Thursday, January 29, 2009

Shakeup at the University of Minnesota Medical School
and the Academic Health Center

From MPR:

U of M medical school reorganizes; Dean out by summer

A reorganization is shaking up the leadership at the University of Minnesota's Medical School. The current dean will step aside this summer as her job is absorbed into another position. University officials say it's part of an effort to save money. The reorganization comes after criticism of the dean's efforts at preventing conflict of interest at the medical school.

St. Paul, Minn. — The reorganization plan was announced in a memo from U of M President Robert Bruininks to the school's Board of Regents. The memo, obtained by MPR news, outlines a plan to combine leadership positions at the medical school and the University's Academic Health Center on July 1st.

Deborah Powell's position as the U's medical school dean will be merged with the senior vice president for Academic Health Services. That job is currently filled by Frank Cerra.

After a summer transition period, a search will begin to fill that new leadership role in the fall.

Calls to the medical school and to Bruinicks were directed to University spokesman Dan Wolter.

"The goal here is to first and foremost to consolidate and strengthen leadership in the medical school and to achieve cost savings."

The move is not based on Powell's performance as dean, Wolter said.

"Dean Powell has been a strong and effective leader at the medical school and she will stay with us in a role in a role of medical education."

[Sure, Dan, whatever you say...]

Some were critical of Powell when in 2006, she accepted a paid position on Pepsi's corporate board. Those critics said it was a conflict of interest for the dean to sit on the board of a company that produces products that are linked to health problems like obesity and tooth decay. Powell defended her position and said it was a chance to have her voice heard by the leadership of the company.

[A member of the board of directors of a company has a fiduciary responsibility to help that company make money - not to have her voice heard ... She was paid approximately $130 K for this service in 2007.]

In 2007, Dean Powell formed a task force to revamp the medical school's conflict of interest policy. That policy governs interaction between the U's doctors and researchers and medical companies.

Some task force members said proposed changes to the policy didn't go far enough in preventing conflict of interest.

Powell faced more criticism late last year after the Star Tribune reported task force co-chair Dr. Leo Furcht was reprimanded in 2004 by Dean Powell herself for violating the school's conflict of interest policy. That policy is still being developed and has not been released.

Wednesday, January 28, 2009

Changing of the Guard at U of M Medical School

fromFrank B. Cerra
reply-to"Frank B. Cerra"
toMED-ALL@oris2.ahc.umn.edu
dateWed, Jan 28, 2009 at 4:01 PM
subjectPresidential Announcement
mailed-byoris2.ahc.umn.edu

TO: Medical School Faculty and Staff

I want to share with all of you the memo below from President Bruininks in which he outlines his decision to combine the position of Senior Vice President for Health Sciences with that of Dean of the Medical School. We are at the very beginning of the transitional work this will require, and I’m certain you have many questions about the impact of this news on you and your department or division.

In short, there is much work to be done before we have answers to many of those questions. However, I can tell you that the University of Minnesota’s Medical School remains one of the most important assets of the University, and the public depends on the work we do to sustain the health of both families and the economy.

We are indebted to Dean Powell for her leadership over the past several years. She and I are working together on transition issues and discussing a future administrative role for her in the area of medical education.

I plan to engage all of you in the work that needs to be done. Please feel free to contact me on my direct e-mail at cerra001@umn.edu with any questions or concerns.

Frank B. Cerra, M.D.
Senior Vice President for Health Sciences
McKnight Presidential Leadership Chair

Tuesday, January 27, 2009


Bad, But Not Surprising, News for the U of M

The feared chop from the Governor came. This isn't necessarily the end of the story, but it is time for OurLeader to roll up his sleeves and start giving serious consideration as to how to solve our problems. I hear rumors that Driven to Discover may be finally going down. How about an official end to the Strategic Propaganda Initiative and ambitious aspirations for becoming one of the top three public research universities in the world [sic]?

Everyone who can should go to the conversation OurProvost is holding this Thursday afternoon. Information here.

[I have teaching obligations that day and will not be able to attend - a big disappointment as I had asked for such conversations in an op-ed in the Daily last semester. Glad that this is finally happening. See:

"The time has come," the Walrus said, "To talk of many things: Of shoes—and ships—and sealing-wax— And cabbages—and kings—“ ]

From the Daily:

In a move that would cut $151 million from the University of Minnesota’s state aid over the next two years, Gov. Tim Pawlenty proposed a cut Tuesday of more than 8 percent from state higher education for the upcoming 2010-11 biennium.

There has been speculation that the state could receive more than $3 billion in federal money, a sum that Pawlenty said would contain some money for higher education.

Pawlenty said he would continue to push for a cap on tuition increases at state schools at a rate close to inflation, but beyond that would let the University’s Board of Regents and the Minnesota State Colleges and Universities system Board of Trustees determine how to deal with their share of the cut.

University President Bob Bruininks said he was disappointed Pawlenty didn’t make higher education a priority in his budget.

“I don’t believe you can have a strong, vibrant economy if you don’t make higher education a priority,” he said.

While voicing his opposition to the proposed tuition increase cap, Bruininks said students would not face a large tuition increase.

“We have no intention of putting these reductions on the back of students,” he said.

In 2003, the state cut more than $198 million from the University’s budget. Tuition increased more than 14 percent each of the two subsequent school years.

Bruininks said to avoid similar increases, the University would first look to cut costs and delay investments before raising tuition.

Higher education currently makes up more than $3 billion in state expenditures. At 8.5 percent, it would be the fourth largest share of the state’s general fund in Pawlenty’s proposed budget.

Rep. Tom Rukavina , DFL-Virginia and chairman of the House Higher Education and Workforce Development Finance and Policy Division, said the state would need to find additional revenue sources to close out the deficit.

“It’s shortsighted on his part,” he said of Pawlenty’s higher education cuts. “I’m not going to sit here and nod my head and agree that all of this could be solved with budget cuts.”

