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January 30, 2009

Conversation With the Provost - It's a Start

I was unable to make the meeting yesterday and am really sorry. About one hundred people were there in person and around the same number logged into the website. Very few students showed up.

It is hard to fault the administration for the time of the meeting, but I have students working in my lab at that time and we already had another critical meeting scheduled. It should be noted that the meeting was held on short notice, but even that is understandable.

But here goes a report of the activities. It sounds like some of us malcontents and "doubters" had input. It is about time.

From the Daily:

‘Town hall’ meeting at U addresses economic woes

David Introwitz

The University of Minnesota held an open discussion Thursday to talk about its future in light of recent economic times.

The discussion’s hot topic was Gov. Tim Pawlenty’s proposal of a $151 million cut to the University of Minnesota’s budget for the upcoming 2010-11 biennium.

The event, moderated by University Provost Tom Sullivan and University Relations Vice-President Karen Himle, came at a time when the University will “cross the line? where state support becomes substantially less than the tuition revenue coming from students, Sullivan said.

“The state is essentially saying we’re going to put this on the backs of our students,? Sullivan said. “This has never happened before in the state of Minnesota.?

Sullivan outlined seven budget principles to guide University administrators in deciding what will get cut when the state Legislature finalizes the budget in either late May or early June.

“We’re taking [budget cuts] as of Tuesday very seriously and beginning to model what that might look like for our University,? he said.

Students and faculty were also encouraged to participate electronically on the University website if they couldn’t make it to the discussion in person.

At the forum’s end, 89 people were signed on to the website, and about 100 people attended in person, Himle said. The meeting was held at Fraser Hall.

Faculty and staff who were present represented a variety of viewpoints across different departments. Several of them took advantage of the opportunity to speak frankly to the provost about the University’s actions.

Eva von Dassow, an associate professor of classical and near eastern studies, accused Sullivan of proposing cuts in the past only at the bottom of the pay scale.

“We’ve been losing positions due to the hiring pause, with no guarantee that we’ll ever get them back,? Dassow said. “You do not maintain the quality of the University by cutting its living flesh.?

Student Paul Strain, an MSA member, voiced concerns that the student body felt “insulated and unaware of how these cuts are actually going to affect them.?

Only a handful of students were in the room among a vast majority of faculty and staff.

Ranking Student Representative to the Board of Regents Jordan Bronston said he wasn’t surprised that there weren’t a lot of students in attendance, but that he hoped a similar discussion could be held specifically for students in the near future.

Major Shakeup At U of M Med School - Strib Story

From the Star-Tribune

Shakeup in U of M's med school leadership

By CHEN MAY YEE, Star Tribune

January 29, 2009

In a major shakeup at the University of Minnesota Medical School, university president Robert Bruininks has decided to combine two top jobs, removing Dr. Deborah Powell as dean and temporarily turning her duties over to Senior Vice President Frank Cerra.

Cerra will assume Powell's duties July 1, and a national search for Cerra's replacement will begin in 2010.

In a memo to the Board of Regents, Bruininks said he was combining the job of senior vice president for health sciences -- currently held by Cerra -- and that of medical school dean into a single position.

The move was motivated by the need for "strong, focused leadership for the health sciences and the ability to align and streamline resources and core administrative functions in this severely challenged economy,'' Bruininks said.

He said he expects to appoint Cerra's successor by the fall of 2010.

University spokesman Dan Wolter said the move was "purely a cost-saving mechanism" for the money-losing school. He said Bruininks had asked Cerra to cut $7 million to $10 million in administrative costs. Powell currently draws a salary of $242,149 a year while Cerra makes $439,570. Wolter said it had not been decided if Powell would get a pay cut in her new role.

Powell came on board in 2002 to great fanfare as the medical school's first woman dean. A former pathology professor and dean of the University of Kansas medical school, she was the first outsider in decades to lead the medical school. She arrived at a time when the school had rebounded from a series of research scandals in the early 1990s.

At the time, Powell said one of her goals was to raise the school's national ranking in research grants. Powell began a wide-ranging modernization of the school, dubbed Med2010, and introduced a more flexible version of the traditional four-year medical degree, allowing students to take time off for other pursuits and finish in six years.

The school has improved its reputation for primary care under Powell, according to U.S. News & World Report, but it has struggled to improve its national ranking for research funding. In 2000, the school ranked 27th in funding from the National Institutes of Health. Five years later, it had slipped to 31st place.

Meanwhile, the school has labored under a series of ethics questions. Late last year, the Star Tribune reported that Dr. Leo Furcht, whom Powell named as co-chair of an ethics task force, had been disciplined for secretly steering a $501,000 research grant to his own company.

In 2004, Powell banned Furcht from conducting industry-sponsored research for three years.

In 2007, Powell appointed Furcht to co-chair a new task force to reform the school's conflict-of-interest policy. However, task force members were not formally told of the disciplinary action against Furcht, and the episode prompted internal complaints among students and faculty.

"After that came out, the students were very upset, and the sense was she never took conflict of interest seriously,'' said Josh Lackner, a fourth-year medical student who was a member of the task force. "To many people, this was a very embarrassing illustration of that.''

Powell herself has faced questions for her board seat on PepsiAmericas Inc., a Minneapolis-based bottler. In 2007, she received $130,000 in cash and stock for sitting on the company's board, according to a proxy statement.

January 29, 2009

Reorganization of the Medical School and the Academic Health Center

Straight From the Horse's Mouth

U of M restructures leadership of Medical School, Academic Health Center

Contacts: Daniel Wolter, University News Service, (612) 625-8510

MINNEAPOLIS / ST. PAUL ( 1/29/2009 ) -- University of Minnesota President Robert Bruininks announced his plans to combine two key administrative positions in the university's health sciences area: senior vice president for health sciences and dean of the Medical School. Current Senior Vice President for Health Sciences Frank Cerra will be appointed to the new position, subject to approval by the university's Board of Regents.

