'Hub of everything': Vice chairs work behind-the-scenes to achieve departments' strategic goals

When it comes to casting the vision for a department at the Indiana University School of Medicine, department chairs take the lead. But vice chairs run point for getting the work done — on schedule, within budget and through complex collaborations.

“Vice chairs are the right hand to the chair,” said Angie Rinehart, who started her career at the medical school 31 years ago and has been vice chair of clinical and academic administration for the Department of Obstetrics and Gynecology since 2016. Before that, she held a similar role with the Department of Ophthalmology.

While vice chairs rarely get the limelight, their role is critical to departmental operations.

“It’s the hub of everything,” Rinehart said. “We’re always in some kind of budget process, no matter what time of year.”

Vice chairs not only work with department, division and school-level leaders but also with IU Health and its physicians’ group, since many faculty are dually employed with the health system.

“The vice chair has the responsibility to manage everything related to the department, including all three missions — clinical, educational and research — two different employers, two different budgets, and a number of competing priorities and goals,” explained Brad Burbage, MHA, vice chair of administration for the Department of Pediatrics since 2009.

Andrea Ligler, MBA, vice chair for the Department of Pathology and Laboratory Medicine, describes the role this way: “We are essentially a CEO of many small businesses. We have tremendous fiscal responsibility and a very large scope.”

Along with budgeting, vice chairs work in talent recruitment, legal compliance, employee relations, space planning, system process improvements, charitable endowments and more. Their scope includes “all of the difficult conversations,” Ligler said.

Lisa Landrum, MD, PhD, MS, credits Rinehart for helping her navigate the complexities of departmental finances and stakeholders while transitioning into her new role as chair of the Department of Obstetrics and Gynecology.

“Some of the most recent difficulty (in health care) has surrounded shortages in the labor force,” Landrum said. “These changes have been catastrophic for several academic departments and institutes across the country. Despite this, our department has weathered difficult times and remains on sound financial footing. I would give much of the credit for this to Angie in her guidance as the vice chair of finance.”

 

What does it take to be a vice chair?

“When I grow up, I want to be a vice chair for financial administration in health care!” said no child ever.

Burbage wanted to be center fielder for the Cincinnati Reds or a point guard for the Cleveland Cavaliers. “When reality set in, I thought I was going to become a mechanical engineer,” he said.

So then, how does a person wind up in this job that is as vital to medical school operations as it is complex to explain?

Rinehart began as a preschool teacher, then moved into office jobs when her children were young. When her family moved from North Carolina to Indiana, she landed a position with IU School of Medicine and used her tuition benefit toward a bachelor’s in business administration. She started out as a human resources specialist in the Department of Medicine and worked her way up through various business management roles before becoming vice chair for the ophthalmology department.

In 2014, Rinehart participated in the Indiana Healthcare Leadership Academy, which connected her to industry leaders outside of IU as well as rising physician leaders at IU School of Medicine.

“Developing those relationships is very important,” Rinehart said. “It makes a difference in how connected you feel to the organization.”

Her greatest mentor was Charlie Fox, former vice chair for the Department of Medicine.

“We have quite a few administrative leaders that grew up under Charlie Fox’s tutelage,” Rinehart said. “He was an incredible leader. He encouraged me and gave me opportunities to grow.”

Rinehart remembers Fox once saying she might be “too nice” for the vice chair role, which often involves leading change — and dealing with those who resist it.

“I learned to be tougher and learned what I’m empowered to do,” Rinehart said. “It’s staying calm, approaching people with the facts and saying, ‘let’s get through this together.’”

 

 

What keeps vice chairs motivated?

Still a teacher at heart, Rinehart has mentored many others on their way to administrative leadership — some who went on to become executives with IU Health and other health systems.

Ligler also mentors rising administrative leaders. In 2022, she partnered with the IU Kelley School of Business on a project with graduate students in medical management. That spurred an ongoing initiative for the pathology department to host students each summer, with a goal to increase the pipeline into pathology and laboratory medicine.

Ligler has a master’s in business administration and worked in pharmacy finance before joining IU in 2012 as business manager for the pathology department. She’s currently nearing the finish line on a doctorate in organizational leadership; her research aims to expand the medical laboratory science pipeline through interprofessional learning with nursing staff.

Burbage has also helped his department through many expansions and improvements benefitting its overarching missions.

“We have grown a lot in the 15 years that I have been in this role, and it has required careful and strategic planning to make sure that our faculty and teams have the resources to deliver on our mission and goals,” Burbage said of his time in pediatrics. “We are in new research buildings and new clinical locations throughout the state, and we are educating many more students, residents and fellows now.”

While the role of vice chair is demanding, those who hold the position say they enjoy the variety of tasks each workweek brings. It’s no surprise these administrative executives also enjoy a variety of interests outside of the office.

As someone living with hypoparathyroidism, Ligler works with the pharmaceutical industry to advocate for patient resources and treatments. Rinehart loves to garden and shares the beauty of her outdoor space with colleagues by using garden photos as her background for videoconferencing.

After 31 years at IU School of Medicine, she has thought about retirement. But Rinehart wants to see her department through its current leadership transition first. For over three decades in administrative management, her motivation has come from doing meaningful work.

“My position is not clinical, but I really like that I can contribute in a non-clinical way to the greater good in improving health care, access and outcomes in Indiana and beyond,” Rinehart said.