Sen. Sandy Pappas, chairwoman of the Senate’s higher education finance committee, called the deficit “unprecedented.”

While meeting with Bruininks on campus Tuesday, Pappas said the state needs to remain committed to supporting students.

“We don’t want to impact their quality [of education], and we don’t want to make them pay more,” she said.

Echoing Rukavina, Pappas said Pawlenty is not “putting everything on the table” when it comes to finding more revenue sources.

“The governor certainly hasn’t come up with any ideas about how we’re going to maintain the quality of our University while we cut,” Pappas said. “We have a governor who will not consider all options.”
Kudos to Pappas, Rukavina, and even, gasp, Bruininks for their positions. I am glad to finally see Bruininks commit to no large tuition increase. This is a late conversion, but late is always better than never.

Monday, January 26, 2009

Continuing Medical Miseducation? CMnotE

UD posts on Dr. Mejicano's CME dilemma over in Badgerland. This doc has been continuing to shill for hormone therapy for menopausal women. The poor man has been harrassed by the Wisconsin Sentinel Journal and the university finally took down the website once the paper got wind of it. Life is so unfair... The media just picks on these docs so unmercilessly.

In a p.s. UD points to another site that has also turned this rock over, the Carlat Psychiatry blog. They, too, do the dirty on Dr. Mejicano but since variety is the spice of life, let's look at some of the sordid tale there:

University of Wisconsin + Wyeth = Biased CME

In the fall of 2002, the Women’s Health Initiative stopped its NIH-funded clinical trial of hormone replacement therapy, because women randomized to receive hormone therapy (estrogen + progesterone) had more breast cancer, heart disease, and strokes than those not taking the drugs.

This presented Wyeth, the manufacturer of the implicated drug Prempro, with a problem: a potentially catastrophic loss of income.

They responded the way drug companies generally respond when their product is shown to be hazardous. They ramped up their marketing. They criticized the methods of the study. They emphasized the need to weigh risks vs. benefits.

And, according to this riveting article from the Milwaukee Journal Sentinel, Wyeth deployed an army of ghostwriters and academics to create a one-sided $12 million CME program which is under investigation by the Senate Finance Committee.

According to the article, Wyeth hired a marketing communications company called DesignWrite which teamed up with UW Medical School to create an organization they named “The Council on Hormone Education.” This council was composed of 40 academics in the field, 34 of whom had ties financial ties to Wyeth.

Sounds pretty academic.

But when John Fauber and Susanne Rust, the investigative reporters, showed the materials to independent experts in the field, here were the reviews:

--Jacques Rossouw, chief of the Women's Health Initiative branch of the National Institutes of Health said, according to the paper, that “the views expressed in the course are not those of the general scientific community and are not suitable for a university medical education course.” "There is a history of this kind of thing from Wyeth," Rossouw said. "The materials regurgitate lines that I have heard and read many times, and I have come to believe (though I do not know) that this is part of an overall marketing strategy to the profession. It is not good science because it fails to strive for any kind of balance."

--Raymond Gibbons, a professor of medicine at the Mayo Clinic and former president of the American Heart Association, “said he also found material relating to heart disease one-sided. He noted that the materials inappropriately gave observational data equal weight to rigorously done, randomized clinical trials. ‘It's a lot of post hoc analysis,’ he said. ‘I don't see the other side of the argument.’"

-- Marcia Stefanick, an investigator with the Women's Health Initiative, told the Journal Sentinel that “since the results of the first large clinical trial on hormone therapy were released in 1998, drug companies have been trying to minimize the concerns….They are very eager to keep coming up with ways to show it isn't harmful….There is this constant attempt to get women back into it."

--Anthony Scialli, an adjunct professor of obstetrics and gynecology at Georgetown University's School of Medicine, put it simply: "It is pure, undisguised marketing.”


It’s not really so complicated. UW took in $1.5 million from Wyeth to help them advertise Prempro in the guise of CME. Money clarifies the mind and sharpens incentives.

Meanwhile, UW is involved in several other ongoing big ticket CME initiatives. These include:

--Pfizer’s $12.3 million smoking cessation program.
Pfizer happens to make Chantix, an embattled smoking cessation drug.

--Boehringer Ingelheim’s program on restless leg syndrome
. The company happens to make Mirapex, a drug for RLS.

-- Bayer HealthCare Pharmaceutical’s course on premenstrual dysphoric disorder. Bayer happens to make Yasmin, an oral contraceptive being touted as a good treatment for…yes, premenstrual dysphoric disorder.

If you want to enjoy these advertisements, you’d better get on it. I’ll wager that the chastened university will be soon be shutting down these websites as well!

These are the kinds of things going on in our own backyard. They are the reason why reform is needed in medical schools across the country and at the University of Minnesota. Let's get on this, Dr. Cerra, Powell, Furcht, et al...

Sunday, January 25, 2009

[from Bob's recent Spamogram]*


But Walking the Talk?


We Don't Do No Stinking Walking!


[*So if this claim is true, Bob, why is the average debt at graduation for our students $25 K -the highest of our supposed aspirational peers? And our six year graduation rate 60% - for shame...]

From the Daily:

Bruininks, railing against Pawlenty’s goal to cap tuition increases at state schools this session, said tuition increases would be on the table, but would be, “the last thing on the list” of possible revenue sources for the University.
“Anyone in higher education who thinks they’re going to solve this budget problem with high tuition rates is whistling in the wind,” he [Bruininks] said. “I don’t think it’s responsible and it’s not the position I would take at this time.”
[The key weasel words here are: "at this time." see: From the Department of Better Late Than Never]

“We will do everything possible to keep this burden as low as possible on students,” Bruininks said. “We’ll do everything we can to protect the jobs of our employees.”

State funds make up 70 percent of funding for the University, Bruininks said. It accounts for more than three quarters of total spending on both student services and faculty compensation.

[Hmmm, 70%? The number quoted for the percent of state support seems to be a function of which U of M administrator is doing the talking...]

