In 1979, 3 years after I joined the faculty of Harvard Medical School, E. Digby Baltzell, a sociologist and historian at the University of Pennsylvania, published Puritan Boston and Quaker Philadelphia. The book described the differences in lifestyle, public achievement, and cultural contributions of the influential elites of the two cities going back to Benjamin Franklin, William Penn, and Stephen Girard, to Adamses, Cabots, and Lowells. Baltzell's thesis was that the Quakers placed more emphasis on being good, kind, and understanding, while the Puritans put greater value on success and the devotion to their chosen vocations. Baltzell wrote, "Philadelphians have valued noblesse, while Bostonians have placed greater emphasis on oblige."

Having had my medical training and early academic career at the University of Pennsylvania, then working to establish myself in the Harvard environment, I found considerable truth in Baltzell's analysis. As I look back on a 30-plus year career split equally between Harvard Medical School and the School of Medicine and Public Health at the University of Wisconsin, Madison, I am struck by the even greater contrasts in culture, values, leadership style, and work ethic between the "Eggheads" of the Ivy League and the "Cheeseheads" in Wisconsin.

I received the first indication of these differences when one of our outstanding residents returned to Harvard after 2 years of fellowship training at Wisconsin. I asked him to describe the difference between the two institutions. After a few moments of thought, he replied, "The people in Wisconsin are as smart as the people at Harvard, but they put greater emphasis on building collegiality."

Extreme competition and stress

During my years at Harvard, particularly during my service on the Promotions committee, the mantra was "good is the enemy of excellence." Nothing less than academic excellence was tolerated. Lives centered on academic and professional achievements, and the work was unrelenting. Faculty members were extremely competitive, and the stress level was high. Character failings and disagreeable personalities were overlooked when productivity and work quality were high. The emphasis was on creating new knowledge, and contributions to the community, state, or region were valued little. For junior faculty members, tenure was a formidable hurdle, and only a few won it. The administration did not impose a great burden on the faculty's time, and the faculty was supported by a strong infrastructure. Although there was a strong sense of tradition and pride, humility was not abundantly evident.

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Harvard's administration was strictly "top down." In a dispute, the administration could be counted on to line up behind the department chair, and, in extreme cases, the faculty departed and the chair stayed. The dean explained to me on one occasion that he backed his chairs 100% until the day he fired them.

My decision to leave Harvard and accept a position as chair of the Ophthalmology and Visual Sciences Department at Wisconsin was difficult. The dean at Harvard tried to get me to stay by selling me on Harvard's greater prestige. But the culture and leadership in Madison, particularly the concept of faculty governance with the tradition of making decisions on the basis of consensus, intrigued me. In university governance, the faculty was the final authority. Donna Shalala, then chancellor of Wisconsin, recruited me and convinced me that she was dedicated to bringing academic excellence to the university just as she had upgraded its athletic programs.

Shalala recruited a new dean for the medical school, a visionary charged with moving the medical school's ranking into the top tier. During my first weeks on the job, the new dean requested that I demonstrate the "Harvard work ethic;" I was the first one to work and the last to leave. Instead of being impressed by my example, my faculty became concerned about me. More than one asked me if there was anything they could do to help me get organized because I seemed to be spending too much time at work. I compounded the bad impression by planning a symposium during the 1st week of the deer-hunting season. I soon realized I was out of step with the faculty.

When Bill Clinton was elected president that fall, Shalala left to become the new U.S. Secretary of Health and Human Services. Our new dean also left. Both were replaced by administrators with extensive experience at the university. They reflected the values of the community.

In time, I became aware that although excellence was encouraged, the mantra in Madison was "Don't let excellence drive out the good." The universities of Michigan, Minnesota, Iowa, and other Big Ten Schools were our peers and rivals, and few were interested in hearing about how things were done at Harvard. In the mid-1990s, when our department broke into the top ranks of the U.S. News & World Report and Ophthalmology Times listings, I proudly announced our achievement to our advisory board. To my surprise, two members came up to me after the meeting to tell me, "At Wisconsin, we don't boast about such things." On another occasion, when the dean was asked to explain the medical school's slippage in ranking, he said, "We are getting better; it is just other institutions are getting better faster than we are." This was accepted by the faculty.

Protect personal time

The difference in culture and values is manifest in many ways. The faculty members separate their family and personal lives from their careers. People give an honest day's work, and when necessary a long day's work, but they strongly value and vigorously protect their personal time. There is, for the most part, a strong sense of collegiality, and individuals applaud their colleagues' accomplishments. This is coupled with an essentially accepting attitude. Junior faculty members are hired with the expectation that they will obtain tenure, and mentoring committees work diligently toward this end.

The fact that Wisconsin is able to maintain a top research university despite a relatively small population is a source of pride among the state's citizens. This support is repaid by the university with a spirit of contributing service and knowledge to the state and the region. The administration makes many demands on the faculty's time but provides limited infrastructure and support. Teaching is a top priority, and faculty members compete for exposure to students.

The differences outlined above for the "Eggheads" and "Cheeseheads" are generalizations, certainly. Exceptions abound, at both schools. But taken as a whole, I believe these characteristics reflect real differences in the culture of these, and other, institutions. The choices of hiring committees and self-selection by faculty candidates perpetuate faculty culture and traditions. Both systems obviously have their place and serve their institutions' purposes.

As I considered these differences, an intriguing idea occurred to me for an experiment—a thought experiment, since it will probably never happen. What if for a year, or possibly two, the leadership and administration of the two institutions were switched? The president of Harvard would be exposed to the collegiality, faculty governance, and sense of community service that are the hallmarks of the Wisconsin system. The chancellor and provost at Wisconsin could learn from the respect for excellence and the work ethic that defines Harvard. Each school could learn much from the other.

Photo (top): Hidde de Vries

Dan Albert is the Emmett A. Humble Distinguished Director of the Eye Research Institute, Professor and Chair Emeritus, the F. A. Davis Professor, and the Lorenz E. Zimmerman Professor in the Ophthalmology and Visual Sciences Department of the School of Medicine and Public Health at the University of Wisconsin, Madison.

Dan Albert is the Emmett A. Humble Distinguished Director of the Eye Research Institute, Professor and Chair Emeritus, the F. A. Davis Professor, and the Lorenz E. Zimmerman Professor in the Ophthalmology and Visual Sciences Department of the School of Medicine and Public Health at the University of Wisconsin, Madison.
10.1126/science.caredit.a0900002