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June 30, 2009

We don't need no stinking Graduate School...

Er, hold that thought.

In a stunning display of the lack of consultation for which this administration will long be remembered, the CEO and the Provost at the U of M made an abortive attempt at dissolving the graduate school by executive fiat. They are still picking porcupine quills out of their posteriors on this one. First a stacked committee was appointed to vet the decision but even that group showed a collective display of backbone that must be an embarrassment to the masters of Morrill Hall. The president was left with the choice of going along with the Provost's original plan and almost certainly going down in flames or cutting the Graduate School baby in half. He chose the latter.

For an institution with supposed aspirations of being one of the third best yadda, yadda, this whole episode leaves one wondering whether it isn't time for President Bruininks to step aside this year so that a successor can be found. The Regents are prepared for the job of replacing him. The new person could come aboard with a year to get the Good Ship Gopher set for the trip over Minnehaha Falls in 2012.

In the mean time President Bruininks could try to stay out of trouble, bask in the glory of the House That Bob Built, and devote himself to straightening out the EFS mess.

From the Daily:

University of Minnesota President Bob Bruininks announced his decision Friday on the restructuring of graduate education. The Graduate School will retain its current name and reporting line to the Office of the Senior Vice President for Academic Affairs and Provost, the president's report states. This differs from the University's announcement in February, which said the school would disband and reorganize into an Office of Graduate Education.

Graduate and Professional Student Assembly President Kristi Kremers , who was also a member of the Committee on Graduate Education -- the group charged with making implementation recommendations in February, said the decision is a "step in the right direction."

She said she's glad President Bruininks agreed with most of the recommendations and is allowing more time for decisions to be made.

"It's definitely an area where you can't make swift changes and expect great results," Kremers said.

COGS President Mandy Stahre said she was also thankful the president supported most of the committee's recommendations but had questions unanswered and was concerned with the level of communication between the University and its faculty, staff and students.

"There's still a lot of questions about how a lot of this is going to be implemented," she said. "And I still have questions about how is this going to improve graduate education."

President Bruininks (finally?) feels the heat

President Bruininks made some mysterious remarks about his charitable giving on an MPR interview a while back, hinting of his generosity and how much it pained him to be questioned about a ten percent salary cut. More details are below from the Daily.

Bob, why don't you just come out and cut your salary by ten percent? Also that of all administrators being paid more than, say, 250K$. This would be a lot cleaner and not subject to ambiguity. If you want to make charitable donations - great. You and your wife certainly have a lot of money if you can afford a million dollar condo.

But what's below just doesn't wash. The money does not go into the general university budget where it is needed. The one that is used to pay the salaries of those about to be laid off, remember?

Please wake up on this issue. You have already done yourself - and the university - tremendous damage in this matter. Think of the message that you are sending.

From the Daily:

Bruininks pledges to donate salary increases

University of Minnesota President Bob Bruininks plans to give all of his salary increases during his time as president back to the University -- an action he says will total more than the 10 percent cut some are asking him and other administrators to take.

To date, Bruininks and his wife Susan Hagstrum have donated $231,000 to the University, according to the University of Minnesota Foundation. Bruininks' salary has increased $160,000 since January of 2002.

A 10 percent cut to Bruininks' base salary of $455,000 would mean $45,500. He earns about $750,000 with benefits.

Bruininks said he has not made these donations public until now because he said he and his wife wanted to be modest about their financial contributions.

"I really think one's charitable contributions should be done for the best of reasons, not to draw attention to yourself," he said. "But since people have made a real issue of it and suggested that I may be insensitive to the needs of people in this very challenging economy, I thought I ought to at least reveal the commitment we made more than seven years ago."

Bruininks is the 7th highest paid public university president in the United States, according to a study by The Chronicle of Higher Education in November 2008.

The AFSCME Local 3800 union has said the freeze is not enough and is asking the 254 University employees paid over $200,000 to take a 5 percent pay cut.

"The fact that he gives money is all well and good, but he makes $750,000 year," Chief Steward of AFSCME Local 3800 Cherrene Horazuk said. "It just doesn't wash for me."

Horazuk said, "Many employees from all employee groups give money, make charitable donations to a variety of causes that is entirely different than the issue of salary."

Athletics Director Joel Maturi -- the 10th highest paid administrator at the University as of September 2008 -- said he understands the critical eyes on the University's top paid administrators.

"When people are making significant dollars, ... I understand that people wonder if we should be making as much as we do, it's a very valid question," Maturi said.

However, Maturi said he feels that University administrators are paid market, or competitive, wages.


To quote one of the few straight-talking and admirable administrators around:

From the College of Design Memo From Dean Fisher May 26, 2009 Monday Minute, May 26, 2009

Dear Colleagues,

Mark Twain once said, "Action speaks louder than words, but not nearly as often." One action the college has taken has certainly registered with the University.

Our leadership group -- Associate Deans Kate Solomonson and Marilyn DeLong, Assistant Dean Kate Maple, Chief of Staff Kathy Witherow, and I -- may be the only college deans at the U taking a 10 percent reduction in our appointments next academic year in order to help balance our budget. That reduction equals 26 days without pay, which some of us will spread out across the year and others will take mostly during the summer. I commend my four colleagues for joining me in this voluntary reduction; such an action does not happen nearly as often as I think it should among the leaders of organizations in times like these.

EFS - University Community, Please Read

EFS - when the system is fixed, the beatings will stop
Senate Committee on Finance and Planning Tuesday, June 2, 2009

[My apologies for the length of this post. But anyone on campus impacted by EFS should really read it. Dr. Bruininks - this includes you.]

Senate Committee on Finance and Planning Tuesday, June 2, 2009

One guest read excerpts from an email message he had received from a user.

I am writing a long email. I have the time because I am unable to perform any of my actual job responsibilities due to the slowness of the system. I have four screens open and I am not able to complete any of the processes. I am probably making the system even slower by trying to do the four things at once. I have spoken with another person this morning who has twelve screens open, trying to get any one of her processes to work. What is our option . . . go away from 10:00 a.m. until 4:00 p.m. and work 2nd or 3rd shifts so we can do our work?

This email is going to sound angry--that seems to be what people hear when we call the helpline. It is not an anger issue. It is about a desire to put in an honest eight hour day accomplishing the work of the University and providing help and financial support to the departments assigned to me. . . .

This is supposed to be a robust, efficient, resource saving solution to our financial needs. Where is any of that after almost a year up and running?

I do not want an answer to this email--I have heard all the excuses. I do not want a "ticket," which will be either ignored, answered incorrectly in two or three weeks, or closed because the "system is working." It would do me a world of good to find out that money has been spent on consultants or employees who actually know why the system is not performing in a way that supports the workforce, and can fix the problems.

We are all conscientious workers who are trying desperately to get all the activities of the current fiscal year closed out so the 2nd year of EFS/PeopleSoft can be opened cleanly. I retire in seven business days, so it is not for myself that I have written this email. It is out of dedication to this university and admiration for the educational and research goals of this University. I sincerely hope that someone will take this situation seriously, invest as necessary to fix it, acknowledge that the purchase and implementation were not properly planned for and it is not the users who are to blame for the system problems. If this could be accomplished before another year passes with the same problems unresolved, that would be a dream come true.

Mr. Erikson reported that he has talked with people about EFS and they have nothing good to say. Processes take up to twice as long to complete, that the system is wasteful, and that some processes are extremely cumbersome and non-intuitive. The system is wasting people's time. Or they have problems with follow-up, Ms. Kersteter said, such as trying to get information on balances; when they cannot, they do not spend money, thus reducing the quality of customer service.

Professor Seashore said one of the least-appealing research findings she has come across in her career is that executives who make a bad decision continue to invest in that decision because they do not want to admit they made a mistake.

Everyone wishes for do-overs, Professor Seashore said; who in the University will look at the system and say "enough, it is not worth the money to make it work inadequately forever"? The University cannot go on and put in another year with a system it cannot fix. This is like corporate executives who make the same mistakes over and over.

One staff member distributed copies of changes that have been made in the financial system since 1989. In these cases, it was said, things were made better as a result of the changes and jobs were made easier. That has not been the case with the conversion to EFS.

Where is PeopleSoft in all this, Mr. Erikson asked? This is supposedly a mature system, not in a beta version; why don't they have a team here on a daily basis helping the University work through the problems it is having with their software? Aren't there performance metrics built into the contract with PeopleSoft? Professor Seashore recalled that Mr. Volna had told the Committee that the University made local adaptations to the system that PeopleSoft had not approved. Couldn't he reverse those decisions, Mr. Erikson asked? That is a good question, Professor Martin said; the University bought a product with warranties. But the warranty is broken if one changes the product, Professor Seashore observed. Mr. Rollefson said Mr. Volna had to make the changes--or try to change the University's culture.

[Change the universities culture? What the hell was the matter with the culture pre-EFS? Are we all a bunch of lazy stupid people and it is our fault because we stubbornly refuse to change our culture. What an arrogant statement to make.]

Professor Seashore said there is a need to set priorities, which should be developed by a broad user group, not a narrowly-drawn committee. When the University installed CUFS, it acknowledged there was a problem and spend the money to fix it, Mr. Rollefson said. The uncomfortable reality now is that the University has spent $50 million on EFS and may need to spend more to get it to work the way the University needs--and that could require a lot more money. This Committee needs to know, Professor Seashore said, not two people sitting in an office discussing the problems.

Professor Martin said it is a reasonable question to ask Mr. Volna. He has teams working on EFS problems; when will the system work? One guest said he suspected it will take until August because of the need to prepare budgets. It was suggested that Mr. Pfutzenreuter has directed that the system must be made to work without major problems by December.

[Again, the arrogance: "Make it so, Spock..."]

For morale purposes, people need to receive information on how long it will take to create accurate information, Professor Seashore said. When the system is fixed, the beatings will stop. The morale problem is directly related to the fact that people cannot get their jobs done.

The EFS situation is another failure of leadership - at the highest level.

U. of Wisconsin Academics Win Collective-Bargaining Rights

From the Chronicle:

More than 20,000 academic employees in the University of Wisconsin system have collective-bargaining rights now that the state's new budget has been signed into law. Those covered include tenured and tenure-track faculty members, part-time and full-time lecturers, and adjuncts, among others. The law, long sought by the Wisconsin chapter of the American Federation of Teachers, paves the way for the federation to begin organizing campaigns.

June 28, 2009

Education light

You want frills with that? That will be extra.

From the Chronicle:

Arizona State Official Describes 'No Frills' College Education

Students in Arizona may have a cheaper option to get a bachelor's degree from Arizona State University if a proposal to create a "no frills" program is approved by the state, the university's chief financial officer told an audience at the National Association of College and University Business Officers' meeting here today.

Morgan R. Olsen, executive vice president and chief financial officer of Arizona State, spoke at a session about "the new reality" for colleges in the wake of the financial crisis, and what kind of changes might occur because of tighter resources. Mr. Olsen said his university was considering operating more than one business model, providing different student experiences at different prices.

Under the "no frills" model, students would attend focused classes at a different location than the university's current campuses. The programs offered would be in high-demand areas such as business and education, and the teacher-student ratio would be higher, Mr. Olsen said.

The program is envisioned as a middle ground between the state's research universities and its community colleges. Students would receive Arizona State degrees, but they would not have the student-life or research opportunities available to students on the main campus. Tuition would be lower than the cost of attending one of the existing campuses, probably not exceeding the amount of a full Pell Grant, Mr. Olsen said.

The presidents of all three of Arizona's public universities presented the proposal to the state's Board of Regents this month as a way of increasing the number of bachelor's degrees granted in the state, according to an Associated Press report. If approved, Arizona could have one no-frills location in place by the fall of 2010, with more to follow.

The message today at the Nacubo meeting was that colleges cannot continue operating in the way they did before the recession. When asked by the moderator, Kai Ryssdal of public radio's Marketplace, what the financial future looked like for universities, both Mr. Olsen and another panelist, Yoke San L. Reynolds, vice president and chief financial officer of the University of Virginia, predicted it would get worse before it got better.

"The next two years, at least, have great potential to be even more challenging than now," Mr. Olsen said.

Given the plans of ASU's megalomaniac president to expand enrollment to one hundred thousand students these developments are quite a turnaround. The idea that we can spend a lot less to turn out college graduates is probably going to be attractive to governors and state legislators across the country.

This is why we need leadership at the U with vision and enthusiasm who can connect with our state legislature rather than continuing to whine about their suggestions. Curiously, I don't remember the legislature ever turning down the U when they were asked for money for students or buildings for teaching. If the U had asked for money for the interior renovation of Folwell, rather than the Bell, they would have gotten it.

Time to wake up or will we have to wait for a new CEO?

As Arenas Sprout, a Scramble to Keep Them Filled

We make the NYT:

In the inaugural season for the new ballparks for the New York Yankees and Mets, the teams have been embarrassed by television shots showing vast areas of premium seats going unsold.

But those who study sporting facilities say empty seats may become even more commonplace here, as New York faces a glut of sports arenas.

Five major complexes -- four existing and one planned -- will soon be slugging it out within an area 30 miles wide.

At least two of the existing arenas already lose money, and experts say further casualties are almost guaranteed.

"Five arenas is not going to work," said Mark S. Rosentraub, a professor of sports management at the University of Michigan. "I don't think four works, even in a market as large as New York. There's competition in every direction and there aren't enough events."

In the Minneapolis-St. Paul region, the Target Center, which is owned by the city of Minneapolis, vies with the publicly subsidized Xcel Energy Center in St. Paul. The Minnesota Timberwolves basketball team plays at the Target Center; the Minnesota Wild hockey team plays at Xcel Energy Center. Both sites are losing money, and they must also compete with the University of Minnesota, which has two arenas.

And then of course the House That Bob Built will be opening this fall...

Dr. Schulz on media abuse

After I pulled the trigger on this one, I logged on to University Diaries. Lo and behold, Margaret Soltan had a post that blew Dr. Shulz's op-ed away. For a good example of her SOS style, please see:

(The above is actually a link, click to see article - browser probs?)

Our psychiatry department head, Dr. Charles Schulz, has an op-ed in the Pioneer Press:

Docs and drug companies -- manage the relationship, don't destroy it Charles Schulz

Much has been written over the past few years about the relationship between doctors and the pharmaceutical industry. So I would like to disclose the following right now: I have worked with multiple companies over the years on sponsored research and as a consultant, and I continue to do so. During this time I have published a number of papers regarding this work -- including some pertinent negative results concerning the drugs these companies make.

A recent Pioneer Press report noted I have received less money from industry in the last year. Why? Because nothing is more important to me than the reputation of the Department of Psychiatry at the University of Minnesota Medical School, and I am concerned that the media portrayal of all physician-industry relationships as bad could affect public perception.

What the media stories do not mention are the advances that have been made because of these relationships, which are managed carefully by institutions such as the University of Minnesota, where the Institutional Review Board approves all studies for human subjects and the Sponsored Projects Administration negotiates all contracts with industry.

Physician-researchers need to partner with industry to develop new treatments. It is the system we have in place. The National Institutes of Mental Health do not fund development of new compounds in psychiatry; their focus is on funding basic science and mechanisms of action after approval.

When it comes to clinical research to improve and develop medicines and bring them to market, it is industry that funds that work. And the research to develop new drugs is very expensive, costing $800 million and even up to $1 billion to get a drug discovered and available for patients.

When I consider the field of psychiatry, the advances made because of new medicines -- studied in research institutions and developed by pharmaceutical companies -- have been enormous and life-changing. Before we had effective medications, one out of two hospital beds was taken by a mentally ill patient. We no longer warehouse psychotic patients and drug them with opiates to "manage" them. Now, we have better ways. Better medications.

Because of the partnerships between physicians and industry and the medications that have resulted from these relationships, many psychiatric patients were able to leave institutions. Now, because of the advances in psychiatric medicine, patients in our department -- who are mothers, fathers, sons, daughters and friends -- can be treated as outpatients. Many have jobs, support families and contribute to society.

Are the psychiatric drugs we have now perfect? No. All drugs have side effects, and the drugs I prescribe my patients are no different. The leading edge of our research now focuses on predicting which medications, which compounds, will be effective for our patients. The goal remains to help people live independently, or with the fewest restraints on their freedom. In our department, we develop programs that integrate efficacious medications with effective psychosocial treatments. There are always new discoveries to be made, and it is truly unfortunate that the public is hearing only one side of the story from the media.

Do physician-industry relationships need to be managed? Absolutely. Has the increased scrutiny in the past couple of years resulted in constructive changes? Yes. But the answer is not to break these ties completely. My patients of the future are counting on them.

Charles Schulz, M.D., heads the Department of Psychiatry at the University of Minnesota Medical School.


Dr. Shulz,

Your argument that "the media portray all physician-industry relationships as bad" is a straw man.

You are well aware, I am sure, of the serious abuse of this relationship by the leaders of your field in academic medicine. I will not cite chapter and verse.

If nothing is more important to you than the reputation of the Department of Psychiatry at the University of Minnesota Medical School, then why don't you do something positive about the foot-dragging on the Conflict of Interest policy at the University of Minnesota medical school? As you are well aware, the goal of such a policy is NOT to sever all industry/university relationships but rather to place them on, shall we say, a little higher ethical plane than they have been in the past.

That two years have elapsed since this process was begun is an indication, apparently, of the importance our leaders place on this topic. Another indication is the selection of a violator of our present COI policy as one of the co-chairs of the original committee tasked to begin this revision.

Actions speak louder than words, Dr. Schulz. Or defensive op-eds in newspapers...

My late uncle was a psychiatrist and a damned good one. He would be heart sick over recent developments in academic psychiatry. Please show some leadership in turning this situation around.


Your U of M colleague, Bill Gleason

June 26, 2009

President Bruininks Cuts Grad School Baby in Half

From OurCEO:

I am pleased to share with you my final decisions related to selected recommendations of the Committee on Graduate and Professional Education. A PDF version of this report is available on the Provost's web site:


The document has been describe by one astute observer (twitter) as: "over the top new managerialism-speak."

There are other stylistic similarities to material that has issued from OurProvost's office in particular an over fondness for parallelism.

Fortunately, not everything has fallen into OurProvost's lap. Some of the loot will go to the VP for Research, Dr. Mulcahy. This is an improvement over the original attempt at a putsch by OurProvost.

You can't lose them all.

Regent Frobenius on Graduate Tuition Problem

I've pulled out about 2.5 minutes from this week's Regent's Board meeting on the budget. It is posted on the Periodic Table. Putting videos on this site right now is a little more complicated and I don't have time.

I have to go out of town for about a week and will not have much time for posting. I am sure that a lot of folks will be glad to hear this, maybe even some of the inhabitants of Morrill Hall?



A red bird has solved the problem:

Unfortunately, the motion was not seconded. There was no further discussion.

Too bad...

Fire Sale on Tuition at the U - for out of state students, that is...

There is a very interesting letter to the editor in the Strib today. This situation is a consequence of our administration's attempt to game the numbers as a part of our ambitious aspirations to be one of the top three public yadda, yadda.

The way this works is we offer ridiculously low out of state tuition to non-residents. Our market rates are only about $2000 over in-state, whereas our competition is more like $10000. This allows us to pick high scoring (SAT, ACT, etc.) students from out of state and get up our numbers, at least that is the hope of the geniuses in Morrill Hall.

Meanwhile qualified Minnesota residents are denied admission. It is exactly this kind of behavior that feeds the public's bad impression of the University. There is a reason why the U is an easy target for the charge of elitism and arrogance - because there is some truth to it.

Time for a change, President Bruiniks? Let's get back to the same price differential as our (legitimate) competition. Trying to cherry-pick at the expense of Minnesota residents is inappropriate behavior.


Make out-of-state students pay more

Recent articles covering undergraduate tuition increases at the University of Minnesota have discussed only in-state tuition. We must also examine tuition for students from other states.

Beginning in the fall of 2008, the University of Minnesota adopted a new tuition structure for new nonresident students that set their tuition at $4,000 per year more than resident tuition, resulting in a nonresident tuition (including fees) of about $14,600 for new students. This is about $7,000 less than the $21,500 they would have paid had they matriculated the previous year.

While I support the concept of attracting top students from other states, I do not believe that such a drastic nonresident tuition reduction was necessary to do so. Data for the 2008-2009 school year from the College Board website shows that the other nine public universities in the Big Ten Conference have much higher nonresident tuitions and much greater differences between resident and nonresident tuition. Minnesota is far more generous than the other schools.

Minnesota had the lowest nonresident tuition -- about $14,600 (including fees) vs. $21,800 to $33,000 at the other schools. Similarly, Minnesota had the lowest difference between resident and nonresident tuition at $4,000, compared with a range of $11,000 to $22,000 at the other schools. Minnesota would still compare favorably if nonresident tuition was set at $8,000 above resident tuition (about $18,600).

Due to the economic downturn and state budget crisis, the University of Minnesota should modify its nonresident tuition structure to reduce the burden on in-state students.


June 24, 2009

Job cuts simply fuel the fire...

Steen Erickson nails it in his comments on the Daily article: "University employees wait for budget axe to fall"

I agree that senior administration should take cuts. At my low level, even I'd take a cut if it would preserve my job. President Bruininks, there is no argument that anyone is "overpaid" among the highest paid employees at the university - in this environment, that's a very poor argument to make. The argument should be that these are extraordinary times, which call for extraordinary measures. The richest can always afford a cut far more than the poorest, and where will "the best and brightest" go? Sure there are some who have money to buy folks away from us, but those who would leave might have to change industries - and I would hope that people are at the U because of the mission, not because they've hit the jackpot and are getting rich. Most people that I admire at the U are here for the intellectual and educational stimulation, not the "huge" salaries. On the contrary, it seems to me that many could make far more if they went to industry! (but perhaps not at this moment in our global economy?)

I would ask the highest paid employees - the top 10% - would you lose your home if you got a 10% cut? I doubt it.
But the lowest or the middle earners just might lose their home if you lay them off. Would you have to go on welfare, food stamps, declare bankruptcy, and move in with friends or family (if you even could)? The lowest and middle earners might just face those burdens.

To you, the cut would mean a less lavish vacation. A few less dinners at 5-star restaurants. A new Lexus instead of a new Mercedes. To the lower and middle income earners, it may mean survival.

Is it socialism to help people in times of great need? Is it unfair to ask the richest to give something back to the community that made them rich when that community needs them? Is it unjust to try to avoid our own contribution to the state unemployment rolls, which every one of us pays for - if we can prevent it? And where will the money come from to pay the unemployment, food stamps, and whatever else? The state is broke! Last I heard, the state wants to cut social services!

Human decency. Civilization. Christian. Buddhist. Whatever you want to call it, it is incumbent on all of us to solve this problem. Not by adding to it with layoffs, but by tightening our belts, starting at the top. Model the behaviour you want to see. Lead by example. Demonstrate your commitment to this University and its mission. Yell from the rooftops that this is only temporary! But you can solve the problem without layoffs if you'll only share some small part of the pain with the folks at the bottom.

Bless the College of Design for having the decency to attack the problem from a human, compassionate, civilized perspective (hopefully the somewhat confusing comments about Design laying off, but then taking reductions to prevent layoffs, isn't quite accurate?). If only the rest of "us" would take a lesson from them.

U of M regents approve job cuts, alcohol ban

I watched the Regents Meeting video stream. Lots of interesting stuff happened with long term implications. When the video stream is posted for download, I'll make a condensed video of the meeting that contains only the best parts...

In the mean time, here is some information that just appeared on MPR:

Minneapolis -- The University of Minnesota's governing body today approved a budget that will eliminate jobs on campus and hike tuition for students. The board has also approved a controversial ban on the sale of alcohol in the U's new football stadium.

The university's 12-member Board of Regents passed the budget on an 11-1 vote, with John Froberius [sic] casting the dissenting vote.

Froberius had moved to lower the tuition hike for graduate students by $4 million, but no one seconded the motion during the meeting Wednesday morning.

The budget also will increase in-state tuition for undergraduates about 3 percent, and calls for a 7.5 percent tuition increase for most graduate students. Law students at the university will see an increase of as much as 15 percent.

In a separate measure, the board also approved a ban on alcohol at TCF Bank Stadium, set to open on campus in the fall.

The move comes after lawmakers passed a measure requiring the university to sell alcohol throughout the school's new football stadium, or not sell it at all. The university's original plan was to sell alcohol to fans in premium suites.

The measure also bans the selling or serving of alcohol at the school's basketball and hockey facilities.

It is a little difficult for the Regents to make budgetary decisions when they are playing with less than a full deck. Many of them are concerned about this, and the administration will have some 'splainin to do next year.

I missed the first 15 minutes. Once the video is available, I'll have more on this.

President Bruininks gives another non-answer to salary cut question...

In an editorial, the Daily asks some questions of our leadership:

Questions for our budgeteers

Is the well-off leadership at the University not thinking hard enough about alternative cost cutting or are they just not listening?

These questions beg of the University community the following: If our enlightened and bountifully compensated leaders cannot find more novel ways to reduce expenses, are they truly worth the salaries we afford them?

To which OurCEO replies in another place in the same issue:

While cuts are being made across the board at the University, faculty and staff at the College of Design have taken their own actions of self preservation, which includes a 10 percent voluntary salary cut from five members of the school's leadership team -- including Dean Tom Fisher -- to prevent widespread layoffs.