“[Bruininks] understands the responsibility of the University to the Bell Museum, and our stewardship of the state institution and that’s why we are back with this request again,” [VP Kathleen] O’Brien said.

[WHAT?]
As commenters pointed out:

Administration logic: x = not x

Don't these statements seem even a little contradictory?

“We will do everything possible to keep this burden as low as possible on students,” Bruininks said. “We’ll do everything we can to protect the jobs of our employees.”

“[Bruininks] understands the responsibility of the University to the Bell Museum, and our stewardship of the state institution and that’s why we are back with this request [a new Bell museum building] again,” O’Brien said.
and:
I'd also ask about all the reports this century detailing how the portion of true per-credit costs that the state picks up, reportedly now less than 25% (down from close to 50% a generation ago), can be reconciled against the statement here that the state, and tuition, provides 70% of funding for the U?

I'd assume this means that the state is picking up roughly 20%+ of costs that would otherwise be part of a higher tuition, for everybody; and furthermore that state grants to individual students based on need inflate that 20-25% figure up to a whopping 70%? Can that be possible?

You'd have to have the the large majority of students receiving a large majority of their tuition funding from the state in order to have the state directly funding 70% when tuition costs in general are only picked up to the tune of 20-25%. So say the math.

What am I missing here?

Friday, January 23, 2009

Mayo Clinic Hits the Blogosphere...

Maybe we should try this at the U of M and at Fairview-University Hospital?

From the Pioneer Press:

Mayo Clinic entered the blogosphere Thursday morning with a blog where patients and employees can post comments.

"People like to talk about their experience at Mayo, and actually look for ways to do that," said Dr. Thoralf Sundt, a heart surgeon and chair of Mayo's marketing committee.

The blog, "Sharing Mayo Clinic," (http://sharing.mayoclinic.org) will focus on positive patient experiences. But it will also accept criticism, along with family stories and posts from Mayo employees.

Mayo has begun using social networking options extensively as a marketing tools, including FaceBook and YouTube. More than 500,000 unique Mayo patients get treated yearly, the blog says.

"These patients and their families and friends, and 50,000 employees and students are part of a global Mayo Clinic community," the blog says. "The goal for the Sharing Mayo Clinic blog is to provide a virtual place for this community to connect and share their experiences."

Sundt said there's a queue of people waiting to make blog posts.

"This is exciting as it will enable patients and their families to tell their stories about their experiences at Mayo, and to offer a behind-the-scenes view of Mayo from various employee perspectives," said spokeswoman Elizabeth Rice. The most-popular Mayo Web links have been for patient stories, which led Mayo to start the blog.

More than 90 percent of people who comment about Mayo give praise, Sundt said, and each person with a good experience tells 40 other people about it.

Now, Sundt said, "we're just sort of giving them the platform to share." The blog is monitored for language and content. But, in general, Mayo wants an open forum that accepts most comments.

Mayo officials also hope for suggestions about how to improve quality of service. They expect patients to share tips about how to best use time between appointments, and about Mayo services.

"The quality of the experience is key," Sundt said.
Ah, openness and transparency, isn't it great? Now if Mayo could just get on board with their conflict of interest policy... But then, nobody's perfect, right, Bob?


Wednesday, January 21, 2009

Ouch! That Hurt...

UD posts on a recent Daily letter to the editor:

The University of Minnesota - dominated by sports, devastated by medical school scandals - really has slipped. An alumnus writes to the university newspaper:

The latest ethics scandal at the University of Minnesota involving the dean of the medical school and a faculty member she appointed to review and improve ethical practices who turned out to have a whopping and profitable conflict of interest himself, underscores the need for a president who is more interested in the academic side of University life than in the athletic side.

This all happened on President Robert Bruininks’ watch, and one hopes he learned something about how to properly do his job at the Insight Bowl and will give us taxpayers our $700,000-a-year money’s worth — his annual salary. (Maybe the University should establish an Oversight Bowl at its new, needless, wasteful football stadium.)…

We must not allow another ethics scandal to occur on anyone’s watch at our once-proud University.

UD’s covered the decline of UM for a long time. She concludes that the university needs a new president.

For those who missed the story over break - front page, above the fold, Sunday Strib - before Christmas, please see:

Conflict of Interest at the U Medical School?

and Openess And Transparency At the University of Minnesota

Monday, January 19, 2009

A Faculty Member At The University Of Minnesota Speaks Up
About The Actual Priorities of Our Administration

[Note added 1/20]
=================
UD in her inimitable way has picked up on this. From her post;


Dropkick Me Jesus

In the Minnesota Daily, a very pissed professor says what needs to be said.

It would be nice if the newspaper received five or ten of these a day. But only a few professors have the guts to write them.

...

The author is Eva von Dassow.

No ancient religion, of course, can hope to compete on her campus with the Glory of the Gridiron.

=================

Or the Strategic Propaganda initiative, or MoreU Park, or a new highly paid administrator...

[The med school recently hired a new Associate Dean - for what used to be a half-time job - at a salary, according to the Daily, of $266 K. Given the way the med school does arithmetic, that is obviously a lower limit... ]

From the Daily:

Last fall, upon concluding the Community Fund Drive, the University of Minnesota administration imposed a “hiring pause” in anticipation of reduced state support. Faculty and staff positions that become vacant will not be refilled. Most searches for new faculty, including replacements, have been cancelled. Funding for teaching assistants is to be reduced.

There will thus be fewer instructors to teach courses; therefore, fewer courses will be taught. Students will not be provided the full curricula they were offered when they decided to come to the University. Many students will be unable to complete their degree programs in their intended form — at least not in a timely fashion. Programs that were already understaffed are being crippled and students are left with inadequate course offerings to meet their needs. Meanwhile, the administration proposes to raise tuition even higher.

I invite the University community to consider how the administration’s cancellation of faculty searches comports with the University’s core mission and stated goals, the larger financial picture and the annual tuition hikes. Note that we are not talking about increasing the numbers of faculty through incremental hires, but simply about preserving what we had up through last spring.

