CHARLOTTESVILLE, VA (CVILLE RIGHT NOW) – UVA President Jim Ryan has responded to last week’s letter to demanding the resignation of University of Virginia Health System CEO Craig Kent and School of Medicine Dean Melina Kibbe.

A letter sent on behalf of 128 medical school faculty contains a litany of allegations. Among them are hiring doctors with questionable qualifications, excessive money for executives despite shortages at the clinical level and explicitly threatening people who speak out against the Board of Visitors.

UVA President Jim Ryan’s letter expresses “disappointment in this particular tragedy” and said some of the allegations “have unfairly –and I trust unwittingly– cast a shadow of the great work of the entire health system and medical school.”

The full letter is seen below.

To the Medical School Faculty:

I am writing in response to the letter I received this week expressing numerous concerns and grievances about the leadership of UVA Health and demanding that the Board of Visitors immediately fire Craig Kent and Melina Kibbe. The letter indicated that it was sent on behalf of 128 medical school faculty.  But it was signed anonymously and only a small, hand-picked number of board members (4 of 19) were invited to see proof of who actually signed it. I was not invited to see the signatures.

The letter itself is daunting.  There are many accusations.  There are few details.  Some of these accusations are fairly evident references to specific matters that we have already addressed or are actively working on.  Others are new to us, but we will do our best to run them to the ground and get to the bottom of them.  Even though it is difficult to investigate generalized and anonymous claims of wrongdoing, without specific details or names to follow up with, we will do our best to investigate.  We will then take the appropriate steps based on what we find.  Once the dust of this particular controversy settles, we will figure out how best to move forward as a community.

In the meantime, I have to convey my disappointment in this particular strategy.  Our provost, Ian Baucom, and I have been meeting with small groups of faculty over the last couple of months to hear their concerns.  We have already addressed some of them and have been working on ways to address others, some of which you will hear about next week.  Ian and I have been working with our colleagues, in other words, in good faith to address some of the challenges raised.

Instead of continuing down that path, some faculty decided to take a different path, and hence this letter, signed by 128 faculty.  It is unfortunate, in my view, that these faculty have taken this route.  They have besmirched the reputations of not just Melina and Craig.  Instead, through some of their allegations, they have unfairly—and I trust unwittingly—cast a shadow over the great work of the entire health system and medical school.

128 faculty represent roughly 9 percent of the medical school faculty.  It bears noting that national surveys consistently show that, across the country, 8-9 percent of medical school faculty are dissatisfied.  It also bears noting that UVA’s medical school has had six deans in the last 16 years.  And it bears noting, finally, that the group of faculty who wrote and signed the letter do not suggest that the allegations be investigated nor that Craig and Melina be afforded due process; instead they demand that they be immediately removed.

The letter itself is exclusively and harshly critical in its appraisal of Melina and Craig.  I have worked together closely with the two of them for the last several years.  What is described in that letter is not a full or fair representation of who I have seen.  It also does not give them any credit for the remarkable work they have done to strengthen the health system.  My inbox, meanwhile, is overflowing with testimonials from some of the 1200-plus faculty who did not sign the letter, who attest that the health system today—under Melina and Craig’s leadership—is in the best shape it has ever been in, and that they have addressed changes that have needed to be made for more than two decades.

I have learned from experience that change is difficult.  I have also come to learn that how it is managed matters.  Recognizing and rewarding the hard work of our faculty and staff matters.  Treating each other with respect and dignity matters.  Giving faculty and staff a voice—and really listening, especially to criticism—matters.  So, too, does making hard decisions, even when they are not universally popular.  Leaders who cannot do these things should not be leading.  I know that Melina and Craig have tried to do all of this.  I also know that they would acknowledge that they haven’t always gotten it right, which is true of all of us in leadership positions, myself included.

I will reserve final judgment in this instance until we have done a thorough review.  Despite the unusual and unfortunate way in which they have been presented, we take these allegations seriously.  As I mentioned, we will investigate them, and we will take the appropriate steps in response.  We will also ensure that no one connected to this letter will face reprisal.  Criticism must not only be allowed but welcomed, and those who raise objections should obviously be prepared for disagreement but never face any fear of retaliation.

All that said, at this point in time I find it difficult to believe that the right answer here is to force yet another change in leadership, only to bring in new leadership who will inevitably fail to satisfy 1400 faculty members and thousands more health system team members.  I think the real work, regardless, is to come together as a community to have a conversation—a real, honest, and ongoing conversation—about how to manage change.  We all know change will continue to come to health systems and academic medical centers across the country, regardless of what we do at UVA and whether we like it or not.  Our collective challenge is to figure out how best to navigate that change, so that it benefits our patients, our doctors, our nurses, and all of our team members who have worked so hard to make the health system at UVA one of the best in the nation, and the place that our community rightly counts on for outstanding health care.

Best,

Jim Ryan
President