title: The "Fourth Mission": The Time Commitment of Anesthesiology Faculty for Management Is Comparable to Their Time Commitments to Education, Research, and Indirect Patient Care.
abstract: Academic anesthesia departments have management responsibilities (e.g., coordinating sedation, directing the operating rooms [ORs], informatics, ongoing professional performance evaluation, staff scheduling, and workroom inventory management). For each of the 64 faculty, a survey sampled 10 weekdays and 4 weekend days of professional activity over N=56 days. Faculty time in managerial activities was 126% of time spent on education, 107% of time spent in research, and 112% of time spent on mandatory indirect clinical support (e.g., fire safety training). The 95% lower confidence limits calculated using Fieller's theorem were 107%, 89%, and 91%, respectively. Corresponding bootstrap limits were 107%, 89%, and 90%, respectively. Thus, although our College of Medicine tripartite mission includes clinical care, education, and research, administrative activities constitute a "fourth mission" of our department.
authors.affiliation: From the *Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa; and †Department of Anesthesia, University of Iowa, Iowa City, Iowa.
authors.forename: Franklin
authors.initials: F
authors.lastname: Dexter
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Wachtel
authors.forename: Michael M
authors.initials: MM
authors.lastname: Todd
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Hindman
mesh_terms: D000761:Anesthesia Department, Hospital; D000776:Anesthesiology / Q000193:education / Q000706:statistics & numerical data*; D035843:Biomedical Research / Q000706:statistics & numerical data*; D004501:Education, Medical; D005180:Faculty, Medical; D006785:Hospitals, University; D006801:Humans; D007484:Iowa; D005791:Patient Care / Q000706:statistics & numerical data*; D011216:Practice Management, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors