1. Case 1: Disruptive faculty at morning report 1.Patterns of behavior ar not usually developed at the age of 70. Behavior patterns are difficult to change after years of avoidance. 2.Seniors want to be recognized for their contributions 3.Begin to deal with behavior—the issue is behavior not age. Senior faculty have a lot to offer. Take advantage of them. 4.Most faculty—regardless of age want to do a good job and want to be perceived as good teachers. 5.Base discussion on objective data and reaching their goals. (Use teaching evals)

2. The evil Division Chief

3. Case 2: The “Lazarus—or Freddy Kruger” Division Chief 1.The title of Division Chief is not recognized in the faculty code. It is an administrative appointment that serves at the discretion of the chair and perhaps the hospital. Same goes for Chairs. Faculty positions, not administrative positions are protected. 2.Ask for faculty decisions in writing as it is not uncommon for people to change minds.

4. Case 3: Health issue 1.Health issues must be dealt with sympathetically but directly. 2.Utilize University or Hospital HR and your department administrators. 3.Do all you can to help faculty receive health benefits. 4.Be consistent about how one handles health issues so that no one can feel they are not being treated fairly. 5.All faculty should have job descriptions, especially part time faculty.

5. Stepping aside or clogging the Pipeline: Academic Leadership in a modern pediatric department May 2, 2010 F. Bruder Stapleton, MD Chair, Dept of Pediatrics University of Washington

6. Bruder Stapleton, MD has documented that he has no relevant financial relationships to disclose or COIs to resolve.

7. Unapproved or Off Label Disclosures for Bruder Stapleton, MD Bruder Stapleton, MD has documented that his presentation will not involve discussion of approved or off-label, experimental or investigational use.

8. Clogging the Pipeline: For Chairs--Truth or Myth In 2003, mean time as a chair was 5.6 years. Turnover was 17%/year. In 2007, 17% of chairs stated they were considering stepping down in next year During a ten year period, two depts. had 5 leaders and four had 4 leaders

9. AMSPDC Data on Women Chairs Showing Progress 1993 = 13 Chairs 2003 = 11 Chairs 2010 = 20 Chairs

10. Long-standing stable senior leadership by a chair is not by definition a bad thing. From the perspective of a clogger ;0)

11. Why? 1.Stable chairs have opportunity to develop trusting relationships with hospitals and deans. 2.Stable chairs know faculty and can plan for careers over years. 3.Stable leadership allows developing departmental culture, strategic vision and accountability.

12. When do you get into the leadership pipeline? 1.Recent generations want more personal time and are often reluctant to seek or accept leadership responsibilities. 2.Mission based budgeting and required focus of research leaves less time for uncompensated leadership positions. 3.Ambitious faculty are balancing personal/family commitments and careers.

13. A case study: Our Department at the University of Washington

14. Department of Pediatrics Faculty Numbers March 2010 YearMenWomenTotal Dec200010068168 20039478172 200510984193 2006121116237 2007136135271 2009151152303 Mar 2010163169332

15. Department of Pediatrics March 2010 RankMenWomenTotal Professors 58 22 80 Professor Emeritus 11 4 15 Research Professors 1 0 1 Research Professor Emeritus 2 0 2 Associate Professors 28 40 68 Associate Professor Emeritus 1 3 4 Research Associate Professors 2 3 5 Research Assoc Prof Emeritus 1 0 1 Assistant Professors 45 66 111 Acting Assistant Professors 3 7 10 Research Assistant Professors 1 2 3 Acting Instructors 6 5 11 Clinical Instructors 3 2 5 Other 1 15 16 163 169 332

16. Who leads in our Academic Pediatric Department?

17. Division Chief Group 4 Vice Chairs 1 Associate Vice Chair 18 Division Chiefs 3 Education Leaders 2 Quality/Safety Leaders (9 are women)

18. Leadership Opportunities in our Department Approximately 75 Division Chiefs Section Heads Education (student, resident, fellows, CME) Medical Directors of units (ie PICU, ED) Clinic Directors Quality Improvement Research Center Directors Hospital committees Medical Staff leadership University committee chairs Search committee chairs

19. Each of these roles provides opportunities for personal growth, management, creativity, and recognition.

20. In 2003, our Department changed its mission statement to include the concept of faculty success.

21. Our Mission Through excellence, innovation and collaboration, we will improve the health of all children and adolescents by educating the pediatric and physician leaders of the future, advancing research, advocating for children and providing the nation’s best primary and specialty pediatric clinical care. In partnership with our health care and academic institutions, we will create a collegial environment where academic faculty can reach their personal and professional goals.

22. How can a Chair build talent? Offer leadership opportunities Listen to goals and be proactive in promoting leadership Understand appropriate timing for offering opportunities Never stop coaching Provide leadership resources

23. Departments are so complex that without many leaders, success is impossible. Attaining senior leadership is the result of success in intermediate leadership roles. The more diverse the experience, the more competitive one is for larger leadership positions.

24. The pipeline is actually wide and offers many opportunities to grow into leadership positions of increasing responsibility in concert with one’s time and interest.

25. Time to retire?

26. OK, now the question that people keep asking me… When are you going to retire or step down???

27. Sometimes the decision is made for you. In my opinion, the time to choose to retire (or step down) is when one’s energy is devoted to the status quo and not on moving the department forward.

29. OR……….

30. In other words… Like the definition of old age, the time for you to choose to retire (or step down) is when your memories outnumber your dreams.