BigU MedSchool Task Force to Probe Doctors on the Dole

In an earlier post, Minnesota Doctors on the Dole, Mr. Bonzo, suggested that perhaps BigU’s Medical School should weigh in and give us ethical guidance.

He was, of course, being sarcastic. For background about the controversy over the MedSchoolDean's serving on the Pepsi board, see SourceWatch: A Project of the Center for Media and Democracy.

From the Pioneer Press:

U to probe drug makers' payments to doctors

Conflicts of interest, impact on quality of care at stake

By Paul Tosto and Jeremy Olson

Article Last Updated: 07/07/2007 03:12:07 AM CDT

Concerned about the money some doctors take from pharmaceutical companies, the University of Minnesota Medical School is asking an internal group to take a closer look at those payments and their possible influence on treatment.

Led by two U doctors, the group plans to examine the relationships between university physicians and drug firms and whether money creates conflicts of interest.

The move comes a few months after a Journal of the American Medical Association report showed doctors across Minnesota, including some doctors at the medical school, collected more than $30 million from drug firms between 2002 and 2004 for research, travel, meals, consulting and lectures.

"As we recognize our medical school's strengths," the dean, Dr. Deborah Powell, wrote in a May memo, "we also need to examine an area in which we may have some vulnerabilities: our relationships with pharmaceutical companies."

Powell said she wasn't calling for an immediate ban on payments, but she acknowledged "there are problems when some physicians present educational efforts funded by companies that appear much like marketing."

What is the pharmaceutical industry getting for its money? That's the lingering question.

For some, the payments issue is more about objectivity.

"It's a patient-safety issue," said Josh Lackner, the U medical school student who worked with Public Citizen on the research.

Drug salesmen, he said, befriend doctors because "they're paid by for-profit companies to do this. Befriending doctors is a job, and it's a job because it actually works."

What changes would he like to see?

"A good starting point would be barring faculty from speaking on behalf of pharmaceutical products and to also think about limiting paid positions on pharmaceutical boards," said Lackner, who hopes to land a spot on the U task force.

Let's hope that someone like Lackner is on this task force. Another good person would be Robert Jeffery:

But Robert Jeffery, a nationally known researcher and a director of the Obesity Prevention Center in the U's school of public health, worries Powell's PepsiAmericas duty ultimately may hurt the university.

"There is a level of 'ick' among quite a few faculty and students here," Jeffery said. "There definitely are some sour feelings. When you're talking about some of the most powerful people in the university backing it, it makes it distasteful."

(The above material may be found in a previous post with a citation to the original source that can no longer be directly linked. )

It is a little hard to take advice from an institution that seems to be reluctant to discuss its own apparent ethical problems. Let's just hope that the doctors heading the task force are people respected throughout the community for their integrity, fairness, and independence. Otherwise such a task force is not going to be particularly credible.

Bonzo

U pops the age-old question: Coke or Pepsi?





From the Strib:

With Coke's contract ending, the company will have to fight to defend its control of the campus.

By Jeff Shelman

Last update: July 05, 2007 – 8:44 PM

Coca-Cola has enjoyed exclusive rights to sell its products on the university's campus, after winning the contract from Pepsi-Cola in the mid-1990s. But the contract ends in a little more than a year, and the soft drink giants are gearing up for a rematch.

By the end of this month, the local divisions of Coke and Pepsi are expected to submit proposals as part of the university's food and beverage contract, and a decision will be made in the months that follow. The 1996 contract with Coca-Cola was worth $28 million to the university, and the new contract, which will also include "pouring rights" to the new TCF Bank Stadium, could be even richer.

"We obviously want to get high quality," University President Robert Bruininks said. "We want a lot of choice in this response, and we want good price. "This is a really important contract for us."


The most visible part of the contract has to do with control of the 400-plus drink vending machines and numerous fountain units. This contract -- which is scheduled to run for 10 years and could extend to 16 years -- has the potential to be even more lucrative for the University of Minnesota than the previous deal.

Part of that is because the scope of this contract includes all five campuses. But it's also because the winner will also have a prominent place on scoreboards at TCF Bank Stadium when the on-campus football stadium opens in two years. The company will also receive one suite and eight club seats for the stadium along with the right to use the plaza for "public display or sampling," once a season.

Coca-Cola's corporate practices around the world have come under criticism on a number of campuses. The University of Michigan quit selling the company's products for a while, and protests have occurred at other Big Ten schools, including the University of Illinois and Indiana University.

The University of Minnesota formed a "Coca-Cola working committee" to examine the company's labor practices abroad and, in a December report, found evidence of improper corporate practices "inconclusive."

On the Pepsi side, there have been concerns raised at the university about Dr. Deborah Powell, dean of the medical school, being on the board of directors of PepsiAmericas. Based in Minneapolis, PepsiAmericas handles bottling in part of the United States, Central Europe and the Caribbean.

A different bottling company, Pepsi Bottling Group, will be the unit bidding for the university's business.

Twould be nice if there were some campus discussion on this matter. Don't hold your breath. But as OurLeader states above, a lot of money is involved and we have a stadium to pay for. We wouldn't want little things like corporate bad behavior or conflicts of interest to get in the way of a big contract for BigU, would we?

Bonzo

Needle Stick! The Latex Gloves Come Off...

Apparently Some Duplications are OK
(Children's Hospitals),
But Not Others (Medical Schools)?

`When I use a word,'
Humpty Dumpty said,
in rather a scornful tone,
`it means just what I choose it to mean
-- neither more nor less.'

The potential new medical school, a joint effort between St. Thomas and Allina, has been the subject of earlier posts. See for example:

Earlier Thoughts of BigU Administration Concerning
Possibility of St. Thomas/Allina Medical School

The frustration level of BigU's administration at not being consulted on the matter seems to be surfacing.

(Mr. Bonzo thanks a friend for calling this post to his attention.)

From the Minneapolis/St. Paul Business Journal:

U official questions UST medical school

Minneapolis/St. Paul Business Journal

June 29, 2007

by Lauren Wilbert

The University of St. Thomas and Allina Hospitals & Clinics' idea to jointly build a new medical school in the Twin Cities is generating some concern in the local health care community, particularly within the University of Minnesota's medical program.

St. Thomas and Allina's proposed school would produce primary-care physicians in family practice, internal medicine and pediatrics, areas where doctors are projected to be in increasingly short supply. The organizations this week hired Pittsburgh-based Tripp Umbach to oversee their summer-long feasibility study of the new school. Tripp Umbach is a consulting firm with a Minneapolis office that has led studies for several startup medical schools nationwide.

Some health care leaders, including Dr. Frank Cerra, who leads the University of Minnesota's Academic Health Center are skeptical that producing more graduates would solve the looming shortage.

Instead of building a new school, he said, the health care community should focus on solving issues of reimbursement for primary-care doctors and how to pull other medical practitioners, such as nurses and pharmacists, into the mix.

"Just increasing the capacity to train physicians isn't really an answer to the problem," Cerra said. "There is a work force issue, yes. But we need to wrestle with the cost of medical education and the debt incurred."

Cerra said he would rather see the U's hospital work with Allina's Abbott Northwestern Hospital, for example, to coordinate their primary care residencies. A new school might only duplicate programs that already exist. [Apparently this argument does not apply to children's hospitals.]

Mary Brainerd, CEO of Bloomington-based HealthPartners, agreed with Cerra that other options should be studied besides training more doctors.

She is skeptical that a primary care physician shortage is due to too few students entering that field. It could be that the aging population is simply creating a need for more doctors who can be a "quarterback for the care you get," Brainerd said.

"I'm not sure what that quarterback role will look like," she said. "Maybe it's more nurse practitioners working with specialists. With the shortages, we'll have to get creative."

But Tom Rochon, St. Thomas' executive vice president of academic affairs who is a co-leader of the feasibility study, disagreed. "It's very clear that our region needs more doctors, and it needs more doctors in family practice," he said.

The demand for more physicians will be one of the main issues addressed by the feasibility study. If it finds the school wouldn't help the community, it won't be built, he said.

The study also will look into the cost of opening a new school, recruiting faculty and students and space needs of a new school.

"One of the challenges we'll face is [determining], 'How do we make sure we're filling this gap we've identified and not just producing more researchers?' " Rochon said. The school, instead, would aim to put more practicing physicians in the Twin Cities and rural Minnesota.

"We don't think we're competing against or detracting from the [programs at] the University of Minnesota," he added. "Hospitals accept residents from multiple medical schools.

Rochon acknowledged that the partnership with Allina makes for a sensitive situation with the U of M, which sends medical students to Allina hospitals for training.

But the new school and partnership with St. Thomas would not mean fewer residency spots at Allina for U of M students, said Dr. Penny Wheeler, Allina's chief clinical officer.

For its latest clinical training program, university medical school graduates filled only 45 of Allina's 142 primary care residency positions. As talks of a new school go forward, Allina might be able to create additional spots, said Allina spokesman David Kanihan.

Wheeler is working to schedule meetings with various officials at the U of M to talk about how the new school would affect their long-standing relationship, and Allina CEO Dick Pettingill has met with Cerra at least twice so far, she said.

"[The proposed school] is meant to be complementary, not competitive," Wheeler said.

Still, some from the university feel left out of the planning process.

"We've offered to help Allina and St. Thomas in any way possible," Cerra said. "We have 150 years of experience with schools, and so far, they haven't asked for that information." [What is this about? See above. Looks like Dr. Cerra has met with Allina CEO "at least twice so far."]

St. Thomas and Allina's focus on primary care comes as some Minnesota schools are showing a drop in students going into that field. Figures from the U of M's annual residency match program, which places medical students in practice areas, show that internal medicine and family practice have the highest participation.

But those numbers have dropped while class sizes have stayed relatively flat. In 2005, 50 students entered an internal medicine residency and 40 went into family practice. By 2007, those numbers dropped to 39 students in internal medicine and 35 students in family practice.

As Mr. Spock would say: "Interesting."

Bonzo

Open Your Mouth and Say Ah… Or Why Won’t OurGovernor TeePaw Do the Right Thing and Give BigU What It Wants?

Mr. B. has previously pointed out the disconnect between authorizing new bioscience buildings for the U (a blank check, so to speak) and an explanation of where the money is going to come from to fill the buildings with people and equipment. These issues have not been addressed in the latest piece by the Star-Tribune's excellent legislative reporter, Lori Sturdevant.

See:

"If You Build It, Grants Will Come? Or, Could Someone at BigU Please Be Honest and Responsible About Expansion of Biomedical Research?"

Perhaps we should worry more about a way to lower tuition for doctors who plan to do family practice in Minnesota so that they can afford to do this? Agitation on the part of BigU's med school administration indicates that this may be a pressing problem, particularly if St. Thomas/Allina get into the mix. BigU is well aware that there may be a limit to the amount of funding available from the state coffers for the education of future health care providers.

See:

"BigU's MedSchoolDean Comments on St. Thomas/Allina Feasibility Study for New Medical School"

and

"University of St. Thomas to Establish New Med School?

as well as

"Blanket Email from Senior Vice President for Health Sciences, Kudos and Questions for Proposed Medical School"


From the StarTribune:

A moment left unseized
The wait continues for a gubernatorial push for the U of M bioscience plan.

By Lori Sturdevant, Star Tribune

Published: June 03, 2007

Twenty years later, DFLer Rudy Perpich circled the globe, hunting for jobs in industries ranging from chopsticks manufacturing to supercomputing. Then came Republican Arne Carlson, who knocked himself out to keep Northwest Airlines afloat.

So as the clock wound down on the 2007 session, I figured that Gov. Tim Pawlenty would soon start talking up the University of Minnesota's request for fast-track bonding authority for four new bioscience research buildings. Or that legislators would start buzzing about calls from the governor's office, urging a kind look at the university's plan for hiring scores of new faculty.

The university's request was, after all, the only viable, affordable, remotely plausible plan in sight for keeping up with the competition, and snagging a share of the industry that's exploding in research hotspots around the country.

But the clock wound down. A public appeal from Pawlenty to the Legislature never came. If one was made privately, it escaped detection.

When asked May 1 about the university's bid for a separate bonding path for biosciences, Pawlenty's response wasn't negative. It just lacked oomph. "That's a good idea," he said. "Either this year or next year, it should go ahead."

The governor wasn't alone in playing it cool. The Senate was with the U on this request for the second year running. But it was a different story in the House. There, where turf jealousies, regional parochialism and raw partisanship are the order of any given day, several senior DFL members weren't interested in giving the university permission for more than one building at a time. Allowing the Legislature a chance to say no before a building's bonds were issued was proposed. No deal.

"Their view was, 'Come to us every two years and let us take care of you,' " said university lobbyist Donna Peterson.

There are two problems with that view. One: It isn't the depth of state commitment that Academic Health Center Dean Frank Cerra needs to turn top faculty heads. Cerra says that recruiting research superstars takes three to five years to consummate. He needs to be able to promise today that a brand-new building will be waiting in 2012 or 2014.

And two, it pins Minnesota's best hope for a desirable new industry on what has become an unreliable process.

University of Minnesota President Robert Bruininks says he'll be back next session -- or, better still, in a special session -- to try again. Platou says he'll try to keep a major donor on the hook. Speaker Margaret Anderson Kelliher says she'll try to "bring greater awareness to legislators about the competitive pressures involved here."

They are a potent threesome, but they can only go so far.

"It's going to take the governor's leadership to make this happen, "Bruininks said. Providing leadership to develop new industries -- that's what governors do, isn't it?

Mr. B. believes that there are a number of logical disconnects in the above analysis.

Not a Pretty Sight
Avandia - aka Rosiglitazone - Another Medical Train Wreck?


[Note: NEJM is a subscriber based service. But Mr. B. logged on to the site - as you can, too - and was given access to an important paper. Extracts are posted below in the belief that they are important and that this is permitted under the fair use doctrine. Please consult the whole article if this is a matter of medical importance to you. If the NEJM is too heavy duty for you, here is a link to an article in Time.]

From the New England Journal of Medicine Web Site:

Published at www.nejm.org May 21, 2007 (10.1056/NEJMoa072761)

Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes
Steven E. Nissen, M.D., and Kathy Wolski, M.P.H.

ABSTRACT

Background Rosiglitazone is widely used to treat patients with type 2 diabetes mellitus, but its effect on cardiovascular morbidity and mortality has not been determined.

Methods We conducted searches of the published literature, the Web site of the Food and Drug Administration, and a clinical-trials registry maintained by the drug manufacturer (GlaxoSmithKline). Criteria for inclusion in our meta-analysis included a study duration of more than 24 weeks, the use of a randomized control group not receiving rosiglitazone, and the availability of outcome data for myocardial infarction and death from cardiovascular causes. Of 116 potentially relevant studies, 42 trials met the inclusion criteria. We tabulated all occurrences of myocardial infarction and death from cardiovascular causes.

Results Data were combined by means of a fixed-effects model. In the 42 trials, the mean age of the subjects was approximately 56 years, and the mean baseline glycated hemoglobin level was approximately 8.2%. In the rosiglitazone group, as compared with the control group, the odds ratio for myocardial infarction was 1.43 (95% confidence interval [CI], 1.03 to 1.98; P=0.03), and the odds ratio for death from cardiovascular causes was 1.64 (95% CI, 0.98 to 2.74; P=0.06).

Conclusions Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. Our study was limited by a lack of access to original source data, which would have enabled time-to-event analysis. Despite these limitations, patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with rosiglitazone for type 2 diabetes.

