The Periodic Table, Too

Sunday November 22

The above figure was included in a pdf that is downloadable from the Board of Regents site. The document is purported to be the report of the external audit team. Supposedly, that's all there is, there isn't any more. I wonder how much this so-called audit cost? If this is actually all there is to it, then the whole process appears to be a sham.

I'd like to know the numbers behind the bar graph and am looking into the matter. But at first glance they imply that tuition revenue now covers 85% of the cost of instruction at the U. This money, plus state support, should more than cover what it costs to educate a student at the U.

This point is crucial because tuition should not be considered a revenue stream to help fund the ambitious aspirations of the university administration (aka the Morrill Hall crowd) to become one of the top three public research universities in the world [sic]. The cost for this grandiosity should not be on the backs of students and their parents.

More to come on this matter.

In the above video, Regent Allen claims that no new items have been placed on the table during Light Rail negotiations. He also implies that the U's sole motive for intransigence is protecting the research of the University. Neither claim stands up to scrutiny.

"Negotiations between the University of Minnesota and Central Corridor light-rail-line officials stumbled again this week, with the U apparently reinstating tens of millions of dollars to its wish list of payouts and Metropolitan Council Chairman Peter Bell alleging "arrogance" in response."

"The dust-up has caught the attention of state lawmakers, and it looks like they're going to step in. On Friday, state Rep. Alice Hausman, a St. Paul Democrat, said she's planning to convene a meeting Wednesday in Ramsey County offices with leading lawmakers and both sides to try to sort things out. "

As for the question of whether the university is hogging taxpayer money that could go elsewhere, O'Brien said: "The university has a great deal of sympathy with others along the line. Our job as officers is to represent the interests of the university."

Bell, himself a former member of the university's board of regents, bristles at comments like that.

"The arrogance is just counterproductive to moving this project forward," Bell said Friday. "They need to understand that, yes, they have a fiduciary duty to the university, but they also have a duty to the public. ... I always say and believe that the university has legitimate concerns. They need to acknowledge that we have legitimate constraints, and they have refused to do that."

Hausman said she was "very disappointed and alarmed" to learn that on Monday the university reiterated prior demands to be reimbursed perhaps $2 million for U-hired consultants, perhaps $20 million for lost revenue from two parking lots that would be disrupted and for a "free-fare zone" for students traveling between stations on-campus.

"It did feel to me that there were suddenly four or five new things plunked on the table," said the St. Paul lawmaker.

Bell said he has requested a meeting to speak directly to the regents. He said he has been refused.

Breathtaking, sad, arrogant.

Ms. Hausman is the person responsible for the upcoming bonding bill in the legislature. The Morrill Hall crowd would be well advised to pay attention to what she has to say...

Leadership matters. How about showing some, President Bruininks?

Board Chair Allen's remarks are also very disappointing and do not seem to be in accord with the facts. The lack of respect shown for Peter Bell is most telling, especially since he is a former member of the Board of Regents.

Perhaps Chair Allen is afraid of engaging in a frank, honest and open discussion with someone who has views other than those of the University of Minnesota Administration?

Posted by William Gleason at 8:56 AM | Permalink | Comments (0)

Coi_draft.pdf

It is disgraceful that I had to get this document from the media who received it at a press conference held by Mr. Rotenberg yesterday.

The document should have been released first to faculty and staff to whom it will apply. This is typical of the behavior of our administration.

If the administration wants faculty and staff to get on board, they had better start taking their obligations to us seriously.

Bob, Tom?

Posted by William Gleason at 3:41 PM | Permalink | Comments (0)

As mentioned last week, I'm cutting back to Sundays.

It is really hard to decide on what to write about given the events of the week.

I'd encourage readers to check out the article about conflict of interest in the Daily this week. Please pay special attention to the comments.

Questionable ethics: a textbook case

And then there is an article in the Pioneer Press about continued arrogance by the Morrill Hall crowd. I've abstracted, with emphasis, some of the salient points on the Periodic Table:

The Arrogance Continues at University of Minnesota...

But the most amazing document to come at me from the ether was this:

Minutes*
Senate Committee on Finance and Planning
Wednesday, October 28, 2009

I'll just quote some things that caught my eye. Students, faculty, and staff should be aware of what's coming down the pike:

Tuition now exceeds state support as the University's largest revenue stream and tuition will likely be the University's largest source of revenue in the future.

