Incoming Faculty Orientation - Deans Welcome

August 25, 2023

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Nancy J. Brown, MD

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00:02Well, good morning.
00:03It's really good to see you.
00:05And this is one of the more important
00:08days that we have in the year.
00:10Some of you have been here already,
00:13as Linda said,
00:14and you're just changing roles.
00:16But we hope that you're going to
00:19still learn something new about the
00:21institution that you hadn't thought about.
00:23And of course, as a School of Medicine,
00:25we're privileged to have many missions,
00:28education,
00:29research and our clinical mission.
00:32And one of the things that we did
00:35during COVID and it turned out that
00:37Zoom was an excellent media for focus
00:40groups was revise our mission statement.
00:43And I think this captures
00:45a lot about who we are.
00:47We educate and nurture creative
00:49leaders in medicine and science,
00:50promoting curiosity and critical
00:53inquiry in an inclusive
00:55environment enriched by diversity.
00:57Those of you who have been here for
00:59a while know that our educational
01:01philosophy is summed up in
01:04the words the Yale system.
01:06It's been around for a long time,
01:07but we, before it was fashionable,
01:10did not have grades or class rank,
01:12and really treat our students as mature
01:15individuals who are responsible for our own,
01:18for their own and our own learning.
01:21And the consequence for our faculty is that
01:26you get to work with incredible students,
01:28but they will be reaching out to
01:30you for mentorship and engagement
01:32in what you're doing.
01:34And that's what makes this
01:36place a rich place.
01:37And those words enriched by
01:38diversity were not in our mission.
01:41There was nothing about diversity
01:43in our mission state previously.
01:45There's been a lot of conversation
01:47about this following the the SCOTUS
01:49decision this this past summer.
01:52I will say that our entering class
01:54this year is the most diverse
01:56class we've ever had and is also
01:58the most excellent class by all.
02:00You know MCAT grade point,
02:02whatever scores you choose to look
02:06at and we remain committed to that
02:09ideal of inclusive excellence.
02:11We advance discovery and innovation
02:13fostered by partnerships across
02:15the university,
02:16our local community and the world.
02:19We are not a silo.
02:22Here we sit in a community of both
02:24a larger university partnered with a
02:26health system and in a city of New Haven,
02:30which is a an amazing city.
02:34It's a scrappy city.
02:36It's been through a lot over the years
02:39and is one of the most welcoming cities.
02:43I I came here from the South thinking
02:45that you know this was going to be
02:46a tough place to return to and I
02:48was just amazed by how welcoming
02:51this this town is.
02:52And so we we learn even in our
02:56research from all those around us.
02:59And then lastly caring for our patients
03:02with compassion and committing to the
03:03improving the health of all people.
03:05It's not just the physician patient
03:07relationship or the clinician
03:09patient relationship,
03:10but it's our obligation to
03:12improve health across our city,
03:16state and and really the world.
03:20I would say that over the last 3 1/2 years,
03:24there have been some crosscutting themes
03:26to the work that we're doing together.
03:28One is about this creating an environment
03:32of inclusive excellence where everyone
03:34in our school can thrive and to which
03:36we continue to recruit the best talent.
03:38That's why you're here,
03:39this piece of investment.
03:41I'll highlight some of the
03:43things for you as faculty.
03:45You know, it's it's important that
03:48each of you has a mentor regardless
03:50of what you're doing and frankly,
03:52regardless of how senior you are.
03:54One of our emphases has been on
03:57mentorship and sponsorship and we
03:58created up a process called the Faculty
04:01Development Annual Questionnaire.
04:03That is not That is intended primarily
04:06to be a forcing function for you with
04:09your chair or your section chief,
04:12to pose questions that make you reflect
04:14every year about where you're going,
04:16what your aspirations are,
04:17and to give you the opportunity to
04:20share that with your leaders so that
04:22when they're thinking about who to
04:24nominate for something or what you need,
04:26you will come to mind and you will
04:29have those rich conversations.
04:31If you're a physician scientist,
04:33it includes the creation of the Janeway
04:35Society for for those of you who
04:37are in the career development stage,
04:39that also creates a network of
04:42peers across departments and serves
04:44to break down silos.
04:46If you're a clinician, educator,
04:49scholar, and academic clinician,
04:51the workshops on you know how to find
04:55mentorship in the clinical arena,
04:57how to develop your educational talents,
05:00how to prepare your for promotion,
05:03and those kinds of things.
05:04Please,
05:05please sample those things
05:07and take advantage of them.
05:09So related to breaking down silos,
05:12you know we have incredible excellence
05:15here and if it sits in silos whether
05:18that be in basic science departments and
05:21clinical departments and the clinical arena,
05:24we will under achieve.
05:25We have to get everybody in the
05:28room because when you do that,
05:30there's a an energy and a new
05:33way of seeing problems.
05:34And so a lot of the work that
05:36we're doing is about gathering
05:38groups together in new ways,
05:40promoting multidisciplinary grants,
05:41the Office of Team Science.