From the Discussion

Our study has important limitations. We pooled the results of a group of trials that were not originally intended to explore cardiovascular outcomes. Most trials did not centrally adjudicate cardiovascular outcomes, and the definitions of myocardial infarction were not available. Many of these trials were small and short-term, resulting in few adverse cardiovascular events or deaths. Accordingly, the confidence intervals for the odds ratios for myocardial infarction and death from cardiovascular causes are wide, resulting in considerable uncertainty about the magnitude of the observed hazard. Furthermore, we did not have access to original source data for any of these trials. Thus, we based the analysis on available data from publicly disclosed summaries of events. The lack of availability of source data did not allow the use of more statistically powerful time-to-event analysis. A meta-analysis is always considered less convincing than a large prospective trial designed to assess the outcome of interest. Although such a dedicated trial has not been completed for rosiglitazone, the ongoing Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycaemia in Diabetes (RECORD) trial may provide useful insights.34

Despite these limitations, our data point to the urgent need for comprehensive evaluations to clarify the cardiovascular risks of rosiglitazone. The manufacturer's public disclosure of summary results for rosiglitazone clinical trials is not sufficient to enable a robust assessment of cardiovascular risks. The manufacturer has all the source data for completed clinical trials and should make these data available to an external academic coordinating center for systematic analysis. The FDA also has access to study reports and other clinical-trial data not within the public domain. Further analyses of data available to the FDA and the manufacturer would enable a more robust assessment of the risks of this drug. Our data suggest a cardiovascular risk associated with the use of rosiglitazone. Until better precision of the estimates of the risks of this treatment on cardiovascular events can be delineated in patients with diabetes, patients and providers should give careful consideration to the risks and benefits of their overall treatment plans.

Dr. Nissen reports receiving research support to perform clinical trials through the Cleveland Clinic Cardiovascular Coordinating Center from Pfizer, AstraZeneca, Daiichi Sankyo, Roche, Takeda, Sanofi-Aventis, and Eli Lilly. Dr. Nissen consults for many pharmaceutical companies but requires them to donate all honoraria or consulting fees directly to charity so that he receives neither income nor a tax deduction. No other potential conflict of interest relevant to this article was reported.

What a novel concept! BigU MedSchool should hire some people like Dr. Nissen. They could then serve as examples to MedSchoolDean and to other like-minded Med School faculty here at BigU.

The general situation does not look good to Mr. Bonzo. Parallels are already being drawn with Vioxx, e.g. the link to Time noted above.

BigU’s MedSchoolDean Comments on St. Thomas/Allina
Feasibility Study for New Medical School

Mr. Bonzo has previously posted on this topic.

A blanket email was sent to faculty yesterday that is quoted below in full and without any editorial comments.

Mon, May 14, 2007 at 11:13 AM

To: MED-ALL@oris.ahc.umn.edu
Dear Medical School Faculty and Staff,

You may have noted with interest – as did I – that Allina and the University of St. Thomas have formally announced their intention to study the feasibility of starting a third medical school in the state of Minnesota. Like many of you, I had heard that there were discussions in the community as long as six to eight months ago. Now that the two institutions have made their goals public, I wanted to share with you my thoughts on this development.

This medical school was founded before the establishment of the state of Minnesota, and we have significant experience providing medical education to generations of physicians. We have a solid record of ensuring physicians are interested in practicing in communities throughout the state with our Rural Physician Associate Program, and our residency programs have provided generations of leading care to the families of the state. We were recently named one of the top 10 medical schools in the nation for training family medicine physicians.

We educate students from the state of Minnesota to become physicians for the state of Minnesota.

Although I haven’t been asked, I’d be happy to speak with leaders of this fledgling effort. Having spent my professional career in academic medicine in universities across the nation, I have worked with colleagues at the Association of American Medical Colleges to transform medical education for the next generation. Our Flexible M.D. program and the evolving MED 2010 are but two examples. More importantly, I’ve had the opportunity to work with our national educational accrediting programs, providing an opportunity to witness firsthand what leads to success or failure in the current environment.

Do I have concerns? Certainly. Medical education is an expensive undertaking that requires significant resources to drive its success. This medical school today is an $800 million enterprise and many of its sources of revenue are shrinking, including federal Medicaid dollars dedicated to education and many state programs.

Medical education is not simple. In our Medical School, however, we collectively have a large amount of experience. We have been educating physicians for the state of Minnesota for more than 150 years. The University of Minnesota Medical School was mentioned in the Flexner Report of 1910, which called for reform of medical education, as a school that was doing it right. We still are doing it right.

Deborah E. Powell, M.D.
Dean of the Medical School
Assistant Vice President for Clinical Sciences
McKnight Presidential Leadership Chair

OurLeader Comes Clean On The Management
System Behind BigU's So-Called Transformation

Mr. Bonzo had an "aha" moment today when on BigU's website he came upon a powerpoint presentation that OurLeader gave to the BoRe (Board of Regents) last month. He found it enlightening and helpful in understanding what is currently happening with respect to transforming BigU, which is management speak for the process formerly known as reengineering.

BigU seems not to be able to function without expensive advertising campaigns such as Driven to Discover. BigU's administration also seems to be incapable of action without borrowing some flavor of the month management scheme from the business world, regardless of whether it is appropriate for an academic institution. If some great man at the Harvard Business School has a pet theory, however could we fault OurLeader for trying it out?

Apparently the BoRe eats this up. No surprise given that at least one of them - OurLeader's strongest and most vocal champion - is in the consulting business and for $2000-$5000 will give inspirational talks on such subjects as: Leaders are Learners, Change or Die, Building a Learning Organization, How Great Boards Work, It’s All About People, You Can’t Win Without Teamwork, Inspiring and Motivating Your Staff, Barriers to Change, Moving out of your Comfort Zone. Mr. B. has previously commented that this BoRe member refuses to move out of his own comfort zone and currently does not reside in the Congressional District he supposedly represents. I guess ethical standards are not very high at BigU given MedSchoolDean's Pepsi association, BigU's Coca-cola partnership, and the little matter of inappropriate manipulation of images in papers and a patent.