In short, the University must increase revenue, reduce costs, and develop new academic planning strategies. These are matters of great urgency. The hard work of implementing the report must begin immediately, Dr. Rosenstone concluded.

One can see where the state money goes: It is concentrated in CLA, Duluth, IT, CFANS, and the Medical School. When the University faces a cut in state funds, it is difficult not to go to those units to find the money.

State Economist (Professor) Thomas Stinson and State Demographer Thomas Gillespie will meet with the Board of Regents in December to report on economic and demographic trends in the state. Professor Stinson is predicting that economic growth in the state over the next 25 years will be only one-half of what it is today. The task force concluded that the state will not grow sufficiently to provide enough funding for higher education.

The covenant between the University and the State of Minnesota defining the rationale and responsibilities for state support of higher education needs to be strengthened.

[Covenants are by mutual agreement. The legislature and the citizens are not interested in a high tution model. Deal with it?]

"Operating costs, the cost of academic excellence, and the University's appetite for new academic investments are now rising faster than revenues."

[Exactly...]

In order to give one an idea of the appetite for investments, Mr. Pfutzenreuter pointed out that "the initiatives that have emerged from the strategic positioning process require an incremental $400 million to $600 million in new and/or reallocated recurring resources."

[And it is unfair to students to finance this on their backs and the backs of their parents.]

And the idea that the state funds can be replaced with private funds is not realistic, Dean Finnegan added. Professor Martin reported that to do so for only a fraction of appropriation would require that the University raise about $800 million per year.

"The shift in revenues, rising costs, and increased competition are enormous challenges that require a paradigm reset in our academic and financial strategies for the future. The challenges demand a new portfolio of academic, fiscal, administrative, and planning strategies as well as sharper incentives to advance the excellence of the University of Minnesota." He repeated the point that there is no magic bullet, and that UMore Park gravel, selling land, and other strategies alone will not be sufficient.

Another problem, Dean Finnegan observed, is that the state is significantly overbuilt in higher education.

[Dean Finnegan, please amplify. Does the word Rochester do anything for you? Is the U overbuilt? Or are you referring to all those other state institutions who are getting your piece of the pie?]

There is a difference between the University and a typical business, Professor Konstan said in response to Dean Davis-Blake's comments. Any business will have units that are profitable for the long term. Every unit in the University receives a subsidy; just because it brings in revenue does not mean it is paying for itself. One can say research is important, but the more that is done, the more money the University loses. That is probably true in everything the University does.

Professor Konstan said it also felt like a lot of responsibility for the solution is being pushed down into the business units, which avoids solutions that are across and between units. No dean can decide to invest in two colleges, or realign six colleges into four. The Committee also has no sense of what is NOT on the table. The "Promise of Tomorrow" scholarships? The University could say it will support 4,000 students with the scholarships--but no more. The University calls a lot of things "must" because of its values, and it may need to decide which of the "musts" it will not compromise on and those that it will.

[Crucial. Professor Konstan is a smart guy, thank God he is on this committee.]

What about the timeline, Professor Konstan asked? Dr. Rosenstone said that is a question for the President.

[And here's the big point. Dr. Bruininks is a lame duck. Do you - members of the U community - really think that the skids can be greased for a major reorganization and that anybody (good) is going to come in here under the developing circumstances? Or perhaps we'll just promote the Provost to president and continue along merrily?]]

Professor Morrison said that in his view the University faces two problems, not one. The first problem is July 1, 2011; the second problem is the next two or three decades. Someone must think about what the University is going to do on Friday, July 1, 2011. How much money does the University have in stimulus funds, he asked? (About $89 million over two years, all but $11 million of which has been allocated, most of it for tuition mitigation and middle-income scholarship program, Mr. Pfutzenreuter said.) So the University will lose about $45 million per year, Professor Morrison concluded, and must either continue to mitigate tuition or bump up tuition by a large amount. The middle-income scholarship program is recurring, so has a tail, Mr. Pfutzenreuter said, and when the money to stop buying down Minnesota resident undergraduate tuition is gone, returning students will see a $740 tuition increase.

If that cut were $150 million, which would not be unexpected with a state deficit of $7 billion, Professor Morrison said, and the disappearance of the stimulus funds, the University could face a shortfall of $200 million. On a base of state funds of about $600 million, that is a 33% cut. He said he was not sure some realize this is coming, and the University must think about strategies for July 1, 2011 and for the long haul. The task force report addresses the long haul and the University appears to be whistling in the wind about 7/1/11.