"Our 154-year old medical school plays a foundational role in serving the needs of Minnesota," said Bruininks. "It is my considered judgment that this combined role will result in a number of key benefits, including strong, focused leadership for the health sciences and substantial cost savings through the ability to align and streamline resources and core functions in this severely challenged economy. This change will best position the University of Minnesota and the [Academic Health Center] to play a central role in shaping the future of healthcare for Minnesota and the surrounding region through excellence in our core mission of education, clinical services and health research."

Cerra, who has led the Academic Health Center since 1996, first came to the university in 1981 as director of surgical critical care. In 1995 he was named dean of the Medical School after serving briefly as head of the Department of Surgery.

Bruininks also outlined transition steps:

- Review and action on Cerra's appointment by the Board of Regents at the May 2009 meeting;

- Commencement of a national search for the new senior vice president and dean during the first quarter of 2010, with an anticipated appointment by the fall of 2010; and

- Transition to new leadership (working with Cerra and other senior University leadership and the leadership of our community partners) during the 2010-11 academic year.

If the Board of Regents approves Cerra's new appointment, he will assume the combined role July 1, 2009.

During the next several months leading up to the July 1 effective date, Cerra and current Medical School Dean Deborah Powell are working together on transition issues and are in discussions concerning a future administrative role for Powell in the area of medical education.

January 28, 2009

Changing of the Guard at the U of M Medical School

from Frank B. Cerra
reply-to "Frank B. Cerra"
to MED-ALL@oris2.ahc.umn.edu
date Wed, Jan 28, 2009 at 4:01 PM
subject Presidential Announcement
mailed-by oris2.ahc.umn.edu

TO: Medical School Faculty and Staff

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

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

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

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

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

Driven to Discover: How to save $521,000?

Simple – no more (useless) Driven to Discover television advertisements

Today the Medical School Dean sent out a blanket email that included a December 12, 2008 memo from VP Karen Himle.

“…in 2007 the University (excluding Athletics) spent over $1.9 million on paid media. This includes television, radio, magazines and newspapers and the internet. Driven to Discover television advertising during 2007 totaled $521,000. University Relations has canceled television expenditures related to the Driven to Discover campaign effective January 1, 2009. I encourage you to assess advertising expenditures in your own areas to determine whether they too can be discontinued.?
Karen L. Himle Vice President, University Relations

Finally, something has been done about the incredible waste of money that is Driven to Discover.

January 27, 2009

Governor Pawlenty's Proposed Cut For the University - $151 Million Dollars

From the U's press release:

MINNEAPOLIS / ST. PAUL ( 1/27/2009 ) -- The following is a statement from University of Minnesota President Robert Bruininks in response to Gov. Tim Pawlenty's proposed budget for the 2010-11 biennium, which includes a cut of $151 million to the university:

...Gov. Pawlenty's budget recommendations today are just the first step in a long budget process. His proposal for the university's budget carries with it enormous consequences. It will impact the quality and affordability of the education we provide. It will impair our ability to serve as a job creation engine for the state through research and development. And, it will have an inevitable impact on our workforce, tuition and our ability to attract research grants - just as it did five years ago when the state cut $195 million from the university.

We made difficult choices then - including closing colleges and Extension offices - and are prepared again to make tough decisions. This year, I hope policy-makers will continue to give us the flexibility we need to address this substantial budget cut, and that they will look beyond short-term fixes to consider the long-term trajectory we are on. Minnesota's system of higher education has always been an asset, educating our workforce and turning new discoveries into new jobs for Minnesota. In these challenging economic times, there is no more forward-looking investment to be made than in maintaining - or even enhancing - the quality of education in our state.

At the U, we are fully prepared to do our part to deal with this state budget problem. However, we are hopeful that lawmakers and the governor will come to realize that higher education is the best kind of long-term economic stimulus and that, together, we can minimize this proposed reduction.

January 26, 2009

From the Department of Better Late Than Never - OurProvost Wants to Have a Conversation


What took you so long, Tom?

OurProvost does not have a great track record in the conversation department.

For background about his previous (lack of) activities in the area please see:

Conversations With The Provost

Are We Ready For A Conversation Yet?

And of course the sad tale of OurProvost's aborted attempt to start a blog for the purpose of discussing the glories of the Strategic Propaganda Initiative (as a colleague called it) can be found in the post:
University of Minnesota Provost Launches Blog, Hold That Thought...

Sadly, OurProvost just didn't have the time as his spokesperson put it.

Oh well, as the community organizer Saul Alinsky often pointed out, sometimes people do the right thing for the wrong reasons. I understand community organizing is in right now, Tom.

Provost Sullivan invites faculty, staff, and students to join him in a discussion about the University's academic mission in a declining economy. This is an open forum to listen to your suggestions and discuss ideas. If you are unable to attend in person, you are welcome to participate electronically: Visit the Economy and the U website the day of the event for details.

Thursday January 29, 2009
101 Fraser Hall, East Bank

Co-sponsored by:
Faculty Consultative Committee
Office for Student Affairs
Minnesota Student Association
Graduate and Professional Student Assembly

January 25, 2009

Greed and Corruption On Our Medical School Faculties.

UD provides a link to an article on this topic in her recent post with the above title.

From the original source:

Weston Library hosts distinguished author of 'On the Take'

Every profession has its ethical problems, and, as Dr. Jerome P. Kassirer makes clear, the medical profession is no exception.

In his talk at the Weston Library on Jan. 14, sponsored by the Friends of the Weston Public Library, he focused on the problem of improper connections between the pharmaceutical industry and doctors, and of doctors who put profits ahead of the welfare of patients.

