JamesLHollyMD.com

	James L. Holly, M.D.

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Letters - UT Chancellor April 2017 Moral, Legal, Ethical

April 10, 2017

Dr. William McRavin
Chancellor, UT System

In your interview with Chris Wallace on April 9, 2017, you referred to your November 5, 2015 address to the University of Texas Board of Regents entitled “Leading in a New World,” (Chancellor William H. McRaven’s Remarks to the Board of Regents,Nov. 5, 2015). I have read that address and coupled with your May 23, 2014 UT Commencement Address and my experience serving on the Search Committee when William Henrich became President of UT Health San Antonio in 2009, I realized what a remarkable and appropriate event your election as UT Chancellor was. I have shared your 2014 Commencement with hundreds of people, and my wife of 52 years tells me that I am getting better at making our bed. I look forward to sharing, “Make Your Bed, Little Things That Can Change Your Lifeâ€¦And Maybe the World,” with another generation of young Americans.

My wife Carolyn and I met you and your wife at the naming of the UT Health School of Medicine in February, 2017 and had a brief discussion about our grandson who earned his Green Beret in Special Forces in 2016. He is assigned to the _______ . He is currently deployed to _____. We are very proud of him and pray for him daily. Also, my wife and I hope to attend the 50th Chancellor’s Council Annual Meeting & Symposium, April 28th.

I was taken in your Fox interview with your commitment to teaching 250,000 students the importance of being “moral, legal and ethical.” The following link is to two brief summaries of the “achievements, advances, awards and accreditations” made and earned by the medical group which I founded in 1995, Southeast Texas Medical Associates, LLP, (SETMA, LLP), (A Brief Summary of SETMA’s Achievements, Advances, Awards and Accreditations).

After 20 years in solo practice, upon founding SETMA, in 1995, I enunciated the following principles for how SETMA would conduct its business. These principles have stood us in good stead over these past 22 years, as they did me for the 20 years before SETMA.

Ethical, Equitable, Eternal

SETMA maintains three standards of measuring any decision, all three must be met before we undertake any action.

First, we ask the question, ‘Is it legal?’ - this involves ethics. If an action is not legal, we need go no further in our evaluation; we will not do it.
But, even if an action is legal, we are not yet at the point of decision; we move to the second step of our evaluation, which applies a higher standard. We ask the question, ‘Is it right?’ - this involves equity, i.e., is it fair to all parties.
However, even if a decision is right, this does not get us to a final decision. Before we decide anything, we go one step further and ask the question, ‘Is it righteous or moral,’ - this involves eternity. If it is not moral, no matter how legal and right an action may be.”

As with any new enterprise, early on and even now, there were and are financial pressures. One of the reasons for having principles and commitments is that they guide you through difficulties. Without them, compromise and mistakes will occur. SETMA was founded on principles of business-decision making and they kept us from serious mistakes. The principles are: ethics, equity, eternity.

As stated above, all decisions had to be legal. We referred to that as ethics (When I was a child there was a chain of “drug stores” called Ethical Pharmacies. They only sold “legal” drugs.). One of my requirements of my children in colleague was that they had to take two courses, ethics and logic.
All decisions had to be fair. We referred to that as equitable. Decisions had to be good for bother parties rather than being a zero-sum game with winners and losers.
All decisions had to be moral or right. We refer to that as being eternally significant.

Early in our history SETMA’s principles were put to the test. In January, 1996, we arrived at the point that we wanted to provide health insurance for our employees. After applications and interviews were done, the insurance agent told me that there was one employee whose health history was such that if we insured her our annual premium would be $10,000 higher than it would be if she declined the insurance or if we dismissed her. Intuitively, the right decision was obvious, but with defined principles to follow, this was also an easy decision to make. I asked the agent, “Is there any legal way that I could ask her to decline the insurance?” He said that anything we said would be a violation of the law. I then said, “She is a faithful employee and even after knowing that once all five practices were together she will probably not have a job, she stayed with me. Do you think it would be fair, to dismiss her over the cost of insurance?” He agreed that he thought it would not be. Finally, I said, “Do you think that in the grand scheme of things that this lady came to my practice without insurance which she desperately needed and in the providence of God that her needs were going to be met by our insurance?” He agreed that that was possible.

I told him, “Then we will insure her.” This was at a time when $10,000 was a serious expenditure for SETMA. He marveled. When I called her to tell her she would have insurance, she wept. In June, when our new office was available, we kept her on, working at a job beneath her training, but paying her professional salary. Almost one year later, we discovered that the person who was performing the professional services for which this lady was trained was incompetent. Without any disruption to care, the lady with the insurance problems was able to move into the job for which she was trained. We had blessed her and now she was blessing us. SETMA’s history is filled with stories like this.

The principles upon which we founded SETMA and our responses to these pressures contributed to our building a team. During your interview, I was struck with the similarities between our principles and yours.

In SETMA, we began to know that we could not only survive pressures but we could surmount them and succeed in the face of them. And, we could do that internally with ourselves and externally with others with whom we would work. We began to learn that team building not only involved how we related to one anther but also to how we related to those outside of SETMA.

Dr. McRavin, I look forward to hearing how your plans for the UT System unfold. I applaud your application of principles of loyalty, honor and integrity to the UT System.

Sincerely yours,

James (Larry) Holly, M.D.
C.E.O. SETMA
www.jameslhollymd.com

Adjunct Professor
Family & Community Medicine
University of Texas Health San Antonio
The Joe R. and Teresa Lozano Long School of Medicine

Clinical Associate Professor
Department of Internal Medicine
School of Medicine
Texas A&M Health Science Center

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