Tom Kosakowski, USA

Health Sciences Ombuds, University of Southern California

Tom became the first Ombuds for the Health Sciences Campus at the University of Southern California in January 2019. In this role, Tom works with faculty, staff, administrators, trainees, and students affiliated with five teaching hospitals, schools of medicine and pharmacy, research laboratories, and off-campus clinics.

Before this, he was the Ombudsperson for the UCLA Health System for 12 years. He served on the Board of Directors of the International Ombudsman Association including a stint as President and is a reviewer for its journal. He frequently teaches and mentors new ombuds and has published ‘The Ombuds Blog’ since 2006.

Prior to this, he worked as an attorney and served as a court-appointed mediator of the Los Angeles Superior Court. Tom graduated from Occidental College and earned his JD from Loyola Law School.

Ombuds have helped universities to become compassionate

My guest Tom Kosakowski is Health Sciences Ombuds at the University of Southern California. Tom explains how ombuds programs were initiated in the US in the late 1960’s and how they have evolved and progressed over time by serving all stakeholders. He also talks about how the changing university student profile is contributing to the adoption of these programs and why ombuds programs are needed. We also address how medical schools are unique settings for ombuds’ services and what the future of ombuds as an institution will be across the globe. As an institutions, ombuds seems to be growing and has proven to have helped universities be more progressive and compassionate in the last three decades.


IE: Welcome back to another program of We can find a Way, a podcast about conflict resolution. My name is Idil Elveris. In today’s program, my guest is Tom Kosakowski. He became the first ombuds for the Health Sciences Campus at the University of Southern California in January 2019. In this role, Tom works with faculty, staff, administrators, trainees and students affiliated with five teaching hospitals, schools of medicine and pharmacy research laboratories and off campus clinics. Before that, he was the Ombudsperson for the UCLA health system. For 12 years, he served on the board of directors of the International Ombudsman Association, including a stint as president and is a reviewer for its journal. He frequently teaches and mentors New Ombuds and has published the Ombuds blog since 2006. Before all that, he worked as an attorney and served as a court appointed mediator of the Los Angeles Superior Court. Tom graduated from Occidental College and earned his law degree from Loyola Law School.

As one can see, he is very involved in the institution of Ombuds. Thanks to Tom, I even learned that a university in my native Turkey already had an ombudsperson. So as you can imagine, there was a lot of talk about Ombuds, why it was needed, especially in universities, how it came about, its prevalence in the health sector and the future of Ombuds. Now let’s turn to the interview that took place with Tom on 26th of January. Thanks for agreeing to talk to me.

TK: Sure, I’m happy to.

IE: Please tell me, why is an Ombuds office needed in a university, of all places? And when did all of this start?

TK: I think the brief history is that in the United States, Ombuds started appearing in universities in the late 1960s and early 1970s when there was a wave of student unrest, primarily about the Vietnam War, and the students didn’t feel like they were being heard by the administrators of the university. So, a few universities appointed ombudsmen to sort of act as a spokesperson for the student body. Michigan State University has the longest running Ombuds Office that had its origins 50 years ago, and there were several other universities that quickly followed and those early ombudsmen and they were almost all men were often long time insiders who were trusted by the University President, but who were seen as empathetic and responsive to the student concerns. And they could help the administration really understand and act as an intermediary for the student issues. In this way, I think they were acting as advocates for students. Since then, the field has evolved considerably. Most Ombuds no longer serve just students on a campus, but they serve all stakeholders. They don’t have a mandate of advocating for one group. They are more neutral. They actually have characteristics that are defined by a professional association: The International Ombudsman Association, which has four ethical standards for organizational ombuds and the vast majority follow those four standards that come from IOA. There are hundreds of universities that have ombuds programs.

The university is one of those organizations that had its origins in medieval times and it hasn’t evolved that much. There still is a lot of built in hierarchy. You know, privileges are held by tenured faculty who are in many ways immune from pressures that employees in other sorts of organizations are. There’s a big power differential and protection for the faculty and so it can sometimes feel like the students and staff are very disadvantaged. At the same time, universities have begun to be very diverse. We are encouraging more people who are first generation university students. We are attracting more international students, more people of color. And so these new different voices are coming into the university and seeking their way. This whole setting basically can create the opportunity for misunderstanding and conflict. And the universities are trying to change in response to this. And so, I think Ombuds are uniquely positioned to help both individual constituents who are looking for assistance, but also for the organization as a whole to respond to trends and broad based concerns. So the way IOA defines the role of an organizational ombudsman, there are really two purposes. One is to be that dispute resolution expert to help with individual discrete issues that come to their office directly. And their second role is to be an agent of organizational change by serving as an upward feedback mechanism to supplement formal mechanisms that are in place to help the university know about and respond to things that the Ombuds is hearing about on an informal basis.