Marilyn Delong , associate dean at the College of Design, said about 30 staff and faculty at the school total are taking reductions, saving the University an estimated $115,000. Their reduction would equal about 26 days without pay for the five leadership positions.

Many are calling on Bruininks and other top administrators at the University to do the same -- take a pay cut of up to 10 percent.

Phyllis Walker, president of AFSCME 3800, said University central administration should be required to take a 10 percent pay reduction, a cut that she estimates could save the University more than $7 million.

But Bruininks said "the University is not strengthened by weakening its competitive positions."

"The University's top administrators are not overpaid by any comparison I have seen, and many find ways to give back to the University," he said.

Is Dean Tom Fisher overpaid?

Osmo Vanska? Kaywin Feldman? Joe Dowling?

Did they weaken their competitive position by taking a pay cut? No, they strengthened it.

They demonstrated leadership, something that is in short supply in Morrill Hall lately.

June 23, 2009

Prosecutors seek records in Medtronic fraud probe

I've mentioned this sad situation before:

This Is Obscene - Medtronic Paid the Surgeon Accused Of Falsifying Study Nearly $800,000

Thomas Lee of the Strib reports:

Federal prosecutors have subpoenaed Medtronic Inc. over documents relating to a bone growth study authored by a former U.S. Army surgeon suspected of fraud.

The U.S. Attorney's Office in Massachusetts also ordered the Fridley-based medical device giant to turn over information about "contracts, research grants, speaking and education programs, and payments for certain named physicians," according to documents filed Tuesday with the Securities and Exchange Commission.

The company said it will comply with the subpoena.

Overstated benefits

Kuklo is accused of making false claims about the use of the company's Infuse bone-growth product to treat bone and spine injuries in soldiers hurt in Iraq. At the time, he was a paid consultant to Medtronic.

Officials at Walter Reed said an investigation found that a study conducted by Kuklo and others overstated the product's benefits in healing bones shattered in warfare. The study was published in a British medical journal, which later retracted it.

Medtronic has confirmed that Kuklo became a consultant in August 2006 but said his work for the company was not related to the Walter Reed study. The company has acknowledged it paid Kuklo $800,000 for consulting services. He remained a consultant with Medtronic until early May.

Happy Talk About EFS - Frank Weighs In...

Dear Colleagues,

I've heard from a number of you that the University's new financial system, EFS, has caused challenges and difficulties for you. I commend you for your patience and ask for your continued support to financial staff as we work to manage immediate and longer-term concerns.

First, those working in EFS will face additional work during this final month of the University's fiscal year-end.

* The University's fiscal year ends June 30, which will require activities to close out the accounts of the University. These year-end requirements add significantly to the workload of financial staff.

* The financial system will not process requisitions or purchase orders in the usual manner between June 19 and July 6. Please note this does not mean units will be unable to purchase. Financial staff can assist with necessary purchases during this window of time--but using alternative methods also will add to workload.

Secondly, University leadership and financial staff are seeking ways to improve the efficiency and effectiveness of the EFS system going forward.

* President Bruininks recently formed an EFS Executive Oversight Committee to track difficulties and to improve the efficiency and effectiveness of EFS.

* University-wide work groups (including representatives from the AHC) recently formed to prioritize EFS issues, so that central technical, policy and process solutions can be pursued with speed and efficacy.

* The single greatest area of challenge with EFS remains financial reporting.

Leadership and the above-named committee and work groups are working on both short- and long-term improvements for significantly improving the reporting capabilities of EFS. We seek to improve access to data and improve tools for accessing and analyzing data.

Our goals are to make as many enhancements to the system as possible by Dec. 31, 2009. I know your staff are working very hard to assist in these improvements.

This fiscal year has been a challenging one. Working together, we have made great progress. I look forward to working with you as we continue to meet the challenges ahead.

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

More happy talk?

If you're not sure whether something is happy talk, there's one sure-fire test: if you listen very closely while you're reading it, you can actually hear a tiny voice in the back of your head saying "Blah blah blah blah blah...."

A lot of happy talk is the kind of self-congratulatory promotional writing that you find in badly written brochures. Unlike good promotional copy, it conveys no useful information, and focuses on saying how great we are, as opposed to delineating what makes us great.

Happy talk is like small talk-- content free, basically just a way to be sociable. But most web users don't have time for small talk; they want to get right to the beef. You can-- and should-- eliminate as much happy talk as possible.

Non-Happy Talk description of EFS:

"It's under water."

Some points to ponder concerning medical education

1. The U should establish a six year integrated BA/BS-MD program.

Students would be admitted to this program out of high school. There are many such programs in the US. This would allow us to attract very high quality students to our MD program. Integration between the undergrad/MD program would require careful thought and planning.

2. Rather than dragging out the time it takes to be trained as an MD - as seems to be currently fashionable - every effort should be made to shorten the length of time.

The single most important change to make medical school more affordable is to shorten the time needed to three years. This can be accomplished in a number of ways.

Too MUCH integration of the curriculum can also make it difficult for students to get credit or pass out of courses taken as undergraduates, such as biochemistry. It should be possible to do basic sciences in one year followed by two years of clinical training, IF the basic science requirement is carefully spelled out.

3. Ideas about improving medical education need to come at both the undergraduate and medical school curriculum level. For example, students do not need two semesters of organic chemistry. If the right stuff is put in one semester of organic chemistry, then biochemistry could be taught with this background. If high school chemistry courses ever got up to snuff, then one semester of gen chem should suffice.

We hear a lot of talk about change from our leadership. How about some in the undergrad/MD curriculum. How about taking steps to cut down on the terrible burden of debt that distorts career choices for our med students?

June 21, 2009

Still Conflicted After All These Years...

and we coulda been contenders.

The University of Minnesota administration initially expected to re-organize the Graduate School in a couple of months. This ludicrous idea indicates the lack of understanding around here about how to get things done.

Another recent example of poor management skills is the denial, foot dragging, and weary negligence in the area of conflict of interest policy. One of the co-chairs of the policy writing committee was himself a violator of the existent policy. Sure gives you confidence in the work of the committee, doesn't it? We coulda been contenders in this area, but no...

Yet another summary of this embarrassment is provided by MPR:

U of M medical school's ethics plan a work in progress

by Tim Post,

Minneapolis, Minn. -- After a year and a half of work, the University of Minnesota still does not have a new conflict of interest policy in place for its 450 faculty, 990 residents and 920 medical students.

It's a complicated issue and will take time to sort out, medical school officials said. But some are frustrated with the pace of the process, and say the university has missed an opportunity to draft a tough policy that protects patients.

Josh Lackner and two dozen others
in the University of Minnesota medical community came up with 14 pages of recommendations to prevent conflict of interest at the U of M's medical school last fall.

Lackner, a recent med school graduate, doesn't see many of those suggestions in a draft document being used by med school leaders to create a new conflict of interest policy.

"There are two pages left," Lackner said. "And there are still some good things in it. But there are some notable problems I think."

Here are some of the problem Lackner sees.

The recommendation that within five years the university stop using industry money to fund continuing medical education, or CME, is absent.
Doctors from across Minnesota attend CME classes in order to keep their licenses current. In 2007, medical industry money paid for half of the University of Minnesota's $2.3 million CME budget.

One item being considered forces U medical school employees to report outside income above $500 from any one source. The current threshold is $10,000. The task force that looked into the issue recommended that all outside income regardless of amount be reported.

Allan Coukel, director of the Pew Prescription Project, a Boston-based group that monitors conflict of interest policies at the nation's medical schools, has followed the U's effort to rewrite its policy. Coukel thought early on the U was headed in the right direction.

"It looks like at one stage they were considering policies that really would have put them in the first rank nationally," Coukel said. "And now they're circulating a document that we can say is a modest advance, but they've squandered a chance to be a national leader."

At lease one person involved with a task force in the early stages of the new conflict interest policy says the process should have been more open to public input.

"And that really throws me for a loop," said Gary Schwitzer, a professor in the U of M's school of journalism. Schwitzer has investigated conflict of interest issues in the medical field in his years as a health journalist.

"For this to have any legs, for it to gain any traction, for it to gain the public's trust, it has to involve public input," Schwitzer said.

Currently the final document is being considered by a team of deans and department heads in the medical school. A spokesperson for the school says there are plans to take public input on the final plan, but they are still looking into the best way to do that.

Some say it's simply taken too long for the med school's leadership to come up with a new document. At one point, the document was expected to be ready by April.

Medical schools across the country scrambled to shore up their conflict of interest policies when, in 2006, the Journal of American Medical Association called for colleges to revamp their conflict of interest policies to avoid any influence by pharmaceutical companies on patient care, education or research.

That report was followed by a New York Times report in June 2007, that raised questions about four Minnesota psychiatrists who received payments from pharmaceutical companies even after they were disciplined by the state medical board. At least one had spent time teaching at the U of M.

State's med-tech boom stalls to a crawl...

A regular correspondent sends me the following message:

"As I said, our current models for innovation are broken. Money alone will not solve the problem, even if more of it were available."

This remark was stimulated by an excellent and perceptive Star-Tribune article this Sunday:


Kevin Nickels' company has developed a new way to treat hard-to-heal wounds and, like many medical entrepreneurs, he believes the discovery can reduce suffering and save lives.

What's missing? Paying customers. Celleration has been turned down for coverage by Medica, HealthPartners, Blue Cross and Blue Shield of Minnesota and the giant federal Medicare program. "There is not enough money to go around,'' Nickels said. "Payers are saying 'Stop: We just can't afford what you're selling.'"

The result is that medical technology, long an engine of Minnesota's economy, is slowing to a crawl. The industry has shed more than 1,000 people in the past year and the chill is threatening what analysts call Minnesota's "innovation ecosystem.''

"This could have a long-term negative impact on the Twin Cities," said Mike Berman, a prominent medical device entrepreneur and investor.

"They just don't have the money to invest," said Thomas Gunderson, a longtime med-tech analyst with Piper Jaffray. Because the market for public offerings has essentially dried up, so has the expected windfall that makes investors rich.

If a device doesn't treat a chronic disease affecting a large population, their interest wanes further.

In Minnesota, venture capital investments in medical device startups fell sharply between mid-2008 and early 2009, and most of this year's money went to just one company, Atritech Inc. of Plymouth, which makes a device to prevent strokes.

"Something is fundamentally changing," said Berman, the entrepreneur. "We won't get back to the go-go years anytime soon."

Insurers used to evaluate devices solely on benefits and performance; now payers want companies to demonstrate "comparative effectiveness," O'Connell said. That's a much higher standard that requires a device maker to prove that the technology is significantly better than devices already on the market.

One reason is cost. Americans spent $2.3 trillion on health care last year, or more than 16 percent of the nation's total economic output, up from $243 billion, or 9 percent of GDP, in 1980.

Even though medical devices account for only about 1 percent of total health care spending, the government attributes a large chunk of the rise in costs to use of new technology and lack of reliable information on medical outcomes, quality of care and cost.

Speaking last year to the annual conference of the industry group Life Science Alley, Dr. Reed Tuckson, chief of medical affairs for UnitedHealth Group Inc., said the medical device industry tends to favor innovation over usefulness.

"No one can sustain the escalation of health care costs,'' Tuckson said. "There are lots of smart people here who take innovation and market it to people, so they want everything. But the innovations are more expensive than what they are replacing."

Last month, for example, Medicare declined to cover virtual colonoscopies, ruling that "there is insufficient evidence ... to conclude that screening CT colonography improves health benefits for ... average-risk Medicare beneficiaries.''

Investing in med-tech "used to be worth it," said Mark DuVal, managing partner of DuVal & Associates, a Minneapolis law firm that advises drug, food and device companies. "Should we still be in medical devices?'' he asked. "It's just not what it used to be."

And what, you might ask, are the implications of all this for the U?

Begin: rant

The people calling the shots at the U are the administration. And they are really not interested in what the faculty think about where we should be going. This is a fundamental mistake for which we are paying now and will pay in the future if this behavior continues.

Someone with a PhD in Ed Psych and a lawyer are not going to be able to make the kind of decisions necessary, especially when they do not have a technical background and are continually bamboozled by the people South of Washington Avenue.

We always seem - in our administration - to jump on something just at the point where it goes under. Because it takes our administration that long to recognize a good thing

Recall how Mark Yudof - and I love Mark Yudof - was considered to be a Hero of the Soviet Union when he pushed the cell and molecular biology business...

wtf? Faculty knew for years that this was the place to go. By the time we jumped on the bandwagon it was too late. Same for the vaunted translational research. I gather that our latest attempt to ladle gravy from this bowl has bombed and so-called improvements in personnel did not impress.