So the flavor of the month is? The secret we've all been waiting for?

"Welcome back, Kotter!"

That would be Harvard Business School professor emeritus, John P. Kotter, and his marvelous and apparently foolproof "Eight Step Process of Creating Major Change."

Now it has always seemed to Mr. Bonzo that the transformation program at BigU was inauthentic, top-down with no real faculty input, unrealistic in its goals and expectations, and inappropriate for a university. But it is difficult to argue with someone when you don't know the intellectual underpinnings for their activities, especially when it appears from their actions that they don't have any. Now, properly implemented, it might be possible to transform the BigU using the Kotter system, but clearly anyone with even a primitive knowledge of the system will be aware that BigU has made a major botch of its implementation. Mr. Bonzo is also greatly disturbed by the lack of transparency and the manipulation of opinion that is antithetical to the idea of a university. Where, exactly, did the idea come from that BigU should become GreatBigU? Who, exactly, decided that we are Driven to Discover? An advertising agency, a consultant ? These decisions were certainly not made by the faculty, students, and staff at BigU. Nor does it appear that these stakeholders have bought into the program.

[As an aside, Mr. B. loves the use of the word stakeholder. It brings to mind a vision of Dracula at a crossroad in Transylvania at high noon with a golden stake through his heart. Now there is a stakeholder. ]

Kotter and other beer of the month management types (Covey, anyone) have not been particularly successful at causing meaningful change in the business world, let alone in education. They have, admittedly, made a great deal of money for themselves from the gullibility of managers both in real business and the business that education has become. Mr. B. is a great fan of Chris Argyris, also at Harvard, who dares to criticize both Covey and Kotter. He has written insightfully about the disconnect between theory and practice in change management systems embodied by the cliche "failure to walk the talk" oft used by the late Paul Wellstone.

Mr. B. has more to say on these matters, but not tonight and probably not for a while. A hellish month is ahead including about eight hours of lecturing on nanotechnology for a general audience in BigU's Compleat Scholar program. This will be fun, but a lot of work. The topic, however, has legs. I'll post the stuff somewhere and put a link on the PT. He will also be going to New Orleans in mid-May for a graduation. This will no doubt be a hard trip, because he has not been in NO since well before the hurricane.

Auf wiedersehen,

Bonzo

Coke or Pepsi? The Age Old Question

BigU is a Coke franchise. BigU's MedSchoolDean serves on the Pepsi board of directors. Mr. B. has previously written on this embarrassing situation. One post is It’s the Ick Factor… BigU MedSchoolDean Sits on the Pepsi Board.

There really are ethical problem here. It is amazing that the administration seems to be ignoring these issues. Usually they are quite interested in having "conversations" on topics related to achieving greatness, but so far not on ethical matters. At least someone at the Minnesota Daily is finally willing to ask: "The question is, does he [OurLeader] have the guts to face these concerns?"

Adri Mehra in today's Daily:

Bruininks must answer for Coca-Criminals
The University must be responsible world citizen

You can't beat the real thing, and in Coca-Cola's case, that includes a tangled web of apparent lies, intimidation and murder that would make the management of Guantanamo Bay sob with tears of joy and envy.

In December 2005, New York University and the University of Michigan banned all Coca-Cola products from their campuses following Rutgers, Oberlin, Bard and Minnesota's own Carleton College in the removal of the company's bloody stain.

It is thus far past time for University of Minnesota President Robert Bruininks to address these issues with Coca-Cola, as our school has the largest remaining contract with the corporation.

The question is, does he have the guts to face these concerns?

Why don't we ask him?

Further sordid details are presented in the piece, but you get the idea. I admire Mr. Mehra for speaking out about this. When Mr. B. was young, this is what newspapers did. Doesn't seem to be so popular anymore, either at the local or national level.

And unfortunately, I don't have much hope for Mr. Mehra's question being answered let alone anything done about the situation. After all, we have to pay for a Twin City Federal Stadium and the road to becoming one of the top three public research institutions (in the world) will necessarily be paved with gold. So however could OurLeader afford to end BigU's lucrative financial arrangement with Coke?

Now, let's see - where did I put my tea...

Mr. B.

OurLeader Gives 2007 State of the University Address
Ambitious Aspirations to Greatness

Mr. B. had hoped to get a transcipt for comment. But tempus fugit and he cannot wait any longer. This article from BigU's website will have to do.

Bruininks delivers State of the U for 2007

By Rick Moore

April 6, 2007

President Robert Bruininks ... used the address to highlight some of the many achievements made across the University system since the strategic positioning initiative was launched two years ago.

The goal of that initiative, to become one of the top three public research universities in the world, is designed to urge all U campuses to live up to their heritage of achievement and public responsibility, he said.

"The good news is that this goal is now well established," Bruininks said. "All of you know it, our supporters are drawn to it, and our peers are taking notice. 'Top three' is aspirational and audacious, but that's not to say it can't be achieved.

Hmm… These words would seem to imply that BigU could become one of the top three public research universities in the world, nicht wahr? Or have I missed something in this statement of ambitious aspirations?

"We must continue to set aggressive goals in critical areas of academic responsibility and to truly measure what we value, but we must not get caught up in rankings or begin 'teaching to the test.' We aspire not to ranking [sic], but to stature--and achieving this aspiration requires a deep and abiding cultural commitment to excellence in everything we do, from the education of our students to advancement of knowledge for the public good."

