Faculty Values

To the Editors:—The article by Pololi et al.¹ presented fascinating data. We were gratified that it corroborated findings we published in 2003², although the recent article used much more sophisticated methods to get data from a larger and better defined study population. We too found that physicians were beset by large organizations whose leadership did not share their values, and were at times ill-informed, incompetent, self-interested, and even corrupt. Two of the striking interviews summarized by Pololi et al. were with faculty whose institutional leadership appeared to put revenues ahead of patient care, teaching, and research, thus forsaking the core values of physicians and academia. Four of the interviews were with faculty whose leaders allegedly used deception for personal and professional gain (i.e., “a situation of major unethical use of funding,” “fraudulently creating data for a research project,” “we’re lying to the people who are doing our school evaluations, we’re putting things on paper that we do that we don’t do,” “that’s what I think he felt he had to do—hide money, lie about money, or at least cook the books a little bit.”)

We were curious, however, about the conclusion of the article, suggesting better congruence between “individual and institutional values,” without specifying which values were held by which individuals. The faculty portrayed in the article seemed to hold traditional professional and academic values dear. However, some faculty felt that some of their leaders valued profit more than patient care, teaching, or research. Some faculty felt that some of their leaders valued self-interest over honesty. Why promote institutional values that are more congruent with such leaders’ values? Instead, why not promote leadership with integrity who support traditional professional values and their organizations' traditional missions?