[Professor Morrison is another old timer who also really understands what is going on. When he speaks, we should all listen. This includes the Morrill Hall crowd..]

The University will also be in transition, Mr. Pfutzenreuter said, with a new president presumably coming in to office. Professor Morrison agreed, observing that the current president will leave office the day the University goes over the cliff. It is the responsibility of those at the University now to not let that happen, Vice President Rosenstone pointed out. He agreed with Professor Martin on the need to get everyone at the University to understand the new reality, and how to engage across the institution to make changes necessary to advance the excellence of the University.

[Given what has gone on around here - Graduate School coup, AHC re-org by executive fiat, smothering General College, strategic propaganda initiative, just as a couple of examples - it is going to be difficult to engage across the university. The blame lies at the feet of the Morrill Hall crowd expecially the individuals sitting in the president and provost's office, as well as the cultural czar.]

Mr. Pfutzenreuter said he was "question fatigued." Everyone asks questions about how to deal with the situation but no one provides answers.

[Ah but many of us - or at least some - have provided answers. The Morrill Hall crowd just doesn't like them and has been in denial.]

If one wants the faculty to know about the situation, it will be necessary to send someone to every department meeting, Professor Konstan said. Or one could try the blue-ribbon task forces in each college as a way to reach a more-interested subset. He wondered if one really wants to approach faculty now--leading to them worrying about the financial future rather than doing their jobs.

In terms of faculty involvement, Professor Luepker said, Committee members listen to the information but they are also representatives of groups on campus. What deserves repeating is that while people like to focus on the state cutting its appropriation to the University, the University also has $80 million in additional costs each year. That applies to everyone; all can see what they would do with more money. It is time to recognize, with Pogo, that "we have met the enemy and he is us." He and Professor Oakes were recently at a faculty meeting and asked for time to report on what FCC is doing; the chair was concerned about frightening the faculty and distracting them from their teaching and research.

It is important to involve more faculty members in thinking about these issues, Professor Seashore said.

[Our administration has avoided this solution like the plague. Our provost has talked about conversation, but he is not interested in one. The most frequent comment from our president lately has been no comment. Show us you're serious and a lot of faculty would get involved. Otherwise, don't waste our time.]

Professor Martin said there was task force consensus that the University needs a culture change. In response to Professor Seashore, she said that no one believes that DECISIONS will be made at the department level, but people must understand the situation.

Dean Finnegan agreed with Vice President Rosenstone that for whatever reason, the state has only so much money to invest in the University (there could be more if the state were to deal with the problem of over-built higher education, but until it has the fortitude to do so, the state is stuck where it is).

[There he goes again... Let's be a little more specific about your sniping, here, Dean Finnegan - what, exactly, is on your mind?]

Is it possible to get faculty to have an ownership culture in the University, versus a "reside in" culture, Professor Konstan asked? That used to be the case; for it to work, it must go hand in hand with trust.

[On the money, again, Professor Konstan. Time to stop the posturing in Morrill Hall?]

Some remember the mid-1990s, when some members of the Board of Regents blamed the ills of the University on faculty tenure, Dean Finnegan said, and those were dreadful times. The conflicts caused deep rifts and no one wants to return to that situation. Professor Chapman said he understood but that it will be difficult to do something with programs to deal with the pending situation if there is no way to achieve financial savings.

[Ah, especially in the AHC, some of the major players in the attempt to destroy tenure are still pretty high up the greasy pole...]

State support remains crucial and the University needs to develop a new compact with the state "that more clearly articulates the long-term rationale and responsibilities of the state to support teaching, research, and outreach."

[I think this is, indeed, possible. But not the way the Morrill Hall gang are planning. If you want the legislature to play ball, you are going to have to get down on your hands and knees, put on the sack cloth and ashes, and apologize for bad, arrogant, behavior lately. Then you have to agree to a covenant that INCLUDES a high quality/reasonable tuition model. You simply cannot view tuition as a "revenue source." Figure out what it really costs to educate a student for a year. Tuition + the state's contribution cannot exceed this. If you are really serious about trying to save the university from itself - this is the simple roadmap. If I am incorrect about this, let's have an honest dialog? Bob, Tom?]

Professor Luepker noted that the University has talked about the $250 million in new Medical School buildings north of the football stadium. Is there any projection of the return-on-investment for those facilities, or the patents it will take to pay them off? The task force did not see any such data, Dr. Rosenstone said, but that is the type of question that needs to be asked regularly.

