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Greenberg responds to questions from June 15 meeting During a “Town Hall” meeting June 15, MUSC President Ray Greenberg, M.D., Ph.D., answered questions from faculty members on issues that concerned them. During the next few weeks, The Catalyst will publish those questions with Greenberg’s answers. The intent is to encourage further dialogue on issues of concern to the MUSC family. Questions, comments and concerns can be addressed by e-mail to president@musc.edu. Michael Wallace, Gastroenterology  I have questions about recruiting particularly young faculty.  Having interviewed a number of young faculty recruits and being a recent young faculty recruit myself, I’ve noticed two issues that have come up in essentially every person who I’ve interviewed who have subsequently decided not to come:  The perception of ongoing racial prejudice in the state of South Carolina and not so much in the university itself but certainly in the state and the national headlines that we’ve received.  The other is the state of education in our state and in our region. And although our region is better than many parts of the state, it at best claims to be average.  Although these aren’t particularly university issues, they are issues that affect the University very much and if we have to turn over 8 percent of our faculty every year, what can we do as a university to try and provide an example to these people that we are making an effort to provide a more diverse group of employees and faculty and to promote an opportunity where young faculty members can provide education for their children? Dr. Ray Greenberg: When you look at the number like 8 percent you need to remember that 2 percent or 3 percent of that is retirement and so forth. There are departures for pure career advancement and family reasons so it’s like the unemployment rate, there’s going to be a natural rate of 4 percent or 5 percent of regular turn-over. We need to keep it, in my opinion, as low as we can.  In respect to the diversity issue and the culture of South Carolina and how people come from other parts of the country to view how we deal with race issues, I hope that on that particular issue we’ve made some progress this year. As an educational institution, we have a moral responsibility to be part of the solution here. Are we serving the whole community? We’ve got to work on it and diversity issues.  We’ve made tremendous progress in diversifying our student body, and it’s been somewhat uneven across the university, but we’ve made significant progress. We still have a long way to go with our faculty and staff.  For the school issue, there are points of light here. George Tempel has devoted a substantial amount of his time in working to produce and improve math and science education here. Mayor Riley asked me to serve on a special task force that he’s put together to network to work around the system to improve the quality of education. The presidents are on that sort of ex-officio. Dr. Sanders and Gen. Grinalds is on that.  I’m hoping that the group will help bring to light some of the things that we can do.  When I was up at Norfolk looking at things they do on campus, they focused on a health sciences magnet school on the campus of their institution.  I’ve suggested to Joe Riley that it is something we ought to think about.  This is a tough time to start looking at something like that, but the truth of the matter is that we have a responsibility. If we view our educational mission so narrowly that all we focus on is the education of health care professionals and we’re not concerned about educating the public and we’re not concerned about starting early in children’s careers by getting them interested in pursuing health careers, I think we’re failing in some fundamental way. Jack Crumbley, Surgery I’d briefly like to address the institutional malaise at least on the clinical side of the house.  Many of us who practice in the hospital find ourselves practicing in a situation where we feel like we’re “swimming in molasses.” It is very difficult to get even minor things done. I do much of my work in the operating room and I need only to say the words “SPD” to have people understand what I’m talking about. I think it's going to be very difficult to retain clinical faculty as long as clinical practice is made difficult by the institution rather than facilitated by the institution. I would appreciate the opportunity to hear your feelings about this. Greenberg: In the Medical Center it's my hope that moving to a hospital authority would allow us to have a much higher level of accountability in terms of quality performance for everybody on the health care delivery team.  We need to create reward structures that are more market-based and reward excellent performance. We need to have a culture where excellence is part of the team.  I don’t want to disagree with your comment at all, but one of the nicest parts of my job that the rest of you don’t see is the feedback that comes back to my office from patients commenting on their experiences here. I would say that the ratio of extremely positive comments run 10 to one in the favorable category and the unfavorable ones are almost exclusively billing issues. In the six months that I’ve been here, I’ve seen complaints about someone being treated brusquely by a staff person or shuffled around and lost in the system. The doctor is another customer, and I’m afraid that we’re not as customer friendly as we need to be to our medical practitioners. That’s something that we have to work on.  Crumbley: I would pose that your comment and your experience is a result of the sheer force of will on the part of a fairly dedicated clinical faculty.  Greenberg:  I wouldn’t dispute that. Crumbley: I would also like to briefly address the support staff issue that was raised earlier. I know that there is a crunch for dollars, but I we’ve got to stop making some wrong-headed decisions like paying for parking. I’ve been on vacation this week and have been driving around in my car a little bit, flipped on talk radio from time to time, and it’s amazing the number of comments on talk radio about the wrong-headedness of adding financial burdens to an already underpaid support staff in the hospital. That needs to be rethought, I think. Greenberg: There hasn’t been an increase in parking here in 14 years. Our parking rates (including faculty) are substantially lower than they are at the College of Charleston. I realize they don’t have the hospital workforce there. One of the problems that we’ve had is our facilities planners came in and told us that we need 3,000 more parking spaces on campus to accommodate our needs. There is only one way that we have available to build parking. Within the state system it’s parking revenue that has to be used for the bonds to build parking. We need to make the decision if we need more parking or not and what’s the fairest way to allocate that to individuals. I’ve heard extraordinary comments about how this has been such an issue and there are people leaving because of it. I’ve actually gone to the Human Resources Department who interviews everyone leaving and in fact, very few people have mentioned this. I’ve received some e-mails from employees and have tried to respond sensitively and as caringly as I can, but this is a challenge. We’re a place with 9,000 employees with grossly inadequate parking at the moment.  Greenberg: We now can charge parking as a pre-tax item, which means that the benefit to the person varies by income level that they’re at. But even in the lowest income categories, you won’t pay more, but actually pay less for your parking.  The typical RN if I know the salary base correctly, will not pay a penny more because it’s going to come as a pre-tax expense. It’s going to reduce their FICA a little bit, but that’s negligible. The true burden to the person in terms of increased cost to them will be nominal.  Also, I just got an e-mail from an employee who questioned why the administrators are not paying any more. Well, what she’d done was look at the chart published in the Post and Courier and it had stayed constant across the four years. What she didn’t realize was we absorbed the full increase for the administrators, immediately rather than phasing it in as we had done for everybody else. We were not making it easy on the administrators, we were saying that if we were asking people to pay then we would pay more and pay it right up front.