"My subject," he said at the outset, "is the conflict of interest in the contemporary practice of medicine." He began by telling the group of almost 80 people in the room that drug company representatives make frequent visits to doctors’ offices, bearing a grab bag of free samples and an artful sales pitch. He went on to point out that many doctors receive favors, such as lavish dinners or expense-paid trips, from drug companies as inducements to prescribe their products freely. Many doctors work cooperatively with the manufacturers of drugs and medical devices, he stated, to market and promote these products. The marketing effort might include lectures by doctors to their peers or articles submitted to medical journals, both usually presenting the products in the best possible light.

"Many doctors," he continued, "claim not to be influenced by the blandishments of the pharmaceutical companies."

To illustrate his skepticism about this, he cited a little experiment of sorts in an "upscale Italian restaurant in northern New Jersey, showing that all it takes to influence people is candy." Waitresses distributed free candy to patrons in varying amounts, and sure enough, those who received the most candy left the biggest tips!

Candy is dandy, and as for the rest of that old saying, Dr. Kassirer might change it to, but cash is even sweeter. He asserted that "there are legions of stories about doctors receiving large amounts of money." The quid pro quo might vary from simply pushing certain drugs or diagnostic tests for their own patients to the practice of "ghost writing," in which "a professor of medicine is paid to put his name to a study," passing himself off as the author and thus ensuring the credibility of the study.

Dr. Kassirer also spoke of doctors who receive payments and other benefits from pharmaceutical companies while serving on committees charged with drawing up objective evaluations and/or recommendations for the use of new drugs and procedures. He gave as an example a committee that issued guidelines in 2004 for using the cholesterol-lowering drugs known as statins. The joint committee, representing the American Heart Association, the American College of Cardiology and the National Institutes of Health, had nine members; seven of them were closely connected to the manufacturers of statins. "Why," Dr. Kassirer asked rhetorically, "aren’t committees like this composed of doctors who have nothing to gain from the committee’s recommendations?"

Dr. Kassirer cleaves to the old-fashioned view that "the primary goal of the physician is not to enrich himself, but to take care of the sick." While he acknowledged that plenty of doctors still subscribe to that view, he lamented "the epidemic of doctors who don’t."

Increasingly, the media have been reporting, he noted, on medical research practices that subordinate safety to profit-making potential and on doctors who are questionably involved in the promotion of pharmaceutical business. He cited recent articles in The New York Times and The Wall Street Journal.

All this "conflict of interest" contributes, in his view, to the rising cost of health care and, more importantly, it "leaves patients open to the dangers of inadequately tested drugs." He urges patients "not to be passive, to inform themselves about their ailments, and to question doctors on proposed treatments."

Dr. Kassirer is in a position to know whereof he speaks. He has been for many years a professor at the Tufts School of Medicine, and was editor-in-chief of the New England Journal of Medicine from 1991 to 1999. He is the author of "On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health" and other books and articles on this topic.

At the end of the talk, Dr. Kassirer responded to numerous questions and comments from the audience. In one response, he alluded to laws in Vermont and Minnesota requiring drug companies to disclose payments made to doctors in those states, and he said that a number of irregularities have come to light as a result. He added that a similar bill has been introduced in the U.S. Senate by Sen. Charles Grassley, R-Iowa, and Sen. Herbert Kohl, D-Wisconsin. It’s called the Physician Payments Sunshine Act (S. 2029), and its sponsors envision it as at least a partial remedy for the ethical lapses in contemporary medicine that Dr. Kassirer decried in his talk.

January 22, 2009

Medical School Ethics Is Not An Oxymoron

From the Daily:

BY Bill Gleason PUBLISHED: 01/22/2009

“No one ever told task force members — at least not me — about the history of [Professor Leo] Furcht and [Medical School Dean Dr. Deborah] Powell. Maybe everyone else knew. But I was the outsider on this task force — the journalism guy from across the street. I am disappointed and feel misled.?

-Journalism Professor Gary Schwitzer commenting on his HealthNews Blog on UThink.

I can understand how Professor Schwitzer would be disappointed with Powell and Furcht. A lot of people share that disappointment.

It is difficult for me to criticize the Medical School because of the many good people who work here: Warren Warrick, Karen Ash, Abhi Humar, David Hunter, Keith Skubitz, Doug Yee, and Dave Thomas. I could easily list a page more of wonderful colleagues. But criticism has become necessary because — in adminspeak — mistakes were made.

According to University investigative reports obtained by the Star Tribune: “A professor who is leading the University of Minnesota Medical School’s effort to write tougher ethics rules was himself disciplined in 2004 for secretly steering a $501,000 research grant to his own company.?

Powell appointed a conflict of interest policy violator, Laboratory Medicine & Pathology department chair Leo Furcht, to serve as co-chair of a panel tasked to recommend a new conflict of interest policy for the Medical School. Dr. Powell’s husband is a medical school faculty member in Dr. Furcht’s department.

Dr. Leo Furcht, the chairman of lab medicine and pathology, was reprimanded for a “serious violation? of university conflict-of-interest policies in connection with a grant from Baxter Healthcare for stem cell research at the Medical School, according to the investigation, which the newspaper received through the state’s public records law.

Responses to the Star-Tribune pre-Christmas news report about this situation are telling. Dr. Powell justified her appointment of Furcht without disclosing his violations by saying: “I did not think it was relevant.? The Star Tribune further reported that “Frank Cerra, the university’s senior vice president for health sciences, said Friday he was familiar with the case but couldn’t recall details. He said Furcht’s experience could help inform the conflict-of-interest committee's work.?

This doesn’t pass the smell test. Furcht is accused of having in years past diverted about a half million dollars in research funds. He has made millions of dollars in what seem conflicted business dealings. Someone’s moral compass is demagnetized.

As Margaret Soltan, an English professor at George Washington University, writes on her blog: “[An editorial] in the Minneapolis Star Tribune notes that the most charitable description of what’s been going on at the clubby University of Minnesota medical school would be ‘bizarre.’?