Having chaired one of the cancelled searches, I can attest that hiring new faculty is a labor-intensive process.

...

We had almost carried the search to a successful conclusion; after the long process of reading applications and conducting preliminary interviews, we had identified three excellent candidates to invite to campus.

Then, on Dec. 9, the bulk of our work having been completed, CLA notified CNES that our search was cancelled.

...

The time and effort put forth by faculty, students and staff to conduct the search had been wasted.

For what? To save the cost of hiring a starting assistant professor, whose salary would be in the range of $55,000 per year, plus benefits. Compare that to the salaries of top administrators and athletics coaches. It’s nice that the University’s top brass froze executive compensation upon imposing the hiring pause. But it doesn’t hurt to have your salary frozen at several hundred thousand dollars per year.

President Bob Bruininks said in a Dec. 4 e-mail message to employees that the administration’s objectives during the current economic crisis are to “maintain the core strength and quality of the University” and to “increase productivity … while improving service and efficiency.” How does cutting faculty positions serve to maintain quality? How does it improve service and efficiency to withdraw curriculum from students trying to complete degrees? How does it increase productivity to waste employees’ time by canceling searches that are underway? I could have taught an entire course in the time I spent chairing the search in ancient religion or used that time for research. Besides reducing productivity, when the University administration throws our time away, it throws away its putative commitment to excellence.

The administration’s communications addressing the University’s financial problems always refer to the state, the state’s budget deficit and the state’s appropriation to the University — as if the hiring pause, with all its consequences, simply results from Minnesota’s strained economic situation. I submit that the University’s financial position would be much better now if the administration had not chosen to spend large sums on things it wanted, regardless of whether those things have anything to do with the University’s core academic mission. This past year has seen the purchase of a new financial system — essentially a software package — for the price of $28 million. The old financial system worked fine; the new one does not.

Everyone can point to favorite examples of profligate spending, and most would point first at athletics (the costly new stadium and the high salaries of coaches) or at administration (the ever-increasing number of vice presidents), with its many “initiatives” of dubious purpose and effectiveness (notably the Strategic Propaganda Initiative, as it would rightly be called).

Few would point to academics and claim we have too many faculty teaching too many courses, doing too much research and working with too many students. But it is we who are the University: the faculty and students — and, yes, the coaches, too — together with the staff who facilitate our work. The administration is not the University but, properly, its servant.

This administration serves the University ill by reducing faculty positions and thereby decimating academic programs. It does a disservice to students and, thus, to Minnesota by cutting instruction and curriculum while raising tuition. Students: You came here expecting better. Don’t settle for less while you’re asked to pay more.

Eva von Dassow is an associate professor.

Thank you Professor von Dassow for speaking up. I hope that others will also. It is time for a re-ordering of priorities at the University of Minnesota. The Strategic Propaganda Initiative as well as the laughable "ambitious aspiration to be one of the top three public research universities in the world [sic] " are exacerbating this disaster.

Saturday, January 17, 2009

Medical Payola - It Isn't Going To Stop By Itself

The latest shocker is reported in the WSJ and concerns a huge problem in Badgerland.

[Added later: Margaret Soltan on her University Diaries blog and Gary Schwitzer on his health news blog have both given this topic the exposure that it should have. Sunshine is the best disinfectant. Highly recommended reads.]

From the Wall Street Journal:

Medtronic Paid Researcher More Than $20,000 -- Much More

A prominent spine surgeon and researcher at the University of Wisconsin received $19 million in payment over five years from Medtronic Inc., one of the country's largest makers of spinal devices, according to a senator who is investigating potential conflicts of interest in medicine.

The surgeon, Thomas Zdeblick, received the payments while helping Medtronic develop and promote a number of spinal products. Medtronic's $19 million in payments to Dr. Zdeblick from 2003 to 2007 went "greatly" beyond what was evident in disclosures he made to the university, Sen. Charles Grassley said in a Jan. 12 letter to Kevin P. Reilly, ...

Friday, January 16, 2009

A Sad Day...

Star Tribune files for Chapter 11 bankruptcy

Facing sharp revenue declines, the newspaper seeks bankruptcy protection, hoping to cut costs and restructure debt.

Last update: January 15, 2009 - 11:06 PM

The Star Tribune, saddled with high debt and a sharp decline in print advertising, filed a Chapter 11 bankruptcy petition Thursday night.

Monday, January 12, 2009


(Hidden)
Cost of Doing Business

Why are the buildings needed?

"This is an effort by the university to grab market share" of federal research dollars, Pfutzenreuter said.


Not so fast, please. From Inside Higher Ed:

Expanding research may be a worthy goal in higher education, but doing so comes with significant costs that aren’t recovered by grants alone, according to a study published in Academic Medicine this month.

Researchers at the University of Rochester School of Medicine & Dentistry found that the cost of supporting newly recruited scientists costs an additional 40 cents over every dollar these new faculty generate from grants. While colleges may grow in prestige by expanding their research base, they’re likely to dole out more money in start-up packages and other benefits for new faculty than they bring in through grants, the study asserts.

The landscape of federal funding for research has also changed since Rochester began its study in 1999, which marked the start of a now-dwindling effort by Congress to double the budget for the National Institutes of Health. With those dollars drying up, it’s possible that colleges will see even larger shortfalls as they expand research operations, Guzick said.
Something to think about President Bruininks, Provost Cerra, Mr. Pfutzenreuter?

Sunday, January 11, 2009


From the Department of Better Late Than Never...

MPR (01/08/09)

"We know the stress that tuition puts on students and we're doing everything we can to cushion that increase," Pfutzenreuter [University of Minnesota Chief Financial Officer] said. "We're going to continue that effort as we move into the next round of budget reductions."
Regular readers of the Periodic Table will recall the public interchange between Mr. Pfutzenreuter and Represenative Tom Rukavina that is memorialized on the Periodic Table at left:

"They're going to lose a lot of friends at the Capitol if they jack up that tuition," he [Tom Rukavina] said. "They're pricing themselves out of work if they keep going up 7.5 percent."