The thing about a university - as opposed to industry, and I worked at 3M for ten years - that gives us an advantage is that we can afford to take the long view. Of course this requires vision, foresight, and some TRUST in our faculty who know where the football is going to come down in a couple of years.

We SHOULD have been whacking away at nanotechnology in a serious way many years ago. Witness the bow to nanotechnology made by our chemistry chairman as he departs to be dean of science at Purdue.

We also have to walk the talk of being green. We need an almost evangelical fervor in this effort. We should use our skills in the IT area to produce and install wind, solar, etc. We should be doing serious work on green chemistry and what I will call agricultural chemistry.

Dr. Bruininks needs to have the Morris president down to talk about green things and how to lead in this area.

There are some damn smart faculty, students and staff at the U. We have shown in the past that we can innovate. We have a fantastic Institute of Technology and many great docs and researchers in the Academic Health Center. Why are we in such deep doo-doo?

You know my answer to this rhetorical question - less than stellar leadership.

Things are going to change quite a bit in this department in the next few years. For God's sake, let's make an effort to get some new, young, outside blood in here with proven ability to lead and to move things forward. Let's not make the same mistake yet again by promoting from within. Those responsible for making the present mess are not likely to clean it up in the future.

End: rant

Happy Father's Day to those appropriate!

Excellence Within Our Means - A Novel Concept?

Remarks of WB Gleason to Regents and President Bruininks

Board of Regents Meeting Open Forum
University of Minnesota, June 17, 2009

I've carved out what I had to say at the meeting from the complete video available on the U's web sit.

In case you are wondering, President Bruininks was present at this meeting. So the first half of the talk was addressed directly to him.

Time for a change, President Bruininks?

June 19, 2009

Further Lessons for the U from the Minnorch

Osmo Vanska cut his own salary and the orchestra trimmed back its ambitious aspirations for Orchestra Hall renovation. Perhaps the U might keep this in mind while planning for its own future buildings and renovations, e.g. the Northrup project?

From the Strib:

In a scaled-back project, architects have been hired to update the 1974 building's exterior and open up its cramped lobby spaces.

The Minnesota Orchestra unveiled Friday a $40 million project to remodel its 35-year-old hall in downtown Minneapolis. That represents a significant telescoping of a project envisioned two years ago as a $90 million endeavor.

When Kuwabara and partner Marianne McKenna were introduced at an Orchestra Hall press conference Friday, their themes centered around "transparency" in the exterior, reinventing the hall's lobby and "opening up the building to the city," in McKenna's words.

KPMB was chosen from 100 architects. The orchestra wanted someone with renovation expertise in the arts; KPMB has credits at the Goodman Theatre in Chicago and Canada's National Ballet School as well as a drama center at the University of Michigan that bears a striking resemblance to the old Guthrie Theater.

Time to demonstrate leadership and flexibility, President Bruininks?

Dog Eats U's Homework - We Get Grade of "I" in Conflict-of-interest Policies

The latest version of the student AMA scorecard has surfaced. The U has gotten the grade of Incomplete as a result of their strategic policy of foot dragging.

Gary Schwitzer, in his most excellent blog,
tells the sad story:

By Gary Schwitzer on June 16, 2009

The American Medical Student Association today released its 2009 scorecard on academic medical center conflict of interest issues.

The group gave A grades to:

Mount Sinai School of Medicine, New York, NY
University of California San Francisco School of Medicine
Mayo Medical School - College of Medicine
University of Pittsburgh Medical Center
University of California Davis School of Medicine
University of Texas Medical Branch at Galveston
University of Pennsylvania School of Medicine
Johns Hopkins School of Medicine
UCLA David Geffen School of Medicine

The group said this about my local school - the University of Minnesota Medical School:

This institution has informed us that they are revising or developing their policies. However they have provided material for review.

Most of the policies regulating conflict of interest at University of Minnesota Medical School demonstrate progress towards a model policy, but could be strengthened further. There are no policies regulating off-site educational events or pharmaceutical samples, and oversight and sanctions for noncompliance are not clearly established.

This institution made a new or revised policy submission to the AMSA PharmFree Scorecard in 2009. Their status is In Process. Their grade improves provisionally from a D to a C.

This institution has not consented to allow their policy to be publicly posted or quoted for illustrative purposes.

A provisional C. This comes after the school spent a year researching and writing new conflict of interest recommendations. Hmmmm.

But we're in no hurry around here... Why not?

Serious Mistakes at the U Have Long Term Consequences

Tenure wars, illegitimate actions with respect to the graduate school, unbelievably bad graduation rates in the past, various athletic scandals - things like this have consequences long after they have occurred. A recent article, concerning Florida State's punishment for recent misdeeds, once again cites some of our past sins:

TALLAHASSEE, Fla. (AP) -- The NCAA infractions committee intends to uphold sanctions against Florida State that would take away wins in 10 sports, including as many as 14 by football coach Bobby Bowden.

The NCAA said 61 Seminole athletes cheated on an online test in a music history course from the fall of 2006 through summer 2007 or received improper help from staffers who provided them with answers to the exam and typed papers for them.

"The most severe penalties are appropriate when the academic mission of the university has been compromised," the June 2 infractions committee response said, citing the academic misconduct at the University of Minnesota that led to basketball coach Clem Haskins' firing.

A former academic counselor at Minnesota admitted to having written more than 400 papers and take-home tests for Gophers basketball players between 1993 and 1998 and said Haskins was aware of the cheating.

June 18, 2009

Dave Durenberger on Money-Changer Takeover of Hospitals

From Dave's Newsletter - June 18, 2009

"Just in the last week I've seen three signs of the post-bail-out economy. All in hospitals. President Obama suggests the Congress will find ways to expand public access to healthcare in changing Medicare payments to hospitals. He suggests they might get moving on productivity, a word poorly understood in the industry. Speaking at an event for Minnesota pediatricians, I suggested that the $500 million of our money the Twin Cities hospital industry is investing in three new children's hospitals might have been better spent on improving the health of moms and kids."

"A physician being honored for 35 years as the father of innovative neonatology (and saving lives of preemies) says pediatricians were in unanimous agreement with me on this before the money-changers at the hospitals decided otherwise."

June 17, 2009

This Is Obscene - Medtronic Paid the Surgeon Accused Of Falsifying Study Nearly $800,000

Poor Earl Bakken... He is a wonderful man. I've met him and he - and a lot of Medtronic employees - must be sick over this. Some of my students and friends have worked at Medtronic and this situation is truly sad.

From the Wall Street Journal:

Medical device maker Medtronic Inc. says it paid nearly $800,000 over the past three years to a former Army surgeon accused of fabricating a study that reported positive results for one of the company's key spine products.

Some of the consulting payments occurred during the time that the surgeon, Timothy R. Kuklo, was shopping his favorable study of Medtronic's Infuse bone-graft product to medical journals. The paper, ultimately published last August in the Journal of Bone and Joint Surgery, reported advantages in healing the legs of injured soldiers when Infuse was used.

Game, set, match...

Dr. Polly, does this qualify as a conflict of interest?

Frank - Dr. Cerra , let's get off our butts and do something about our conflict of interest policy at the U of M, now...

I can't possibly believe that you agree with Dr. Polly's view:

"A former Walter Reed colleague, Dr. David W. Polly Jr., who is also a Medtronic consultant, said he believed that Dr. Kuklo's data was "strong" and the episode had been overblown."

And the icing on the cake is that Dr. Polly has been giving lectures in the U of M's mini med school about conflict of interest.

"Physicians and industry relations"

There's no debating it: The relationship between physicians and industry is paramount to the vitality of the medical profession. David Polly, Jr., M.D., professor and chief of spinal surgery in the Department of Orthopedic Surgery, tried his best to prove that point during his presentation at Mini Medical School.

June 16, 2009

Those Jungle Drums You Hear Outside Morrill Hall, President Bruininks...

Ask not for whom the drums beat, they beat for thee...

From the Daily:

Lay off and take a cut

Before laying off any University employees, President Bruininks and other administrative leaders should take a pay cut. Pending annulment announcements, University of Minnesota funding may be reduced an estimated $177 million over the next biennium, and as a result President Robert Bruininks has announced the need for some excruciating budgetary decisions.

Most recently, he revealed the reduction of more than 1,200 paid positions at the University. Many of these will come in the form of natural employee attrition, whereby open positions go unfilled or early retirement incentives sweeten the pot for those soon to retire. Unfortunately for hundreds of University employees, attrition alone won't bring solvency.

That means layoffs.

During tough financial times at the University, emotions and animosities can run high. It seems as though University faculty inevitably become pitted against staff, both of whom would likely prefer to see the shortfall mediated by increasing students' tuition.

The polarizing nature of budget cuts means that a strong and dedicated leadership is all the more important for maintaining our sense of community at the University.

Before a single employee becomes laid off, President Bruininks and the broader University administrative leadership should practice a little self-sacrifice.
A mere 10 percent pay cut would suffice; anything to illustrate solidarity and empathy to those employees who will flat-out lose their job.

Dean Thomas Fisher and four others in leadership in the College of Design announced they would take voluntary 10 percent cuts in late May.

Other college deans and administrators should follow suit before a swath of lower-earning University employees are dealt pink slips. The University could save hundreds of thousands of dollars if the 25 highest paid administrators took just a 10 percent pay cut.

It's highly inappropriate if not outright cruel for administration to dole out sympathetic platitudes along with pink slips when they haven't yet taken a cut themselves.

U Cuts Apparently Slightly Less Severe Than Expected...

From the Strib:


Higher education hit is big, but not as much as expected

Pawlenty splits $100 million in cuts to higher ed between U of M and MnSCU. The U had based its budget on a bigger cut.

The hit to higher education is big -- $100 million split between the two public systems -- but not as bad as many officials had expected.

Gov. Tim Pawlenty announced plans to unallot $50 from the Minnesota State Colleges and Universities system and $50 million from the University of Minnesota system for fiscal year 2011. That's a 7.5 percent cut to MnSCU's appropriation and a 7.4 percent cut to the U for that year.

In his press conference, Pawlenty pointed out that under rules for the use of federal stimulus dollars, he could have cut more.

The University of Minnesota had built its proposed operating budget on the assumption that Pawlenty would reduce its 2011 appropriation by $73 million

The Word From West Laf... New Science Dean is a Gopher

From West Laf:

Purdue selects College of Science dean

An administrator from the University of Minnesota has been named the dean for Purdue University's College of Science.

Jeffrey Roberts, currently the chairman of Minnesota's department of chemistry, will start at Purdue this fall, according to a statement released today.

"Jeff Roberts is a distinguished scientist and outstanding academic leader who emerged as the top candidate in our national search,"
said Randy Woodson, Purdue's executive vice president for academic affairs and provost, in the statement. "His vision for science research and education and his tremendous capabilities as a leader will ensure the continued national prominence of the College of Science at Purdue University."

Roberts has been at the University of Minnesota since 1990 and directed the University of Minnesota Research Site for Educators in Chemistry, a National Science Foundation-supported initiative, from 2001 to 2007. He specializes in the fields of physical and materials chemistry and his research interests focus on aerosol surface chemistry.

Purdue's College of Science is made up of seven departments: biology, chemistry, computer science, earth and atmospheric sciences, mathematics, physics and statistics.

There are 328 faculty members in the college and annual enrollment is more than 1,000 graduate students and almost 3,000 undergraduates, according to Purdue.

Maybe splitting IT into a College of Engineering and a College of Science wouldn't be such a bad idea? Our Administration seems always to be looking to those who are doing things differently from us - see the Graduate School fiasco - as a source of new games to keep them occupied?

Congratulations to Jeff. The chemistry department has suffered some heavy losses in recent years. These losses indicate the high quality of chemistry faculty members. In order to do strong interdisciplinary work it is necessary to have strong disciplines. Chemistry ( and physics and math, and ...) are crucial. Let's not get so carried away with the interdisciplinary business that we neglect the fundamentals. This advice is applicable to a lot of other things going on in Morrill Hall lately...

Jeff Roberts, department of chemistry chair, leaves the U for Purdue

For background, see the earlier post:

Purdue College of Science Dean Search

Dear Members of the Chemistry Department:

It is with very mixed emotions that I announce I will be leaving the University of Minnesota to move to Purdue University, where I will become Dean of Science. I have told Dean Crouch about my decision, and he has begun putting a plan in place to appoint an interim department chair. I will work closely with that person to ensure as smooth a transition as possible.

I will be leaving for Indiana in early August, but not without a good deal of sadness. I have enjoyed working in the Department of Chemistry very much, and I do not look forward to leaving my many friends here.