Fortunately, there are people on campus willing to speak up as Gary Schwitzer has. Carl Elliot of the University’s Center for Bioethics, not a member of the panel, has commented in the Star Tribune that Furcht’s task force involved in developing new rules on financial relationships with industry should itself be free of conflict of interest and that Furcht should be removed from the committee.

The AHC and the medical school administration are fond of talking about change. Doctors Cerra and Furcht have been administrators since before re-engineering days – during the brief reign of terror of AHC Provost William Brody and the ill-fated tenure wars at Minnesota. Dean Powell is nearing the end of a distinguished career. She is currently a member of the Board of Directors of Pepsi-Cola for which she was compensated $130,651 in 2007, according to a proxy statement. She has said that one of the benefits of her work for Pepsi is the opportunity to learn how organizations plan and handle succession. Perhaps this experience could be put to use here at the University?

The larger issue of national importance is the wide spread problem of conflicts of interest in medical schools. As the former editor-in-chief of the New England Journal of Medicine, Marcia Angell, put it in the January 15 New York Review of Books:

“[A]pologists might argue that the pharmaceutical industry is merely trying to do its primary job — further the interests of its investors — and sometimes it goes a little too far. Physicians, medical schools, and professional organizations have no such excuse, since their only fiduciary responsibility is to patients. The mission of medical schools and teaching hospitals — and what justifies their tax-exempt status — is to educate the next generation of physicians, carry out scientifically important research, and care for the sickest members of society. It is not to enter into lucrative commercial alliances with the pharmaceutical industry.?

The conflict of interest issue has dragged on for more than a year and a half at the University. Let’s repair the credibility damage done by the Furcht appointment and other disclosure issues. Professors like Schwitzer shouldn’t be pulled up short by questionable practices in our university. Foot-dragging in this matter is not appropriate while we are trying to convince the citizens of our state to support their public medical school. Let’s get a policy to the Board of Regents as soon as possible for their approval.

Bill Gleason is a University Medical School faculty member and a 1973 University graduate. Please send comments to letters@mndaily.com.

January 21, 2009

The Annotated Obama

Obama's inaugural speech was strangely soothing and vaguely familiar. This was not accidental. The world's greatest newspaper, the American paper for Americans, has a great parsing of the speech, posted here in full:

From the Chicago Tribune:

Obama's inauguration speech, annotated

By Julia Keller, Patrick T. Reardon, Steve Johnson

A great speech doesn't speak only to the audience at hand, even if that audience numbers in the billions and engulfs the globe. A great speech also speaks to the past.

For a better appreciation of Obama's address, we've highlighted passages in which the president seemed to be not just speaking to us, but also echoing those who have gone before. Instead of quoting a great many famous documents directly and frequently, Obama chose instead to touch upon them gently and gracefully.

"My fellow citizens" "Not my fellow Americans. That was the key here. He's playing up citizenship," said Bruce Buchanan, University of Texas government professor and author of "The Citizen's Presidency." "That was a novelty. It's almost universally 'My fellow Americans,' in modern times at least." In a speech that sounds the call to citizenship loudly, Obama returns to the word explicitly in his conclusion, saying that "giving our all to a difficult task" is "the price and the promise of citizenship."

"still waters of peace" This phrase recalls the first two lines in the King James translation of Psalm 23: "The Lord is my shepherd, I shall not want. He maketh me to lie down in green pastures: He leadeth me beside the still waters."

"set aside childish things" This is a reference to the lines in Paul's First Letter to the Corinthians (13:11): "When I was a child, I used to talk as a child, think as a child, reason as a child; when I became a man, I put aside childish things." Stephen McKenna, chairman of the media studies department at Catholic University, said: "It's also a reference to his own victory speech, where he talked about the need to put away the 'partisanship, pettiness and immaturity that has poisoned our politics for so long.'."

"our better history" This phrase echoes the concluding phrase of Abraham Lincoln's first inaugural address: "The mystic chords of memory, stretching from every battlefield and patriot grave to every living heart and hearthstone all over this broad land, will yet swell the chorus of the Union, when again touched, as surely they will be, by the better angels of our nature."

"their full measure of happiness" An echo of the last line of the Gettysburg Address, in which Lincoln wrote, "It is rather for us to be here dedicated to the great task remaining before us--that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion."

"Concord and Gettysburg, Normandy and Khe Sahn"
The Battle of Concord (April 19, 1775) was part of the first military engagement of the Revolutionary War. The Union victory at Gettysburg (July 1-3, 1863) was the turning point in the Civil War. The invasion of Normandy by Allied troops (June 6, 1944) was a turning point in World War II. The siege of U.S. troops at Khe Sahn (Jan. 21 to April 8, 1968) was one of the bloodiest battles in the Vietnam War.

"This is the journey we continue today."

The word "journey" is more momentous and historically inflected than a flat, ordinary word such as "trip." Yet it isn't as pretentious or stuffy-sounding as "voyage" or "odyssey." It echoes proverbs such as "A journey of a thousand miles must begin with a single step."

"Our workers are no less productive than when this crisis began."

While emphasizing the nation's strengths despite its economic travails, Obama echoes one of the central themes of Franklin Delano Roosevelt's first inaugural address, arguing that the country has all it needs to renew prosperity, except for leadership and revived confidence. Roosevelt, speaking to a cold March audience in the midst of the 1933 banking crisis, similarly said, "Our crises come from no failure of substance. ... Plenty is at our doorstep, but a generous use of it languishes in the very sight of the supply."

"pick ourselves up, dust ourselves off."
This is an allusion to lines in the song, "Pick Yourself Up" (music by Jerome Kern, lyrics by Dorothy Fields), sung in the Depression-era movie "Swing Time" by Fred Astaire and Ginger Rogers: "Nothing's impossible, I have found./For when my chin is on the ground,/I pick myself up, dust myself off,/Start all over again."

