First, a disclosure:  I am a tenured surgery faculty member at the University of Utah.  That said, I think that the bias I bring to what I’m about to write is quite the opposite of what might be expected based upon that fact.

An op-ed by Nick Kristof in last Sunday’s New York Times has touched off a firestorm debate in the blogosphere and on Twitter regarding the role and relevance of tenure for those cloistered in the ivory tower of academia.  This column hit home for me for two reasons, both quite personal.

A significant portion of Kristof’s column digs into the fact that in political science in particular that those in academia have largely removed themselves from the public dialogue about politics.  Some want to argue that putting oneself into the public arena via Social Media is anathema to academic productivity (n.b.  a significant portion of my scholarly efforts right now are focused on demonstrating this is a myth).  The International Studies Association, an organization at which I presented research in one of my prior incarnations, recently proposed that editorial board members for their journals not be allowed to blog.  Perhaps the reactionary nature of what Kristof describes in his essay serves as a solid reminder to me why I left my graduate studies in political science and have looked back with no regret.  I simply could not see how my complicated econometric models were going to effect political change since they were incomprehensible to the Mothers marching in the Plaza de Mayo.  I was fortunate to work with some incredibly brilliant minds during my graduate career in political science, particularly having Mike Ward as my research mentor, but I do have a sense of frustration that most people have no knowledge of this community of individuals hard at work on issues of peace, human rights, and conflict resolution in international relations.  I know I could have had a good and intellectually challenging life in political science; I just happened to have an epiphany during my 2nd year of graduate school at CU that it wasn’t the life that I was supposed to have.

Then, there’s this issue of tenure in terms of how it relates to academic medicine.  The whole debate about tenure’s appropriateness and relevance is nothing new.  Kristof, however, quote Anne-Marie Slaughter that disciplines “have become more and more specialized and more and more quantitative, making them less and less accessible to the general public.”  I can think of no field for which that is more troubling than in medicine, particularly with the current push for patient and families to participate in shared decision making.  Participate in a little thought experiment with me here, if you will:

• Criteria for academic promotion is scholarly activity on arcane things
• Arcane things are, by definition, inaccessible and incomprehensible to the general public (and, for that matter, to people outside of a given specialty)
• Patients and families are supposed to use what information to participate in “shared” decision making?

Summary:  Traditional scholarly activity in medicine is contradictory to what is being proposed as a best practice in social medicine.

While that may be an exaggeration, it sets up what we all really need to think about- why do we do what we do in terms of our scholarly work, and how can we make sure that those who most need to know about it (i.e. the patients, if we’re doing clinical and translational work) know what we’re learning?  Because if we’re in medicine, isn’t the focus supposed to be on the patient and what is best for them?