Despite Rukavina's intent to keep tuition low, Pfutzenreuter stands by the fact that the Legislature can't decide how the University spends its money.

And in response to Pfutzenreuter:

"Tell him to sue me," Rukavina said. "It's in the bill, tell him to sue me."
And from the minutes of a faculty committee meeting in September of 2007, before the budget had even been proposed, it is clear that Mr Pfutzenreuter and the Regents had already decided to ask for 7.5%:

Minutes
Senate Committee on Finance and Planning
Tuesday, September 18, 2007

"Will the Regents support a 7.5% tuition increase, Professor Martin asked? They have been told it is part of the budget plans, Mr. Pfutzenreuter said. Professor Chapman suggested that 7.5% will be seen as quite high. Mr. Pfutzenreuter agreed but pointed out that for Minnesota residents the legislature provided funding to buy down the increase by 2%, so it will only be 5.5% (for students from households with an income of up to $150,000). Professor Chapman said he was sorry to see such an increase in an election year; Mr. Pfutzenreuter said the other choices are increased state funding or less new investment."
As Orwell put it:

"He who controls the present, controls the past. He who controls the past, controls the future."
Re-writing history is a common tactic of OurAdministrators, as I have pointed out in the past, e.g. from an earlier rant:

Which goes to show that if you wait long enough as a U of M administrator, people will eventually forget your past sins and you can feel free to re-write history. (I was a very strong supporter of the new Science Classrom Building. There is no conflict between teaching and research. I am for stature rather than ratings. I strongly support General College. I strongly support a higher minority enrollment. General College must go. I am against re-engineering. I am for Kotter's Eight-Stage Process of Creating Change. This is a land grant institution.)

And so it goes.

Bonzo

Friday, January 9, 2009

Kling, Kling, Kling On The Trolley...

From Minnpost:


Kling! Kling!

Did MPR deliver noisy LRT ultimatum?

By David Brauer | Friday, Jan. 9, 2009

MPR will sue unless light-rail is silent and vibration-free — at least in front of its doors, the PiPress' Dave Orrick reports. MPR's Bill Kling delivered the March 1 "ultimatum" that demanded alignment veto power, though the PiPress doesn't quote anything that sounds so absolute. An MPR spokesperson disputes the "ultimatum" characterization; MPR's own story is decidedly less brinksmanship-esque. Met Council head Peter Bell won't promise zero harm, but argues $800,000 of mitigation will work.

More LRT: The MPR spokesperson acknowledges nearby St. Paul firetrucks are already heard indoors, but trains are potentially much worse. The Strib says MPR should pipe down.


Sunday, January 4, 2009

MPR and LRT

From the Star-Tribune Letters to the Editor:


Adding natural sounds to Bill Kling's creation

Not one to underestimate the importance of his creation, Minnesota Public Radio President Bill Kling has already asked us for a significant piece of our income while we live, a major part of our estate when we die, our car whether we're ready to get rid of it or not, and we can expect that one day he'll want our first-born children. All this for "noncommercial" radio, meaning that commercials are limited to 25 or 30 seconds each.

The University of Minnesota has determined that its advanced instrumentation can coexist with the light rail line down Washington Avenue. What is so sensitive about MPR, other than its sense of entitlement? Let's make sure that the good of the state, the region and city, rather than MPR, is the criterion for routing this exciting new transportation system.

P.T. MAGEE, ST. PAUL

Friday, January 2, 2009

Roy Poses, M.D., in his outstanding blog Health Care Renewal, has posted:

The Conflicted Authors of the University of Minnesota's New Conflicts of Interest Policy


This is an excellent overview of the situation at Minnesota with respect to conflict of interest in the medical school.

A sample:

So let's see... the University of Minnesota committee charged with drafting a new conflict of interest policy included members with conflicts of interests who did not reveal these conflicts to other members of the committee. Its chair had committed a "serious violation" of the current conflict of interest policy, which was known to the medical school dean who appointed him, but which was not revealed to the rest of the committee. That same medical school dean seems to have her own significant conflict of interest, a financial entanglement about which her previous pronouncements have been at best naive.

[Health Care Renewal is a very popular blog. To date there have been about half a million visitors and the site averages about three hundred visitors a day. "Sunshine is the best disinfectant."]

Wednesday, December 31, 2008

Openness and Transparency At the University of Minnesota?

As someone who was stonewalled in his efforts to learn about the exact nature of the relationship between Leo Furcht, the University, and MCL, it is good to know that there are professionals at the Star-Tribune who are more dogged and stubborn than I am.

From the Strib's Whistleblower Blog comes the answer to the question:

How did the Star-Tribune get the disciplinary report for Leo Furcht out of the University?

U kept quiet about doctor’s disciplinary action, but public records spoke

Posted on December 23rd, 2008 – 11:33 AM
By James Shiffer


The story Sunday about the past ethics problems of the co-chair of a University of Minnesota ethics panel was an example of first-rate watchdog reporting by my colleagues Maura Lerner, Josephine Marcotty and Janet Moore.

The story also reflected the dogged effort by Lerner to extract public records from the University of Minnesota, after Marcotty got a tip that questions had been raised about a corporate grant for stem cell research at the university. University officials found several ways to avoid handing over a public record until Lerner wore them down.
Here’s the timeline:


Nov. 7: Lerner makes her first formal request to the U for audits involving Dr. Catherine Verfaillie, who had done research under the contract. She knew from her experience that audits are usually public records.

Nov. 14: The university responds: “The entire file is apparently attorney-client privileged information.”

Nov. 17: The university: “The University’s department of audits conducted a review under the direction of the Office of General Counsel, subject to the attorney-client privilege. It was not a regular audit. The report to the General Counsel’s Office is nonpublic under Minn. Stat. sec. 13.393.”

Nov. 17: Lerner responds to the university: “What is the difference between a review done by the department of audits, and an audit? What difference does it make who requests it?”

