, this complexity, in addition to the intricacies of health system interfaces in academic settings, can also predispose us to some of the siloes we encounter today in academe. Siloes that weaken us, that create large blind spots, that create internal inequalities based on arbitrary sizes of the silos, not intrinsic value. Often re-enacting the parable of the blind men who first meet an elephant.
And as our knowledge base has continued to expand we have found ourselves in need of a broader view, a higher (or deeper) understanding, of the wholeness and interactivity of things. Because as our disciplines have drilled down into the fundamentals of many fields of study, we have also found that many of our areas of knowledge about, overlap, and impact on, or impacted by, many other areas and fields of knowledge. And the role of our faculty has become increasing more complex and variegated.
And so – like academic leaders across the country – we began to talk about multidisciplinarity, interdisciplinarity, transdisciplinarity, and cross-disciplinarity.
And yet, as often happens, these efforts in academics have been generally modest. While we genuinely aimed to pursue transdisciplinary knowledge in order to obtain a more holistic understanding of our respective fields, our academic structures, promotion and tenure protocols, and reward systems did not fully support such endeavors.
To be clear, interdisciplinary and transdisciplinary organizational structures in academia have been with us for some time. Graduate schools are an early example of an interdisciplinary unit, and comprehensive cancer centers are examples of transdisciplinary entities. But their boundaries are often ill-defined, and even if they are well defined the need for additional transdisciplinary units is still great.
But as we often remind ourselves – structure should follow function. And so it should as we pursue our goal of transdisciplinarity.
So how do we create an organizational structure that supports the robust and productive interdisciplinary and transdisciplinary academic and research units that our future needs, while respecting and to significant degrees preserving the academic structure that has brought us so far? And of course, a most important question…. “What does this mean for me and how does this affect me?”
These are important questions we need to try and answer as we once again (and not the first time on this grand transformative journey) face a complex problem. But before we answer these queries lets review the structures we are proposing to create, or more clearly define, in our enterprise.
In the health system we are better defining the purpose, scope, and boundaries of interdisciplinary clinical Service Lines and Centers of Excellence. And in the university we are defining university-wide transdisciplinary and interdisciplinary research Institutes (including the Cancer Research Center, really a research institute), Research and Educational Training Centers, Research Service Core Facilities, and Research Laboratories providing service. And while I will not review the details here (see: Organizational Units at Georgia Health Sciences University & Health System), it is worthwhile reviewing the general principles that underpin these guidelines.
Firstly, we should embrace a few strategic principles…
- We must be future-oriented. We are working to create the structure that will not only serve us well today but should help us meet and craft the future, not just waiting for the future to reach us. As Abraham Lincoln (or was it Peter Drucker?) reminded us that… “The best way to predict the future is to create it”.
- We must strive to see the whole. While each of us is heavily imbedded in our specific disciplines (since by definition a ‘professor is one that teaches or professes special knowledge of an art, sport, or occupation requiring skill’) we must also recognize that many of the problems that we face today, from how to ensure the growth and success of a university, to understanding the impact of prevention on healthcare costs, to the origin of malignant growths, and beyond, require us to understand that we are part of a ‘whole’. Increasing the power of the whole.
- And, most critical, and most difficult of all… we must always think and act collaboratively and collegially. While it may seem obvious, we should always strive to ensure that our decisions are as transparent as possible, and that we try and engage all relevant colleagues proactively in our decision-making. A principle even more critical when operating in the matrix environment that our enterprise is today. And this is can be very difficult for those of us who are accustomed to operating in the siloed structure that is academe today.
Secondly, we should embrace a few simple operational principles….
- Institutional authority is paramount. All resources and personnel are under the ultimate authority of the employing agency, whether health system or university, as is the hiring and firing of any and all personnel. While some of these authorities may be selectively delegated in a codified manner, they are never relinquished.