IE: So basically we’re seeing an institution that was established because of social unrest, but then over time, taking a different mission, more in tune with the understanding of an organizational ombudsman that you see today in international organizations and I mean Bretton Woods institutions or even larger corporations.

TK: I think in the last two or three decades, Ombuds have helped universities become more progressive, more compassionate, more humanist. That’s a big reason why they’re being created.

IE: A lot of universities don’t have ombuds offices or is it a best practice to have them? Like, how do the universities approach it these days?

TK: Certainly, there’s no legal mandate for universities to have these. In the US, there are non-profit accrediting bodies that sort of certify that universities and colleges have met the minimum standards and are accredited. And there are a couple of those that are recommending Ombuds as a best practice. I think it’s evolving as a best practice in higher ed. There’s evolving research that shows that there’s a benefit for the organization, not just universities but any kind. About a decade ago there was a study of US federal agencies that found that workplace mediation has a huge cost benefit. It doesn’t cost very much to implement a workplace mediation program and then you reduce your litigation costs and employee turnover and other expenses. That understanding applies to Ombuds as well. Universities realize we can help make things work more effectively, more efficiently here.

Also, as the landscape in higher ed has changed because of Title Nine. Title Nine is a federal mandate that requires that universities treat their male and female students equally. Initially, for the first couple of decades, it really was applied to athletic programs. You couldn’t have 20 teams for the men and two teams for the women. So it helped encourage parity, has been broadened to ensure that no one is disadvantaged in education because of their gender or as a result of sex discrimination. There have been some changes in the way Title Nine is being interpreted which imposes new obligations on universities to receive and investigate misconduct on the basis of gender. So one of the things that’s changed for students, at least from the time that I was a student, it used to be that students could go to a faculty member that they trust and say: “This is a terrible thing that happened to me last weekend at a party off campus and I’m really upset by it. And I don’t know what to do or who to trust”. And that professor could confide in the student and offer them some resources and support. The way Title Nine is interpreted now, as an employee of the university, that professor can’t keep that conversation secret anymore. They have to report it for investigation. And so students are seeing a dwindling number of resources that are available to them that can provide confidential advice and help. During the Obama administration, they were recognizing this problem and encouraging more support for students that are facing these sort of problems. And they did say that there need to be more confidential offices for students to go to. Ombuds fit that description a mandate of confidentiality. That’s one of our four ethical characteristics.

IE: There is a trend. Do you know how many universities have it?

TK: My best estimate is that at least half have an Ombuds office. Initially, it was big research universities that seemed to have an ombuds office because they had more students and financial ability to create new programs. But in the last decade, I’ve seen growth at smaller schools, public junior colleges, community colleges. So they’re adopting these as well.

IE: So what are the most common issues your office deals with?

TK: The predominant model for university Ombuds is to serve all the stakeholders. Faculty, staff and students can come to us with any sort of issue that relates to the university. There are a few universities, they’re definitely the minority, where the Ombuds will serve only students or students of a certain program. A good example of that is that are couple of medical school ombuds offices that serve only the med students. But that’s not typical. Generally, what I see from reading other Ombuds annual reports is that a third to almost half of our visitors are staff members. These are people working for their career at the university and they develop issues that come out of their dysfunctional work place and they don’t know who they can trust. They don’t want their problem to become part of -non-academic stuff- and oftentimes their complaint can be against a powerful administrator or a tenured faculty member, and they don’t feel like there’s easy recourse. And so they’re looking for options. Sometimes it’s nearly half of our casework involves staff members.

And then perhaps a third are students. Usually it’s undergraduate students who are just sort of learning those life skills and social conflict management tips, socialization. They’re living away from home. Their parents aren’t doing the problem solving for them anymore. They’re in this new environment with a lot of complex relationships and policies, and they just need some assistance navigating the university. If English is their second language, if they don’t have a family experience, that can give them insights to the university that were important for them. And then the balance come from faculty administrators. Sometimes parents will call us, sometimes alumni will call us. That’s typical. I work at a university that has a large medical center. I don’t know if I should give general information about the context.

