Where are “U”?

April 7, 2014 by School of Medicine Webmaster   |   Leave a Comment


We are engaged in a strategic planning process that is as much about change as it is strategy. A diagram that I particularly like depicts change along a “U”-shaped curve on a temporal and internal/external perspective axes. (See image above)

Before change begins we are operating at the status quo and using automatic ways of thinking, acting, interacting, and behaving. On this diagram, this state is depicted as Denial. Organizationally, this is our current culture.

The next stage in the process of change is Resistance. Everyone’s natural reaction is to resist change. Resistance manifests with feelings of anxiety, debate, bargaining and wishful thinking. Even individuals who have been longing for change can find this period unsettling.

Many of you have told me that you are feeling a little uncomfortable with the conversations and activity that our strategic planning is generating. My interpretation is that we are moving out of the status quo to the resistance phase of the “U” curve.

This is a critical time to push forward rather than to pull back. To use my flywheel analogy again, we have started to move the wheel and our concentrated effort to keep pushing now will get us more quickly into a the comfortable phases of exploration and commitment.

I appreciate the time and effort that so many of you are contributing to the various work groups. Thank you for helping to make us better.

Nancy E. Dunlap, MD, PhD, MBA
Dean, UVA School of Medicine
James Carroll Flippin Professor of Medical Science

Filed Under: General


Comments (5)

  1. Mark Yeager says:


  2. Given that a natural reaction is to resist change, in addition to pushing forward with concentrated effort, what are some recommended techniques and procedures that may help move us toward more exploratory mindsets and behavior patterns?

  3. Cynthia Carrigan says:

    Dear Dean Dunlap;

    First, I applaud you in the quest to change the status quo at UVa. I have been associated with the SOM since 2007 when I began working with the EGS/Trauma Division in the Dept. of Surgery. Having come from a corporate environment I soon discovered that the UVa environment was very different to what I was acustomed. However, I love the group with who I work. However, I have observed over the last 6+ years that change does not come quickly in this environment, and certainly not without some angst along the way. Since I haven’t worked in other departments since coming to UVa, I don’t have a broad scope for comparison, but one of the major things I’ve observed is that with the yearly evaluation process, the doctor whom I support on a day-to-day basis has virtually little if an input into my evaluation. Instead for the past years my direct supervisor who had never observed me on a daily basis to see exactly what I did was the sole evaluator in the process. It’s been extremely disconcerting going into an evaluation only to see the identical scoring from the previous year and learing from the doctor who I support who is very happy with my work and motivation having no opportunity to provide input. The supervisor has never (until recently) as much as substituted in any department clinics, had very limited interaction with patients or scheduled a surgery, managed an extremely busy surgeon’s clinical and academic calendar and travel schedules. I have 30+ years in the medical environment, including starting a medical transcription business which my husband now oversees, managing 2 private physician practices and working in multiple hospital settings. In summary, I suppose my question is what does it take to achieve a higher level within a UVa department and see the physician whom one supports contribute substantially to your yearly evaluation and position? I would venture to say that there are probably less than 5% of the support staff who are at the top of the evaluation scale, amongst >30 staff positions in General Surgery. Our morale is certainly very low, and the recent re-slotting in HR has left many wondering.

    Finally, thank you for taking the initiative to move forward. As long as we don’t go backwards, we will, in the end, have succeeded. I would welcome the opportunity to meet you at sometime in the future. The physician whom I support, Dr. Michael D. Williams, speaks of you with the highest regard. I look forward to the things ahead at UVa!

  4. AJ says:

    To reach there on a fast-track;

  5. James Clark, MA says:

    Wondering if there is any iniative at all towards UVA medical center and UVA school of medicine towards developing a program to treat substance abuse/addiction ?? Previous to current role at ID Clinic, have worked in Hospital as liasion from Region Ten for 7 years, in an SA intervention and Referral to Treatment provider. Looking at the human cost and financial costs of Substance abuse disorders, it seems beyond belief that there is no comprehensive Substance use treatment program. (UVA CARES is NOT a treatment program) The epidemic of prescription drug abuse alone would indicate a need to fund a program to address this issue. The number of patients identified as substance abusing in the ED and on general medicine units is very high, and there are no comprehensive resources or Staff to directly begin a treatment program. Currently working in the ID Clinic providing SA and MH counseling under a Department of Health Grant, not a direct program of the UVA health System

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