05:44So again,
05:46please sample those things,
05:49building and stewarding resources necessary
05:52for you to to make the discoveries
05:56and and observe what you're what
05:59translate observations into discovery.
06:02So that includes everything from
06:05beefing up our core so that
06:07they're more user friendly.
06:08A lot of work going on right now
06:10in the Yale Center for Clinical
06:12Investigation to make sure that
06:14you have access to the resources.
06:16I'll talk about alignment but
06:18the notion that every patient we
06:21see in the clinic or the hospital
06:23really should be participating in
06:25research and education and how do
06:28we make that that possible.
06:29So building resources there.
06:32And then lastly alignment that
06:35is realizing the full potential
06:38of our relationship with you on
06:40the Haven health system.
06:41And we've had a 200 year relationship
06:43I I would like in it sometimes
06:46in the past to a sibling
06:47rivalry you know or parallel play where
06:50we're not always haven't always been
06:52talking to each other and we're in
06:54a period of time I think coming out
06:56of COVID when we really had to work
06:59together and we discovered what that
07:01looks like and we are making significant
07:04changes that I think you will benefit
07:06from over the next several years.
07:08So one of the things that we're doing
07:11is a an aligned strategic plan.
07:14So we have, we've done strategic
07:16planning university wide for research,
07:18we've done it for education for diversity.
07:20We've never sat with the hospital
07:22and said how do we work together
07:24and that's ongoing right now.
07:26And these five pillars of that
07:28strategic plan came from and exercise
07:31where leaders across the school and
07:32the health system were asked to say
07:35you know what differentiates us,
07:36what's the most important thing
07:38for us to continue to develop.
07:40And I'm always happy to point
07:42out that at the two ends of these
07:45pillars leading edge clinical and
07:48translational research and continuous
07:50learning and innovation are there.
07:52And so this is not just a strategic
07:55plan about how we provide better
07:57clinical care and how we what,
08:01what service lines we grow
08:03in those kinds of things.
08:05But it's the essence of being an
08:08academic health system and why you're
08:10here and not at HCA, the others.
08:13The second thing that we've done
08:15as part of alignment is create
08:18this aligned physician enterprise.
08:20So again,
08:22for those of you who've been here
08:23a long time,
08:24you know that Yale Medicine has
08:25been is our faculty practice plan,
08:27the employed faculty.
08:29And then there's Northeast Medical Group,
08:31which are who are wonderful physicians,
08:34often are alumni.
08:36You are employed by the health
08:38system and we didn't,
08:41we didn't interact and that meant
08:44that sometimes we were even competing
08:46for bringing new, you know,
08:48should this faculty member be a
08:50faculty member or be a member of any
08:53MG we had parallel access systems,
08:55billing systems, you name it.
08:58So very inefficient and really
09:01frustrating to our patients.
09:03So this is now structured where
09:05we haven't changed the employment
09:07agreements or anything about where the,
09:10where the physicians sit,
09:11but it all rolls up to a chief
09:14physician executive who is Peggy McGovern,
09:16our CEO of Yale Medicine.
09:19And Peggy is not able to be here
09:21this morning,
09:22but you'll hear from her right hand leader,
09:27Bob our Coker Senior Vice President
09:29there right now is Richard Goldstein
09:31who has led an EMG in the past.
09:33So this is a work in progress.
09:35It just started in January,
09:37but this is from Peggy.
09:39The aspirations as to what we can
09:41do with this structure.
09:43So obviously you can provide better
09:45quality care to your patients
09:47if you're talking to each other.
09:50You can start to get into things
09:52like standing up
09:55SINS integrated networks so that
09:58you can provide better value care.
10:02We have tremendous opportunities
10:04in IT and digital health.
10:07We have an aligned electronic
10:11health record and Lee Schwam who
10:13may be here this morning is now
10:16leading our digital health efforts.
10:18I mentioned just the simple
10:20things of you know,
10:22aligning compliance and finance and
10:23things that may seem a little bit boring,
10:26but that really improve your life because
10:28they also will eliminate some of the
10:30duplicate work that you have to do.
10:33So those are a few things and it
10:35will take time and I hope that
10:37you will be engaged in that work
10:39with Peggy and and bobber.
10:42So I'll end with two slides.
10:46Underlying everything that
10:48we do are our values.
10:52And if you hear nothing else from me,
10:55I hope it's that you understand that
10:57we are a valuedriven institution.
11:01These,
11:02this particular wheel came from a
11:05group of leaders who gathered together
11:07actually shortly before I arrived.
11:10But I think it speaks to what we're about.
11:14So, you know,
11:15I don't know that we need to say
11:17that we should have integrity,
11:19but reflection and communication is,
11:23is really hard.
11:24I can tell you and I'll apologize
11:26ahead of time,
11:27I will under communicate about
11:30something that we're doing because
11:32it's just impossible to reach
11:34everybody in every possible way.