[And I have asked this question from the very beginning. No one was interested. Q.E.D.]

There are other compelling reasons to do the research, Dr. Rosenstone pointed out, but the financial questions have to be asked. Professor Morrison said that supposedly the cost of the facilities is to be covered by the indirect-cost recover funds that will be generated to pay off the bonds. But there is a gap between the indirect-cost rates and actual costs, Dr. Rosenstone pointed out again, and one must fully account for the personnel costs in the new facilities.

[Exactly. And these points were made by me on two different blogs. Absurd claims were made by Frank Cerra and Fitz on this.]

In terms of real estate, the University owns 27,616 acres of land, and some it is critical to teaching, research, and outreach.

[Cough, cough... Any reasonable person would look at that number and start thinking about selling some of this land. But apparently not the Morrill Hall crowd. They are still in land acquisition mode.]

Professor Morrison asked if it is possible to have a compact with the state. He noted that he has spent a lot of time at the legislature; one can deal with this year's legislators, but next year things will be different. The compact with the state was written in 1851 and it has broken down, and he said he was not sure anyone could deal with the fact that it was broken.

[Dr. Morrison is pessimistic about a new compact. I disagree, but have to admit that he has an enormous amount of wisdom and experience. I think that a new compact is possible if we move from the high tuition model in return for better support. Look at Ohio State. No tuition increase in three years. What exactly is going on there?]

Since the early 1980s, the University has asked for general funds and that the Board of Regents be allowed to invest them. Maybe it is time to rethink that approach, and to put undergraduate students, some of the activities in agriculture, medical education and so on, at risk for loss of appropriations and let the legislature know what will happen if fails to provide funds.

[Try it. This would be an incredibly stupid thing. First you would look foolish to the public if you took it out on undergraduates. And second, you need money from the legislature. If you try to pull a stunt like this, you will regret it.]

The scope and size of the central administration needs to be re-examined and whether it is providing value. When he came to the University, there was the vice president for academic affairs, the vice president for finance, and the vice president for lobbying--and that was it. Now there are staffs and staffs; the administration can do more to control the size.

[I could cite chapter and verse on this. And I am tired of the administration chopping a few peons in their office as human sacrifices. Let's seem some actual Vice Presidents/Provosts and associate vps and assistant vps phased out. Chiefs of staff? Maybe if you need a chief of staff, you have too much staff? Or you are irrelevant?]

Second, what is to be done with units showing a profit, Professor Morrison asked? Should they stand on their own resources, or should the central administration cream off the profits? The 300-pound gorilla in the discussion is the Academic Health Center. If the AHC goes a separate way, as seemed to be suggested last week, what will that do to the calculations? He surmised that it could make the situation worse.

[Horse, barn door, locked...]

Tuition is the revenue stream with the highest potential for significant, long-term growth, although not without restraint.

[No it is not, and it is key that this be understood. It is not a "revenue stream." It is a reflection of the cost of education and not a parameter that can be adjusted when the U is short of money because of its ambitious aspirations.]

It must build upon its tremendous progress over the past decade and continue to advance the quality and reputation of a U of M education.

[The time for posturing is over. "tremendous progress"? Give me a break. You are asking student to pay more, for less. It is time for brutal realism about our situation, not Mary Poppins prattle.]

Crookston, Duluth, and Morris are now at or over-market in their tuition rates. There is need for a candid conversation about the quality of education and how the University compares with its competition, about the supply of qualified students, and where additional investments in program quality, scholarships, recruitment, and the student experience are needed.

[As I was saying...]

Should the University serve more undergraduate students beyond Minnesota and the reciprocity states?

[Ah, that would be no. Hidden here is a question about revenue and ambitious aspirations. The fire sale on out of state (not reciprocity) tuition is something that needs serious discussion. We are turning down qualified Minnesota students for what?]

Should the University continue to move to higher tuition with higher levels of financial aid for undergraduates of modest financial means?

[That, too, would be no. Even though the Morrill Hall crowd would have us believe that this is the only way possible, there is obviously another model, e.g. Ohio State where there has been no tuition increase in the last three years, no layoffs, and a 2.5% pay increase this year. How can this be? Why don't we hear the admin speak to what is going on in Ohio?]

