Changes That Are Cold and Distant
John N. Gardner
The end-of-year holiday period is one in which I do many things I haven’t set aside the time all year to do:
- Hosting visits from wonderful children and grandchildren
- making charitable contributions
- income tax preparation
- making vacation reservations for 2016
- putting up and taking down a tree and other decorations
- holiday letter to people to whom I used to send Christmas cards
- phone calls to lifetime special friends
- writing some in the same cohort
And it was in that latter category this year that I wrote a man who used to be my wife’s and my family physician. We became his and he ours right after he graduated from medical school, the epitome of the best our higher education system educates and trains. He was charged with the very latest knowledge, idealism, optimism, youthful but mature energy, with his total adult life open before him. Eventually he moved on to another part of the country but we have stayed in touch. He is doing very “well” in terms of the way we conventionally measure success in terms of attainment of professional excellence and success. But he wrote me a line that I just can’t get out of my mind—keeping in mind this is a physician with 1100 patients and so busy it takes a new patient six months to get an appointment with him:
“The changes in medicine make it cold and distant”
“……cold and distant….”
“……cold and distant…..”
I wish I could make that thought go away. This is now what I wanted for my friend. This is not what I want for myself and my loved ones in our US medical system. This is not what I want for our students either—not only in our medical system but in our higher education system too—the latter being the critical preparation process for delivery of professional medical care.
On the board of directors of the non-profit organization I am privileged to lead, we have a director who is a very, very successful entrepreneur from the health care industry. He keeps pointing out to me and the other fellow directors the parallels he sees between the changes in our health care system and those in our higher education system.
Some of the most obvious parallels:
Example: the increased role of government regulation in both sectors
Example: the increased role of technology in delivering the core processes of both
Example: the huge costs of this increased reliance on technology
Example: the increased demands for public scrutiny and accountability of “outcomes” from both systems
Example: the decreased autonomy of the formerly most powerful members of the two comparable professions: professors and physicians—whose status, power and compensation is now less than the administrators who “manage” these systems
Example: “managed” care and “managed” delivery of the college experience
Example: rapidly rising costs that outpace annual inflation rates with said costs being passed on to consumers
Example: the lack of political will to make universal access to both health care and higher education a birthright, an entitlement
Example: unequal access to both systems as a function of race, ethnicity, socio-economic status
Example: mergers and consolidations in both
Example: not-for-profit colleges and hospitals becoming increasingly more and more like for-profit institutions in both sectors
Example: struggles and even closings of small, rural, private colleges/private hospitals
I could go on with this enumeration of parallels but I think the above list is sufficient to make my point.
I don’t know anyone who has spent any time in the US healthcare system who has not found some contexts and interactions within that system that are truly “cold and distant.”
As I think of my friend’s evocative phrase, I find myself wondering how accurate a characterization this would also be for many components of the American college going culture and experience.
Asking the right questions:
I hope my readers will join me as we start this new year by considering this description of higher education along with some questions:
Does “cold and distant” describe some components of your campus culture?
What does that mean very specifically and operationally?
What are the consequences of this for student learning, success, retention, graduation, health and welfare?
Does it really have to be that way?
What would account for whatever is cold and distant?
Who is accountable for this?
How did we get to be this way?
What would it take to ameliorate that?
What would be the cost benefit ratio for taking the necessary steps to do so?
What is keeping us from doing so?
Recognizing that there may be elements of my own institution that are “cold and distant” about which I have no say and control and not even any ability to influence, what could I do to insure that those elements under my control and influence will not be characterized in this manner? Yes, each of us must reduce this to our level of locus of control. We all have some level of locus of control.
A New Year’s Resolution
As I prepare for my work in higher education for 2016 I am going to keep this phrase foremost in my mind and strive to do what I can to make this less descriptive of the changes we are making in American higher education.
This is my new year’s resolution.