Many large universities in the United States, they’ll have a separate campus for medical activities where they train doctors or nurses, pharmacists. Oftentimes they will have at least one teaching hospital where they can provide training. But then they’re also doing those clinical activities where they’re seeing thousands of patients a year as well. And these medical centers are sort of semi-autonomous within the university structure. There are often times at a different location, a few miles away and they have a big hospital and they have their own teaching facilities. So oftentimes, universities will have a separate ombuds designated for that group of stakeholders. Those medical centers oftentimes have their own culture and…

IE: It is like that everywhere

TK: It really does bring in a whole lot of prestige and a lot of money. But then it also brings a lot of litigation and conflict as well.

IE: And therefore, you are working at the health section of the Ombuds office of the University because it’s a different category from what you’re describing. It has also evolved that way because it’s a different setting. What is so different about the health sector? Please tell us about the sector.

TK: Before I came to USC, I was at the big Public University in Los Angeles, the University of California, Los Angeles, and they have a medical center as well. And I was the ombuds for that medical center. These medical centers are unique because they have the typical university structure with students and students that are training in professional programs. There are junior faculty, faculty that are not on tenure track, faculty that are going to become tenured or are tenured. And then there’s this overlay of clinical activities where you’re treating patients. There are the demands of that work, which doesn’t have an analogue on a main campus. And then the research can sometimes be highly lucrative.

So in the US, a lot of medical research, scientific research is funded by federal grants from the National Institutes of Health and other federal agencies. Doctors and scientists will set up laboratories where they will become an investigator for a new scientific project to research a new drug or understand a new medical biological process. So, they’ll create a lab and they’ll have grants that come in every year, $2 million for them to do research and that can supplement their faculty income. Those labs will oftentimes generate intellectual property patents in new drugs and new procedures and new tools. Those patents are then jointly owned by the faculty member and the university. So, a lot of these MD and PhD researchers that are running labs at medical centers are very valuable to the University because they’re bringing in 1 million or $2 million a year and sustaining important research that adds to the prestige of the university. They’re employing half a dozen people in this research lab. They’re training students so they become very powerful. And if they have tenure, it’s difficult to fire them. They operate very autonomously in many cases. It’s sort of hard to prevent bad behavior or even manage conflict when it comes up.

IE: Quite interesting because this is in harmony with what you have said before, which is almost half of complaints, applications to the Ombuds office is coming from non-academic staff who probably feel like the least placed to complain or who feel least powerful in this structure, that you have just described.

TK: Right. And the staff are also there for a longer time. You know, the students finish their course, they earn their degree, they are gone and the staff can be working there for a decade or two. And the dysfunction just continues to be an issue for them.

IE: I would ask you to please describe the difficulties of being a health sector employee. You’re talking about the organizational parts of it from the standpoint of the university maybe, but are we seeing those kinds of issues at your university as well?

TK: I think you’re right. In Los Angeles right now, we’re having a big surge of COVID cases. So I think a lot of those issues are being put to the side while the frontline health care workers are just doing as many hours as they can. I will probably see more cases as the curve starts to come down and people have a little bit of time to breathe and think about what has happened over the past year and realize that there are some issues that they need to address. In the US in medical training, most medical students leave their university when they earn their degree, and they go do a period of training at another institution. It’s called a residency as baby doctors. These trainees thrown into working with patients in a hospital from day one. And usually these training programs last three years. So oftentimes we see these trainees that are providing medical care. They’re living in a new city where they’re having to isolate themselves when they’re not at work and they have lost all that social interaction they would normally have when they go to start their training, not meeting their colleagues and their supervisors after work for dinner. They’re not having a picnic on the weekend with their family can come to. They’re just going to work and coming home. They’re losing out on all that important social interaction that help and that sort of information about how their colleagues think and work and what their perspectives are. They’re missing all that. And so I think it’s a difficult time for medical trainees. I’m going to see that lead to miscommunications and misunderstandings and conflicts in the years to come, I think.

IE: What do you think is the future of Ombuds programs internationally? Is the world waking up to this institutional framework or is it just a US thing? I know you’re, engaged in the International Ombuds Association. Please tell us more.