"We will restore science to its rightful place." The first of several direct repudiations of the Bush administration, which has been widely criticized for politicizing science in government. Later Obama said: "We reject as false the choice between our safety and our ideals," a reference to what many saw as the subversion of the Constitution in the name of national security after the Sept. 11 attacks. Obama also references Hurricane Katrina and, calling to mind the course of action in Iraq, said that "our power" does not "entitle us to do as we please."

"not whether our government is too big or too small, but whether it works." Obama is trying to set aside the long-running argument over President Ronald Reagan's criticism, echoed by Republican leadership since, that government had grown too big.

"slaughtering innocents" While saying that the U.S. will stand up to those "inducing terror and slaughtering innocents," Obama uses language that recalls the biblical slaughter of the innocents in Matthew 2:16 in which King Herod sought to induce terror and advance his aims by trying to kill the newborn Jesus: "When Herod realized that he had been outwitted by the Magi, he was furious, and he gave orders to kill all the boys in Bethlehem and its vicinity who were 2 years old and under, in accordance with the time he had learned from the Magi."

"Jews and Hindus--and non-believers."
Several scholars agree that this is the most overt reference in an inaugural speech to the fact that many Americans do not believe in a god. "This is inclusion by a very wide margin," said Karlyn Kohrs Campbell, an expert in presidential rhetoric at the University of Minnesota, perhaps in reaction to a campaign that was, at times, religiously divisive. "He kind of litanized the non-believers," said McKenna.

"A new era of responsibility." "There's very little that's memorable" in the speech, Campbell said. "It's a speech that's full of crisis and demands. ... The most memorable phrase, I think, is the 'new era of responsibility.' That encapsulates the speech."

"Our Founding Fathers ... drafted a charter to assure the rule of law and the rights of man" "The big struggle in any institution is between change and continuity," said Campbell. "Obama represents change. So it's very important to hear the sound of continuity. He's saying, 'I believe in traditional ideals. I hold traditional values. I remember American history.'."

"these words read to the people"
These words came from a Dec. 23, 1776, Common Sense pamphlet by Thomas Paine. George Washington had it read to the Continental Army troops before crossing the Delaware River Dec. 25 and attacking Trenton successfully the next day. The more familiar part of the pamphlet is: "These are the times that try men's souls."

"children's children" This phrase occurs 14 times in the Bible, such as in Psalm 103, verses 17-18: "But the loving kindness of the Lord is from everlasting to everlasting on those who fear him, and his righteousness to children's children, to those who keep his covenant and remember his precepts to do them."

"eyes fixed on the horizon"
This phrase recalls the 1965 folk song by Alice Wine "Keep Your Eyes on the Prize," a civil rights movement anthem as well as the "Eyes on the Prize " documentary series about the civil rights movement that ran on public television in 1987 and 1990.

January 20, 2009

Dr. Donald Gleason - U Prof and Prostate Cancer Pioneer - Has Died

Emma Carew writes a nice profile of the late Donald Gleason. Dr.Gleason is not a relative but in my early days at the U, after he had retired, I used to get phone calls about once a week from people wanting to speak to "Dr. Gleason."

From Emma's interesting aricle:

In medicine, technological advances and breakthroughs happen at lightning-paced speeds. But in the realm of prostate cancer, one major development, the Gleason grading system for tumors, has stood the test of time. The man who developed the grading scale in 1966, Dr. Donald Gleason, died of heart failure on Dec. 28.

Gleason, a former professor in the University of Minnesota Medical School, was 88 years old.

His work is described by former colleague Akhouri Sinha, an associate professor of genetics and cell biology, as “the gold standard? in prostate cancer diagnosis and treatment.

Gleason developed the grading system while working at the Minneapolis VA Medical Center, where Sinha first met him in the early 1970s.

Gleason grew up in Litchfield, Minn. during the Great Depression, his daughter Ginger Venable, 46, of Eden Prairie, said.

Gleason started school at the University of Minnesota in 1938, working his way through college as a waiter.

Two months before the end of World War II, Gleason enlisted in the army to pay for medical school. He was later recalled during the Korean War. Unable to find a job after the war, Gleason and his wife Nancy spent six months in Paris, where he studied language and art. Venable said she and her sisters each own one of their father’s paintings.

Gleason was a frugal, modest man, Venable said, but his one indulgence was sailing on Lake Minnetonka.

Venable said the family will remember Gleason as a renaissance man, interested in cooking, medicine, languages and learning.

“He was always learning new things, and kind of instilled that in his children and nine grandchildren.?

Dr.Gleason's obituary has appeared widely in the national press. But I like Emma's story best. Bill Gleason

January 19, 2009

Twenty Billion Dollars A Year

for gifts and payments to doctors from the medical industry?

The Pioneer Press has reprinted an editorial from the the Wisconsin Journal Sentinel. Here it is in all its glory - read it and weep.

The medical industry has 20 billion reasons to expect cooperation from doctors in marketing its products. That's how many dollars the industry spends each year in payments and gifts, according to Senate estimates.

The practice should be banned outright, but for now, we'll settle for full disclosure, which a Senate bill introduced in 2007 by Sens. Herb Kohl (D-Wis.) and Chuck Grassley (R-Iowa) would require.

The Physicians Payments Sunshine Act, which the senators say they will reintroduce within days, would require makers of drugs and medical devices to disclose payments they make to physicians. The payments would be available for review online through the U.S. Department of Health and Human Services.

The Journal Sentinel's John Fauber described a favored tactic in his series "Side Effects," which was published last week:

A prominent university physician comes to town to educate local doctors about a drug. Using slides prepared by the drug company, the speaker does what the drug company cannot: talks about off-label prescribing — using the drug for purposes for which it was not originally designed. While not unethical, Fauber reports, such prescribing often has no scientific evidence to support it.

