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Search begins for dean of medicine

Unorthodox search questioned by some

Thursday, January 31, 2008

The new dean of medicine and biological sciences will have a familiar face, President Ruth Simmons announced over winter break, and the faculty advisory group charged with narrowing down the list of candidates will be smaller and swifter than usual. The University is seeking to replace current Dean of Medicine and Biological Sciences Eli Adashi, who surprised much of the Brown community when he announced his resignation in December under the pretense of a need for “fresh leadership” in the Warren Alpert Medical School.

The newly formed advisory committee marks a sharp break with University tradition in both composition and direction, drawing criticism from a number of faculty members and administrators. Instead of a large and inclusive committee conducting an expansive search, all of the faculty advisory group’s nine members are affiliated with the Division of Biology and Medicine and will consider candidates only from within the division. Simmons also stated that she hopes to move “as swiftly as possible” to have a new, fully empowered dean in place by the time Adashi formally steps down at the end of June.

“I am confident that this will allow us to have a rapid and smooth transition in the leadership of the Division,” Simmons wrote in a Dec. 21 e-mail to Brown faculty members. “This work is of the highest importance to all of us.”

Changing gears

The haste of this approach contrasts starkly with the way the University – and particularly the Med School – has traditionally selected high-ranking administrators. Following the resignation of former Dean of Medicine and Biological Sciences Donald Marsh in 2002, the University appointed Professor of Medicine Richard Besdine as interim dean and launched a three-year search that considered a vast pool of candidates from around the world. That search committee, which eventually chose Adashi, had 20 members, including professors from outside the Division of Biology and Medicine, representatives of local hospitals, a Corporation trustee, then-Vice President for Campus Life and Student Services David Greene as well as undergraduate, graduate and medical students.

None of these groups is represented on the current advisory committee.

Associate Provost Pamela O’Neil PhD’91 said the small size and exclusive makeup of the committee is intended to expedite the process of selecting the new dean. After the dean serves “a normal three-year term,” O’Neil said the University may conduct a more extensive search.

“We wanted to have someone in place right at the time Dean Adashi left,” she said. “We thought that a smaller advisory committee would be helpful instead of a larger one, which could take years.”

O’Neil, who staffs the advisory committee and is present at every meeting, said the University is looking to promptly appoint a dean from within the Division of Biology and Medicine in order to maintain “forward momentum” on a number of fronts. In his time as dean, Adashi reshaped the Medical School’s curriculum, raised its national profile and further developed the Program in Public Health. He had also been working closely with Rhode Island hospitals, which have become a key interest of the Medical School in light of the proposed merger of state healthcare giants Lifespan and Care New England.

“Over the last few years we’ve been trying to build closer ties with the hospitals,” O’Neil said. “We thought it would be best to have someone empowered who can help build that relationship.”

Dissenting voices

The University’s unorthodox approach has raised concerns among a number of faculty members and administrators who feel that the gains in speed and efficiency may not be worth the losses in comprehensiveness.

“Brown has a long tradition of being inclusive in who it involves in searches for important leaders,” said Clinical Associate Professor of Medicine Roy Poses ’73 MD’78. “This committee is much smaller and is essentially only faculty from the Division of Biology and Medicine.”

Poses, who is a voluntary faculty member and does not get paid for the teaching services he provides to the Medical School, said the desire for a speedy selection process does not obviate the need for the University to be thorough in the voices it hears and the candidates it considers.

“These are concerns, but they are normal concerns and apply to any search,” Poses said. “The trade-off for cumbersomeness is inclusiveness.”

Poses agreed with O’Neil that a member of the Division of Biology and Medicine would likely be in a better position to strengthen the University’s relationship with Rhode Island hospitals. But he cautioned against choosing someone closely affiliated with certain hospitals and not others.

“There is more than one hospital in Rhode Island,” Poses said, suggesting that the University should be wary of conflicting interests.

Associate Dean of Medicine for Clinical Faculty Arthur Frazzano said he shares many of Poses’ concerns and added that the committee’s lack of clinical faculty – practicing physicians like Poses who also teach medical students – suggests the over-1,200 clinical professors’ interests may not be represented.

