Ask the Dean Archive
Question:
This is a follow up question from your response that was posted a few weeks ago regarding the requirement of all employees returning to work in person. How is this being monitored? There are several departments that are not requiring their employees to be on site every day. This is not fair to those employees who are working onsite while others in a department are working from home.
Answer:
Each department chair/unit leader is responsible for monitoring and ensuring compliance with this policy, just as unit leaders are responsible for ensuring compliance with all college and university policies. If there are concerns with regard to compliance, employees are welcome to report a possible violation by utilizing the University’s Ethics and Compliance Hotline or by submitting a Professional Conduct Comment to the COM-T Professionalism Committee.
Date Answered: 7/25/2021
Question:
Regarding the return to work for the COM-T staff, is this a department choice or is the expectation that every employee return to work? If it is not a department choice, how will this be implemented?
Answer:
Thank you for your question. This is not a department choice but an expectation of all COM-T employees. Per my June 4 Message from the Dean: “As we previously indicated in the Weekly Updates and Messages from the Dean (April 25th, May 16th), all COM-T employees are expected to return to work, in-person and consistent with their conditions of employment prior to President Robbins’ March 13, 2020 email, on or before July 1st. This expectation is consistent with President Robbins’ Transition Back to Work and Provost Folks’ Guidance on Return to Work emails outlining the plan for university units to resume most regular, in-person operations by the start of the 2021-22 academic year.”
Date Answered: 6/27/2021
Question:
What mechanisms could be created so that The University can promote a unified academic culture for all within the UAHS?
Answer:
At the request of UAHS, we asked the chair of the Dean’s Faculty Advisory Committee, who vets the “Ask the Dean” questions, for clarification on the meaning of “a unified academic culture.” He advised that getting clarification of the anonymously submitted question was not possible, but that he believed the question may have been about “…the differences that exist for physicians who work clinically. How can the benefits and protections be unified for those who work for Banner and those who work for the University?”
As I shared in my June 20 response to a similar question, benefits are employer-specific, so differences between employer offerings will exist. Banner-employed faculty are also Affiliate Designated Campus Colleagues (DCCs) and have UArizona Benefits that are associated with Affiliate DCCs. Also note that all faculty, whether employed by UArizona or Banner, report through their academic departments, either to their chair or their division chief, and any specific concerns should be discussed with their supervisor.
Date Answered: 6/20/2021
Question:
What can be done to eliminate the differences between Banner- and UA-employed faculty in time off (vacation, sick-time, university closure; these do not roll over for Banner employees), 401k matching, qualified tuition reduction benefit (for Banner employees - some of QTR is taxed as income), and library online access?
Answer:
Benefits are employer-specific, so differences between employer offerings will exist. Banner-employed faculty are also Affiliate Designated Campus Colleagues (DCCs) and have UArizona Benefits that are associated with Affiliate DCCs.
Date Answered: 6/20/2021
Question:
How do you hold department leadership accountable for bullying faculty/staff? What mechanisms exist to communicate these issues anonymously?
Answer:
COM-T does not tolerate bullying. Reporting of such behavior can occur through standard management channels, beginning with an individual's immediate supervisor. When that is not possible, the University’s Compliance Office is available. It offers an Ethics and Compliance Hotline where concerns about legal or policy violations or unethical conduct can be reported anonymously, 24/7. Compliance Office personnel review and investigate reports of suspected misconduct or non-compliance, as appropriate.
Date Answered: 6/20/2021
Question:
Do you talk to faculty who are leaving to understand if improvements can be made in various departments?
Answer:
At this time, COM-T does not routinely conduct exit interviews with faculty who leave the institution. Banner University Medicine reaches out to all faculty members leaving the organization to gain feedback on their experience and to identify any opportunities for improvement.
Date Answered: 6/20/2021
Question:
Promoting diversity, particularly increasing numbers of URiM, is a major (and laudable) goal of The University of Arizona. Faculty leaders in the COM are being asked to articulate their strategic plans to promote diversity. Nevertheless, at the highest levels of leadership in both The University and Banner, the top individuals are all white men (i.e., Drs. Robbins, Dake, Abecassis, Carr, Whelan and Lee). Thus, leadership at the highest levels is remarkably undiverse and not different from what it was 70 years ago. Leaders need to model the behavior that they seek from the faculty. What is the strategic plan for recruitment of individuals who are URiM at the very highest levels of leadership of The University and Banner?