At the end of the night, everybody goes home happy. The drug companies believe they have a chance to sell more drugs. The speaker is often paid as much as a few thousand dollars. The local doctors get a convivial dinner with drinks.

But most patients don't have a clue about these connections. And the practice likely increases the cost of medicine and certainly calls into question the credibility of some university research.

Deans of the UW Medical School and the Medical College of Wisconsin say they want to tighten up their conflict-of-interest policies, and they should do all they can. But universities have their own conflicts. Allowing outside work might mean they can afford to pay their docs less. And no single university can afford to risk losing top talent by unilaterally cutting off a source of income.

Congress is the best venue to look for solutions, and the Kohl-Grassley bill is a good place to start.

-- The Milwaukee Journal Sentinel

Nice title for the proposed legislation. Sunshine is the best disinfectant. Maybe the U and Mayo won't have to do anything about laughable conflict of interest policies? Senators Kohl and Grassley will take care of the problems for them.

January 17, 2009

OurLeader's Response to The Governor's State of the State Address


"Denial ain't just a river in Egypt."

Governor Pawlenty made a few pointed, but indirect, remarks about the University of Minnesota in his address recently.

OurLeader has responded. From his press release:

Despite deep state budget reductions, the university has made education more affordable through new tuition reforms and extraordinary increases in scholarship support.

Bob, your statement simply isn't true. If tuition and living expenses rise at a rate higher than the rate of student aid, then net cost grows. This is called mathematics and not wishful thinking. If you really didn't make any money by raising tuition because of aid increases, then what would be the point of raising it? This is called economics and it is not wishful thinking either.

I have pointed out on numerous occasions that our record, relative to our peers, is a disgrace as far as the debt load upon graduation and the graduation rate itself.

Claiming that the graduation rate is increasing is not good enough. When my son graduated from high school, the four year graduation rate at Minnesota was 28%. He went to Arizona and graduated in four years. When the baseline graduation rate is lousy, improvement is easy, and perhaps not to be bragged about. Maybe a little shame over our pitiful job in the past is more in order?

Facts are facts and denial is not the answer.
I remind you once again of the Kiplinger data. For once, I'd like to hear you publicly admit that we have a problem here. Continuing to ignore it is going to destroy your remaining credibility.


(For a related post that makes clear that OurLeader's statement is an attempt to re-write history, see: From the Department of Better Late Than Never... Recent history is there reviewed which seems to contradict OurLeader's statement above.)

January 15, 2009

"Elevate them guns a little lower!" - A Checklist

I have written before about the simple checklist concept and its effect on health care. Fairly simple - and inexpensive - changes can lead to significant improvements in the practice of medicine.

For background, see:

A Lifesaving Checklist? According to the Government This Is Unethical and Illegal

Time reports on a recently published study of results obtained from using the checklist.

Wednesday, Jan. 14, 2009 Study: A Simple Surgery Checklist Saves Lives By Maia Szalavitz

Sticks and stones may break your bones — but if you need surgery, the right words used in the operating room can be more powerful than many drugs. New research published today in the New England Journal of Medicine, found that when surgical teams heed a simple checklist — as pilots do before takeoff — patient mortality rates were cut nearly in half and complications fell by more than a third.

The study — which included 7,688 patients in eight hospitals around the world — saw death rates drop from 1.5% before the checklist was instituted to 0.8% afterwards. Serious complications fell from 11% to 7%. Study sites included Seattle, London, Toronto, New Delhi and Ifakara, Tanzania. (See TIME's A-Z Health Guide.)

"We were not anticipating such a dramatic reduction," said lead author Dr. Atul Gawande, an associate professor at the Harvard School of Public Health and a staff writer for The New Yorker magazine. "We had initially planned the size of the study to pick up a 15% reduction in complications."

The checklist included 19 items to be carried out throughout the surgery — seven before anesthetizing the patient, seven just before the first incision and the rest before the patient leaves the operating room. The study included six checklist items, all involving basic safety issues, such as whether the identity of the patient, site and type of surgery were confirmed correctly, whether enough blood was readily available in case of excess bleeding and whether all the sponges used in surgery were accounted for after the operation.

Although having the checklist on hand improved compliance by surgical teams — 57% of the teams involved in the study carried out all checklist items, up from 34% before the study began — there were still many teams who did not adhere completely to the list. That's why Dr. Peter Pronovost, who won a MacArthur "Genius" Award for creating the concept of medical checklists and studying them in intensive care units, remains skeptical of the current study's remarkable results. "I wish checklists were Harry Potter's magic wand, but they're not," he says. "The behavior changed trivially, not enough for that reduction to be real. Like the stock market, if it sounds too good to be true, it probably is. That said, I think funding research to improve quality and safety has to be a priority."

Gawande disagrees with Pronovost's critique. "There's a synergy between the items on the checklist," Gawande says. "Any one thing at any given time might not add up to much, but the net effect of all of it put together — especially making for more effective teamwork — matters."

Gawande believes that his checklist has already saved at least one life in his own operating room, where he performs 8 to 10 operations a week. Like many doctors, he resisted using it at first. "I thought, 'Oh, I've got to do this checklist because I designed the thing.' I didn't expect to see a difference."

However, in one case where he was preparing to remove an adrenal tumor, the anesthesiologist realized during the checklist rundown that extra blood might be required but was not on hand. The blood was brought to the OR — and the patient did need it during surgery. "I'm convinced that the fact that the anesthesiologist caught that was what saved this man's life," Gawande says, adding that his team averts at least one potential problem via the checklist every week.

Whether these changes can be sustained over time is another question. Gawande and his colleagues note in the paper that a phenomenon called the "Hawthorne effect" may be largely responsible for the checklist's success. The effect was named for a series of experiments designed to determine how to increase productivity in a factory in Chicago. All of the tactics implemented by the study leaders improved worker output during the experiment — but researchers realized that the effect they were really measuring was a boost in motivation among workers who knew others were watching.

