Dr. John R. Raymond, Sr., President and CEO

Dr. Joseph Kerschner, Interim Dean and Executive Vice President

Q&A from first Town Hall Meetings

Feb. 18, 2011 College News - The first Town Hall Meetings with Dr. John R. Raymond, Sr., President and CEO, and Dr. Joseph Kerschner, Interim Dean and Executive Vice President, were held Tuesday, Feb. 1, at the Clement J. Zablocki VA Medical Center, and Feb. 15 & 16 in the MCW Alumni Center.

The meetings included a PowerPoint presentation from Drs. Raymond and Kerschner and a question and answer session. Below are questions asked during the three Town Hall Meetings by audience members on-site and in remote locations throughout campus. Answers were provided by either Dr. Raymond or Dr. Kerschner.

PowerPoint presentation from the February 2011 Town Hall meetings (PPT)

WebEx webinar conference replay (stream)

Town Hall Survey

Dr. Raymond plans to hold Town Hall meetings on a quarterly basis, so please watch InfoScope for information on the dates and locations of future meetings.

Q: Will the leadership transition impact the current Chair searches?

A: We plan to move forward with the Department of Medicine Chair search, which is now down to two finalists. We feel comfortable about this search and hope to finish the process in the next one-to-three months. Dr. Kerschner has recused himself from the Otolaryngology search because of his ties to the department, so Dr. Raymond will be overseeing it. The plan is to interview the two finalists for that position. Three finalists have been selected for the Neurology Chair position – all of whom have terrific national reputations – but the leadership transition may have impacted this search. We are evaluating, and may change the search process. The search for a new Radiology Chair is early in the process, and no interviews have been conducted yet. The department is holding its own discussions and may decide to put the search on hold. That decision will come in the next two weeks. It is expensive for an institution to bring in four new Chairs in one year, so we need to evaluate if it is in our best financial interest to move forward with all of these. For those that we do move forward with, we want to make sure we put together packages the College can live with financially over the next five years. We do not expect there to be any additional searches needed as a result of the change in leadership.

Q: How is the College doing financially?

A: We are doing well this year. People are working hard and making good decisions. But we need to read the tea leaves and in doing so, we see there could be problems down the road. We are probably over-committed and over-promised. We need to look at how we pay out our promises. An example of this would be payments to new faculty for things like programmatic packages. An option might be to extend out the timeline for making these payments.

Q: Will we move forward with the pathways component of the new medical school curriculum?

A: I believe the pathways component offers an exciting opportunity for the students, and the alumni I have spoken to seem to be most excited about that component as well. I do think we need to reevaluate aspects of the pathways component - especially at its impact on the time commitment of faculty advisors.

Q: Will there be more information on why there was a leadership transition?

A: We can say that Dr. Ravdin does not have health issues, which many people were speculating about. I can also say it was a mutual decision. We have a long-standing commitment to protect individual privacy, and do not discuss individual personnel matters.
We are not cleaning house, and people do not need to live in fear.  

Q: What will you guys do to improve staff morale?

A: There are some things we are doing or plan to do, including increasing communication and transparency. We want to become a culture of openness. But this question needs to be turned around to the employees. What do you plan to do to improve morale? Each of us needs to play a role in this. There are many great things going on at the Medical College of Wisconsin, and when we come to work, that should show. Smile at each other. Make eye contact. These things can go a long way.

Q: Will we expand the size of the medical school class size?

A: We have a large medical school class size – it is the third-largest in the country for private medical schools.. Increasing the size of our medical school class is being looked at, but there are several things we need to consider:
•    Do we have enough faculty members to expand it?
•    If we have the faculty, we would need more space, so what would the financial impact of expansion be?
We are feeling pressure from state legislators to expand our class size so we can train more primary care doctors and geriatricians. The state provides almost $3 million annually to the Department of Family and Community Medicine to help train primary care doctors in residency programs, and there has been talk this money will eventually get tied to the expansion in class size. Expanding the class size may require us to consider satellite locations in collaboration with other institutions, however. I think this does offer a good opportunity to reevaluate the use of non-physician providers as a way to address the physician shortage.
In the short term, we want to concentrate our efforts on implementing the curriculum changes.

Q: I have heard that adding a pharmacy program and an NP and PA program are being considered. What is the timeframe for such an endeavor?

A: We have talked about expanding our portfolio of educational opportunities, and will be looking into it, but don’t have a timeframe in mind. Part of the reason for not having a timeframe is that we need to consider whether our faculty and staff have the tolerance at the moment for more change. We also would like to see what our faculty’s desire for involvement would be, and we would need to decide if we wish to remain a free-standing medical school or become a university.  
Offering these other opportunities would give us the chance to train our medical students to work on teams with non-physicians. But we will move forward with discussions on this when people around here are ready for it.

Q: Our Office of Technology Transfer is small compared to most institutions. Going forward, how do you plan to expand it?

A:  We need to expand it in a financially responsible manner. The plan is to add one FTE this year and another the following year. We also plan to work with the Technology Transfer Committee to develop ways to generate more visibility. We also want to collaborate with Marquette University, the Milwaukee School of Engineering and the University of Wisconsin-Milwaukee. The Children’s Research Institute has offered to fund a position in the Office of Technology Transfer.