Answer:
Thank you for your question. As a reminder, the premise of the ‘ASK THE DEAN’ feature of COM-T’s weekly update is to promote bilateral communication with COM-T faculty, and to answer questions from the faculty on an ongoing basis primarily regarding and related to COM-T issues. In addition, on March 21st, we invited faculty to submit questions related to the strategic plan. With this in mind, we will frame our response to what the “strategic plan for recruitment of individuals who are URiM” is at COM-T to promote diversity, equity, and inclusion (DEI).
We firmly believe DEI at COM-T and beyond to be a central core mission of our efforts towards achieving the COM-T’s tripartite mission. In fact, this past year, we refreshed COM-T’s mission statement accordingly, and we appointed Dr. Victoria Murrain as COM-T’s Vice-Dean for DEI. We also believe that a strong pipeline towards training the future generation of DEI faculty and leaders is an essential first step towards achieving DEI “at the highest levels of leadership”. To this end, under Dr. Murrain’s leadership, there are several important efforts designed to increase URiM students who matriculate to COM-T. These include but are not limited to the Pre-Medical Admissions Pathway (P-MAP) program; Community College outreach as many of our URiM students begin their academic careers at community colleges; and mentoring of undergraduate students by our student affinity club members. In addition, the Primary Care Scholarship tuition-free program is designed to increase the number of URiM physicians who will practice in underserved areas in Arizona, and there are ongoing efforts to enhance the experience of both URiM students and residents/fellows on our campus. The Anti-racism in Medicine Subcommittees have engaged faculty, students, residents/fellows and staff in enhancing the inclusivity of our campus, resulting in significant changes in the medical school curriculum, evaluation processes, recruitment and retention of faculty, residents/fellows and students. All of these are focused on acknowledging the role of diversity in our academic environment. COM-T is entering its second year as a member of the National Center for Pre-faculty Development in BNGAP (Building the Next Generation of Academic Physicians), which focuses its attention on developing URiM students, residents/fellows and junior faculty to potential careers in academic medicine and leadership roles. We will be nominating our second fellow to the program in the next few months. This fellowship not only encourages networking, but also mentors the participating fellows to complete a project that will enhance the DEI at their home institution.
We have also instituted DEI training across COM-T, and more relevant to your question, mandatory training for all members of our search committees for department chair and other leadership positions. Each of these search committees includes a member of the dean’s Faculty Diversity Advisory Committee (FDAC) or a Diversity Champion and is tasked with ensuring the pool of reviewed and interviewed candidates is diverse.
Also, as you allude to, we have made DEI one of the areas of focus for the COM-T unit-based, metric-driven, directional tactical and strategic plan with the objective to improve efforts towards enhancing DEI at every level for all departments and centers that report into the dean’s office. The strategic plan DEI team is working with every department to identify areas to improve recruitment of a more diverse pool of applicants, including inclusive wording in the position description and advertisement locations that will reach a more diverse audience. Importantly, and to hold senior leadership accountable, the COM-T strategic plan also includes a target metric of increasing URiM representation among our Senior Leadership over the next three years.
Finally, in the preamble to your question, you noted that the top individuals at both the University and Banner are “all white men”. While we are in full agreement that more DEI efforts are needed, we would point out that your selected list of leaders failed to include a number of UArizona and Banner senior leadership (e.g., UArizona Senior Vice Presidents Liesl Folks, Elizabeth Cantwell, Lisa Rulney, Laura Todd Johnson, Nathan Levi Esquerra, and Banner University Medical Center’s CEO Sarah Frost, among others). Again, we greatly appreciate your question and your clear message that there remains a lot of work to be done to achieve the promise of DEI at every level.
Date Answered: 5/9/2021
Question:
What is the status of the new Compensation Plan for faculty who do clinical work? When will it take effect? Will faculty be able to review it and give input before it is implemented?
