The Changing Role and Responsibilities of Chairmen in Clinical Academic Departments: The Transition From Autocracy

Abstract

There is considerable literature dealing with the responsibilities of clinical department chairmen, which primarily emphasizes the importance of developing a sound and facilitating administration. This is dependent on the hiring of appropriate support personnel, developing a representative committee structure, being available to the faculty for their needs, and establishing departmental guidelines, procedures, and policies that apply equally to everyone. Nascent chairmen have an extensive literature available to them concerning academic administration, but a chairman's success is primarily dependent on the possession or development of certain interpersonal skills. Developing a concern and interest in the faculty and staff will come naturally to some and may have to be learned by others. A chairman can attempt to create an excellent esprit de corps by introducing a departmental philosophy that is perceived by the faculty to be supportive. Qualities of the chairman that convey this philosophy are fairness, integrity, compassion, confidentiality, effectiveness, judiciousness, and the willingness to exert considerable effort and time in obtaining recognition and rewards for the faculty. Some of the most difficult tasks for a chairman are (1) the prioritization of his or her responsibilities and activities, (2) representing both the university and the department when their goals appear to conflict, (3) recognizing that an autocratic chairman may administer the department with less difficulty and even appear to have more respect than a democratic chairman, (4) learning to expect less accolades and appreciation from faculty than the clinical chairmen of yesteryear, and (5) resisting the commitment of valuable time to negotiations or battles that cannot be won or to activities that do not benefit the department or the university. There are more than 25 areas of responsibility that are mentioned in this paper. Only a few of them are discussed in any detail. There are many positive aspects of the role of chairmanship. As the years go by, the position becomes easier and more enjoyable and represents the most rewarding and fulfilling position in the medical administration hierarchy. It offers the individual an unusual degree of independence and autonomy not available in any of the other administrative positions in medicine, while still permitting involvement in the scholarly and clinical pursuits of academic medicine and the development of future clinicians and academicians.