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KENT & KIBBE
Dr. Neal Kassell: Kent and Kibbe are the best leaders UVa Health has had in 40 years
DR. NEAL KASSELL
The purpose of this is to memorialize my conversations with the investigators from Williams & Connelly and with University of Virginia stakeholders and the community at large relating to the ongoing issues within its health system.
At the outset, it must be noted that I am deeply committed to the future of UVa Health and the university, having been associated with them for over four decades. I have dedicated most of my career to the institution, with my last formal role being the co-chair of neurosurgery. As the chair of the Focused Ultrasound Foundation, I continue collaborating with numerous departments within the School of Medicine, as well as Engineering, Darden, and Batten. My wife has served as dean of the College of Arts and Sciences, and most of our friends are affiliated with the university in one way or another.
Our circle of friends, past and present members of the Board of Visitors, administrators, deans, chairs, faculty, donors, community leaders, and policymakers, do not hold uniform views on the current issues affecting the health system. The vast majority are staunch supporters of the current leadership of the university and the health system; a few have been vocal critics, having received biased, distorted, inaccurate information. Many have confided in me, granting me unique insight into the dynamics at play.
The incontrovertible fact is that the two leaders of the health system, former CEO Craig Kent and sitting School of Medicine Dean Melina Kibbe, are the most visionary and transformative leaders it has had since I joined the university in 1984. With President Jim Ryan’s support, they have made astonishing improvements in the face of extraordinary adversity. Any missteps there may have been are far outweighed by their accomplishments.
This assessment is based on my extensive interactions with executive vice presidents and medical school deans I have worked with over the past four decades, and I am solely motivated by what is best for the university; I have no personal stake in the success or failure of the current leaders. My history of vocal criticism toward previous leadership should underscore the sincerity of my position.
When Kent and Kibbe commenced their leadership, UVa Health was an institution in decline, saddled with negative momentum. Once, UVa’s School of Medicine boasted 10 departments in the U.S. News & World Report’s top 50 health systems. When they arrived, there were none. The headwinds they faced included:
• Fragmented organization with friction between the UVa Physicians Group and the health system and billing dysfunction.
• Low productivity.
• Poor morale.
• Faculty resistant to change and accountability.
• Vocal opposition from a fraction of the clinical faculty, hostile to the new CEO selection.
• Clinics with extraordinarily long wait times for appointments.
• Severe staff shortages of nurses and technologists.
• Coding and billing dysfunction.
• Public controversy over billing and collection practices.
• Financial instability.
• A Board of Visitors and administration that lacked the bandwidth, experience, and expertise to manage the complexities of an academic health system. (Dealing with the issues of higher education and athletic enterprises is challenging enough even without the issues of academic medicine.)
• A health system operating board that lacked authority to drive meaningful change.
• And the COVID-19 pandemic.
A seismic shift with systemic reform was necessary, and the leadership acted with great alacrity. They have implemented cultural and operational changes to align UVa Health with other leading academic medical centers. They have set clear expectations for productivity and compensation. They have improved scheduling and addressed coding and billing practices. I know these changes have not been popular among a segment of the faculty.
Just as their actions were bold, the results were quick and evident. Patient volumes, both inpatient and outpatient, have surged. Research support has grown at a clip. Facilities are expanding to meet growing demand. Recruitment of clinical, research, and administrative talent has brought fresh expertise, while partnerships with other health systems have extended UVa Health’s reach across Virginia. Improved ratings from Press Ganey and Leapfrog reflect enhanced patient care and safety.
Change is rarely welcome, particularly in academia. A segment of UVa’s medical faculty has long resisted reform and accountability, entrenched in a culture that privileges tradition over innovation. Such cultural habits and lingering bitterness from individuals overlooked for leadership roles have fueled dissent. The resulting campaign of anonymous accusations, media leaks, and smears threatens to destabilize the health system and tarnish the university’s reputation.
The disgruntled physicians raising these issues are highly organized, with a clear and well-executed strategy. Their dissemination of messages through letters, local media outlets, and targeted emails has been effective. Backed by strong legal counsel and media expertise, they have crafted a compelling narrative that has gained traction.
The destructiveness of this campaign goes far beyond the damage inflicted on the health system’s leadership. I am reminded that when large organizations fail, it is less from external market forces than from the flawed internal process. The campaign of smear, unsubstantiated claims, and resentments is a rut that is spreading far. It has had chilling effects on donations, partnerships, and state support for research. Recruitment and retention efforts are hampered. Leadership focus is being diverted from growth and the pursuit of excellence to damage control and salvage, risking years of progress.
The university administration and Board of Visitors have been muted in their response, preferring to let the investigative process run its course. While I understand the logic of such action, the intensity of conspiratorial actions and rumors spreading through the institution and the national landscape is such that I must ask the university leadership to take a more proactive position to protect the university’s reputation.
Silence or passive engagement risks undermining confidence in the institution and its leadership. Accusations have gone unanswered far too long, allowing speculation to fester. No leader, no matter how effective, could emerge from such a process with their reputation unscathed. Neither will the health system’s. The administration and the Board of Visitors must counteract misinformation with consistent, transparent messaging highlighting the recent successes of the health system. Supporters, faculty, staff, and community members must be encouraged to provide balanced perspectives to investigators.
The leadership of Kent, Kibbe, and their team represents UVa Health’s best chance at unparalleled excellence. Their vision, resilience, and competence have guided the health system through its most challenging period. By refusing to indulge in vendetta and resentment, let us turn this crisis into a moment of unity and renewed commitment to the ideals that make UVa a cornerstone of academic and medical excellence.
Dr. Neal Kassell is the former co-chair of neurosurgery at the University of Virginia, as well as founder and chairman of the Focused Ultrasound Foundation.