Nov. 21: The university: “Per your inquiry, the general counsel’s office is retrieving all of the old files to review whether there are public items that would not be considered attorney-client privileged materials. On second thought, they are thinking that not everything in the file is considered protected information. This was not a formal audit, but a request by the general counsel’s office for a review. There were no disciplinary actions as a result of it.”

Dec. 18: The university: “As far as what is public data, there has been no change to our position that the information you requested is considered attorney-client privileged data. Here is the statement I’ve been cleared to provide: The University’s Department of Audits, under the direction of the Office of the General Counsel, conducted a review of the Baxter contract. This was a legal review and not a formal administrative proceeding. Following that review, the Academic Health Center’s Conflict Review and Management Committee also did a review which resulted in disciplinary action against one employee, who was not Dr. Catherine Verfaillie.”

Dec. 18: New request from Lerner: “Any disciplinary action that resulted from the Academic Health Center’s Conflict Review and Management Committee review of the Baxter contract awarded to (or under the supervision of) Dr. Catherine Verfaillie.”

Finally, just before 5 p.m. Dec. 18, the university send the report by email. The subject was Dr. Leo Furcht, who was investigated and disciplined in 2004 based following a complaint by Verfaillie. Read the report here

Lerner, Marcotty and Moore finished reporting and wrote the story the following day. Four years after Furcht’s disciplinary action, the public finally found out about it. A Star Tribune editorial on the situation was published today.

Monday, December 29, 2008

A Solution To The New Light Rail Routing Problem?

The proposed light rail route between Minneapolis and St. Paul has been the subject of much agonizing. For the public good the University of Minnesota eventually has agreed to a route that may cause them a lot of trouble. Recently MPR (Minnesota Public Radio) has come forward with objections to the route because they believe that the proposed siting will interfere with their new building.

In the spirit of Jonathan Swift's commentary, a friend has sent his own modest proposal for a solution to this problem. Obviously, the suggestion is meant to be satiric.



A MODEST PROPOSAL


It is a melancholy object to those who travel through this great Klingdom to contemplate the loss of the Minnesota Public Radio broadcast center. The imminent danger is the construction of the Light Rail Transit line hardly more than an arm’s length from that magnificent palace built with public financing.

The proposed construction has caused MPR, that eternally grateful recipient of corporate welfare, to threaten to “sue in inverse condemnation to recover the value of its $100+ million Broadcast Center plus relocation costs and related fees.”

I think that it is agreed by all parties that it would be a calamity for the good citizens of this Klingdom to be deprived of hearing the same marches, overtures, and waltzes played ad nauseam over the public airwaves. And all parties further agree that it would be far less of a burden on the public treasury to allow MPR to extort an additional $100+ million than it would be to move the route of the LRT at this late date.

Having turned my attention for several years to this important subject, I now humbly propose my own thoughts, which I hope will not be liable to the least objection.

As for the broadcast center, there is a simple solution at hand. In Anno Domini 2004 St. Olaf College sold to MPR “all of Seller’s real property used or held for use in the operation of the Stations (including any appurtenant easements and improvements located thereon).” That provision of the purchase agreement includes Skifter Building, the broadcast center for WCAL, the victim of that necessary public radio fratricide by which MPR also acquired the licenses for 89.3 FM and 88.7 FM. Although overlooked at the time of the transaction, this clever acquisition of Skifter Building now demonstrates the true genius of our King Kling and his alacrity in seizing the opportunity to take advantage of the Regents of St. Olaf College for the common good. The relocation costs for moving the MPR center to Skifter Building will not diminish the public treasury by too great an amount.

But my intention is far from being confined to provide only for the relocation of the MPR broadcast center. It is of a much greater extent—to provide for a tranquil setting “far from the madding crowd’s ignoble strife” in which His Majesty may contemplate the next victim of his insatiable desire to expand his empire.

Surely the Regents would consider an offer from MPR of its $100+ million condemnation award to be more than generous for the purchase of the entire campus of St. Olaf College. Then the MPR logo may replace the cross on the top of Boe Chapel, and a dollar sign in gold may be placed on the altar.

Relieved of the monetary obligation to maintain the Northfield campus and of those worrisome legal and moral obligations to honor promises made to the WCAL donors to operate a public radio station “for generations to come,” the Regents could depart from their wilderness in the country. Then they could use their newly acquired riches from MPR to develop on-line courses that reflect their “core values,” such as a new and very profitable course entitled Greed is Good.
As for that tiresome Christmas Festival at St. Olaf College, which has been repeated each year for almost a century, it may be replaced by the MPR production of How the Grinch Stole Christmas!

I think that the advantages of the proposal which I make are obvious and many, as well as of the highest importance. I profess, in the sincerity of my heart, that I have not the least personal interest in endeavoring to promote this most necessary project, sharing with MPR no motive other than the public good.

(Your humble and obedient servant offers the most profound apologies to Mr. Jonathan Swift.
)

Wednesday, December 24, 2008

Chickens, Home, Roost...

I don't have a whole lot of sympathy for the administration of the University of Minnesota. Their plan for becoming one of the top three public research universities in the world reeks of hubris.

It doesn't take a rocket scientist or a serial law school dean to figure out that the economy is cyclic, trees don't grow to the sky, and a set of defensible priorities is needed right now.

High quality leadership - for which we are certainly paying - does not sit around whistling in the dark.

We look foolish and greedy to insist on going over to the State legislature and asking for about $200 million in new funding. If the current administration is incapable of playing with the cards they've got, perhaps new leadership is warranted?


Instead of trying to focus on the wonderful things that are going to happen ten years down the road, Bruininks, Sullivan, Pfutzenreuter, Cerra, Powell, Furcht and company need to start attending the church of what is happening now.

Let's admit our past mistakes and our true standing in the universities of the BigTen - our actual competition. A defensible goal is to be one of the best universities in the BigTen - and we are far from that.