Answer:
Thank you for your question. Teams from BUMG, UAHS, COM-T and COM-P have been working together for the past year on a refreshed clinical compensation plan. After several review cycles, the outline of the proposed plan was presented to and reviewed with the Clinical Leadership Group in March. Beginning in April and going into May, members of the plan design team have been having additional small meetings at a departmental level to review the features of the new plan including: 1) refreshing of the rate/wRVU, 2) management of a non-wRVU capture plan, and 3) how to value time spent in academic and clinical leadership roles by specialty. All feedback from these important meetings is being reviewed by the combined leadership team to ensure that the proposed plan is both clear and transparent. Once these preliminary meetings conclude in May, a series of faculty meetings will be held to review features of the proposed plan to allow for additional questions and feedback. Please look for these invitations in June. At the end of this last cycle of review, the plan will be finalized and presented to the Academic Management Council for approval. After approval, the final plan will be implemented in accordance with the mandated notification period.
Date Answered: 5/2/2021
Question:
Medicare increased the number of RVUs linked to office-based E/M visit codes starting January 2021. Although Banner is charging Medicare these new rates, they continue to use 2020 rates to calculate physicians’ RVUs. This has greatly disturbed many of the faculty in the COM as their performance targets and incentives are directly linked to RVUs. How can the Dean advocate for the faculty to correct this?
Answer:
Thank you for the question. The first step in advocacy is to fully understand the situation.
As you correctly point out, CMS finalized changes to the MFS in January 2021. Based on the related December 2020 AMGA update, for 2021, “the agency is increasing relative value units (RVUs) for a subset of evaluation and management (E/M) codes. To offset the increase for these codes and comply with budget neutrality rules, CMS finalized a significant decrease in the conversion factor”. As a result of these changes, many specialties may face significant reductions in revenue based on reductions in $/RVU. While you are also correct that “performance targets and incentives are directly linked to RVUs”, it is also true that compensation benchmarks are linked to RVUs, and formulaically reflective of $/RVU. Thus, changes will include both increases and decreases across the various BUMG disciplines and specialties, and the financial impact of the reduction in the $/wRVU remains unclear. Moreover, with the high degree of variability of volume in the midst of the pandemic, and with the impending implementation of a new compensation plan, it seems prudent to hold off making any changes for at least a year until the full impact can be fully assessed and understood. Also, the national annual benchmarks for productivity are in evolution, so it is generally felt that until those stabilize this year, it would be extremely challenging to set initial salaries and track progress. This is an important consideration given that both RVU productivity and compensation benchmarks are based on data from the prior year, and therefore both assessments might prove inconsistent. For these reasons, it would seem that to adopt new $/wRVU values without accounting for the impact on compensation per wRVU could potentially create more problems than it solves. It should also be noted that for these same reasons, a majority of multi-specialty medical groups in the US have opted to freeze rates for one year to assess the impact.
Deliberations around this issue have been ongoing, with the sentiment that to ensure stability in physician compensation, it makes sense to maintain the existing conversion factors. We fully anticipate that through careful review of coding patterns over the course of this year, it will be possible to predict the long-term impact, and ensure that our compensation plans and revenue cycle strategies are aligned for both provider satisfaction and overall fiscal health. Stay tuned.
Date Answered: 4/25/2021
Question:
What is the likelihood of a UCAP/Staff Advisory Council please?
Role: to provide a review panel and make recommendations on UCAP/Staff concerns.
Answer:
Thank you for your question.
The University Career Architecture Project (UCAP) was launched January 27, 2020 to better “manage compensation at UArizona”, and replaced the previous “classified staff and appointed professional categories of employment with market-based job functions and families”. Please visit the UCAP webpage https://hr.arizona.edu/content/university-career-architecture-project-ucap for FAQs.
To answer your question, we reached out to Ms. Chante Martin, Assistant Vice President for Human Resources and COM-T’s HR contact for the Health Sciences Colleges. Chante informed us that HR has been working with the two existing committees for appointed and classified staff to address UArizona staff concerns. The Appointed Professionals Advisory Council (APAC) represents staff employees by taking an active role in shared governance and advising the University Administration and other UArizona organizations on matters of concern to UArizona staff. Following implementation of UCAP, APAC has been working with the Classified Staff Council (CSC) to redefine the structure and shape of our shared governance organization. Should you have any further questions regarding UCAP, appointed or classified staff issues please contact APAC or contact CSC . Also, Ms. Chante Martin can be reached at chantemartin@arizona.edu.
