February 7, 2005
The Executive Committee of the Manoa Faculty Senate has considered the recommendations of Regents' Task Force on the John A. Burns School of Medicine (JABSOM). In responding to this report, we cannot speak with authority on behalf of the Senate, which has not yet adopted a formal resolution on the matter. However, we understand that the matter is of some urgency, and so we wish to let you know our views now. We are convinced that the position we express here is widely shared among the Manoa faculty.
We see two main intersecting issues: one relating to the internal constituency of a "health sciences unit"; the other relating to the location relevant units--within Manoa, or at the System level.
The Task Force recommended that the JABSOM, the Cancer Research Center of Hawaii (CRCH), the Pacific Bioscience Research Center (PBRC), and possibly the School of Nursing (which might be made a unit of JABSOM), be removed from Manoa and joined in a single unit at the System level--effectively forming a separate UH campus. This is the first and central recommendation of the Task Force, and it provides the context for all the other recommendations.
Let us dissect this recommendation. First, moving CRCH and PBRC outside of Manoa would be a serious error in our view. These units are an integral part of the research and instructional environment of UHM. Every one of our colleagues in these units, without exception, is opposed to being removed from Manoa. They feel that such a move would have a serious negative impact on their effectiveness. And, their removal would weaken the rest of Manoa. These faculty have created very successful entrepreneurial research units in the University, and we take their views very seriously. We will not reiterate their reasons, which have been presented fully in their own written statements and in meetings with senior System administrators. We have heard no persuasive argument in favor of the proposal to remove CRCH and PBRC from Manoa.
Second, we strongly oppose having the School of Nursing report to JABSOM. In this we concur both with the Nursing itself and with JABSOM's own administration, which is also on record as opposing this move.
The third question involves the position of JABSOM itself. This matter is more complex. JABSOM has embarked on an ambitious plan to expand and to re-create the School as a leader in peer-reviewed science and as an "engine [...] for the biosciences industry in the State." (Report, p. 6) Many at Manoa and throughout the University are sympathetic to this vision. JABSOM has argued that the effort will require the School to act more like an entrepreneurial business, able to respond agilely to opportunities, unfettered by bureaucratic controls, and able to accept substantial risks and uncertainties in order to achieve a larger long-term goal. The Report suggests that JABSOM needs a "different, more independent governance structure,." It is suggested that moving outside Manoa, to the System, will foster the requisite "culture of entrepreneurship," as Dean Cadman puts it in his response to the Task Force Report.
We fully understand that JABSOM will be taking large risks. Under very optimistic assumptions, JABSOM may operate at a deficit of many millions of dollars each year for some time into the future. Under different assumptions, these shortfalls may be several times as much. It is possible that governmental agencies, private enterprise, and individuals in Hawaii will consider the long-term benefit to be worth the risk. Nevertheless, we are adamant that the current core instructional and research activities of the University must not bear the brunt of this risk.
JABSOM must be able to act autonomously in an aggressive entrepreneurial fashion; at the same time, the rest of the University must be protected from potential damage from an extremely risky endeavour. The University must create an environment in which these two concerns can be balanced. JABSOM should be permitted to succeed or fail on its own--neither hampered by nor subsidized by the rest of the University. It is unclear to us whether this can be done; and, if it can be done, whether it will be easier to create this environment within Manoa or at the System level. Manoa itself has recently launched an initiative to explore the concepts of responsibility-center management at the College level. Conceivably, these principles might be applied to creating a suitable entrepreneurial environment for JABSOM.
We have no definite recommendations to make on the matter of the location of JABSOM, but we do feel that the concept of "culture of entrepreneurship," needs substantial elaboration before a decision can be made on the administrative location of JABSOM. Under the circumstances, the burden of proof must be on those that propose removing JABSOM from it current location.
The Task Force also recommended the creation of a Vice Presidential office for Health Sciences, at the System level. We see no need for such a position at this time.
Recommendations 2 and 3 of the Task Force deal with the responsibilities of the Vice President, essentially pointing out the need to coordinate health sciences initiatives. Coordination is desirable, though a Vice President is not necessary for this.
Recommendation 4 suggests an "entrepreneur in residence." We concur with the Dean of JABSOM that this is not necessary. It is premature to propose particular offices.
Recommendation 5 proposes a designated University Hospital. We see no persuasive argument for this, and the Dean of JABSOM has argued convincingly against it.
Recommendation 6 suggests a concentration on certain designated fields of excellence. Certainly, this makes sense, especially in the context of limited resources and the consequent need for focus.
Recommendation 7 proposes that an independent financial study be conducted of JABSOM's projected costs and revenues. We agree with this recommendation: it is a most urgent matter. Until there is a realistic assessment of the financial situation, many of matters involving risk-assumption and entrepreneurship cannot be adequately addressed.
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