“The clinical faculty want to be recognized for the contribution they give to the education of the students,” said Frazzano, who said he has received e-mails from confused and concerned clinical faculty members. “Without the clinical faculty providing their services, we wouldn’t be able to run the programs we do – they need to be heard.”

Frazzano said he intends to distill his concerns and those of the clinical faculty into an e-mail to Simmons and Provost David Kertzer ’69 P’95 P’98, who will make the final decision on Adashi’s successor.

Poses already has.

“A hasty process involving insiders who will choose another insider gives the appearance of being more attuned to the vested interests of the insiders and those they represent than the broader mission of the school and the university,” Poses wrote Jan. 23 to Simmons, Kertzer and O’Neil. “I urge you to revise the process so it is less hasty, more transparent, and more representative of students, the broad Brown faculty, and alumni.”

Responding to concern

O’Neil said the committee is making every effort it can to hear from the different constituencies at Brown and has invited clinical faculty members, hospital representatives and students to speak at meetings.

Medical Student Senate President Jeremy Boyd MD’09 has already met with Kertzer and spoken in front of the advisory committee, which he described as “very receptive regarding student concerns” in an e-mail to The Herald.

“I have been in contact with the Provost since the day of Dean Adashi’s announced resignation,” Boyd wrote. “And while there is no student on the committee, there has been an open flow of communication between the Medical Student Senate and his office.”

Department of Community Health Chair and advisory group member Vincent Mor, a professor of medical science who also sat on the search committee that selected Adashi, said there are differences between the two committees, but “the effect will be the same, only quicker,” because the group is hearing from those parties not on the committee.

“Last time it took so long,” Mor said. “Nobody wants to wait that long.”

The University may be listening to concerned voices in additional ways. Since Simmons announced the eight-member faculty advisory committee in December, one more member, Pardon Kenney ’72 MD’75 MMSc’75 P’03, has joined the group. Kenney now teaches at Tufts Medical School, and O’Neil said that as an alumnus and former president of the Brown Medical Alumni Association, Kenney “can offer a unique perspective.” However, the University has still not heard from any faculty members not affiliated with the Division of Biology and Medicine, and O’Neil said she knows of no plans to do so. When asked why, she said she did not know.

The view from outside

Poses and Frazzano said they’re primarily concerned with transparency. The puzzling circumstances of Adashi’s departure, which came without explanation during a crucial transitional period, combined with the unusual approach in seeking his replacement, has raised questions for them and others that have so far gone unanswered.

“I don’t know why Adashi is resigning so precipitously, I don’t know why the search committee is composed the way it is and the explanations I’m hearing don’t help,” Poses said.

Frazzano expressed a similar desire for answers but offered a potential account of the University’s unusual action. On one hand, the University needs to replace Adashi as quickly as possible. On the other, it needs a strong leader to represent Brown in negotiations with merging hospital groups. To achieve that balance, Frazzano said the University might appoint someone who would be a full-fledged dean in title – a process that requires a formal advisory committee – but an interim dean in effect, appointed quickly and serving only a few years.

“There may even be someone they’ve already selected and are talking to,” said Frazzano, who emphasized that it was only his opinion.

O’Neil said Adashi’s successor would be “fully empowered” and expected to serve “a normal three-year term.” But if this is the case, it would be the first time in the Medical School’s 38-year history that any fully empowered dean – other than Adashi – has served less than 10 years, let alone three. The only other dean to serve a three-year term was Besdine, who served in an interim role.

O’Neil maintained that “three years is considered a normal appointment” and said the committee “hasn’t even begun to talk about candidates.” She said she was unaware of the Medical School’s history of long-serving deans.

Frazzano said one of the dangers of an opaque search process is that those on the outside might read too much into the University’s handling of the search. For his part, Frazzano said he was not upset with the University’s actions, but rather dissatisfied with its explanation of them.

“I don’t think there should be any anger or resentment,” Frazzano said. “It just needs to be clarified.”

When asked if he thought the University’s approach was a good idea, Frazzano smiled.

“Was it a good idea for Rudy Giuliani to stick himself down into Florida?” Frazzano said Tuesday. “It sounds like a reasonable thing to try.”

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