"The checklist is kind of an effort to produce a consistent Hawthorne effect," says Gawande, "It is intended to make people aware that other people expect these things to be done." Researchers checked whether teams behaved differently when the researchers were present and when they were not and found no difference.

As a result of the findings, Gawande says that the U.K.'s National Health Service sent out an alert to all of its hospitals, calling on them to implement the surgical checklist. Five U.S. states — New York, Washington State, North Carolina, South Carolina and Indiana — have endorsed it and plan to require hospitals to use it.

That's quite different from the initial federal response to Pronovost's lists. In 2003, Pronovost convinced the state of Michigan to use three of his checklists in their intensive care units. He worked with hospitals to overcome resistance from the staff to what appeared to be "more paperwork." He published the results of that study in the New England Journal of Medicine: a 66% reduction in infections and an estimated $175 million saved by not having to treat them.

But the federal Office for Human Research Protections (OHRP) did not approve. After Pronovost was profiled in the New Yorker by Gawande in 2007, OHRP shut down data collection on the checklist study, claiming that it amounted to research being done without patients' informed consent. But the ensuing media attention spurred Congress to intervene and Pronovost's program was allowed to continue and expand.

Gawande and Pronovost agree that checklists can be faulty, and that they need to be studied carefully before and during implementation. "Safety should be a patient's right," says Pronovost. "If you are going to ask doctors to give up their autonomy and accept these standards, they have to be based on sound science and implemented wisely."

January 12, 2009

The Dirty Little Secret About Biotech

From the Strib:

Biotech companies follow the money

By THOMAS LEE, Star Tribune

January 11, 2009

When Lisa Jansa, CEO of Exsulin Corp., meets with potential local investors these days, she usually gets the same response: "We just don't do pharmaceuticals," Jansa recalls, "We do devices."

That's not entirely surprising. Minnesota boasts a strong medical device industry. And given the poor economic climate, any available money will unlikely stray far from investors' comfort zones.

"We need to get some investors in Minnesota if we are going to be able to stay a Minnesota company," Jansa said. "Otherwise, we are going to have to leave. Our preference is not to do that. But you have to do what you need to do to get your financing in place."

"If investors [in San Jose, Calif.] say they would like you to [move] to San Jose, the company goes to San Jose," said Jay Hare, a Minneapolis-based analyst with PricewaterhouseCoopers who tracks venture capital investments.

In some ways, Exsulin represents a stubborn problem in Minnesota made worse by the recession: the lack of venture money for early- to mid-stage start-up companies, especially those that don't specialize in medical devices.

Exsulin's "situation is not unique at all," said Dale Wahlstrom, CEO of BioBusiness Alliance of Minnesota, an industry group. "There are many companies in biotechnology and pharmaceutical companies that have good ideas that can be commercialized. But they have a difficult time getting funded in Minnesota. We don't have VCs [venture capitalists] active in that area. We don't have that reputation."

So when OurLeaders try to justify investment in biotech as a means of job creation, please consider the above before buying the argument...

Recall that Dr. Furcht's famous ten million dollar stem cell patent was sold to - a company in Cleveland.

January 11, 2009

Interesting... Part 1. Some Pigs Are Still More Equal Than Others?


Senate Committee on Finance and Planning
Tuesday, December 16, 2008

Professor Martin asked if the economic situation would slow down the plans for the Academic Health Center building projects.

They are part of the conversation, Dr. Cerra said. They have funds for a significant percentage of the 180 faculty who would occupy the new facilities, and the question is whether they can set priorities in light of the possible budget cuts so that most of the lines are preserved. He declared that the University cannot cut, cut, cut, cut, cut or it will simply be a smaller place with the same problems, so it must make strategic investments. The University has decided the biomedical sciences are a priority so they are moving ahead.

From Higher Ed:

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

Something to keep in mind, President Bruininks, Provost Cerra, Mr. Pfutzenreuter?

January 10, 2009

DJ Leary's Comments About Regent Beating

DJ Leary is one of those people who ha(s/d) a great job, writing and commenting on politics in Minnesota. This schizo state is never short of great political gossip.

DJ has emerged from his hibernation long enough to post on the Star-Tribune's YourVoices site, described by the Strib as:

Your Voices features unique perspectives from members of your community. Here you’ll find commentary on current events, public issues and day-to-day life in Minnesota. This is a home for lively conversations and respectful debates.

[Let's hope that both this site and the Strib survive imminent bankruptcy.]

From DJ's post:

I am always amazed when I see people of intellectual substance, with a life resume of unquestioned accomplishment, step forward to volunteer for a public position knowing with a certainty that they are going to take a beating--mostly undeserved--from the taxpayers for accepting a public position of great importance.

Obviously, DJ, they don't do this with a beating in mind. Some do it because it is a public service. Some may have other motives including: prestige, contacts, and the ability to make money in other venues.

While there are those that insist that politics does not enter into the selection process, I will assure you that the public believes that there are few things that take place under the dome with the golden horses that aren’t touched in some way by politics.

Politics enter into the Board of selection process? DJ, I am shocked, shocked, that you would say such a thing. Please see the post: The BigU Regents Selection Process is Partisan Mr. Bonzo is Shocked, Shocked...

Running the University of Minnesota is a big deal; it’s not just deciding whether to sell beer at sporting events or whether to pay million-dollar salaries to football coaches who can’t win bowl games. It is hard work and an enormous responsibility to meet the educational needs of an entire state of people trying to better themselves or their children in a crushing economic downturn.

But DJ, this isn't exactly what the Board of Regents does. They personally don't "meet the educational needs of an entire state..." They listen to what the administration of the University of Minnesota tells them and, for the most part, go along with it.