Lower-division courses subsidize upper-division courses; it would not be possible to have small-enrollment upper-division courses without large-enrollment lower division courses.

[And yet this administration fought tooth and nail to beat down the number of large classrooms in the new Taj Bruininks that replaces the former Science Classroom Building. And this despite input from faculty about how stupid this was. There is a difference between dictatorship and leadership.]

Ms. Stahre said that with respect to increasing tuition and the quality of education, the only time students hear about quality is in the talk about the student-faculty ratio. That is not an adequate measure; how is quality measured? That question needs to be answered much better than it is now, Dr. Rosenstone said. Graduation rate is a proxy. It is incumbent on the institution to demonstrate, in a thoughtful way, why it is a good investment to come to the University.

[Others are not so sanguine. As for commitment to quality education at an affordable cost? Meaningless drivel. The administration has flatly failed on its promises of excellence and affordability." Daily (13 Oct 2009)]

The fourth strategy advocated by the task force is narrowing the scope of the mission. "As important as new revenues, cost-cutting, and efficiency gains are, in our judgment, together they will not yield sufficient new resources to ensure the excellence of our University. We cannot become one of the best universities in the world and meet our land-grant responsibilities without narrowing the scope of our mission to advance a distinctive constellation of excellence."

[Why is there always an assumption in these discussions that we are to become one of the best public research universities in the world? This is insane. Why not one of the best schools in the BigTen? Those of us who have suggested this repeatedly, have been called "doubters" by the Morrill Hall crowd. Please, stop the posturing.]

Big decisions must be informed by data and analysis, Dr. Rosenstone said; in the past, some big decisions have been made without the full analysis one would expect. If the University doesn't have all the money it would like to compete against some of its peers, it needs to play smarter.

[Bingo, Dr. Rosenstone. Do we really need a cultural czar?]

Getting faculty buy-in will be crucial, Professor Roe said; they must feel they have an interest in the identifying solutions and will be listened to if the University is to retain their loyalty.

[Lord, love a duck. Why do you think faculty will buy in? Why should they? When has the faculty been invited to the table for a true consultation? The answer lately is: never.]

What is the next step, Mr. Erikson asked? That is the President's decision, Dr. Rosenstone said.

[He should be tasked to take care of the 2011 problem Professor Morrison identified. We should begin an immediate search for a new executive who can be hired asap. This person should be involved in the long term problems mentioned in this discussion. No one who is worth much is going to come in with the marching orders all tied up in a neat little bundle by his predecessor for implementation. ]

Everyone is expressing the view that there will need to be restructuring and incentives to engage faculty, Professor Seashore said; even if the decision about the big picture is made on high, faculty must be engaged at the unit level--and not all of them have to be, there just needs to be an energized number. Faculty will do this work for very small amounts of money.

[I know Dr. Seashore means well, but this is a truly ironic comment.]

Either this Committee or the Faculty Consultative Committee needs a deep discussion with the President, Professor Konstan said, that hits hard on the point that the University cannot wait, on what the next steps will be or who he has charged with carrying out the next steps. These issues cannot be allowed to slip into the next administration.

Professor Luepker noted that the Faculty Consultative Committee had volunteered for the job but was turned down.

[This takes the proverbial cake. We want faculty buy in. We want faculty on board. Yadda, yadda, yadda...
Leadership, anyone?]

Posted by William Gleason at 10:25 AM | Permalink | Comments (0)

Actually, I've not lost hope, at all.

I think that the current financial situation at the U is going to force a serious re-evaluation of our mission, values, and priorities. The only fear I have is that the ambitious aspirations of our administration will continue unchecked because of a lack of inclusion and true consultation of students, faculty, and staff.

I will be going on sabbatical/research leave to Brandeis University in Boston from 1/1/10 until 6/1/11. In the next two months I have much to do to prepare for this move, so I am cutting back to posting only on Sundays. This will probably continue while I'm gone.

I wish the University nothing but the best. Honest dissent from the party line of the Morrill Hall crowd is part of my responsibility as a Minnesota citizen, and university alum/faculty member.

The Morrill Hall crowd should look on the face of Northrop every day to remind themselves:

The University of Minnesota

Founded in the Faith that Men are Enobled 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

This used to be quite easy. But now the front door of Morrill Hall is locked and only the side and back doors are accessible.

This is symbolic of what has been going on in Morrill Hall lately.