Jeffrey Roberts
Distinguished McKnight University Professor
Chair, Department of Chemistry

The chemistry department at the U has taken some terrible hits in the past few years. It is going to be hard to be an interdisciplinary power with out strong disciplinary input - such as chemistry. This is another example of where the administration needs to be paying better attention.

June 15, 2009

Beware the clock!


Yo-ho-ho and a bottle of chardonnay!

As Governor Pawlenty serves out his lame-duck term, so too does President Bruininks.

Given the financial cliff that the University will shortly be falling from, the sooner a new executive is in place, the better. Two years from now is when the worst will happen. To have this coincident with a new captain coming on board seems unwise.

President Bruininks could best serve the university by announcing that he will retire as soon as his replacement can be found, i.e. at the end of this next academic year. His successor will then have a year to prepare before the Gopher boat goes over Minnehaha Falls.

From the Daily:

Regents elect new chair and vice chair

They will play a leading role in the search for a new University president.

The Board of Regents elected a new chair and vice chair at their meeting Friday.

As University President Bob Bruininks’s term expires in 2011 and he has publicly stated that he doesn’t plan to seek an extension, it’s expected that the Board of Regents, within the next two years, will undertake the task of selecting a new University president, University spokesman Dan Wolter said.

As the board’s new leadership, Allen and Cohen will be responsible for conducting the search.

Allen will appoint a search committee and have a leading role in determining the process of the search, Allen said.

Those responsible for the search for a new president are on board. Damn the torpedoes!

June 12, 2009

Walking the Talk at the College of Design

From the (very small at the U of M) department of putting your money where your mouth is:

From the College of Design Memo From Dean Fisher
May 26, 2009
Monday Minute, May 26, 2009

Dear Colleagues,

Mark Twain once said, "Action speaks louder than words, but not nearly as often." One action the college has taken has certainly registered with the University.

Our leadership group -- Associate Deans Kate Solomonson and Marilyn DeLong, Assistant Dean Kate Maple, Chief of Staff Kathy Witherow, and I -- may be the only college deans at the U taking a 10 percent reduction in our appointments next academic year in order to help balance our budget. That reduction equals 26 days without pay, which some of us will spread out across the year and others will take mostly during the summer. I commend my four colleagues for joining me in this voluntary reduction; such an action does not happen nearly as often as I think it should among the leaders of organizations in times like these.

Wow, just wow...

President Bruininks, other administrators - your turn?

Bad News Bob


U of M budget: Tuition stable, staff layoffs looming

by Tim Post, Minnesota Public Radio

Good news for students who would see minimal tuition increases. Bad news for staff, who are facing job cuts.

Next year, the most they'll see tuition go up is 3 percent, or about $300.

University of Minnesota president Robert Bruininks says for many students and their families, the news is even better. "Very few of them will see any increase, and the increases they do see will be relatively modest," said Bruininks.

Sixty percent of students who pay in-state tuition will see their bills go down next year. That includes a 5 percent tuition cut for students of families who make around $90,000 a year, and a 20 percent cut for students of families making around $50,000.

Here's the bad news. Because the university's state funding will be cut an estimated $177 million in the next two years, school officials must reduce spending -- and that will translate into job cuts and layoffs.

In the next year alone, the university will need to make $95 million in internal cuts. In Bruinink's new budget, that includes eliminating 1,240 University jobs.

"Asking the people who remain to take salary and wage freezes, as we are doing all across the state of Minnesota, is a sacrifice that is needed right now -- and one that our people will support."

Those 1,240 jobs will included faculty, administration and staff. Bruininks says many of the cuts will come through early retirement or by not filling open positions. But he acknowledges there will be at least 400 layoffs.

"Clerical workers are terrified that they're going to lose their jobs," said Phyllis Walker, president of the clerical workers union at the U of M.

"They know that in this economic climate, if they lose their job here, it will be difficult to find another job somewhere else," she said.

University officials will host a public forum next week to discuss the upcoming budget. The Board of Regents will vote on the budget proposal June 24.

Ring that Bell

You'd think that the University of Minnesota administration would just shut up about the Bell for a while in hopes that people would forget their arrogance for requesting funding for it in the middle of severe economic problems for the university and the rest of the state. But hey - it's all about U...

From the Pioneer-Press

Funding for a new Bell Museum of Natural History on the St. Paul campus of the University of Minnesota won't be included in U President Robert Bruininks' upcoming capital request to the state, officials said Thursday.

Bruininks is scheduled to present his preliminary 2010 capital request to the Board of Regents today.

Gov. Tim Pawlenty vetoed a $24 million appropriation for the project last session, which was the second time the request had met that fate. The rejections have "caused a re-prioritization," said U spokesman Daniel Wolter.

Wolter said the U has raised about $9 million toward the project, and there may be other ways to finance it.

"I don't think anybody's ruling it out," he said. "We're assessing what the other options are."

Re-prioritization is a new word in the adminspeak lexicon, at least around here. Glad to hear it. Long overdue.

A modest proposal: Buy a printing press and install it in the basement of Morrill Hall - next to the dry stream of the money that used to flow through it. Then hire a good counterfeiter.

June 11, 2009

Youngest Guantanamo Detainee Freed...


LONDON (Reuters) - The youngest detainee held at the U.S. prison at Guantanamo Bay, seized when he was just 14 years old, has been released after seven years in captivity, his lawyers said on Thursday.

Mohammed El Gharani, a Chadian citizen, was set free five months after a U.S. federal judge ordered him released after reviewing the evidence against him and ruling that it did not prove he was ever an "enemy combatant."

Gharani has already returned to Chad, his lawyers said. There was no immediate confirmation from U.S. authorities of his release.

"It is great news that Mohammed has at last been released, but he will never get back the teenage years that were spent in Guantanamo based on shamefully shoddy intelligence," said Clive Stafford Smith, a lawyer and the director of Reprieve, a human rights group that has fought for his release.

"The idea that it took seven years and a federal judge to sort this out demonstrates just how failed an experiment Guantanamo Bay is."

Thank you Dick Cheney. Thank you Donald Rumsfeld. Thank you George Bush.

And Another One (Hopefully) Bites the Dust

Why we need very strong conflict of interest policies at the University of Minnesota Medical School, the example of the emailing prick from Emory...

UD - as usual on the case - abstracts some damning email form Grassley's bomb of a letter to Emory:

Professor Zachary Stowe of Emory University wants his money, and he wants it now.

An enthusiastic salesman for Glaxo drugs, Stowe spends a great deal of time giving pitches to various audiences. He doesn’t just say things Glaxo wants to hear; he writes them.

“Dr. Stowe is on board for publicity efforts,” writes a public relations person to Glaxo about a press release. “We [want] to secure distribution [of research results] on Emory letterhead — as you know, [this will] provide further credibility to data for the media.”

Stowe loves the money; Glaxo loves the credibility Emory’s letterhead brings. A perfect relationship, undisclosed to Emory, of course…

Senator Grassley attaches to his latest letter to Emory about its enterprising psychiatry professors a series of emails Stowe wrote demanding payment for canceled events.

Email #1: What provisions do you propose for my compensation for the lost time? …. GSK… should cover the cost of the trip as well.

Email #2: I am willing to discuss… renumeration [sic] for a single talk ($2,500) rather than the two scheduled.

Email #3: [Same idea. Still no response.]

Email #4: Now that I have had to invest the time to find some resolution to this problem, I am no longer in a compromising mood. [Now you owe me] $4,500.

Email #5: I do not want to be a prick, but given the time and frustration, [you] should pay me for both talks.

From the comments on this post:

# Michael Tinkler Says:
June 10th, 2009 at 10:43PM

My goodness. In a moment of curiosity I read the pdf. I think the only word for him might indeed be "prick."

# Bill Gleason Says:
June 10th, 2009 at 8:57PM

Reminds me of the old joke about the money-hungry psychiatrist: If you are late, he starts without you.

My late uncle, a psychiatrist, told me this. Of course he actually did therapy, mostly with adolescents.

Surprise, Surprise, AMA Against Obama's Healthcare plans

From the NYT:

WASHINGTON — As the health care debate heats up, the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.

Recently I have engaged in AMA-bashing. This kind of behavior is the reason. These are the folks who campaigned against health care reform long ago on the basis that it was socialized medicine, whatever that means. Thank God for the student American Medical Association.

Spin is in: Brewster coaching record 113-61-1 (.645)


Oh well, I guess there have been worse things done at the U than this...

[e.g., The Ethically Challenged U of M Medical School Administration]

From the Cedar Rapids Gazette:

University of Minnesota head football coach Tim Brewster, at http://www.brewcrewreport.com/, is touting his coaching record as 113-61-1, as you see from the Brewcrewreport snippet I snipped from that site.

OK, Coach Brew. Not many head coaches tout their won-lost records as assistants, but that’s your right. Just like it’s mine to point out you’ve been a head coach for all of two years, and have a won-lost record of 8-17 with a current five-game losing streak.

June 10, 2009

Medtronic Clarifies Kuklo

I've had an interest in Dr. Kuklo for a while. He published work on some apparently non-existent patients at Walter Reed. Recently he moved to WashU. A flap over the Walter Reed work ensued. He is now out at WashU. One of his colleagues and defenders is another Walter Reed refugee who is now on the faculty at the U of M.

For more background see a post on The Periodic Table that includes additional information and links: "Kuklo, Frank, and Polly."

From Minnpost:

Medtronic issues clarification following AP report

Medtronic has issued a clarification to comments made by its CEO, following an Associated Press report today that apparently contradicted the executive's remarks about a former Medtronic consultant now accused of falsifying study results.

A study by Dr. Timothy Kuklo at Walter Reed Army Medical Center found unusually high success rates using a Medtronic bone-growth product to treat wounded soldiers' shattered legs. The hospital's commander later told the New York Times that it has no evidence that the patients ever existed.

Medtronic has downplayed its relationship with Dr. Kuklo but never fully disclosed how much he was paid or when the payments began. Asked on Monday about the company's relationship with Dr. Kuklo, Medtronic CEO Bill Hawkins told CNBC that, "Our relationship began after he left the Walter Reed Medical Center and went to Wash U."

An Associated Press article today about Pentagon employees receiving free travel and lodging from companies and trade groups mentioned Medtronic as one of the big spenders: "Medtronic, a multibillion-dollar medical technology company, spent $93,000 on 86 trips. Fifteen of those, totaling more than $13,000, were taken between 2001 and 2006 by Dr. Timothy R. Kuklo, a surgeon who became a Medtronic consultant after retiring from the military in 2007."

The apparent contradiction prompted Medtronic to issue this clarification to CNBC on Hawkins' statement:

"Bill (Hawkins) indicated that our relationship began with Dr. Kuklo when he joined Washington University. The correct answer is that while we began a consulting relationship with Dr. Kuklo in August 2006, Dr. Kuklo did perform a number of reimbursable functions, including training and education, for the company while he was a practicing physician at Walter Reed prior to that time."

AMA Looks to Put Brakes on Debt Load of Med Students

Where the hell have these folks been?

The AMA has a lot to answer for: leading the fight against "socialized" medicine for many years, systematic discrimination on the basis of age and race, I could go on.

The student AMA on the other hand gives us hope for the future as they seem to be taking a leading position on the need for reform of conflict of interest policies at medical schools.

From the WSJ:

Medical students who went into debt could figure on owing $126,714 in 2007 on average, up from $88,331 in 2000, according to the Association of American Medical Colleges. You can figure the debt tab has only gone up since then.

Such statistics are being cited by American Medical Association as docs prepare for their annual confab in Chicago next week. There are hundreds of policy recommendations on the agenda — including some strategies aimed at reducing the med-student debt.

Suggestions under consideration would take approval by powers greater than the AMA. They include providing tax deductibility for tuition and loans, and expanding state and federal scholarship opportunities.

But another cost-cutting approach is investigating ways to reduce the length of medical schooling
—perhaps through competency-based curriculums, or through combined B.A./M.D. programs. Some schools already offer a variety of such combination programs, though only a handful actually shorten the total length of training.

For those that normally don’t worry about the school loans carried by docs, remember that the med school debt load can have broader implications. It’s one of the most common reasons given for problems like the shortage of physicians and the skewing of medical professionals toward specialty practices.

The single most important move to cut down debt appears to be shortening the time it takes to produce a physician. The best way to do this is through a three-year curriculum. People should look very carefully at what is meant by coompetency or integrated approaches. These can serve to make irrelevant basic science courses that could - if of sufficient quality - be opted out of at the medical school level. There are reasons why many medical schools would prefer not to have a three year option. As usual, follow the money...

How about a serious discussion of a three year curriculum at the U of M medical school? How about an integrated BA/MD program that would take students through in six years. A pilot program of 25 students which would be ramped up to 50 if it proved successful.

The U of M administration in general and the med school in particular likes to talk about change. How about some?