Perhaps if we were honest about our current situation, the state legislature would help us return to what are legitimate priorities: first, the education of the citizens of the state at reasonable cost; second, research; third, new construction.


Bob, Tom, Fitz, Frank, Deborah, and Leo, how about it?


From Minnpost:

By Sharon Schmickle Wednesday, Dec. 24, 2008


As a result of emergency state spending cuts Gov. Tim Pawlenty announced last week, the University of Minnesota and the Minnesota State Colleges and Universities system each stand to lose at least $20 million in funding for the first half of 2009. And they face even more dismal prospects beyond that time frame.

Pawlenty's fiscal slashing came in response to a recession-driven freefall in revenues. The state faced a $426 million shortfall for the remainder of this fiscal year which ends in June. Cities and counties, human services agencies and state offices also took major cuts.

"These reductions in state spending reflect our priorities to protect funding for K-12 education, public safety, military, and veterans," Pawlenty said in his announcement.

The higher ed folks aren't disputing those priorities. But they are arguing that during a recession it is counterproductive to clip the resources that train Minnesota's work force and fuel innovation.

Recovery in the classroom

"Dramatic cuts to the University erode the quality of the education our students receive and slow the creation of jobs and economic growth for the state by shutting off our human capital and innovation pipelines," University of Minnesota President President Robert Bruininks said in a statement responding to Pawlenty's announcement.

In an earlier memo to faculty and staff, Bruininks said: "It is my unwavering belief that the path out of Minnesota's current crisis, and a return to a vibrant and growth-oriented economy, lies directly through the classrooms, laboratories, libraries, and halls of our great educational institutions."

The university's loss actually is much larger than $20 million for the next six months, said its chief financial officer, Richard Pfutzenreuter. Pawlenty's "unallotment" of human services funding took away another $28 million from a medical education program in which experts from the university trained health care workers in clinical settings around the state. The university counted on the funding to pay the experts' salaries.

Pawlenty's take-backs for this fiscal year come on top of a state funding cut of $185 million the university weathered in the post 9/11 recession. This time around, Pawlenty said, the university is cushioned by $15 million in central reserves and $50 million of unspent state appropriations not needed to cover binding obligations.

The higher ed institutions should be able to respond "without dramatic impact on students" because of that cushion, Pawlenty said.

The governor "missed the point" of information the university recently provided to the Legislature, Pfutzenreuter said. True, there is $50 million of unspent state funding, but "that represents money we need to operate the place...pay the phone bills and the general costs," he said.

"Every part of the institution, every unit, will be impacted," he said.

As for the $15 million in reserves Pawlenty cited, the university is saving for a "May surprise," when new information on corporate tax receipts could force another round of state cuts, Pfutzenreuter said.

University officials still are sorting through options for making up this shortfall. Possibilities include halting travel and delaying the purchases of supplies and lab equipment.

"Budget cuts of this magnitude not only reduce our operating budget, but also hurt our ability to attract nearly $700 million annually in sponsored research funding and millions more in private support," Bruininks said.

Dilemma at MnSCU

The sudden loss of $20 million sets up a "real dilemma" for state universities and community and technical colleges in the MnSCU system, said spokeswoman Melinda Voss.

"Our system is the key to the state's economic recovery because the 32 colleges and universities offer short-term retraining certificate and diploma programs, as well as undergraduate and graduate degree programs, that can help newly unemployed residents retrain for new jobs," Voss said.

Campuses already had taken belt-tightening steps as the economy worsened, she said, including:

• Reducing the number of course sections.

• Leaving vacant positions open unless they are critical and also stretching staff to fill in for employees on leave.

• Pulling back on equipment spending, including computer replacements for classrooms.

• Cutting repair and maintenance budgets and postponing some construction and remodeling projects.

• Turning down thermostats and taking other steps to conserve energy.

• Allowing essential travel only and making greater use of conference calls and interactive television.

More trouble ahead

The current trauma may look like a mild cold compared to the pneumonia the institutions could catch as the state moves to make up for a projected $4.8 billion shortfall in 2010-11.

Last summer before financial institutions began collapsing, the university was working on ambitious plans to give pay raises where they were warranted, attract more research and grant more financial aid to students from middle-income Minnesota families.

In all, the plan called for a 9.5 percent state funding increase.

"We are probably not going to get much discussion of that at the Legislature," Pfutzenreuter said.

There's an understatement for you.

Tuesday, December 23, 2008

Bizarre Behavior at the University of Minnesota Medical School

Margaret Soltan, the proprietress of the excellent blog University Diaries, notes the more than charitable editorial in the Star-Tribune:

… in the Minneapolis Star Tribune notes that the most charitable description of what’s been going on at the clubby University of Minnesota medical school would be “bizarre.”

Saturday, December 20, 2008

Front Page, Above the Fold
Sunday Star-Tribune
December 21, 2008



Conflict of Interest at the U Med School?

[Added XII-21: A pdf of the final report of the disciplinary committee is available for download from the Strib's website.]

[Added XII-2-09: if you want to see how cooperative the University of Minnesota was in disclosing this conflict, please see: Openness and Transparency at the University of Minnesota ]
U Doctor on ethics panel was disciplined

December 20, 2008
A professor who is leading the University of Minnesota Medical School's effort to write tougher ethics rules was himself disciplined in 2004 for secretly steering a $501,000 research grant to his own company, according to university investigative reports obtained by the Star Tribune. 
Dr. Leo Furcht, the chairman of lab medicine and pathology, was reprimanded for a "serious violation" of university conflict-of-interest policies in connection with a grant from Baxter Healthcare for stem cell research at the Medical School, according to the investigation, which the newspaper received through the state's public records law.
As a result, Medical School Dean Deborah Powell banned Furcht in May 2004 from any business-sponsored research for three years.
In 2007, Powell named Furcht to co-chair a task force to reform the Medical School's conflict-of-interest policy.

So someone is sanctioned for conflict of interest violations and three years later he is appointed to chair a task force on the matter. Does not compute..