TK: Yeah, I would say that there are three different areas where I’m seeing continued growth. One is in organizations that are affiliated with the United Nations, so they have adopted an office. The success that the UN has seen is being copied by other organizations that are affiliated or model their work on the UN. So emerging development banks, international nonprofits that are promoting conservationism or water resources or things like that, they’re creating ombuds offices for their programs. I think that will continue.

Second, in Europe especially, there is growth among universities. I’ve seen a lot in Germany in the last couple of years and in the Netherlands, Norway and Sweden. In Germany there has been a soft mandate for scientific ombudsman to help ensure robust, honest scientific research. And so, there are ombudsmen that are working with graduate students and scientists at German universities. In the Netherlands, there is a big push from the labor unions and also student groups to create ombuds offices at universities. There is an organization for, but it’s in Europe, European Network of Ombuds and Higher Education, INOHE, and they are growing and becoming a very important and relevant group.

The third area which I think is just beginning to emerge internationally, is to have ombuds in high tech field where you have big growing organizations with lots of different subcultures, international workforce, and they’re trying to adopt a progressive mindset or reflect a progressive mindset in their treatment of employees. And so, I’m seeing new efforts to create ombuds programs. So, Twitter has opened a search for its first ombudsperson, and Pinterest will be doing the same. SAP had an Ombuds program for at least a decade, and they recently just expanded to have an office in the Americas. So that may be the next frontier, you know, wanting to be progressive and treat their employees well, having a diverse workforce. And quite honestly, I think some high tech companies evolved out of the bro culture of Silicon Valley which is a bunch of young single men that are creating a company together and not enlightened about their, you know, treatment of others. Ombuds will sometimes help organizations become more inclusive.

I know that litigation creates case law and important precedent that helps shape our society and guide our organizations, and that’s good. There are some things that do need to be litigated. Not every case should be resolved informally, but I think people need to have as many opportunities as they can to negotiate a resolution if that would be appropriate for them. They need to have confidential resources that they can talk places where they can go and talk about their issues and maybe learn some skills or identify new ways of resolving their concerns. I think these are all things that help people individually; that make the workplace healthier; that make organizations more empathetic.

There are a couple of different kinds of ombuds in the world. Organizational ombuds are kind of a new development. There is a longer and in some areas more predominant type of ombuds. Some people call them a classical ombuds or a legislative ombuds. They have a separate organization and separate standards. The International Ombudsman Institute represents and coordinates and advocates for these types of ombuds. Many of the classical ombuds have a mandate where they have powers to conduct investigations, powers to make formal recommendations to a specific legislative body or executive agency. That’s the kind of ombuds that existed for 200 years. Organizational ombuds are characterized by confidentiality but also informality. So, we’re not part of a formal process and we don’t have formal powers. Neutrality, we’re not advocating for one group over another. Within our organization, a fair amount of independence. So, we have other roles that would compromise our regular work. There are classical ombuds schemes in the United States, several states have them. They are appointed by the legislature. They are in some specific industries. So the long term health care industry in most states has..

IE: Classical one we know.

TK: Yeah, exactly. So I only know of one organizational ombuds in the extractive industries. Shell Oil has an ombuds program.

IE: Thank you very much for spending this beautiful California morning with me via Zoom. I do appreciate your time, Tom.

TK: It was really my pleasure and happy to provide more information for you or your listeners.

IE: In today’s program my guest was Tom Kosakowski. We discussed how the Ombuds programs at universities were initiated in the US, how the changing university student profile is contributing to the adoption of these programs amid the hierarchical structures at the universities. Through the neutral and confidential environment of the Ombuds, universities want students and admin staff as well as the academic staff to feel that the university is being more compassionate towards their demands and towards themselves. Just like workplace mediation, ombuds also work as a feedback mechanism to the administration, not only in universities, but also in getting rid of the bro culture -as Tom put that very nicely of some Silicon Valley firms-. We also understand that medical schools are unique settings for ombuds services, not only in the US academia but also in Europe. Ombuds as an institution seems to be growing. So I hope you enjoyed the program. I will upload a picture of Tom in the Instagram account of We can find a way. Lastly, I would like to close by thanking musician Imre Hadi and artist Zeren Goktan, who allowed me to use their materials in the podcast. And finally, I thank Efsane Şimal Yalçın for her translation. Thank you and see you in the next program.