Jenna Ross Gets (Unfairly) Bashed on Strib Web Site

Anyone who has made comments on web sites realizes that commenters can be a mean and tough crowed. You have to have a thick skin to post on most of these sites or read the comments. One of my friends who is a very good journalist once told me that he ignores the comments. Probably a good practice if you don't tolerate fools gladly.

I have enormous respect for journalists that dates back to my undergraduate days where I knew J-school students in what we used to call the meddler school of journalism at Northwestern. These folks are in general extremely idealistic, intelligent, and hardworking. I put them in the same class - character wise - as social workers, with every intent to praise both social workers and journalists.

So one of our graduates, Jenna Ross, is getting killed - see the comments on her recent article about proposed U of M tuition for next year. People apparently think that 3% increase is somehow outrageous. If you read Jenna's well done article it appears to be the case that about 60% of the students will see NO increase in tuition and fees for next year. If this is true - it is remarkable.

I made my own intemperate comment on the article and it was:

People, please be fair

First, many other state universities have been forced to raise tuition more than the U just to keep their heads above water, i.e. Iowa at 4% and U Washington 7%.

Second, if it is really true that 60% of the student body will actually pay less in tuition and fees than last year, then bully for the U!

Please note that I think the U's priorities are screwed up and the President and his administration should take salary cuts, etc., etc. But give credit where due. Thanks also to Tom Rukavina and the legislature for their role in keeping the tuition pot lid on.

[No doubt I'll shortly be getting an earful about being a lazy U faculty member who drinks fair trade lattes and is always spouting lefty ideas. Some of this is true...]

posted by wbgleason on Jun. 10, 09 at 11:36 AM |

Is Angioplasty Worth The Risk?

Short answer: with surgical backup ...

From CBS News:

Though A Common Medical Procedure,
Many Are Performed At Hospitals
Unprepared If Something Goes Wrong

Angioplasty is one of the most common medical procedures in the U.S.; in 2006 more than 1.3 million were done. But recent studies have cast doubt on its benefits. Now CBS News medical correspondent Dr. Jon LaPook reports on the controversy over whether too many people are getting angioplasty at hospitals that may not be prepared if something goes wrong.

In 2006, Scott Sullivan's mother, Pearl, went to Holy Name Hospital in Teaneck, New Jersey for a heart test to see what was causing her shortness of breath. She never came home.

"I went to the nurse's station and asked, 'Where's my mom?' And you could just tell by the look on the nurse's face that my mom's not alive," Sullivan recalled. "They punctured the artery, and my mom died because of it."

"Have you figured out what happened?" asked LaPook.

"I know what happened in my heart. I don't know in doctor terms," he said. "But they botched the angiogram, the angioplasty."

Pearl Sullivan's family alleges in a lawsuit they did not know the hospital had no on-site cardiac surgical back-up to handle the rare cases, about two to three in a thousand, when something goes wrong and doctors need to operate.

"We think that they're equipped to do whatever's necessary," Sullivan said. "And apparently not."

In the case of Pearl Sullivan, Holy Name said: "We are confident the evidence will show the doctors, staff and hospital acted appropriately and that this death was unrelated to the absence of on-site cardiac surgery."

Three prominent cardiology groups - the American Heart Association, the American College of Cardiology, and the Society for Cardiovascular Angiography and Interventions - say non-emergency angioplasty should only be done with cardiac surgical support on-site.

So why is the procedure still so common in small hospitals?

"Hospitals are competing to establish services which duplicate services right next door," said Dr. Elliot Fisher of the Dartmouth Medical School. "Not to the benefit of the population, but to try to preserve their financial margins. We have a medical arms race going on in this country."

Angioplasty is big business. At about $16,000 a procedure, it's a roughly $21 billion-a-year industry.

"Cardiovascular interventional procedures are big moneymakers for hospitals and for practitioners," said Dr. Steve Nissen of the Cleveland Clinic. "It's tough to walk away from that for a lot of people."

Dr. Paul Mendelowitz at Holy Name says money is not a motivation.

"What I'm telling you is that at no time, did I ever hear, 'We've gotta get into the angioplasty business because there's money to be made here,'" he told LaPook. "That was not the driver. I think the ability to do both emergency and non-emergency angioplasty allows labs to raise their quality because their volumes are higher."

Holy Name performs elective angioplasty without surgical backup as part of a closely-supervised study in 45 hospitals testing whether it's safe.

Why would somebody elect to go to a hospital that doesn't have surgical backup, versus one that does?

"Because Holy Name is their hospital," said Dr. Mendelowitz, "and they've been coming here. And maybe their parents came here. And maybe they bring their kids here. And their doctors are here."

Many experts say too many angioplasties are already being done.

"It's markedly overused," said Dr. Fisher. "Probably 40 percent of the procedures are unnecessary."

He says if patients fully understood the risks and benefits of the procedure, fewer people would have it done, let alone at a hospital without surgical back-up.

Studies show medication can be just as effective as angioplasty in patients who are not showing signs of a heart attack.

"I can tell you this," Dr. Nissen said. "If I needed a heart catheterization, and an angioplasty, I'd have it done in a major medical center. I certainly wouldn't have it done in a small community hospital, where there was no surgeon, there was no back-up."

Scott Sullivan said his family needs answers: "Why, what, when it went wrong? What time did it go wrong? Did they, for three hours were they playing around in there, trying to fix something that they weren't equipped to do? My family needs answers."

Pearl Sullivan signed a consent form both for the procedure and to participate in the study of angioplasty without surgical backup. But her family doesn't believe she understood what it meant.

From the comment section:

As a physician, we are trained never to perform a procedure if we cannot address every possible complication of that procedure. It's a simple rule that saves lives. The "you can get hit by a car by walking across the street' argument just doesn't fly in this case. Damage to the coronary artery is a known and not infrequent complication of angioplasty, and this potential complication must be addressed prior to the procedure being performed. I agree that when hospitals perform angioplasty without surgical back up, the decision is being made with profit in mind and it needlessly puts the patient at risk.

More cuts at UW-La Crosse, but jobs are spared

From the La Crosse Tribune:

University of Wisconsin-La Crosse officials announced another $320,000 in cuts Tuesday, but no layoffs are involved.

Officials instead plan to leave several administrative positions vacant, significantly reduce the level of custodial and facilities services on campus, move a member of the UW-L Foundation staff entirely onto the Foundation's payroll and end a $30,000 general education faculty grant program, Gow said.

Officials on Friday said that the baseball and men's tennis programs would end. The moves all are being done to trim $380,000 from the budget due to uncertainty over whether unionized state workers will give back a 2 percent pay increase as requested by Gov. Jim Doyle, Gow said.

"These cuts, along with the sports, have been the hardest ones to make because we have already done so much cutting," said Gow.

Searches will be halted for administrative positions that include associate dean of the College of Liberal Studies, director of the Office of Multicultural Student Services and director of General Education. That will save another $112,000.


President Bruininks, do these actions give you any ideas about what you could do before laying off people? Oh, and don't forget a 10% salary cut for everyone above $250K. Maybe 20% for those making more than half a mil. I know at least one administrator who is compensated to the tune of $750K...

Blockbuster Drugs Are Dead - Steve Nissen

From MedCity News:

CLEVELAND, Ohio — The medical profession should get behind “innovative” federal regulations that will help win back a skeptical public, and better navigate tougher and tenuous drug pipelines, Cleveland Clinic’s Dr. Steven Nissen told his peers Thursday.

Nissen is a bit fire-and-brimstone when speaking to the public about the U.S. Food and Drug Administration. But Thursday afternoon, he was standing in front of fellow cardiologists — as well as drug and medical device companies — during a lunch speech at the Clinic’s three-day symposium on cardiovascular disease.

Nissen proclaimed dead the concept of the blockbuster drug — the statin that would work for tens of millions, for example. The “low-hanging fruit” in drug development is gone, and harder-to-develop, targeted therapies will be part of the next wave in care.

There are too many drugs that incrementally improve on existing drugs, he said. The federal government can turn companies back toward creating novel treatments — and developing them quickly — in areas like Alzheimer’s, obesity and drug-resistant tuberculosis, Nissen said.

The government should create incentives to develop drugs for such treatments, including extended patent rights for innovative medications, as well as FDA approvals that expire after five years if outcome trials have not been performed in that time.

“If we encourage that kind of regulation, then regulation becomes our friend rather than our enemy,” he said.

There were no questions at this talk, and the crowd applauded politely.

So instead of trying to develop blockbuster drugs from low-hanging fruit, perhaps Academic Health Centers should re-focus on the outstanding practice of medicine? You know, the non-glorious stuff, like good maintenance and care of diabetics, and putting the patient first, rather than viewing him or her as a profit center or a research subject.

To a certain extent we do this in Minnesota, especially at Mayo. But there is always room for improvement throughout the rest of the state. We are fortunate to have a good model.

June 9, 2009

Dr. Atul Gawande's Instant New Yorker Classic on Health Care

Has come to the attention of President Obama.

From an earlier post:

As Dr. Atul Gawande wrote in an excellent recent article in the NewYorker:

When you look across the spectrum from Grand Junction to McAllen—and the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.

From the New York Times:

President Obama recently summoned aides to the Oval Office to discuss a magazine article investigating why the border town of McAllen, Tex., was the country’s most expensive place for health care. The article became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.

“He came into the meeting with that article having affected his thinking dramatically,” said Senator Ron Wyden, Democrat of Oregon. “He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we’ve got to fix.’ ”

Researchers at Dartmouth Medical School have also found wide variations within states and among cities. Medicare spent $16,351 per beneficiary in Miami in 2006, almost twice the average of $8,331 in San Francisco, they said.

The magazine article, by Dr. Atul Gawande in the June 1 issue of The New Yorker, said a major cause of the high costs in McAllen was “overuse of medical care.”

Dr. Elliott S. Fisher, one of the Dartmouth researchers, diagnosed the problem this way: “Medicare beneficiaries in higher spending regions are hospitalized more frequently, are referred to specialists more often and have a much smaller proportion of their visits to primary care physicians.”

In his blog last month, Mr. Orszag wrote, “The higher-cost areas and hospitals don’t generate better outcomes than the lower-cost ones.”

“There is too much uncertainty about the Dartmouth study to use it as a basis for public policy,” said Senator John Kerry, Democrat of Massachusetts. “Researchers can’t explain why some areas of the country spend more on health care than others. There are many reasons spending could vary: higher costs of living, sicker people or more teaching hospitals.”

Comment: Attempts to write off the disparities as due to Kerry's hypotheses seem labored. Gawande looked at El Paso and McAllen where there were great disparities in cost despite high similarities otherwise. Someone is making a lot of money on healthcare. Follow the money.

The Three Percent Solution? Proposed Tuition Increase at U of M

U of M, MnSCU to consider 3% tuition increase
by Tim Post, Minnesota Public Radio
June 9, 2009

St. Paul, Minn. — The University of Minnesota and the Minnesota State Colleges and Universities system are each considering 3 percent tuition increases next year.

The President of the University of Minnesota, Robert Bruininks, will present a draft budget to the U's board of regents later this week that would raise tuition by about $300 next year. But because of help from the federal stimulus package and a new scholarship for middle income families, Bruininks says 60 percent of students would see a slight decrease in their tuition bill.

The U of M Regents will vote on the budget proposal June 24th.

A spokesperson at MnSCU says Chancellor James McCormick will recommend next week that the system's board of trustees raise tuition by no more than 3 percent next year. That amounts to $114 at the state's two-year colleges, and $169 at the state's four-year universities.

Awareness of the Disparity in Health Care Costs

Atul Gawande pointed out, using concrete examples, the tremendous difference in health care costs in two similar Texas cities without apparent difference in the health of the residents.

This situation has been recognized for some time, but nothing much seems to have been done about it. Since we will probably have a serious attempt at health care reform, this discrepancy needs to be widely recognized. The reasons for it may give some clues for all of us about how to decrease the cost of health care without damaging the health of our citizens.

From the Wall Street Journal:

Health Reform: Costs, Variations in Care & Public Insurance

The health-reform theme of the day seems to be widespread variations in health-care costs in different areas around the country. If one city spends twice as much as another on health care without any noticeable benefit for patients, the thinking goes, there must be a way to find some savings.

This is an old idea among health wonks (see the Health Blog’s 2007 interview with Dartmouth’s Jack Wennberg, who has been talking about this for decades), but it has gained currency lately amid the big health-reform push in Washington.

Congress may wind up capping Medicare payments in areas where costs are unusually high, or sparing low-spending regions from cuts in Medicare reimbursement, the New York Times notes in a story today.

In 2006, this morning’s Washington Post notes, Medicare spent $5,812 on the average beneficiary in La Crosse, Wisc., compared with $16,351 in Miami, without clear evidence that the extra spending resulted in better care.

