Tuesday, December 14, 2010

The Minnesota Daily Lets It All Hang Out

 Article on Frank Cerra 

Retiring Academic Health Center VP
and Dean of the Medical School
University of Minnesota

As Cerra, 67, prepares to retire from 15 years of administrative leadership on Dec. 31, he is tying up the loose ends of a tenure marked by new buildings, commercial partnerships, curriculum changes and faculty conflicts of interest.
For a variety of reasons, a majority of faculty members contacted preferred not to share their thoughts on him for this story.

“After 15 years, there are people who don’t agree with some things I’ve done or decisions I’ve made,” he said. “That’s fine. They understand why I made them and what the circumstances were and move on.”
In 1997, Cerra made a bold move: He led the sale of the University’s hospital to Fairview Health Services, vowing to keep it a teaching hospital.

The decision drew a variety of responses, not all of them positive.

Neuroscience professor Robert Miller wrote in a 1999 article in Academe Magazine that the sale was the “single largest disaster in the hundred-plus-year history of the institution” and that faculty members were given no say in the matter.

The lasting effect of the merger is tension between faculty members at the University, whose mission is to educate, and Fairview, which is governed by a board of directors and a bottom line.

The University still owned the hospital when James Carey, a physical therapy professor, first arrived — and it was nice, he said. So nice that he said it’s time to think about getting it back.

Many faculty members are concerned about the potential for imbalance in meeting Fairview’s needs and the University’s needs in the relationship between Fairview and the Medical School, said David Ingbar, professor of medicine.

There’s a fear among the faculty that the primary function of the Fairview-University relationship could be to provide clinicians for Fairview rather than fulfill the University’s academic mission, Ingbar said.

Down the hall from Executive Vice Dean Mark Paller’s spacious office in the Mayo Building is one with Frank Cerra’s name on the door alongside the words “Dean of the Medical School.”

But depending on the day, Cerra could be across the street in his other office, that of the senior vice president for health sciences of the Academic Health Center.

There’s been tremendous disagreement over whether the dual role of dean of the medical school and head of the AHC should remain one or be split in two when Cerra’s successor, pediatrics chairman Aaron Friedman, takes over.

In July of this year, 93 percent of 354 Medical School faculty members responded in a survey that they believed the school should have a dean whose “sole responsibility” is to manage the Medical School.

“There was an overwhelming response that we want our own dean,” Campbell said.

But in an interview last week, University President Bob Bruininks had a different interpretation of the survey. He said that the 93 percent group was, in fact, signaling its desire that the positions stay integrated.
 “I think the overwhelming sentiment is that combining these two positions is the strongest possible position for the University to take in the long-term future,” he said.

The dual role “greatly streamlined the decision-making, it reduced administrative overhead, it strengthens the leadership platforms of the vice president and dean,” Bruininks said.

But many faculty members argue that the Medical School is much larger than other schools in the AHC, so it shouldn’t be handled by someone who’s only focusing part of his attention on it.
The prompt was a two-part question, which also stated that the dean should have a direct line of communication with the president. As the position exists now, Cerra communicates frequently with Bruininks through his leadership role in the AHC.

“We felt that the Medical School was such a driving force of the University and the Academic Health Center, it was worthy of having a direct line — not to be arrogant or anything like that — but just because it’s an important unit that is critical to the overall operations of the University,” Carey said.

If the survey wasn’t clear enough, three months earlier, 35 members of the Medical School FAC sent a letter to Bruininks asking him to restructure the AHC and alerting him of the “need to return the leadership of the Medical School to the position of dean of the Medical School without being combined with the senior vice president of Health Sciences (SVPHS) position.”

In their reasoning, the faculty members wrote that the cost savings Cerra and Bruininks claim results from combining the positions is “not apparent.” Further, the rigid leadership structure distances faculty members from the leadership, jeopardizing the possibility of a fully engaged faculty.

Bruininks wrote back two months later acknowledging that he had received their letter.

Beginning in January, Friedman will assume a slightly different role than Cerra: dean of the Medical School and vice president for health sciences of the AHC. Some of the administrative oversight of the health science colleges that Cerra performed will go to the University Provost Tom Sullivan.
When asked what the differences between his and Cerra’s positions are, Friedman said, “I think it remains to be seen what the real distinctions are. I’m not sure.”

Ultimately, incoming University President Eric Kaler will make the final decision.

For some, that disconnect between faculty members’ desires and administrative decision-making has soured the view of Cerra’s tenure.

While many blame faculty apathy, professor of medicine Gregory Vercellotti said they weren’t always that way, but have grown more apathetic as their power seems smaller.

“We had leadership here that consistently didn’t listen to faculty or didn’t reward faculty input — I’m not going to say punish — but basically that faculty input wasn’t listened to,” he said. “And after a while, faculty said, ‘Well, what’s the use, it’s going to happen anyway.’”

As a surgery professor, Cerra’s reputation was at times fogged with connections to sketchy operations.

A colleague of Cerra’s, David Knighton, was found by the FDA to have illegally sold and promoted his drug, Procuren, through his company, Curative Technologies.

Cerra worked in Knighton’s clinics for several years in the 1980s.

Years later, when Cerra was in the running to become dean of the Medical School, his reputation was again tainted by his controversial relationship with Caremark, a company Cerra and other University doctors were accused of illegally referring patients to.

Under Cerra’s watch, a number of Medical School faculty members were found to have unethical relationships with private industry, including David Polly’s consulting deals with Medtronic and Leo Furcht funneling grant money into his own company, which he later sold.

“We’ve actually had very few of those, if you count them up,” Cerra said.

Eventually, the conflicts of interest became serious enough, however, that they forced the entire University to overhaul its Conflict of Interest Policy, with Cerra and Furcht helping to shape many of the details in the new policy.

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