Furcht, a nationally known scientist and author, declined to comment. He said through a spokeswoman that the matter had been "amicably resolved," and that there was nothing to be gained by talking about it.

Nothing to gain? Why wouldn't the valuable insights of Dr. Furcht on this matter be of interest to the community? The story could have a sort of reformed pirate twist to it, don't you think? Dr. Furcht should use some of the ten million dollars that he made on this patent and use it to employ a mouthpiece the way the big boys in the University administration do. That way he could have the mouthpiece refuse to talk rather than having to do the job himself.


Powell said in an interview that she chose Furcht for the task force because he had extensive experience with national professional organizations on devising conflict-of- interest rules. "That seemed to me to be a compelling reason to appoint him to that role," she said.

Compelling reason? That seems like the logic Parente used to justify playing footsy with McGuire. How about his qualifications from being a conflict of interest policy violator? As we'll see, that comes later.

Furcht's case has come to light in the midst of a contentious internal debate at the Medical School about a new ethics code that would be among the toughest in the nation. 

Across the country, universities are struggling to define the proper relationship between business and academia, as federal investigators probe the ties between doctors and medical companies.

Powell said Friday she did not inform the rest of the task force members about the sanctions against Furcht. "I did not think it was relevant," she said. Furcht had followed the 2004 restrictions to the letter, and "it seemed time to move on and use his expertise, which was considerable," she said. 
Incredible. Not relevant? Someone's moral compass seems demagnetized here. 

But the internal investigation showed how Furcht flouted the university's ethics rules on a research project in which he stood to make millions of dollars. 
Actually that is ten million dollars as we'll see.

Ironically, it didn't even involve Furcht's own research.


'Significant financial interest'

In the late 1990s, a colleague, Dr. Catherine Verfaillie, had made a breakthrough in stem-cell research. When the university declined to patent it, Furcht created his own company, MCL, and filed for the patent along with Verfaillie and another researcher.

Now of course, the sixty-four thousand dollar, whoops that is ten million dollar, question is: Why did the university decline to patent this? Either there was some hanky-panky or someone was incompetent. Which was it?

In July 2000, Furcht lined up a research grant from Baxter to pay for more research, to be conducted in university laboratories, but did not disclose the deal to the university. Instead, Baxter paid the money, $501,000, to MCL.

[tsk, tsk..]


Verfaillie said Friday she performed the research in her university lab, but did not receive the money. Eventually, she contacted the dean, triggering an investigation.

A panel of three faculty members investigated and concluded that Furcht "committed a serious violation of the conflict of interest policy," according to a Dec. 19, 2003, report.

Among other things, they found that Furcht "knew or should have known" that he was required to disclose the financial arrangement with Baxter, because he had "a significant financial interest" in MCL and the stem-cell technology.

Is this what we call a smoking gun?

"In fact, it appears Dr. Furcht stands to personally gain several million dollars from the pending sale of MCL," the report said.

In November 2003, Furcht sold MCL for $9.5 million in stock, sharing 5 percent of the proceeds with the university.

Wasn't that generous of Dr. Furcht? Why did he do this? Out of the goodness of his heart or was there some political pressure? Wasn't this stem cell business somehow supposed to make the University a lot of money? Aren't new jobs and industries supposed to be the justification for requesting funds to support biomedical research and new buildings? And to whom was this patent sold and where are any jobs created by this transaction?


The panel recommended that Furcht be disciplined and questioned whether he should retain his position as department chair. It also raised concerns that he may have misused his position "to personally benefit him and his commercial interests," and recommended further investigation.

In her letter concluding the matter, Powell wrote: "Despite this, I value your managerial abilities as a department head and wish to retain you in this role."

This is a joke. Documentation upon request.


University officials said Friday that the university was reimbursed for the $501,000.

Well that makes it all better, right? No harm no foul? I don't think so.

Frank Cerra, the university's senior vice president for health sciences, said Friday he was familiar with the case but couldn't recall details. He said Furcht's experience could help inform the conflict-of-interest committee's work.

Frank, this is simply a stupid thing to say. You can't be serious. If you are then you need to join the department of demagnetized moral compasses also.


"If they learn from it and they move along in a direction where it doesn't happen again, that's exactly what you want to happen with an ethics policy,'' Cerra said. "If that's the case here, there can be a positive contribution to the next set of rules and interpretations.''

I think the lesson would have been a little stronger if the Medical School had not made every effort to keep the matter under wraps. It is only through some very diligent work on the part of many people that this came to light. And as you certainly realize, Dr. Furcht's participation in the panel casts its work in a very bad light, even if the recommendations are good ones. There is no way that someone like this should have been involved in a conflict of interest panel. And both you and the Dean were aware of Dr. Furcht's having been sanctioned.



Toughening ethics rules

Dr. Doris Taylor, a university heart researcher and member of the task force, said that Furcht was only one of 24 voices on the committee and that he supported the new, stricter policies. "I hear him say all the time, we have to be transparent," she said

"I think he knows what a conflict looks like," she added.

The Medical School is writing new ethics rules at a time when the university has come under pressure to cultivate a closer relationship with Minnesota's high-tech business community and to improve the commercial application of faculty research.


The U's Medical School has not escaped the controversy. Last year, orthopedic surgeon Dr. David Polly was named in a congressional investigation of consulting agreements between some of the nation's top spine surgeons and Fridley-based Medtronic Inc.

This month, two prestigious medical centers, the Cleveland Clinic and the University of Pennsylvania's School of Medicine, said they will use public websites to disclose consulting and research agreements involving their physicians and researchers. That type of public disclosure is a key part of the U of M's proposed ethics policy.

In an interview last fall, Furcht said he has served on two national task forces dealing with conflict of interest in research and education. "I've been working on this issue for some time," he said.
"It's just too important to not attend to this [policy] properly. The public trust is more important than the money involved. You have to ensure that."

If that is true, Leo, why don't you turn all of your MCL money over to the University?