Meanwhile, the WSJ reports today, we could start seeing the first proposed health-reform bill as soon as this week from a Senate committee, the start of a stream of health-reform legislation likely to flow from different committees in both houses in the coming months. Congress is aiming to pass legislation by August and deliver a single bill to President Obama by October.

Two key debates remain
central, the WSJ notes. One is whether to include a national, government-backed insurance plan; a group of Republicans from the powerful Senate Finance Committee sent a letter to Obama on Monday reiterating their opposition to a public plan, which the administration backs. The other debate is, of course, how to pay for health reform.

How to pay? I think we are already paying enough. We spend more on health care than any other country in the world. And there are not many indices of health in which we are leaders.

The goal should be to bring the cost down.

June 8, 2009

Students Pay More as Colleges Spend Less on Instruction, Study Finds

To no one's surprise who has been paying close attention...

From the Chronicle:

Washington — Over the past two decades, tuition has risen at public colleges while money spent on classroom instruction has dropped, suggesting that students are paying more for less, says a report released today by the Delta Project on Postsecondary Education Costs, Productivity, and Accountability.

The report is based on a study that used 20 years of publicly available data from nearly 2,000 higher-education institutions to estimate the full cost of a bachelor’s degree, taking into account variables like state subsidies and private donations. The report was presented here today at a conference sponsored by the U.S. Education Department’s Institute of Education Sciences.

The study found that, at public research institutions, nearly all of the revenue gained through tuition increases is used to offset losses in other revenue categories, such as state funds.

At public four-year institutions, students paid about one-third of their educational costs in 2002 but nearly one-half of those costs in 2006, the study found. At private research institutions, those figures remained relatively constant during the same period, with students paying 75 to 85 percent of their educational costs.

“Tuition increases are not being spent on students,” said Donna Desrochers, the Delta Project’s director for education and economic research, at the conference.

It would be very interesting to compute the true cost of a four year college education at the University of Minnesota. This should be done in an open and transparent way so that the basis of the calculation is clear. No funny business with the intention of misleading the public and the state legislature.

The Tweets of Charles Grassley

I am (usually) a big fan of Chuck Grassley, the Senator from our good neighbor to the South.

But over the weekend Chuck may have gone overboard. Tweets are such fun and so easy. Recently some Minnesota pols learned that there are consequences for being too fast on the tweet.

From the Wall Street Journal:

June 7:

Pres Obama you got nerve while u sightseeing in Paris to tell us”time to deliver” on health care. We still on skedul/even workinWKEND.

June 7:

Pres Obama while u sightseeing in Paris u said ‘time to delivr on healthcare’ When you are a “hammer” u think evrything is NAIL I’m no NAIL

Here’s a White House spokesman’s response to the Grassley tweets from June 7, as reported by the AP:

“President Obama is gratified that the Senate is working hard to bring a health-reform bill to the floor on schedule. He looks forward to continuing his work with them upon his return from the commemoration of Allied heroism at D-Day"

Ouch! That hurt!

Maybe what we need at Minnesota is a "Chief Inspiration Officer?"

After all we've got a Minister of Culture, we are Driven to Discover, and we typically call in consultants when we are in deep doo-doo. This allows administrators to shirk responsibility for what they were not doing...

Today, courtesy of University Diaries, I learned about the Chief Inspiration Officer at the University of Idaho. Since she is from Minnesota, maybe we could get a special rate, no big travel being involved?

From the Spokesman-Review:

Faculty question expert’s earnings

‘Inspiration officer’ paid $112,500 over nine months at UI

MOSCOW, Idaho – The University of Idaho is paying a Minnesota consultant who spends less than two weeks a month on the Moscow campus $112,500 to serve as its “chief inspiration officer,” according to public records.

Rodriguez, a former teacher and missionary who was born in Cuba and has a bachelor’s degree in history from Siena Heights College in Michigan and a master’s degree in human resources from St. Thomas University in Miami, is helping the university adopt its strategic plan and is worth the expense, provost Doug Baker said.

“She’s helping us reshape our culture,” Baker told the Daily News.

Rodriguez, who is with the Minneapolis-based consulting company Volentum, said she helps create global peacemaking communities. In her biography, Rodriguez says she coined several terms, including “peacemaking” and “vitalizing change.”

Rodriguez facilitated a two-day workshop in February, when the university was considering eliminating an undergraduate degree in physics, and it ultimately helped save the program, College of Science Dean Scott Wood said.

“We obviously got to a resolution,” Wood said. “I’m not convinced we would have gotten there without Magaly’s help.”

But physics professor Francesca Sammarruca said the workshop focused mainly on sharing feelings, resolving personal conflicts and did not address the “hasty decision” to potentially cut the degree program.

“The point is that her services cannot help with problems such as ours,” Sammarruca wrote in an e-mail. “That decision needed to be discussed openly and thoroughly between the people involved in a (moderated) professional meeting, and at a much lower cost.

June 7, 2009

Harry and Louise Do a 180

E.J. Dionne Jr., Washington Post Writers Group, writes:
Remember Harry and Louise, the imaginary couple who appeared in the television ads that helped beat President Bill Clinton's health plan 15 years ago? That middle-class duo, which is to say a great many people just like them, has switched sides in the debate. The insurance companies and the drug companies that paid for the ads know that Louise's employer has probably restricted her health coverage or dropped her altogether. And who knows if Harry still has a job?

Chris Jennings, who was a senior adviser on health issues in the Clinton administration, says that all participants in the health care system see a vicious cycle at work unless government intervenes. It involves "more and more uninsured, which means more and more premium increases, which means more uninsured, which means more premium increases."

From the point of view of the interest groups, he adds, "that means less market share for the insurance companies, more uncompensated care by the providers, and less ability for people to afford high-cost prescription drugs."

Are you still wondering why the big interests, so far at least, are playing ball with congressional health reformers and the Obama administration? Leaders of the health industry know that unless more government money flows into the system, they will suffer along with everyone else.

But the toughest behind-the-scenes battles will be about how much the insurance companies, the drug companies and the providers are willing to give up to get a government bailout of the health system. That was the significance of a little-noticed line in President Obama's letter last week to Baucus and Sen. Edward M. Kennedy, the other Democrat leading the health-care battle in the Senate.

Obama wrote that "reform cannot mean focusing on expanded coverage alone." The president stressed that it also had to be about "a serious, sustained effort to reduce the growth rate of health care costs."

That sounds like boilerplate. It isn't. The hardest part of the health care fight, says Ralph Neas, CEO of the National Coalition on Health Care, may not be providing assistance for the uninsured - remember, that means expanding the customer base - but getting all the players to agree to serious cost controls. Neas' coalition includes both business and labor, both of which have been hit hard by spiraling health costs.

So by all means, let's welcome the drug and insurance companies to the health care bargaining table. But let's also remember that they are sitting at that table as a matter of urgent necessity. Negotiators should bear in mind that health care reform is as vital for them as it is for the now underinsured Harry and Louise.

I have a vague recollection of a Saul Alinsky quote something like: Sometimes you can get people to do the right thing for the wrong reasons...

Executive Physicals: An Unnecessary and Possibly Harmful Perk?

With the country's attention focused on health care, the following article provides some interesting things to think about:

From the Pioneer-Press

Researcher puts 'executive physicals' under the microscope

Researcher questions wisdom of the gilded checkups for CEOs

Dr. Brian Rank has created something of a melee in a medicine chest.

The medical director at Bloomington-based HealthPartners is challenging the value of a time-honored special perk for many CEOs: the executive physical.

Year after year, companies offer the CEO and other corporate chieftains a trip to some prestigious medical center — it's often the Mayo Clinic — for the very best physical examination that money can buy.

The visits often involve an intensive one- or two-day set of medical tests complete with a personalized interpretation of the results, and last year just more than half of Minnesota's 50 largest public companies offered them to their chief executives.

But in October, Rank published an article in the New England Journal of Medicine arguing that executive physicals don't necessarily help CEOs and could actually hurt them.

"At a time when many companies are downsizing and restructuring and need to be doing the right thing for everyone, I'm surprised that they would commit resources to something that is unnecessary, unhelpful, expensive and potentially harmful," he said.

Apogee Enterprises CEO Russell Huffer also got a physical last year, at a cost of $3,598, but the Bloomington-based maker of glass products has since decided to eliminate the perk after more than 20 years.

"The (board) committee was following current compensation trends to eliminate perks," said Mary Ann Jackson, a company spokeswoman. "Since Apogee has enhanced the preventive benefits under its employee health plan, it was decided a separate executive health physical program was not required."

That's the sort of thinking applauded by Rank, the medical director for Health Partners Medical Group. He said the harm caused by the executive physical goes beyond the money that companies spend on the exams.

"Many of the centers that provide (executive physicals) tout an environment of exclusivity, personal attention, and luxury of the type one might expect to see at a four-star hotel or high-end resort," Rank wrote in his journal article. "Those who undergo these physicals clearly appreciate the indulgent touches, such as complimentary bathrobes and slippers or the performance of the whole process in a so-called VIP area."

Such amenities perpetuate an idea that wealthy patients are somehow more worthy of better and respectful care, Rank said. That's counter to the move in medicine to try to eliminate health care disparities that are based on income, race, geography and other demographic factors, he argued.

As for the executive, it's unclear whether the intensive set of tests received during the physical really is helpful, Rank said. There is no evidence the lengthy examination provided during the executive physical actually delivers better patient results, he said.

On the contrary, too many exams can be a bad thing.

"Unnecessary testing may cause more harm than good, owing to false positive findings, unwarranted follow-up visits and costs, needless worry, and harmful side effects of the tests themselves," Rank wrote.

Of course our friends at Mayo disagree with Rank.

The Mayo Clinic has been providing executive physicals informally since the 1940s, and in a formal program since 1972. The executive program provides exams for about 7,000 per year, Hensrud said, up from about 2,000 executives in 1999.

Executives can obtain their physicals at Mayo medical centers in Rochester, Arizona or Florida. While some executive health programs might pamper CEOs, executives visiting the Mayo Clinic receive much of their care in the same setting as other patients, Hensrud said.

"We don't provide bathrobes or slippers," he said. "We're certainly not a spa here in Rochester."

June 6, 2009

OurLeader, Misquoted Again?

From the St. Paul Legal Ledger
June 8, 2009 [sic]

In fact, in the final days of the legislative session, the AP quoted University of Minnesota President Bob Bruininks as saying Pawlenty’s proposed cuts to the university were “savage and severe” and would damage the university and the economy. Bruininks said the cuts could trigger a 15 percent tuition increase and a loss of up to 750 additional university jobs. Asked about the university’s concerns at the press conference, Pawlenty said that is what one gets from “whiners.”

OurLeader, in his Daily essay entitled "Clarity critical in budget coverage," claims that the above is not what he said.

I wonder why the media continue to put this out... Dr. Bruininks?

For a related question about administrative compensation, including $740 K pa for the president, please see:

President Bruiniks calls for clarity [sic].

Health Care Reform Being Fitted For Cement Overcoat: Robert Reich


From the Blog of Robert Reich:

How Pharma and Insurance Intend to Kill the Public Option, And What Obama and the Rest of Us Must Do

I'ved poked around Washington today, talking with friends on the Hill who confirm the worst: Big Pharma and Big Insurance are gaining ground in their campaign to kill the public option in the emerging health care bill.

You know why, of course. They don't want a public option that would compete with private insurers and use its bargaining power to negotiate better rates with drug companies. They argue that would be unfair. Unfair? Unfair to give more people better health care at lower cost? To Pharma and Insurance, "unfair" is anything that undermines their profits.

So they're pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers.

Enter Olympia Snowe. Her move is important, not because she's Republican (the Senate needs only 51 votes to pass this) but because she's well-respected and considered non-partisan, and therefore offers some cover to Democrats who may need it. Last night Snowe hosted a private meeting between members and staffers about a new proposal Pharma and Insurance are floating, and apparently she's already gained the tentative support of several Democrats (including Ron Wyden and Thomas Carper). Under Snowe's proposal, the public option would kick in years from now, but it would be triggered only if insurance companies fail to bring down healthcare costs and expand coverage in he meantime.

What's the catch?
First, these conditions are likely to be achieved by other pieces of the emerging legislation; for example, computerized records will bring down costs a tad, and a mandate requiring everyone to have coverage will automatically expand coverage. If it ever comes to it, Pharma and Insurance can argue that their mere participation fulfills their part of the bargain, so no public option will need to be triggered. Second, as Pharma and Insurance well know, "years from now" in legislative terms means never. There will never be a better time than now to enact a public option. If it's not included, in a few years the public's attention will be elsewhere.

