In the month that I have been at Baylor, I have defined the moves that must be made by the Baylor Board and the Board of any
hospital that wishes to become an Affiliated Teaching Hospital. I, now, come to the moves, that must be made by you.
You have four sources of power: (1) President of the College, (2) Chairman of the Department of Surgery, (3) Head of the Cardiovascular
Center, (4) Direct access to the chairman and members of the Board on the basis of personal respect and friendship. This is
too much power to be placed in the hands of one man. The faculty is aware of this and many have strong feelings about it.
Even more importantly, the academic world at large is fearful of his concentration of power.
Before we begin to recruit, decentralization must be agreed upon and implementation of the program started.
You are going to be remembered as the greatest vascular surgeon of the 20th century. The Cardiovascular Center at Baylor will
be a monument to your research interest and drive. The Center should bear your name. You are not going to be remembered down
the ages as a professor of surgery or as president of Baylor College of Medicine.
I recommend that you be made Chancellor of the Baylor College of Medicine, a member of the Board of Trustees of the Medical
School and a member of the Executive Committee of the Board. This gives you a major role in policy making and fund raising.
I recommend that you create a Division of Cardiovascular Surgery in the Department of Surgery which, under the proposed agreements,
will make you automatically the head of that division in Methodist Hospital and that you remain the head of the Cardiovascular
I recommend the appointment of a new President. He should be a clinician who you like and respect.
I recommend the appointment of a new chairman of surgery who has had a large experience in training surgeons with the minimal
use of charity patients. There are several reasons to appoint the new chairman of surgery at this time: (1) you can have great
influence on the selection, (2) the staff would accept the concept of Baylor Affiliated discussion [. . .] in the hospital.
(3) Baylor needs new strength at the executive faculty level and one could move more rapidly in surgery than in many departments,
(4) the new professor of medicine will be more comfortable with a professor of surgery who has no broader power base than
he has, (5) many hours of work at the executive faculty level are needed to clarify school aims and to restructure the administrative
framework so that few people report directly to the president, (6) young professors of surgery have a better eye for emerging
young talent, (7) the new buildings and programs to be developed at Baylor should be guided by the young who are going to
have to live with them.
These changes in administrative patterns are, of course, predicated on the fact that the Baylor and [. . .] agree to go forward
with the development of a teaching hospital.
Necessary moves by the Baylor Board are:
1. Establishment of the following policies:
a. All members of the faculty teach
b. All members of the clinical faculty who create income in the Baylor Methodist complex support financially the teaching
and research programs.
c. All methods of handling income by the faculty be reviewed by the President of the College.
2. The erection of an ambulatory patient complex, connected to a Methodist Hospital. This will serve the purpose of creating
a workshop where the clinical faculty can largely support itself and it will free up enough space in Methodist so that it
can function as a teaching hospital.
3. Establishment of a policy that will permit Baylor to work with Texas Children's Hospital and St. Luke's Hospital
on a similar basis if and when their hospitals are ready to move forward, but if they wish to do so.
Necessary moves by the Methodist Board:
1. The chiefs of departments and divisions in the medical school are the chiefs of the corresponding departments and divisions
in the Baylor Methodist complex. The search committee making the Baylor appointments will have representatives from the faculty
and the hospital administration. The candidates are nominated by the medical school and the hospital has the privilege of
accepting or rejecting the nomination. If the nomination is rejected, a new candidate will be proposed.
2. All members of the Methodist professional staff are members of the medical school faculty. They are nominated by the school
and accepted or rejected by the hospital.
Necessary moves by both boards:
1. The appointment of a Vice President for Business Affairs who will be responsible for the operation of the Baylor Methodist
2. The appointment of a committee that will handle the allocation of space in the Baylor Methodist complex.
If the program describe above can be implemented in the next two months, the future of the medical school is assured. If it
cannot be implemented promptly we will come on tragic times. We can expect more and more discontent among the faculty and
by fall we may well be confronted by resident and student unrest with attendant picketing and demonstrations.
I hope that you can make it clear to the board that these essential moves must be made now. There is nothing that you as President
can do until the boards of trustees act. Meanwhile, your own reputation will suffer because the students, residents, faculty
and community will attribute the lack of action to you. They do not know that you cannot move until the boards of trustees