Sunday, May 24, 2009

No ‘20 minutes per patient’ rule - another reason I like being a professor

After more than twenty years with my health maintenance organization, Kaiser Permanente I was finally able to find a ‘personal physician’ who did not either leave the organization or get transferred after one or two visits. She recognizes me as an individual and has some contextual knowledge of my medical history. She is congenial, professional and seems to enjoy her work. This is a breakthrough. I was coming to believe that the concept of “your doctor” existed only in slick TV commercials of drug companies, Kaiser Permanente marketing brochures, rural hamlets large enough to sustain one or two physicians, and negative ads funded by private insurers opposing government intervention on behalf American’s 40 plus million citizens without health insurance.

At my last visit, I asked her if there was a time specified by Kaiser management for each patient visit. ‘Twenty minutes,’ she said. ‘It used to be only fifteen, but we were able to lobby with management to increase it to twenty. This works very well for patients who are in relatively good health such as yourself. For older patients with multiple health problems and/or who have difficulty communicating, it can be difficult. Then we sometimes get behind schedule.”

This set me to thinking about one of the perquisites that sets the profession of university professor apart from most others - discretion. As economic pressures mount and calls for ‘assessment’ from voices outside academic institutions grow louder, the number of institutions who are able to offer professors significant discretion is shrinking. But at American University, at least for faculty teaching within its nationally ranked programs, considerable discretion is still the norm.

It is not that faculty members don’t put in long hours. I advise young faculty whom I counsel in my role as Director, Center for Teaching Excellence that they should plan on a 70 hour work week, or more, if they expect to successfully compete for tenure. In other words, the demands on their time will be at least as great as for aspiring top-tier young professionals in law, medicine, accounting, and financial services.

But there can be a difference between how professors and those other professionals spend their time. In other postings, I have written about the discretion we have to choose the research questions we investigate. Here I want to reflect on the discretion we have to spend relatively unconstrained ‘face time’ with our students. This is particularly true with MA and Doctoral students, but it extends to undergraduates as well - and even to students who have completed their degrees. If a student stops by my apartment for help with an academic or personal problem, or simply to discuss an issue of mutual interest, I can take the time to be with them. If a former student stops by to seek a letter of recommendation or to discuss professional options, I can make myself available to help. I can show a student’s parents from Asia, visiting America for the first time, the beauty of rural northwestern Virginia where my wife and I have our home. I can take time to help a gifted undergraduate who is struggling to negotiate AU’s sometimes complex and unforgiving bureaucracy. None of these instances are hypothetical, they - and many more - transpired within the last two weeks. On no occasion did I have to enter the time spent on a spreadsheet or prepare an invoice detailing ‘billable hours.’

Whether or not the discretion my generation of professors have been privileged to enjoy will survive the growing commodification of higher education I cannot say. In large degree it will depend on whether or not those of us who have been granted this privilege are seen to be using it wisely, with integrity, professionalism and effectiveness. It will depend whether the current generation of students - future parents, political leaders, boards of trustees and university managers remember instances when a professor took time to connect with them, listen to their concerns and offer compassionate professional guidance that made a difference in their lives.

Labels: , , , ,


Post a Comment

<< Home