Q: To address our financial issues, physicians have been pushed to see more patients. This has impacted clinical research, and I don’t see things changing. Can you address this issue?

A: We can’t impact or change the external pressures on us, and 2/3 of our revenue does come from clinical professional fees. One solution is to focus our resources and invest in other areas of opportunity on the clinical side.  We also need to manage expectations. As we bring new faculty members in, we need to slot them into where they can provide the most utility. Some people want a diverse work life and want to see patients, conduct research and teach, and others just want to see patients. We need to make sure we have the right balance of people who wish to focus their efforts on our different missions. Along with this is the need to be realistic. Some people are better at research or education, and we need to reward them for their dedication to these endeavors.

Q: In light of the new medical school curriculum, will there be any efforts made to recognize the educational efforts of faculty, who will be spending more time teaching students?

A: The institution wants to subsidize and reward the educational efforts of the faculty, and we need to explore avenues for making this happen. We will be paying attention to this during the budget process.

Q: How will we be impacted by the University of Wisconsin Milwaukee’s decision to locate an engineering school across the street?

A: This will be very helpful. We will have easier access to engineers and mathematicians who can assist us with our research efforts. 

Q: What are your plans for diversifying our funding base?

A: We are bringing Doug Campbell back in a strategic advisory role to help us diversify our funding base. We plan to explore all of our opportunities in the clinical areas. This includes exploring ways to access facility fees that are charged when patients see our doctors, which we currently don’t have access to. We also plan to evaluate our affiliation models with community based physicians and hold discussions with our partner hospitals.

Q: Several questions were submitted related to wages and benefits.

A: Currently, MCW spends approximately 72% of our revenue on wages and benefits.  We need to be good stewards of our benefits and also be aware that any changes to benefits would be a trade off of existing dollars.  We all enjoy a health plan which is superior to most in the nation.  We work very hard each year to balance claims inflation and other factors that impact our plan.  For example, Health Care Reform, which includes the government mandate for adult child coverage, added 172 members to our plan on January 1st.  The estimated cost of Health Care Reform for 2011 is approximately $2,500,000 in additional costs to our health plan.  The Institution remains committed to providing a highly competitive total benefit package while balancing the many issues and competing resource needs.

Q: When the College closes because of a snow storm, is there a way to inform employees sooner so they don’t make the drive in to work?

A: It costs us money to close, and we have a mission to treat patients, so our decisions need to take into account our affiliate hospitals and clinics. The day before the snow storm, we posted information and sent out an email letting employees know what may happen and how to find out if the College did, in fact, close. I think we made a good decision. Roads were not bad at midnight, but were terrible at 3:30 a.m.. On days when severe weather conditions are forecast, MCW’s leaders make a decision between 4-4:30 a.m. as to whether the College will remain open. If the decision is made to close, that information is disseminated as quickly as possible through a phone tree, online postings, broadcast e-mails, and notifications to local television and radio stations.

Q: Please explain to us the new budget process.

A: We assembled a 15-member Institutional Budget Committee with representation from all areas of the College to help craft the central budget. The committee has been meeting regularly, and the goal of the committee is to take the mystery out of the budget process and have a more informed employee base.

Q: You have been open about addressing the school’s financial challenges. The endowment has not grown at a rate comparable to other medical schools. Are there ways or plans to grow the endowment faster or expand the Office of Development?

A: The belief that the endowment has not grown is out there, but untrue. The endowment has grown at a respectable rate for an institution with 14,000 alumni. As far as our development efforts, if I can find the funds, I would be willing to invest in the Office of Development. We would like to bring in a consultant to help us determine if the Milwaukee market is saturated, and if our fundraising expectations are reasonable.
Whenever you have a leadership transition, you hope that fundraising doesn’t stall. It appears not to have that at the College, as fundraising is 17% ahead of pace.

Q: Will you seek philanthropic support for the new education building?

A: We will always look for support, but the reality is people tend to invest more in research efforts than in educational efforts.

Q: Can we compensate for our reduced revenue with fundraising?

A: The largest gift the College has received is $10 million from the Kern Family. Milwaukee is a generous city, but we are not in the league of larger cities like Chicago in terms of the gifts available to us. Plus, most gifts are directed to a particular person or cause. Few are given for the general fund.
To do more fundraising, we need to coordinate more with our hospital partners. Combined, we receive approximately $50 million annually in gifts.
Fundraising is one of the primary responsibilities of the President, and while I want to bring in as much money as I can to support our efforts and provide scholarships for the students, it is probably not realistic to think we can count on fundraising as a substitute for reduced clinical revenue.

Q: You said the organization needs to spend $.17 for every $1 in research funding it generates. How is this possible?

A: Paying $.17 on the dollar is a well organized research program. People here work hard and do a good job. Part of what is behind that figure is that not every funding source allows us to charge for indirect costs. As an organization, we don’t mind investing that money, but we need to invest our resources in targeted areas that are sustainable.

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