Volume 1-Spring 1996

"Negotiating For" Protected Time In A Clinical Environment

William Silen, M.D.
Faculty Dean for Faculty Development and Diversity
Johnson and Johnson Distinguished Professor of Surgery

Virtually every young faculty person in the process of negotiation for a first position has been told to insist on "protected time." My experience of many years is that in many instances neither the junior person nor the senior person is truly aware of the meaning of this catch-word.

From the viewpoint of the neophyte faculty person, it is vital that the chief of your division or department understands the use to which you propose to put such time. In many, but not all, instances "protected time" is intended for research. It may be agreed, for example, that 75% of your time is to be solely for research, but it is vital that the way in which the remaining 25% is to be spent needs to be very specifically defined. Teaching and clinical responsibilities can become all-consuming, so that care should be exercised in delineating, very clearly, the expectations in these areas. Furthermore, the junior person must recognize that to a large extent, the fine-tuning of one's expenditure of effort is in the hands of each individual. If every phone call requesting a clinical consultation sends you away from the laboratory because you are anxious to establish a clinical reputation, the chief of your division can do nothing to "protect" you. Take care to arrange clinical coverage with compatible persons whose judgment and skills you respect. Similarly, your commitment to teaching needs to be very clearly specified. Recognize that to hold a faculty position at Harvard Medical School, you must, indeed, do some teaching, so don’t expect to be relieved completely of this responsibility. To recapitulate, while there may be an overall agreement with your chief as to the partitioning of your effort, you, alone, are the ultimate guardian of this precious commodity.

Your chief of service can protect you only from excessive administrative activities or excessive time commitment for teaching. If you are interested in maintaining clinical skills on a continuing basis (in most surgical specialties and other interventionistic disciplines such as gastroenterology or cardiology), an understanding must be reached with your chief as to how much of your salary is to be realized from clinical activities. Beyond that, responses to calls from patients and referring physicians need to be regulated by you in conjunction with colleagues with whom you can rotate call schedules. In specialties where you can have a defined month or two "on service," the task of retaining "protected time" is much easier, but remember that clinical skills rapidly become atrophic from disuse (my bias), or never become fully developed if exercised infrequently.

One final admonition: it is very easy to be seduced into activities such as administrative pursuits, especially if a small amount of pressure is exerted by a more senior person to accept such duties. Such activities can, indeed, consume you if not sharply limited.

"Protected time" is a wonderful concept in principle. The individual seeking protection is instrumental in achieving this goal once an agreement with your chief has been reached on a few basic generalities.

(A different "Negotiating For" will be presented in each issue of Mentations. If there is a specific topic that you would like addressed, please mail, fax or E-mail a note to Faculty Development and Diversity.)