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Is Academic Medicine Ready for Term Limits?

Austin, Jared P. MD

doi: 10.1097/ACM.0000000000003020
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The use of term limits in politics and business has been proposed as a means to refresh leadership, encourage innovation, and decrease gender and racial disparities in positions of power. Many U.S. states and the executive boards of businesses have incorporated them into their constitutions and bylaws; however, studies in politics and business have shown that implementing term limits has mixed results. Specifically, research in politics has shown that terms limits have had a minimal effect on the number of women and minorities elected to office, while research in business indicates term limits do increase innovation. Additionally, term limits may have unintended negative consequences, including inhibiting individuals from developing deep expertise in a specific area of interest and destabilizing institutions that endure frequent turnover in leaders. Given this conflicting information, it is not surprising that AMCs in the United States have not widely incorporated term limits for those holding positions of power, including deans, presidents, provosts and department heads. Notably, a few academic medical centers (AMCs) have incorporated such limits for some positions, and faculty have viewed these positively for their ability to shape a more egalitarian and collaborative culture. Drawing on studies from academic medicine, politics, and business, the author examines arguments both for and against instituting term limits at AMCs. The author concludes that despite strong arguments against term limits, they deserve attention in academic medicine, especially given their potential to help address gender and racial disparities and to encourage innovation.

J.P. Austin is associate professor, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon; ORCID: https://orcid.org/0000-0002-7868-3855.

Acknowledgments: The author wishes to thank Dr. Alex Foster and Dr. Michelle Noelck for their helpful suggestions and edits.

Funding: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Jared P. Austin, Mail code: CDRC, 707 SW Gaines St., Portland, Oregon 97239; telephone: (503) 494-6300; email: austinja@ohsu.edu.

© 2019 by the Association of American Medical Colleges