We aspire not to ranking? If this is so, why does the Provost's office have a whole web page devoted to the topic of "Academic Rankings" which selectively reports ones that are favorable to BigU? How about the US News rankings? How about the Times Higher Education Supplement rankings?

Is OurLeader serious or not about BigU becoming one of the top three public research universities in world? Under which shell does the pea go?If OurLeader is serious then let's all sing "Dream along with me." If this is simply a money extracting ploy, then eventually the university will suffer for this perceived deception even if OurLeader has already parachuted to his hobby-horse riding retirement. It should be noted that BigU already has stature, which is rapidly eroding as the unreality of the top three claim starts to sink in.

Statewide, the U's five campuses and their students are flourishing. The University of Minnesota, Crookston continues to lead the system in online education, Bruininks noted, and recently received the maximum 10-year accreditation from the Higher Learning Commission. At UMD, the Sieur Du Luth Summer Arts Festival has become internationally known for its opera program, with some 120 participants registered this year from Mexico, Europe, and Asia. This fall, Duluth will launch its first-ever doctoral degree, in education. On the Morris campus, student Eagan Heath was recently named a 2007 Truman Scholar, Bruininks said, and last fall UMM's Center for Small Towns and the city of Morris received a national Carter Center Partnership Award for Campus-Community Collaboration.

All of these activities are laudable. But they do not contribute to the University of Minnesota’s becoming one of the top three public research universities in the world. Perhaps this goal should not be a top priority for Coldstate and its citizens?

And the University of Minnesota Rochester continues to expand it academic footprint to meet the education and research needs of southeast Minnesota, building on the U's relationships with Rochester Community and Technical College and Winona State University and its partnership with the Mayo Clinic.

Care should be taken in making grandiose claims about the University of Minnesota Rochester. Given the problems we have with our current funding situation, establishing a new university does not appear to be a very shrewd move and apparently an Iron Range U may be next. But, after all, these are folks who thought tearing down Memorial Stadium was a good idea. We are in the process of paying in excess of 300 million dollars for that mistake.

Despite its many recent successes, the U's path forward is not without obstacles, Bruininks noted.

"All of our aspirations are contingent upon two resources: persistence and funding," he said. "I rank persistence first, most obviously because in this regard we control our own destiny. It is only fair that an institution committed to responsible stewardship would expect to be held accountable by the state and the public. We've identified important strategies that support our view of excellence, but we cannot expect continued investment without continuing reform."

The word reform is currently popular with Administrators at BigU. On her website the medical school dean (of Pepsi-Cola fame) used to call for reform. Judging from recent events, this does not appear to have happened. What exactly is meant by reform? Will it be further ethical training for faculty at the AHC? Will we be cutting the number of administrators or their salaries? The last I heard our president received a rather large salary increase. Resources are clearly going to be a problem at BigU for the foreseeable future. Perhaps we should “elevate those guns a little lower?” Perhaps we should regroup and decide how best to use the limited resources we’ve got, rather than making grand, extravagant or audacious claims?

"Two years ago, I said that Minnesota needs a great research university, and this University truly needs the state of Minnesota," Bruininks added. "I also said that strategic positioning would provide the basis for change and a commitment to excellence worthy of our heritage and our future. "The inscription on Northrop captures this beautifully: It expresses the spirit of a great University, its commitment to excellence, and its service to the greater good. It's a tremendous vision, and I'm humbled by your efforts to attain it--but we clearly still have more work to do."

The inscription reads:

"The University of Minnesota/
Founded in the faith that men are ennobled by understanding/
Dedicated to the advancement of learning and the search for truth/
Devoted to the instruction of youth and the welfare of the state"

It is a wonderful sentiment but subject to diverse interpretation. I don’t see the words “great research university” there. As Shakespeare wrote, approximately, in the Merchant of Venice: "The devil can cite scripture for his own purpose." The last time I had a hard look at the inscription is when I stood outside Morrill Hall and listened to Lou Bellamy and many other articulate people speak in favor of General College. We asked that OurLeader come out for discussion. He did not appear.

At some point serious conversations will need to be held about where we are going. Please let us groundlings know when this happens. Requesting reports that had "deliverables" specified by the administration will not solve our problems.

A StrangeGopher in a strange land (aka Bonzo)

It’s the Ick Factor…
BigU MedSchoolDean Sits on the Pepsi Board

Mr. B. has previously commented on the embarrassing situation at BigU where the med school dean has accepted a position on the board of a company whose products are major contributors to the obesity epidemic and the rotting of children's teeth... Mr. B. does not get the Pioneer Press and thanks a colleague for bringing the following to his attention.

Today the Pioneer Press published a follow up article on the situation:

Posted on Mon, Mar. 05, 2007

U medical dean's Pepsi connection splits peers

Powell sees board role as chance to promote nutrition; critics say she's being used

BY PAUL TOSTO
Pioneer Press

Three months after Powell signed on with PepsiAmericas, though, the questions haven't ebbed. Outside critics continue to ask why a high-profile state health official would join with a firm whose main products are linked to childhood obesity and diabetes. One U researcher wants a "serious conversation" about the ethics of corporate consulting.

Powell said she wanted to be a voice for nutrition in the boardroom. She and her boss — who backs her decision — say the PepsiAmericas position is proper and valuable to the university.

That may not put the matter to rest. The appointment has wound itself into the national debate over how food and soft-drink makers do business. The basic questions: Can a doctor take money from a corporation but stay independent? Is joining a corporate board equal to endorsing its products?