11:36Communication takes many forms and
11:38it's not just outward communication,
11:40it's inward listening and that's
11:43the reflection piece.
11:44And I think that's particularly
11:46important while we're in a fairly
11:48stormy time in this country with
11:51a lot of polarization that we
11:53sit and listen to each other and
11:56and hear the nuances, discovery,
12:00innovation and scholarship.
12:02Again,
12:02that's why we're all here building
12:06and engaged and productive community.
12:08I think we've spoken to that generativity
12:10is this notion of giving back, right.
12:13You will.
12:13You will have had mentors and sponsors,
12:16and you will be the you will have the
12:18opportunity to be mentors and sponsors.
12:20So when that student calls you up
12:23and you're snowed with work and you
12:25just can't take another thing on,
12:28take a deep breath.
12:29And if you can't take on that student,
12:31at least spend a moment with them
12:33and at that time to think with them
12:35about who the right fit would be
12:37and and and how you can help them.
12:39And then diversity and inclusion
12:41again because when we have
12:43different viewpoints in the room,
12:44we we emerge with a with a better construct.
12:49So this is my own personal thing
12:51that I shared with the leaders.
12:52I think in the first week that
12:54I was here it's it's my rules
12:56of engagement for the leaders.
12:58But it will there may be some clues in
13:01here that you might want to take to heart.
13:04So set the bar high.
13:07There is not a conflict between
13:10kindness and excellence, Okay.
13:12So set that bar high.
13:15This is probably the hardest one for people,
13:18which is share problems.
13:20You should feel comfortable
13:21bringing problems,
13:22but I would encourage you to think
13:24through the solutions first a little bit.
13:27So when you come to somebody,
13:29you come to your chair and you say,
13:31this really sucks, don't stop there,
13:35say, and I have a couple of ideas
13:37about how we might fix it right,
13:39And that makes a huge difference to people
13:42adhering to the doctrine of no surprises.
13:45I think you know something will happen.
13:47They'll be an adverse event.
13:52Something will happen in your lab.
13:54And I think sometimes in those
13:57moments we we feel shame.
13:59And I would like this to be an
14:01environment where we don't feel shame,
14:02where we feel like we can go to somebody
14:05we trust and say this happened,
14:07I need to tell you about it,
14:08But that's important for a lot of reasons.
14:10You know, it's often not the first
14:12event that happens but how we
14:13respond to it that matters most.
14:15And so sharing things don't
14:18try to do this alone.
14:20I think anyone who is a brand new
14:23attending has the sense that everything
14:25stops with them and and it's that's
14:29a pretty lonely way to view it.
14:31You'll learn pretty quickly that the
14:33people in this room who have Gray hair know,
14:35have learned the hard way that
14:37you have to consult others.
14:41This is about emails
14:47and I can't tell you how often
14:49I now get an e-mail that says
14:51I'm sorry for the long e-mail,
14:52but 10 paragraphs later there's so much
14:58opportunity for things to get lost.
14:59And man, you know, particularly when
15:01people are reading this stuff on their
15:03on their cell phone and just having the
15:05conversation can be really, really useful.
15:08So think about that.
15:10Avoid triangles and end runs, you know,
15:12So you were section chief didn't
15:14give you the answer that you wanted.
15:15So you go to the chair and the chair
15:17didn't give you the answer that you wanted,
15:18so you go to the Dean's office.
15:22That's a great way to to
15:26annoy a lot of people and lose trust.
15:29And so I think you know
15:31if if you're not getting,
15:33if you believe somebody's wrong,
15:36then getting people together in a room
15:39together so that you're everybody's hearing
15:42the same conversation can be useful.
15:45I think we have to view debate as healthy.
15:47I also think we have to be very honest
15:49in looking at our performance, you know,
15:52whether it's how we're doing clinically
15:54or how we're doing in you know,
15:56educational metrics or whatever it is,
15:59again without shame.
16:00And then we have to have
16:02difficult conversations.
16:04So some of you may serve on the faculty
16:07advisory committee which is truly
16:09a very important group in terms of
16:12anything that we any new policy that
16:14we look at in the executive group which
16:16is the deputy Deans and the chairs we
16:19take to faculty advisory committee to
16:21say here's what we're thinking about
16:22what are your what are your thoughts.
16:24We just did that with one on Monday.
16:27And and it's important to be very
16:30honest and have that open debate.
16:32At the end of the day,
16:33we have to come to a decision about
16:34how we're going to go forward and not
16:36everyone will agree with that decision.
16:38And at that point we all have to say okay,
16:40we've had the discussion and
16:41we're going to go forward.
16:42And then my last one is,
16:46you know, please,
16:48it's a good way to remain
16:50retain your perspective,
16:51which is just don't forget to laugh
16:53every once in a while because this
16:55sometimes things can be pretty absurd.
16:57So that is what I have and I don't
17:02know if you want to do go straight
17:04to Baba or any quick questions
17:13okay, great.