- Logic and common sense must prevail (e.g. clinicians must have a primary appointment in a clinical department a clinical work creates the highest level of risk, faculty titles must be tied to university teaching effort and must be hired through the university, an individual may have more than one supervisor depending on what she/he spends her/his time or effort on, etc.).
- The establishment or continuation of transdisciplinary units critically depends on the availability of a number of trigger factors. These may include critical faculty and programmatic mass, return on investment, cost (direct and opportunity), and the endorsement of strategic leadership.
- All units must have clearly established metrics for assessing progress, success, and relevance, and should be evaluated regularly.
- As faculty and staff roles become more complex, it is no longer enough to simply think of these individuals as one single entity; rather a faculty member may have multiple roles, with dedicated effort assigned to each. For example, a faculty member may be a clinician in a service line for 40% of his or her time, a researcher in an Institute for another 30%, and serve as professor in an academic department the remaining time. This principle speaks to the need to craft careful plans around faculty, denoting their goals, efforts, and respective funding sources, prior to hiring and at the annual review.
- Monies follow effort. In other words, monies and resources should be designated for a particular effort. If the faculty member carrying out that effort joins a different unit or ceases to perform those activities then that support can and should be transferred as needed. And this follows closely on the heels of
- We needed to ensure the sufficient faculty effort is dedicated to the core mission of the university, teaching, and that of the health system, clinical care. The creation of transdisciplinary units should not take away, in any manner, from the fulfillment of these two core missions.
- The integrity of the faculty appointment, promotion and tenure process must be preserved, which is subject to significant outside (USG, SACS) regulation.
Finally, we need to embrace a few newer management principles…
- We need to understand and embrace working in a matrix environment. Individual faculty, or even staff member, may have multiple supervisors. And consequently the recruitment, hiring, on-boarding, periodic evaluation, compensation review, promotion, and so on, of these faculty should automatically mandate consultation and agreement between all those with relevant and significant supervisory authority over the activities of that individual. Regardless of who has the primary administrative responsibility for managing the process.
- We need to better understand the difference between codified conditions and powers, and value statements. For example, authority, accountability and attribution are all powers or responsibilities that are delegated via an accepted and codified process (rules and regulations, protocols, procedures, etc.). Alternatively, responsibility, control, and ownership are value statements, which may or may not be codified, around which much of our behavior occurs.
- We must understand that if a supervisor is able to ensure that the members of her/his units act positively and proactively only by using codified authority… then she/he and the respective unit is doomed to failure. For control, a value statement denoting the ability to direct the direction of a strategy or tactic, or the usage of personnel effort and/or resources, arises from the use of many other mechanisms, the most important of which is influence and authority over available resources.
So what does this mean to leaders of transdisciplinary units, such as directors of university-wide Institutes and Centers, and health system-wide service lines?
This means that many will see significant gains in scope of authority, but with significant additional managerial responsibilities, including the evaluation of faculty, the prudent management of limited fiscal resources, and the overseeing of operational details. This will also require skilled collaboration with other leaders.
However we should also recognize that there will be a variety of such units, some more defined and fiscally and organizationally robust than others (see figure).
And what does this mean for academic department chairs? Rather than considering this an erosion of authority, a chair can expand her/his scope of influence as now they will have a number of high performing transdisciplinary unit leaders as obligated partners in the management of discrete activities. Moreover, Chairs will influence a wide range of transdisciplinary unit activities as these will require the consent, assent, or cooperation of the Chair.
So what about responsibility over resources? That is something that the guidelines (see: Organizational Units at Georgia Health Sciences University & Health System) do not address in a granular fashion. Because all resources first and foremost belong to the institutions, and because not all transdisciplinary units are constructed similarly. And because we will always need to identify innovative, collegial, and effective manners of ensuring maximum return-on-investment on scarce resources.
Finally, we all should understand that these are not perfect guidelines that they are a work in process, a ‘sculpting in clay’ if you would, and that together we will continue to reassess and tweak over time. As we help create the future.