It has been hard to watch what’s going on at Northwestern Health Sciences University, but we may not have to watch it much longer. Its current president has directed a thorough purging of institutional memory, homogenization of its professional cultures, and mismanagement of a number of important relationships. It is not only losing relevance, it may be slowly going out of business.
Arguably at its peak in terms of brand, mission and vision in 2000-1, when Northwestern College of Chiropractic added programs and became Northwestern Health Sciences University, the school could claim significant thought leadership and vision. It accomplished remarkable things in a very challenging health care marketplace. It had regional organizations and institutions eager to partner with it on innovative projects. Since then, the short tenures of its succession of presidents, differences in their skills and focus, and now a widening gap between accomplishments cited and a rapidly changing health care marketplace are creating conditions where questions about the school’s longer term survival have to be raised.
Having a non-DC as president is a challenge, because of how much the profession is part of the school’s history and a source of student referrals. It’s certainly possible to have a non-DC come in and have or develop a respectful, nuanced understanding of the professional culture, but that does not seem presently to be the case. And it may be that the only way for NW to grow and stay viable is to scrub chiropractic sensibilities from its leadership. But of the three sentinel provider professions NW trains, chiropractic has operated the longest in the health care marketplace, and the challenges chiropractors face are probably not unique to one profession. School leaders will likely argue that interest in chiropractic is ‘softening,’ but without chiropractors in leadership positions empowered to help them solve that, it becomes easy to look beyond the chiropractic program for viability–exacerbating the program’s decline. If conditions for acupuncture and massage graduates ‘soften,’ what then?
To outside appearances, the school leadership has already moved on. Seemingly without an understanding and sensitivity to the concerns and input of its DC graduates, NW’s leadership has challenged those in the field to go along with a vision that does not have much visible chiropractic input. And it’s not just professional relationships that have suffered: in the twenty months since the most recent president has been in office, what can only be described as a purging of most institutional knowledge, organizational and professional memory has taken place. In addition, much of alumni engagement, development relationships, and other aspects of Northwestern’s social and historical fabric are all weakened or unproductive.
It’s not just DCs who are being discarded or marginalized. A senior, non-chiropractic leader with significant skills and institutional memory was recently let go under another ‘reorganization’ that simply re-establishes her same management portfolio in a ‘new’ position. ‘The chiropractic program at Northwestern’ has an accomplished DC as its Dean, but neither he nor any other DC seems to be empowered to do anything meaningful about the institution’s culture. While national searches are being mentioned to replace released leadership in student affairs, alumni affairs, development, and marketing, based on what’s happened no observer can have much confidence that successful candidates will be expected to understand how to navigate the effort required in recapitulating strong relationships with alumni. (This isn’t the first time repairs have been necessary: after Dr. Cassata left, alumni were similarly disaffected and marginalized. It took several years of focused efforts to re-engage alumni and get their backing for the school’s direction.)
I’ve heard from scores of alumni over the last several years, and those who endorse the direction of the school and its leadership don’t often claim to be inspired by the school’s direction; more often they’ll allow that they don’t know what else can be done. There is no emotionally compelling vision that engage alumni and that results in their support and contribution. The succession of failed, ineffective or caretaker presidents has drained the school’s alumni—its most important resource—of a good deal of its optimism, hope, and engagement. Coupled with the real challenges facing chiropractic nationally, hearing alumni say they won’t send their kids or patients to chiropractic school is as powerful a statement as can be made. Some are still visibly supportive, but their ranks are thinning. Many don’t see Northwestern as a solution; they see it as part of the problem.
The school’s alumni relationships are an asset that’s being squandered in multiple ways. Walking the hallways of Homecoming in February felt more like a wake than a celebration. There are enough options for CE credits that the school may find itself adding to alumni disaffection by weak programs and the aloofness of the school president. Homecoming used to be a vibrant cultural experience; it would be interesting to see how many would describe it that way now. There’s a reason why the institution’s presidents used to take great care in their relationships with chiropractic alumni. Most alumni aren’t likely to think the president has to be a DC, but most are likely to think that their engagement should be sought, valued and rewarded. How many would describe it that way now?
When an institution’s leader blames their alumni for being disengaged, the wrong source of the problem is being considered.
Ultimately, the school will either survive based on its current direction or it won’t, or its direction will have to change. But here’s the thing: no one has waited around for the school to sharpen its focus and effectiveness, and NW is demonstrably less differentiated from educational competitors now than it was just a few years ago. Adding undergrad students is great, but if you aren’t providing careful stewardship of the three sentinel provider professions that form the school’s foundation, other schools will find it easier and easier to peel off prospective students. Word gets around.
School leadership recently trumpeted stable enrollment, media placements and notable endorsements for some of its extra-programmatic efforts. Those accomplishments are great, and good people are working hard to improve the school. It’s not clear, however, that these accomplishments are significant enough to improve the institution’s prospects for survival.
An emerging darker vision suggests that there may be a different outcome for this opaque and cryptic direction–if not by design, then as a response to opportunity and a lack of perceived options and solutions.
Several years ago, in conversations with then-president Jeff Nelson, one inescapable sense was that under his leadership and with diminishing options, the school might end up in a place where it could no longer remain in business. His incoming optimism waned quickly. What emerged as a possibility happens in business all the time: assets (including professional programs) can be sold off or closed down, freeing the core business to go in a different direction or cease operations–a ‘business success.’ The pressures then facing Nelson haven’t changed, and seen through that lens, it’s hard not to view what’s going on at NW any differently than asset stripping. Payroll’s been pruned; cultures have been diluted and homogenized; thought leadership, regional standing, stature and relevance have dissipated. Non-professional program enrollment increases can be duplicated by nearby competitors more established and sharply tuned to the marketplace. Internally, those still employed must be getting whiplash looking over their shoulders. If the school seeks to be ‘a premier health sciences university,’ it’s challenging to squint hard enough to see that outcome when recent specific accomplishments are tabulated. And with the ranks of institutional memory thinned to the point of amnesia, there are few people around any more to argue the point.
The school’s Board of Trustees is in a challenging position. They had every reason to be excited when the latest president was hired, and they have had every reason to accept his action plan–even with misgivings and at the cost of most of the school’s historical, professional, significant personnel assets and longstanding leadership. New blood is often invigorating. But based on what’s visible externally, the resulting erosion of stature and lack of visionary, strategic leadership, one has to wonder if the Board truly is confident in where the school is headed. If it is, or in the absence of any visible efforts to change things, then alumni and other stakeholders will have to determine how confident they are in turn.
Some—even a good number—of alumni and other stakeholders will look at this perspective and wonder what all the fuss is about. Some are clearly still engaged (see ‘good people’, above), but many have also given up. The school’s chiropractic alumni association has never been an activist organization, but it has been an important source of consultation, buy-in and evangelization. Now they are as marginalized as the rest of the profession—inside and out. The last time it was this bad, Dr. Cassata was in charge and disaffected alumni leaders were clear: either he goes or we do. But times are different, and present day alumni are challenged just to stay in business, so over time it’s become easier for them to disengage from an alma mater that seemingly cares less whether they stay or go. For both leadership and alumni, the same holds true: it’s not the words, it’s the actions.
Does the school need to change direction? On the outside looking in, many details can’t be known. And it’s impossible to know what might compel the Board to step in more forcefully if the school’s balance sheet health continues to look good. But a good number of people who’ve been deeply invested in the school, its development and success are concerned about what’s taking place. The hope here is that, very soon, a clear understanding of how the school’s culture is being slowly shredded and its future being placed at risk creates a strong and visible response.