NEW BOTTLES FOR VINTAGE WINES - THE CHANGING MANAGEMENT OF THE MEDICAL-SCHOOL FACULTY

Medical schools are being challenged to develop innovative mechanisms of faculty governance and manage ment that enlist faculty in meeting t he demands of a competitive marketplace. The authors describe some of these mechanisms in this article, which is the result of case studies made in 1997 of ten schools. Measures to increase the accountability o f faculty to the strategic directions of the school include having app ointment letters that specify explicitly the roles and responsibilitie s of the faculty member, conducting annual performance reviews based u pon more objective criteria, tying salary to performance, lengthening the pre-tenure probation period, instituting post-tenure review, and r edefining the salary guarantees of tenured faculty. Equally important is balancing these policies with initiatives to strengthen the account ability of schools to their faculty. Improved methods of communication between administrators and faculty and more efficient processes to en able faculty to participate in decision making are appearing. Formal a pproaches to mentoring and faculty development are being implemented, Recognition and reward programs are being strengthened. Alternatives t o tenure are being developed in recognition of the need for increasing ly diverse roles of faculty and to ensure job security. The reengineer ing of the processes that will lead to shared vision and accountabilit y will require massive cultural change. The realization of these goals is likely to depend on the skill of medical school managers and the a bility and willingness of faculty members to work collaboratively and creatively in designing new methods to accomplish old missions, Next m onth's AAMC Paper will explore changes in the structure and management of medical schools and their owned or closely affiliated facilities t o improve the efficiency of achieving their core missions.