I don’t know all of those, whose names have been put forward, but I know the public work of at least three and I would guess that they are a Democrat, a Republican, and an Independent. Their individual backgrounds seem to make my point: Why would one of these people who have achieved such heights of accomplishment in their lives want to tarnish the memory of their enormous personal contributions by undertaking a position with a virtual guarantee of harsh public criticism.

Tarnish the memory? Other than David Metzen, name one regent who sat on the board ten years ago? The average citizen is much more likely to remember the name of our university presidents and their accomplishments or lack thereof.

Consider the three people on this list of recommendations whose work I know personally: Clyde Allen, Jr., Kathryn Roberts, and Anita Pampusch. Allen is currently vice chair of the Board of Regents, a former Commissioner of Revenue and once was the director of research for the Minnesota Taxpayers Association, a group I am never going to agree with. Kathryn Roberts, ran the Minnesota Zoo for ten years moving it from the brink of disaster to a position of international renown before she became the CEO of Ecumen and dedicated her skills to making life better for Minnesota’s senior citizens, of which I am one. Anita Pampusch has the most direct skills for helping to guide an institution of higher education into an unknown future because she has done it before. As the former president of the College of St. Catherine, her vision helped maintain and grow one of the few private women’s colleges in this country. She recently retired as the head of the Busch Foundation, Minnesota’ second largest foundation.

You are absolutely right that Ms. Pampusch is one of the most qualified persons yet to stand for the Board of Regents. But you have to understand that the Board of Regents is not the same as the Board of Directors of a company, nor should they be.

I know of nothing to make me believe that the others recommended by the Regent Candidate Advisory Council are not of similar background and noteworthy public service accomplishments. And, while I am enormously grateful that people of such prodigious achievement are willing to give of themselves to be of counsel to my University, it still makes me marvel, and I applaud their enthusiasm to continue to serve us, their neighbors tirelessly.

I don't know Kjell Bergh from Adam, but I wonder if someone in the same line of work, Denny Hecker, would be regarded as qualified?

By the way: Being a member of the University of Minnesota Board of Regents does not pay anything but it does consume the time of about two fulltime positions in the executive job market.

But there are of course some interesting bennies. Trips to China, trips to bowl games... And whether state funds from the University are being used or money raised through the University oif Minnesota Alumni Association is irrelevant.

January 9, 2009

U pleads for lower budget cuts

From the Daily:

Speaking before the Higher Education Budget and Policy Division, Pfutzenreuter said academic and support programs across the entire University system would be forced to reduce their operating budgets due to Pawlenty’s December cut.

Pfutzenreuter also outlined the University’s reaction to the cut it received in 2003.

“No one escaped budget cuts at the University back at that time,? he said.

Students assumed 46 percent of the cut that year through tuition increases, and faculty and staff carried another 15 percent of the load through salary freezes and other means.

Pfutzenreuter said everyone should expect to share a similar burden this time around, though administration is trying to avoid the double-digit tuition increases inherited during that time.

Sen. Sandy Pappas, DFL-St. Paul and chair of the division, said ideally students and staff would take none of the brunt of the bad economy.

“I don’t want students to have to carry any more of the load,?
she said. “There’s no good answers and good decisions with this whole thing. I think the University made the decisions [in 2003] as best they could and it resulted in most of it being borne by students.?

OurAdministration and the Board of Regents as late as December were still talking about going over to the state legislature and asking for approximately two hundred million dollars in new funding.

Time to wake up, Bob? Pfutz?

Kiplinger Best Value Publics – 2009

The information about how the U stacks up against other public institutions can be found online.

Once again it illustrates how far we have to go.


January 7, 2009

Daily Takes A Hit

For economic reasons, the Daily is having to cut back. Maybe OurLeader could learn something from the student newspaper?

From the Strib:

U student newspaper to eliminate one daily edition

By JENNA ROSS, Star Tribune

January 7, 2009

Starting this month, the independent student newspaper at the University of Minnesota will cease publication on Fridays and expand its coverage online.

Advertising had been declining steadily, and in September, "everything blew up," said Vadim Lavrusik, the paper's editor-in-chief and one of three co-publishers.

Without cuts, the paper's revenues were headed 30 to 35 percent below budget for the year, said co-publisher John Scholz. So the team announced changes. Among them: slashing bonuses, paying per story rather than per hour, combining the sports and news sections, publishing four days a week instead of five.

"This was our way of thinking for the future and the sustainability of the Daily as a news organization, moving it online," Lavrusik said.

Some student newspapers, especially those run separate from their schools, have been hit by the same trends. This fall, the Daily Californian at University of California at Berkeley and the Daily Orange at Syracuse University cut publication from five to four days.

The Minnesota Daily has a staff of more than 150 and circulation of about 20,000. Its online readership ranges from 10,000 to 15,000 unique hits daily, Lavrusik said.

The staff plans to expand the amount and the display of sports and entertainment content throughout the weekend and create a "portal" for student groups to chat and announce their events.

"Some people would say, you're not going to be providing as much to the university community," Scholz said, "when actually, we're going from a five-day content source to a seven-day content source."

January 3, 2009

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

Dr. Roy Poses, in his excellent blog Health Care Renewal writes above the above topic. For an overview of the current medical ethics quagmire at Minnesota please see his post.

An excerpt:

Finally, it turns out this is not the first time Dean Powell has made an appearance on Health Care Renewal. In 2007, we posted about how in addition to serving full-time as medical school dean, she has a part-time position as a member of the board of directors of PepsiAmericas, raising concerns about conflicts of interest. (See those raised by the director of the public health school's obesity center.) Although Powell suggested that her position on the board would be to provide "knowledge about obesity," she was not hired by PepsiAmericas as an obesity consultant. Instead, as a board member, her main duty is to protect the financial interests of the share-holders and the corporation as a whole. Were she really to mainly function as a "voice for nutrition," she would be violating her fiduciary duty to her share-holders, a duty, by the way, for which she her total compensation was $130,651 in 2007 (see this 2087 proxy statement).

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