We appreciate your willingness to submit questions to this newly developed section of the weekly COM-T update. As a reminder, the premise of this exercise is “to promote bilateral communication with faculty”. During one of our regular meetings, the COM-T Dean’s Faculty Advisory Committee (DFAC) had suggested that as part of COM-T’s weekly update, an opportunity be provided for “the Dean to answer questions from the faculty on an ongoing basis”. In response, our IT department, working with BioCommunications and with Dr. Arthur Sanders (on behalf of DFAC) quickly established a dedicated page on our website that could be used as a submission form “hyperlink” for faculty to submit questions. In turn, the DFAC committed to review questions from the faculty, to vet through them, and to submit these with the expectation of a response “from the Dean”. We hope this mechanism continues to fulfill the original premise. We would also like to point out that this section is by no means the only mechanism for getting questions answered from the Dean’s office. Everyone should feel free, at any time, to reach out by emailing DrAbecassis@medadmin.arizona.edu.
Date Answered: 4/11/2021
Question:
It seems that the College of Medicine, through its policies, regards faculty who do clinical work primarily as clinicians who must earn their salaries through clinical work and must compete for teaching or administrative support to “buy-down” clinical time. This is very different than faculty in other Colleges at the University – Nursing, Pharmacy, Law, Engineering, etc.
The University of Arizona contract we are obliged to sign each July states: “If you perform professional clinical practice activities through B-UMG and that relationship ceases, your University appointment and employment will terminate unless otherwise specifically determined by the University (in which case your compensation and benefit arrangements will be adjusted accordingly)”. While faculty realize that if they terminate clinical activities with B-UMG, their salaries would be adjusted similar to terminating a grant, contract, or VA appointment, why should terminating Banner activities result in loss of University faculty appointment?
Similarly, the model used for distribution of educational funds for administrative activities is having faculty apply for a specific “job” (course director, thread director, ass. dean, etc.). The faculty would receive funds for part time salary support to “buy-down” their clinical time. This separation of faculty work reinforces the concept that faculty in clinical departments are primarily hired to do clinical work and need to “apply” for other “jobs” to be involved in the COM activities. Please comment on these policies and the implication for faculty who work in clinical departments compared to the other professional Colleges at the University.
Answer:
Thank you for your submission. I will respond by attempting to answer your question as well as by addressing your request for a comment (both in bold characters above).
You asked: “…why should terminating Banner activities result in loss of University appointment?” In your question, you do not specify whether you are alluding to a UArizona-employed or a Banner-employed faculty-physician who “terminates clinical activities at BUMG”. I will therefore answer your question addressing each of these two circumstances separately:
A. UArizona-employed and appointed faculty-physician provides “clinical activities at BUMG”: you specifically refer to the language that says that if a faculty-physician ceases to perform clinical activities through BUMG and the relationship ceases, the faculty-physician’s employment with UArizona will terminate unless UArizona decides otherwise. As you are probably aware, the academic affiliation agreement (AAA) between UArizona and the Banner Health system speaks to the need to have a faculty appointment in order to have clinical privileges and deliver care on behalf of BUMG. The AAA further provides that BUMG is the exclusive faculty practice plan for COM-T with certain limited exceptions. Additionally, it provides that BUMG shall employ all faculty-physicians practicing through BUMG with certain limited exceptions. To be clear, the language you refer to in your question clearly provides that if a UArizona-employed faculty-physician ceases to conduct clinical practice through BUMG, UArizona does, in fact, have the option to continue employment of that faculty-physician and continue their faculty appointment. It is not, as you suggest, automatic. However, UArizona would not be allowed under the terms of the AAA to permit that faculty-physician to conduct clinical activities through any other avenues while remaining employed by UArizona. If UArizona were to continue that employment relationship, that faculty-physician would not be permitted by us to engage in clinical activity through any other provider, and that faculty-physician’s compensation would be adjusted accordingly.