Posted by William Gleason at 8:39 AM | Permalink | Comments (0)

"There have been a lot of false statements made about tuition increases. He [Sullivan] said the discussion should focus on the marginal average cost to students of a tuition increase, factoring in tuition discounting, scholarships, fellowships, and other financial aid support."

Faculty Consultative Committee
Thursday, January 24, 2008

What are those false statements of which you speak, Provost Sullivan? That tuition is too high? Your claim that increases in scholarships make up for increases in tuition and that the access problem is something that people are making up?

From a letter written by CLA Dean Parente recently:

"Twenty, thirty, forty thousand dollars. That's how much many of today's students owe when they graduate from college. But their debt isn't due to lack of foresight or saving. The cost of higher education has so far outpaced inflation that increasing numbers of students are borrowing more than ever to pay for college. As a result, many students can't afford to pursue their dreams and aspirations that a college degree makes possible."

Which is more important? The ambitious aspirations of our undergrads or of the Morrill Hall Crowd?

For futher information please see the Periodic Table post: CLA Dean Parente's Vision of Student Debt Differs from that of the Morrill Hall Crowd at University of Minnesota

Posted by William Gleason at 2:49 PM | Permalink | Comments (0)

From the Durham Herald Sun:

DURHAM -- The dean of the Duke University School of Medicine said today that leadership in difficult economic times, and any time, takes collaboration. Dean Nancy Andrews spoke with Duke Chapel Dean Sam Wells Tuesday afternoon at the Duke Clinic as part of the deans' dialogue series.

Andrews said the medical school has two worlds -- the health system, where the majority of faculty work, and the medical school, which is dealing with the same financial issues as the rest of the university. The health system is relatively healthy financially, she said, but there is stress, including the impact of impending health care reform. Andrews also noted that the National Institutes of Health budget has been flat and medical school research is driven by federal funding.

She gets the most pleasure from her work by watching people develop in their careers, whether students or faculty. She also loves clinical research. She stopped practicing clinical medicine to be able to spend time in her lab, teaching and work as an administrator.

"My dessert at the end of a long day is thinking about the research lab," she said. Andrews loves to hear about clinical research, she said.

Wells asked Andrews about her role as a female leader. She said that she, like some other women, has been underestimated and felt invisible in the workplace. She hopes that is changing, she said, because all kinds of leadership and talent needs to be drawn from a larger pool than in the past.

Andrews said she has learned the most about leadership by listening to people.

"I can't just be seeing things through my own eyes. I need a bigger picture," she said.

Andrews said that leading during difficult economic times means being aware that the economy is affecting people different ways, at home and work.

"Ultimately what I'm most worried about is helping people see the strength in this organization," she said. Andrews thinks the down time of the economy will last longer than people anticipate, and it is important to come together.

The economy "makes us think of things that don't cost money," she said. "Our greatest resource is the people we've got here -- it's not the money. In a way, that's the silver lining."

Andrews hopes her legacy at Duke is helping people improve health and make scientific breakthroughs. When faced with a problem, she said, you roll up your sleeves and do the best you can. When the best isn't the right thing, it's time to change course and do better, she said. Andrews said being a leader means promoting the work of others, not just yourself.

Leadership matters. We need a full-time dean at the University of Minnesota Medical School.

Right now we have a part-time dean and a gaggle of vice-deans. Given the economic and political turmoil we face at the medical school, this is unsatisfactory. I have yet to talk to a senior faculty member who does not agree that we need a full-time dean.

Frank? Bob?

Posted by William Gleason at 5:26 PM | Permalink | Comments (0)

and few seem to be interested.

"Why is the current system not serving the academic mission? This is like trusting the people whose last rocket didn't reach the moon when they say this next one will -- why trust the rocket scientists who failed? Will this arrangement just be in place for the next dozen years and then will there be something new?"

From:

Professor Luepker next reported on the last Board of Regents' meeting, where Senior Vice President Cerra made presentation on "Evaluating Integration of the Clinical Enterprise." Copies of the slides that Dr. Cerra used with the Regents were distributed to Committee members. This is a massive reorganization in a major portion of the University, Professor Luepker commented, and it caught his attention not only because it is a new direction for health-care settings but also because this is a billion-dollar-per-year enterprise (or more). The reorganization proposes the integration of the Fairview hospital management corporation with the University of Minnesota Physicians (UMP) and the University of Minnesota.

It struck him, Professor Luepker related, that apart from the financial magnitude of the proposal, there are a number of other questions that should be addressed.

