The Faculty Senate yesterday approved a resolution asking university leaders to advise Stanford Health Care to adopt a single, uniform method for assessing the competence of faculty members practicing medicine at its hospitals and clinics.

Biology Professor Robert Simoni presented a resolution regarding late career practitioners at Stanford Health Care that was approved by the senate in a secret ballot on Thursday. (Image credit: L.A. Cicero)

Under a policy adopted in 2013, faculty members aged 75 and older are required to undergo a complete health screening and peer assessment of their clinical skills every two years at Stanford Health Care, formerly Stanford Hospital & Clinics.

The senate approved the resolution in a secret ballot vote of 20-9, with two abstentions. The resolution says:

“Be it resolved that the Faculty Senate of the Academic Council recommends to the University leadership that it advise Stanford Hospitals and Clinics, Stanford Health Care, Stanford Medicine, that age discrimination in competency testing end, and that patients be safeguarded by a process that is the same for all faculty age-groups.”

At issue was Stanford Health Care’s “Late Career Practitioner Policy,” which has been a difficult and contentious issue since it was adopted.

Robert Simoni, a professor of biology who presented the resolution to the senate, said the policy was discriminatory because the trigger is based on age.

“Clinical professors over the age of 75 have to submit to a different competency test in order to get hospital privileges than anyone of any other age,” Simoni said. “That is age discrimination in its simplest form. Lawyers will put a lot of lipstick on it. It’s still age discrimination. There’s just no way of avoiding it.”

Frank Stockdale, a professor emeritus in the School of Medicine who spoke in favor of the resolution, said there is no documented evidence that elderly physicians at Stanford Hospital disproportionately harm patients.

“In fact, the literature shows that most harm comes from younger physicians,” Stockdale said.

Speaking against the resolution, Ann Weinacker, a professor of medicine at Stanford, said Stanford Health Care’s Late Career Practitioner Policy was adopted in a nearly unanimous vote of the Medical Staff Executive Committee, which governs all medical staff working in Stanford Health Care and Lucile Packard Children’s Hospital. The board of directors of Stanford Health Care also approved the policy. In addition, in an anonymous vote, members of Stanford Health Care approved that policy by a simple majority.

Weinacker said the policy was designed to assure high-quality care for patients, to be supportive of physicians, and to identify issues that may be pertinent to the health and clinical practice of medical staff members. She said other professions, such as airline pilots, go beyond testing by enforcing mandatory retirement ages. She also said that Duke University requires mandatory retirement from clinical practice at a certain age.

“Many physicians, as they develop these limitations, recognize and restrict their own practices, but not all do,” she said, adding that self-monitoring is not typically adequate to address the issue.

Lloyd B. Minor, dean of Stanford School of Medicine, also opposed the resolution.

“Issues surrounding requirements for obtaining and maintaining medical staff privileges should be addressed through the processes of the medical staff organization at the hospitals,” he said.

“It is not the role of the senate of the Academic Council of the university to tell the independent medical staff organization what the criteria should be for the practice of medicine in the hospitals, just as it is not the role of the hospitals’ medical staff organizations to tell the Academic Council what curriculum should be taught or what should be the criteria for tenure or promotion.”

Tackling the issue of diversity in graduate education

Patricia J. Gumport, vice provost for graduate education and a professor of education, said Stanford is a national leader in initiatives designed to work on the challenge of diversifying the academic pipeline, especially at the PhD level, to improve recruitment and promote academic success.

“It is a systemic challenge, obviously, but I want to tell you about some promising initiatives,” she said.

Patricia Gumport, vice provost for graduate education, gave a presentation on doctoral fellowship programs that aim to diversify academic departments and the professoriate. (Image credit: L.A. Cicero)

One of them is Enhancing Diversity in Graduate Education (EDGE), a fellowship program that aims to recruit and retain outstanding doctoral students who will contribute to the diversity of their academic fields and departments.

“We have scaled it up quite rapidly,” she said. “It started in the social sciences and moved to education. Last year, we launched EDGE in STEM. This year, for the first time, we made EDGE fellowship offers to students in humanities, arts and business.”

Gumport also talked about the Diversifying Academia, Recruiting Excellence (DARE) program, which awards two-year fellowships to doctoral students who want to investigate and prepare for academic careers and whose presence will help diversify the professoriate. It was founded in 2008.

“I wanted to underscore the importance of the cohort effect here,” she said. “We’ve had seven cohorts of DARE fellows so far – that’s 122 fellows; 78 have graduated,” she said. “This is where they are in their initial positions: 81 percent in academia, with 29 in tenure-line faculty positions. We’re very excited about this. There are 28 in postdoc positions. There are two others – one at the National Institutes of Health and another one at Microsoft – who are also using their research skills very well. We have six others who are in lecturer positions and academic administration. We’re confident this program is making a difference, not only for the fellows but it’s also inspiring for the university community.”

Gumport said Stanford is learning – from its own initiatives and from national research – what leads to success in advancing diversity and fostering a campus climate of inclusion that values different life experiences, supports students’ success and equips them to realize their aspirations, whether they want to be intellectual pioneers, entrepreneurs or leaders of change in communities outside of higher education.

“Engagement of leadership at all levels of the university, including faculty, staff and current students, all reinforces our ideals and advances progress,” she said.

Gumport also gave the faculty a preview of Stanford’s new PhD Exit Survey data, which will illuminate the nature of doctoral students’ experiences and inform faculty reflections on changes they may want to make to their doctoral programs.

Senate election result

Hans N. Weiler, academic secretary of the university, announced that the senate had elected Kathryn “Kam” Moler, a professor of physics and of applied physics, as chair of the 48th Senate of the Academic Council. James Campbell, a professor of U.S. history, was elected vice chair. They will serve during the 2015-16 academic year.

The full minutes of the May 14 senate meeting will be available soon on the Faculty Senate website. The minutes will include the question-and-answer session that followed the presentations.