B. Banner-employed and UArizona-appointed faculty-physician provides clinical activities at BUMG: here again, you specifically refer to the language that says that if a faculty-physician ceases to perform clinical activities through BUMG and the relationship ceases, the faculty-physician’s employment with UArizona will terminate unless UArizona decides otherwise. As you know, Banner-employed faculty-physicians hold a UArizona faculty appointment, as stipulated in the AAA to ensure that BUMG care is delivered by physicians with UArizona faculty appointments. The AAA further stipulates a number of academic roles that would warrant faculty-physicians who provide clinical activities at BUMG on a cFTE basis to be UArizona-employed. However, in the case where these stipulations do not apply, Banner Health system is the employer of record. Under these circumstances, in the event that a faculty-physician is no longer providing clinical activities at BUMG, if this is indeed their primary activity, it would seem to make sense that terminating these would by default result in no longer requiring a UArizona appointment. This said, if a Banner-employed faculty-physician plays other UArizona academic roles, for instance at COM-T, terminating their clinical activities would not necessarily result in the loss of a UArizona appointment. In the presence of such activities. In this case, and as you suggest, “compensation and benefit arrangements would be adjusted accordingly... similar to terminating a grant, contract, or VA appointment”, and other adjustments regarding employment would need to be made.
In either of these circumstances, UArizona has a close working relationship with BUMG, and as close and good collaborators, I expect that we would coordinate, around all faculty-physician employment decisions. If there is a specific issue you wish to pursue that was not answered here, please feel free to contact Dr. Bruce Coull, COM-T vice-dean for faculty affairs.
You requested comment on: “[COM-T] policies and the implication for faculty who work in clinical departments compared to the other professional Colleges at the University – Nursing, Pharmacy, Law, Engineering, etc.” I will begin my comment by saying that I don’t think you can compare the UArizona Colleges of Medicine to these other colleges for a number of reasons, including the fact that most of the funds that support clinical departments at Colleges of Medicine come from clinical activities. After clinical dollars, clinical departments have funds allocated to teaching and certain defined administrative duties, but these are far lesser amounts than clinical dollars. Unless clinical departments have access to philanthropic or other funds such as indirect dollars from active grant or residuals from prior grants, or royalties through patents, there are typically no other sources of funding for “academic time” unless a “buy-down” occurs. To be sure, individuals who are truly on academic promotion tracks need “protected time” for scholarly work so that they can be successful in advancing their careers. Resources needed for this are typically allocated as part of “start-ups” for new hires, with an implicit understanding that progress towards a sustainable model will be made through productive endeavors by these individuals. Similarly, “start-ups funds” are also included in the hire of new chairs, chiefs, etc. to ensure protected time allocation for new hires. This is stipulated when individual faculty members are hired and/or at the annual review with department heads when discussing the pending academic year. Also, salaries (and therefore the funds required for “buy-downs”) vary greatly between colleges and are significantly higher at Colleges of Medicine than at other colleges. This is particularly important as the “buy-down” is based on DOE. Thus, given these significant differences and others in the funding sources and structures between Colleges of Medicine and other professional colleges and schools, I do not believe that it is valid to these draw comparisons.
Again, I sincerely appreciate your question.
Date Answered: 4/4/2021
Question:
COM-T is always formulating metrics and strategic plans. I think instead of fancy strategic plans, how about we do the following: let your physicians and researchers do what they are trained to do and support them. This is the best way to move forward. No need for fancy titles or fancy strategic plans. Provide the physicians with additional support (so they are not bogged down with paperwork); provide the researchers with hard money and seed money. They will outshine every strategic plan you have. So I guess my question is: How do we move beyond a strategic plan to just a simple plan which is "Provide a support system”?
Answer:
Thank you for your question. I think this is a great question and clearly very timely. In fact, we are embarking on formulating a “simple plan”, devoid of “fancy titles”, that consists primarily of defining our current situation across our core mission areas, using simple but meaningful metrics. These metrics can then be used by each academic unit to set realistic targets for the next 1, 2, and 3 years, and to identify the tactics needed to get there. To your point about “fancy strategic plans”, unlike more traditional strategic plans, we are striving to engage our academic units and their faculty and staff in a metric-driven mission-specific (“what they are trained to do”) tactical plan (“support system”) with clear targets (“to move forward”). The premise of this approach is to allow us to unmask potential barriers to growth, in order to identify the needed “additional support” to achieve targeted goals. Each unit is expected to engage its faculty and staff in defining its tactics and targets (goals) in each of the mission areas, engendering collective accountability for the defined targets.
I have been having 1:1 meetings with unit leaders, their administrative and business staff, and there are meetings planned between our vice-deans and each unit. We urge all interested faculty to attend these meetings as these relate to your particular area(s) of academic interest so that you can get more informed and engaged in the process. Again, I greatly appreciate your question.
Date Answered: 3/28/2021