-- Where does research and education fit in with this new, integrated organization? The presentation was mainly about the reorganization of clinical practice.

-- Who runs the organization? It appears that the proposed Board of Directors will be composed of non-University people, and it appears that the organization will be run like a business.

-- The intent is to pay clinicians salaries competitive with the community. Clinicians at the University are now paid less than the market; clinicians in private practice work hard, but they do not usually have teaching or research responsibilities.

-- There are no dollars figures included in the presentation, but the amounts involved must be very large. Where will the dollars come from and what is the University getting involved in? One motivating factor is to gain market share and compete better with other health-care systems--but those systems now take University students and train them for free.

There are a number of elements to this plan that go beyond the Academic Health Center, he concluded, and the AHC is such a big part of the University that this issue clearly falls into this Committee's bailiwick.

What leapt out at her, Ms. Kersteter said, is that there is little about the teaching mission in the presentation, and that is more expensive in a teaching hospital. She said she was also concerned about the residency program; if that is done badly, there would be a big impact on the community.

If the new Board of Directors is primarily external, Mr. Erikson said, it is not likely it would focus on the educational mission of the Medical School. One could look at this proposal from a very different perspective and not understand that it more expensive to have a teaching hospital.

Professor Konstan said that if one looks at this from the 50,000-foot level, one can understand that the health-care industry is in a storm and people want to lash the rafts together, but one needs to be concerned that the University doesn't lash itself to a rock, which this could be.

Second, he said he would like to see a statement about the mission that the Board of Directors would be sworn to uphold, because it does not appear the mission would be the same as the University's mission.

Finally, he recalled the time when the University sold its hospital to Fairview; that was supposed to solve the problems.

Now this document shows a whole bunch of problems that weren't solved.

Why is the current system not serving the academic mission? This is like trusting the people whose last rocket didn't reach the moon when they say this next one will -- why trust the rocket scientists who failed? Will this arrangement just be in place for the next dozen years and then will there be something new?

This feels a lot like "trust me," he said.

Professor Luepker said he agreed with Professor Konstan: the mission of the new organization is not clearly stated (and perhaps it is simply economic survival), other than "advance excellence and innovation in integrated patient care, medical education and research."

Professor Olin said this proposal would set up a role conflict for individuals who will work for two organizations: the Clinical Scholar work versus the profit-driven organization. The mission is thus important. There have been two structures in place, one devoted primarily to education and one primarily profit-based. How would this proposal affect AHC finances? How would it address the Medical School deficit?

Professor Morrison said there is a big push in health care to develop integrated systems, and this proposal is oriented in that direction. The federal government may prefer integrated systems in the health plans it supports, and thus require them, and they may save some money. The Mayo Clinic is a model for this kind of integration. Most years it does well. That is the good side. The bad side, he said, that the Mayo Clinic has a good little medical school, but could not run a large medical school in its environment--and they know it. The idea of the plan for the University hospital and clinics seems to be to solve financial problems of the Medical School and the hospital by putting them in a box and separating them financially from the University. The University will provide the research and education infrastructure and the credibility of an academic connection. The financial infrastructure required to run the Medical School and its research operation will be carried by the University.

What chunk is falling away from the University, Professor Konstan asked? As he reads the proposal, he said, AHC faculty who are not completely clinical will be University faculty, but a larger percentage of their time will go to the new health system than they would spend on UMP. He said he agreed with Professor Morrison that this proposal would carve off the viable part of the AHC and leave the rest hanging around the University's neck. He said he worries that the University will go down this path without articulating well what will happen--because that would generate opposition. The role of this Committee is to ask where things are going so "we can shed light on it."

Professor Olin reported, in response to a question from Professor Martin, that the AHC Faculty Consultative Committee has asked for the report from the consulting firm but has been told they are not finished. They have had no in-depth discussion of this proposal, he said. Professor Martin said she hoped the AHC FCC would demand consultation for themselves and their colleagues to ensure a positive academic outcome.

There are two pieces involved, Professor Morrison said: the financial, and the one he is more concerned about, the educational. How is this still part of the University? Do they just need the cover of the University? "Affiliation" with the University does not equal a real relationship with the academic operations of University. He said he was also concerned about how the other colleges of the AHC, Dentistry, Public Health, Veterinary Medicine and perhaps Nursing would fit into this enterprise, and about whether the Medical School could become simply a trade school within the new hospital entity.