But Robert Jeffery, a nationally known researcher and a director of the Obesity Prevention Center in the U's school of public health, worries Powell's PepsiAmericas duty ultimately may hurt the university.

"There is a level of 'ick' among quite a few faculty and students here," Jeffery said. "There definitely are some sour feelings. When you're talking about some of the most powerful people in the university backing it, it makes it distasteful."

Food companies have recruited doctors in recent years to serve on nutrition advisory boards and help with "health and wellness" campaigns. University of California San Francisco Medical School dean and former FDA chief Dr. David Kessler, who spoke at the U two weeks ago on the "obesity epidemic," is an adviser to soda and snack food giant PepsiCo.

Powell's position is different. As a corporate director, she's responsible for directing PepsiAmerica's management and the company's long-term success for shareholders.

The basic dilemma, though, is the same. Can a doctor bridge both worlds?

"Ultimately, it involves a personal risk-benefit calculation of sorts: the trade-off between risk of perceived erosion of credibility and objectivity versus prospects of potential benefit for the public good," said Dr. Michael McGinnis, a senior scholar with the national Institute of Medicine and chairman of its children's food-marketing committee, a panel that in 2005 concluded industry marketing and sales practices were putting "children's long-term health at risk."

PepsiAmericas chief executive Robert Pohlad serves on the dean's board of visitors for the U medical school and asked her to join his corporate board. [You roll my log and I’ll roll yours ?] The company's top management works out of Minneapolis.

Like other outside directors, Powell will be paid in cash and PepsiAmericas stock for her service on the beverage company's board, including a $30,000 annual retainer, $2,000 for each board meeting attended and $60,000 in stock.

Powell said the money didn't factor into her decision. "I didn't know before I went on the board that I would be paid," she said. [This is incredible. Either the dean is extremely naive or...]

Some advocates believe health leaders are naive to think they can change the dynamic in the executive suite.

"When an expert joins this kind of board, clearly it's going to compromise their ability to speak out," said Michele Simon, author of "Appetite for Profit," a book that accuses giant food companies of preaching public health while pursuing strategies that undermine it.

Putting doctors on boards is part of food company strategy to protect their public relations image, she said. PepsiAmericas, she added, now has "the dean of one of the most prestigious medical schools in the country.”

"It seems to me like a very appropriate role for the university, providing there are no conflicts of interest that haven't been disclosed," Cerra [senior vice president for health sciences] said. Citing his travel experience in remote areas of the world, Cerra added he was "awfully glad there are companies like Coke and Pepsi around" to provide a source of drinkable liquid and electrolytes in those regions. [I never realized what humanitarians the Coke and Pepsi folks are; a cynic might wonder if Coke and Pepsi were specifically concocted for this purpose? A long stretch, I am afraid, at justification.]

Powell said she finds it insulting that anyone would think she'd use her position on the PepsiAmericas board to interfere with or inhibit obesity studies or any other research at the U. [Classic straw man argument]

After two board meetings, Powell said, she's already come away with a useful tool from the corporate world. PepsiAmericas, she said, does an excellent job in succession planning for top management, a practice she said she can use in her work at the U. [Maybe she can use this valuable experience in planning for her own succession?]

"Denial, it's not just a river in Egypt."

Other Voices, Other Words

It is not too difficult to find further commentary out there on the Electronic Rialto about this sad situation. Many of them are nasty. None seem to support MedSchoolDean's position (and that of Dr. Cerra) other than an endorsement by a soft-drink bottling organization. Two examples follow.

Saturday, March 03, 2007
Pepsi: Good for What Ails You

Roy Poses, as usual, has a great take on a story that you just could not have made up, even if you tried your hardest.

Deborah Powell, the Dean of the University of Minnesota Medical School, has taken a board of directors position for PepsiAmericas, which is interesting considering that Pepsi consumption promotes both tooth rot and obesity. Don't get me wrong, there is such a thing as responsible Pepsi consumption, but should a Med School Dean be in the position of helping to maximize Pepsi sales? Perhaps she can also be on the Board of Philip Morris or Coors?

Read the whole story, then roll your eyes and/or bang your head, as you deem appropriate.

Thursday, March 01, 2007
Medical Schools Go Better With Pepsi?

With all due respect, I do not believe Dean Powell understood the responsibilities of a director of a public, for-profit company. Her job is not to "make her voice heard" about or thus advise the company about public health or health care policy. Her job is to take fiduciary responsibility for the company for the benefit of its stockholders. Her job is to maximize the financial performance of the company, whether or not doing so is in accord with her, or anyone's ideas about ideal health policy. That is why her new position could lead her into conflicts of interest.

I wonder whether leaders of academic health care who have more acute conflicts of interest, because they also are directors of pharmaceutical, biotechnology, medical device, managed care, or contract research companies, may similarly misunderstood, or rationalized their corporate responsibilities.

If so, they ought to be better informed. But as long as they accept fiduciary responsibility for for-profit health care companies, they are liable to acute conflicts of interest between those responsibilities and their responsibilities to uphold the academic health care mission, which requires putting the care of individual patients first, and creating and disseminating knowledge through free enquiry.

One Can Only Marvel...

Would Alberto Gonzales be a good choice to sit on the Supreme Court and make decisions about the Constitution?

Would Don Rumsfeld be a good choice to sit on a panel investigating abuses at Abu Ghraib or Guantanamo?

Would OurLeader be a good NCAA board of directors member to oversee the athletics policies for Division I schools?

[One could also ask: Would a MedSchoolDean be a good Pepsi board member, but that has already been discussed.]

Mr. Bonzo thinks not on all counts.

Nevertheless, the Daily reports:

January 29, 2007

Bruininks joins NCAA board
The board of directors sets the athletics policies for Division I schools.

The board, comprised of 18 presidents and chancellors from universities that compete in Division I athletics, is the final authority on athletic policies for schools in the division.

Richard Weinberg, a faculty representative to the athletics department and a former member of a number of regional and national collegiate athletic committees, said he thinks Bruininks was appointed because of the value he places on athletics and academics.

"I think that the fact that Bob Bruininks was selected among the presidents of the Big Ten indicates their appreciation of his ability to carry the torch for what intercollegiate athletics is and what it should be about," he said.

[ Ah, excuse me sir. “Meanwhile, as the Star Tribune reported last fall, academics among the Gophers football team under Mason were at the bottom in the Big Ten, with more at-risk students admitted into the Minnesota program than just about any Big Ten school, and with graduation rates the lowest in the conference, especially among African-American athletes.” link ]

Bruininks said he looks forward to addressing a number of issues facing student-athletes, universities and their athletics departments.

"One of my key concerns will be the academic issues related to student learning, academic progress and graduation," he said. "We need to do a much better job in ensuring that our students actually graduate when they come as Division I student-athletes."

Bruininks said the high and rising costs of maintaining intercollegiate athletics programs also worry him.

"We ought to be able to compete athletically without paying somebody $3 (million) to $4 million a year to coach a football or basketball team," he said. "This is sort of an arms race in athletics."

He said the multimillion dollar price tag for recent shake-ups in the athletics department at the University was large, but he doesn't see it as uncommon.

[And is this desirable? And what does he intend to do about it?]

"No one really likes to pay excessively high salaries and no one really likes to buy out long-term contracts, but that is pretty typical of what is happening nationally," Bruininks said. "What has happened here is not excessive in relationship to these national trends."

[Ah, I’m afraid that it is excessive, and someone - OurLeader ? - is going to have to do something about it. “ Bruininks finds himself paying more than $3 million to one coach, Glen Mason, to leave, while needing to pay another coach probably more than $1 million to direct a football program that has shown it can't succeed in the Big Ten. Bruininks is fending off state legislators who wonder why he's paying millions for sports matters out of one pocket while seeking funding for academic programs for his other pocket. It's all the same pair of maroon-and-gold pants, of course.” (link) Mr. Bonzo has written earlier about the salary of the new coach and his assistants.]

Perhaps the NCAA should appoint, instead of OurLeader, some BigTen university president whose athletic graduation rates for minority students are not so shameful. Northwestern or Penn State, anyone? Doesn't OurLeader have enough to do in getting our own athletic house in order and other ambitious aspirations without trying to do a job in which his credibility is already suspect?

Trying to be cheerful in the midst of craziness, I remain,

Your faithful servant,

Mr. Bonzo

Who's the right one, baby ? (with apologies to Ray Charles)

The Daily has an article today about the med school dean's hundred thousand dollar gig on the board of directors of Pepsi:

"Big Business
Medical School dean joins PepsiAmericas"

"While some are excited about the dean's decision, others fear it might raise a conflict of interest."

(This is a little awkward as BigU is a Coca-Cola franchise.)

Mr. Bonzo has commented on this earlier.

Med School Dean on Pepsi Board

Aurum de stercore (gold from dung) is an interesting concept explored by Primo Levi in the Periodic Table. The story describes a consulting gig that dealt with the making of lipstick from chicken shit.

There are many other ignoble ways of making money, arguably involving less admirable means. Recently the Dean of the Medical School at Minnesota signed onto the board of directors of Pepsi-Cola.

The news surfaced locally around Christmas. Old hands at the University will know that the best time for such news to surface is either during the Christmas break or in August, because then no one is around to notice.

Once a minor hue and cry began, the Dean announced that she had thought long and hard about the distinction between tobacco money and money from a company whose product is capable of rotting children’s teeth. Turns out that she plans to be an apostle of change at Pepsi. "I really thought about that a lot," Powell told the St. Paul Pioneer Press. "I thought it was an opportunity for me as a health professional to have my voice heard by the leadership of a major beverage distributor with a global reach."

Others are not so sanguine.

"PepsiAmericas, a contributor to America's obesity problem, clearly wants to affiliate with a physician to enhance its own image," said Michael Jacobson, executive director of the Center for Science in the Public Interest. "What -- other than money -- Dr. Powell expects to gain from such an association is unclear."

“Like all outside directors, Powell will be paid in cash and company stock for her board service. That includes a $30,000 annual retainer, $2,000 for each board meeting she attends and $60,000 in stock.”

There is a further dilemma for medical school faculty interested in consuming the politically correct tooth-rotting drink. Coke or Pepsi? Along with the new Twin City Federal Stadium, the University of Minnesota has a financial arrangement with the Coca Cola company for product placement. See the U’s website on the University of Minnesota Coca-Cola beverage partnership.

What’s a poor upwardly mobile medical school faculty member to do?

Concerning ethical issues raised, Dr. Powell indicated that she would resign if she could not make a difference in the activities of Pepsi. It will be interesting to see whether Dr. Powell “walks the talk,” as the late Paul Wellstone would have said.

"This could be a good opportunity for Dr. Powell to help focus on the health of children and providing more healthy beverages," said Mary Story, co-director of the U's Obesity Prevention Center.