Much the same dynamic is occurring in the House
. Two members who had originally supported single payer told me that Pharma and Insurance have launched the same strategy there, and many House members are looking to see what happens in the Senate. Snowe's "trigger" is already buzzing among members.

All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.

This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.

Continuing Trouble in Paradise - the UH Presidential Search

Dr. Robert Jones recently removed himself from the list of candidates for president at the University of Hawaii. Public sentiment for Dr. Jones did not seem to be especially strong and perhaps this had something to do with it. But I believe that he would have been a very good fit for Hawaii despite being an outsider. With a really good leader UH could be a very sound institution that nailed some niches of true excellence. Agriculture is but one example. Dr. Jones could have been particularly good in this area. There are spectacular observatories and even a supercomputer outpost in Hawaii. Karl Seff, an outstaniding X-ray crystallographer, has been at Hawaii for a long time now. One of his PhD students is now one of the world's leaders in powder X-ray diffraction. For many years work has been done at Hawaii on identifying marine natural products for medicinal and other purposes. The garden island of Kawaii has a university agricultural research center staffed by, among others, a U of M plant pathologist.

But this is now water over the Manawaiopuna Falls.

This unfortunate development left one woman still standing and, unfortunately, she has a potentially fatal flaw.

The Board of Regents at the UH has backed the wrong horse fairly often in the past. They currently have to decide whether to vet the remaining candidate - and take the consequences - or call for a new deck. Since we will shortly be facing a presidential search here at Minnesota, perhaps some lessons can be learned from the UH fiasco?

The situation is described by MercuryNews:

to be continued - computer out of electrons...

Argh... It just gets worse:

Gov. Linda Lingle yesterday said she does not want to get directly involved in the issue, but would support an extension of the search for the next president.

"I'm sure there are going to be some on the board that feel they need to extend it (the search)," she said, adding that "It's a difficult time to attract people."

Former Gov. Ben Cayetano yesterday said he feels the selection committee should submit additional names to the regents in light of the withdrawal of Robert Jones, a senior vice president at the University of Minnesota, as a candidate.

"They should continue their search. To give the regents one nominee, there's no choice at all. It's as if the search committee made the decision," Cayetano said.

He also directly addressed Greenwood's candidacy, suggesting that questions of conflict of interest in the UC system may prevent her from getting the full backing of the community as the new UH president.

And at a time when the university is facing $148 million in budget cuts over two years, strong leadership is vital, he said.

"It's important that whoever comes on, comes on clean and can get the trust of the faculty, the regents and also the public," Cayetano said.

Landon said he doesn't feel the regents are left without a choice, although there are regents "who look at it that way."

The comments are almost uniformly negative, for example:

As a University alumni and employee, I'm saddened that this is the best candidate that the search committee and the BOR can come up. I think it is quite evident, if you read the posts here, that her selection for the presidency is not supported by the public at large. Whereas, the UH system needs to get away from the "good old boy mentality", we have a finalist here who comes from a background that indicates she would perpetuate it. Do people deserve second chances? Sure they do, but not at this level, for such an important position. I'd only favor giving her a second chance for a lower administrative position, not for the Presidency of our primary university. What kind of message will that send? "You can commit wrong-doing and have questionable morality and be rewarded as the President of the University of Hawaii. We don't care, we'll take other people's left overs and give them one of our most important positions in the state".

Ao no ho'i. Hawaii deserves better than this.

June 5, 2009

Purdue College of Science Dean Search

Purdue is near concluding a search for a new dean of the College of Science and one of the candidates is the chair of the U of M's chemistry department.

From the Purdue website:

Leah Jamieson, the John A. Edwardson Dean of Engineering, is chairing the committee, which conducted a national candidate search.

"We have selected four outstanding candidates who will come to campus to share their vision for the college with the Purdue community," Jamieson said. "The high caliber of candidates highlights the reputation of the College of Science as an institution of academic excellence. We look forward to the presentations and to receiving feedback from the community."

Candidates and their open forum dates are:

Jeffrey T. Roberts, chair and Distinguished McKnight University Professor in the Department of Chemistry at the University of Minnesota. Roberts will speak at a forum from 9:30-10:30 a.m. Friday (May 1) in the Lawson Computer Science Building, Room 1142.

Patricia Rankin, associate vice chancellor for faculty diversity and development and professor of physics at the University of Colorado at Boulder. Rankin will speak at a forum from 2:30-3:30 p.m. Monday (May 4) in the Lawson Computer Science Building, Room 1142.

Robert E. Continetti, chair and Kurt Shuler Scholar in Physical Chemistry in the Department of Chemistry and Biochemistry at the University of California at San Diego. Continetti will speak at a forum from 2:30-3:30 p.m. Thursday (May 7) in Stewart Center, Room 206.

Pierre V. Sokolsky, dean of the College of Science and professor of physics at the University of Utah. Sokolsky will speak at a forum from 2:30-3:30 p.m. Monday (May 11) in Stewart Center, Room 206.

Dr. Roberts would be a good fit at Purdue. He is personable, intelligent, and has done an excellent job as chair. In addition he is familiar with strategic positioning and being driven to discover. Analogous adminspeak is used on the Purdue site, the exact phraseology being: "2008-2014 Strategic Plan: Insight, Innovation, Impact" and "pursuing discovery with delivery." Gee, do you think all the BigTen schools use the same advertising agency and get a discount?

Rumor has it that a private plane was sent by Purdue earlier in the week to pick up Dr. Roberts and whisk him off to West Lafayette. He is back in town. Stay tuned...

Medical Bills Drive Most Bankruptcies

From Forbes:

THURSDAY, June 4 (HealthDay News) -- In 2007, medical problems and expenses contributed to nearly two-thirds of all bankruptcies in the United States, a jump of nearly 50 percent from 2001, new research has found.

Since the data used in the study were collected prior to the current economic downturn, it's likely that the current rate of medical-related bankruptcies is even higher, said the researchers at Harvard Law School, Harvard Medical School and Ohio University.

June 4, 2009

Most People Move Right in Old Age, Not Dave Durenberger

from Dave's recent newletter - Commentary from Dave Durenberger
June 4, 2009

Atul Gawande Rolls a Strike:


Rolls another strike in the June 1 issue of The New Yorker. A visit to McAllen, TX, where doctors are currently draining $15,000 per year per Medicare beneficiary from the Medicare program - twice the national average per capita. Twice what doctors up the valley in El Paso are doing. Three times the medicine practiced in Grand Junction, CO.
"Dramatic improvements and savings (in American medical practice) will take at least a decade. But a choice must be made. Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly they cannot do it. Or we can turn to the local medical communities, which have proved that they can. But we have to choose someone - because, in much of the country, no one is in charge. And the result is the most wasteful and the least sustainable health-care system in the world." Gawande's conclusion.

Emory Tightens Up Conflct of Interest Rules at Med School

From the Atlanta Journal Constitution:

Emory University School of Medicine announced a toughened ethics policy Wednesday to better govern faculty and students in their financial dealings with outside industry.

Late last year, Emory became the focus of an ethics investigation by Congress and the National Institutes of Health. The NIH froze funds for a $9.3 million project.

Dr. Charles Nemeroff, the former chairman of Emory’s psychiatric and behavioral sciences department and an international expert on depression, was the central figure in the investigation. Congressional investigators said Nemeroff received $2.8 million in consulting fees from companies whose drugs he was evaluating and he failed to report a third of that amount to the university.

Emory also said Nemeroff earned $800,000 in speaking fees for appearing at industry events for one company.

Attempts to reach Nemeroff, who left the department chairmanship late last year but remains a professor at Emory, and Medical School Dean Thomas Lawley were unsuccessful.

The last I heard, Dr. Cerra was in no hurry to get this problem taken care of at the University of Minnesota, where we have been, supposedly, working on it for a couple of years...

Changes Could Be Coming for Pre-Meds and the MCAT

From the WSJ Health Blog:

Pre-med courses for undergrads have been static for decades, but a report issued today recommends big changes. In a nutshell: Make medical learning more dynamic by requiring a set of competencies rather than a checklist of courses.

The report, “Scientific Foundations for Future Physicians,” was prepared by a panel of 22 researchers, physicians and science educators. The group was convened by the Association of American Medical Colleges and the Howard Hughes Medical Institute, meaning the findings have the potential to change medical education nationally.

From the MCAT’s point of view, it doesn’t matter whether they test on courses or competencies. But the MCAT will need to change. For example, if we require less organic chemistry, the MCAT has to not test on the organic chemistry that disappeared and has to test more on the biochemistry. The MCAT people were on our committee and are re-evaluating the MCAT exam.

It will take a little longer to shift the MCAT than for colleges and medical schools to shift their requirements. Until then, colleges will still have to teach to the MCAT. It’s definitely going to take a number of years.

President Bruininks Calls For Clarity [sic]

[I guess that clarity is the new adminspeak word to use instead of openness or transparency. At this point, either of these words could trip our collective gag reflex or else cause reversal of the earth's rotation due to the induction of world-wide eye-rolling.]

OurLeader has a telling piece in the latest Minnesota Daily:

Clarity critical in budget coverage

Here the old roundballer uses a little misdirection head fake and complains again about media coverage: "My response has been taken out of context by the media multiple times now."

In this awkward piece he also reveals:

"In fact, more than two-thirds of our budget challenge will be met by cost reductions, including deep reductions in personnel."

Which prompts these thoughts:

Before you make these deep reductions in personnel, I believe that you have a moral obligation to take a salary cut as do the rest of our highly paid administrators. I suggest 10%.

As you know, your predecessor, Mark Yudof, has just mandated a system wide salary cut for administators of the UC system. You must also be aware that leaders of the major cultural organizations in the Twin Cities have taken significant salary cuts: the Guthrie, the Walker, the MIA, and the Minnesota Orchestra. Presidents of colleges and universities throughout the country have taken significant salary cuts.

Actions speak louder than words. Be a leader - set a good example, please?

A commenter on President Bruiniks' article doesn't go for the head fake either:

Plainly and clearly: Salary cuts needed at the top

I'm a University employee, albeit on the tail-end of the University's food chain. My mandatory 10% time reduction/salary cut goes into effect next Monday. The dean of the college in which I work took a voluntary 10% cut, as did the assistant and associate deans and the chief of staff.

It's time for the University's top administrators to take similar cuts. It's time that the local media, starting with the Daily, start asking why not.

On Healthcare: The Public Does Get It

Gary Schwitzer, on his most excellent health care news blog, calls attention to a topical California survey that concludes:

The non-profit Center for Healthcare Decisions just completed a study, What Matters Most, documenting what 1,200 Californians believe are the most important services for coverage by health insurance.

Len Nichols of the New America Foundation said, "The findings could have national influence as Congress begins deliberation on major health reform….this is perhaps the best representation we have of the public's view on a lot of these complicated issues."

“Leaders often assume that the public is not willing or capable of setting priorities for health insurance,” center executive director Marge Ginsburg said in a press release. “The fact is, when given a chance to speak up, the public is fully capable of making decisions that affect them as patients, as taxpayers and as citizens who want a role in developing a fair and affordable healthcare system.”

What did the survey show? "One thing we heard loud and clear is that the public is not willing to share high costs," Ginsburg said. "Most people said they would elect to take more areas of coverage away rather than paying higher premiums and copays. Everybody's very conscious of the fact that if you make cost sharing too expensive, it's counter-productive. It doesn't matter what wonderful things you offer in the way of coverage. If people can't afford it, they just won't use it," Ginsburg said.

Two comments:

1. Gary has been doing an outstanding job of health journalism here at the U. We are fortunate to have him.

2. I often hear remarks from administrator types that we have to participate in the medical arms race because the public wants it. I doubt this and the survey mentioned above certainly doesn't support this idea. No one went out and asked the public whether they wanted a new children's hospital at two million dollars per bed... In the end the public ends up paying for this overkill in the form of higher medical costs for all.

June 2, 2009

UD's Take on Alcohol in the House That Bob Built

The Daily has an article. UD comments:

A Worthy Conundrum for One of Our Leading Universities:

As the University of Minnesota’s spanking new football arena, named in honor of a local bank, gets ready for its first game, the best minds on campus have set to work on this question — Whether tis nobler to suffer the drunkenness of outrageous students, or take arms against the lot, and by opposing, end them… Hm…. Hm…

Should we let students in the cheap stadium seats drink alcohol? Some will act up, costing us money in extra police protection, lawsuits and stadium damage — and we’ve already come close to bankrupting ourselves with this astoundingly cost-overrun stadiumAt the moment, we want to be able to sell alcohol only to the rich people in the premium seats, and to withhold booze from the poor students… That seems the wisest way to go…

Yet even as the university grapples with this question, the legislature has stepped in:

(here UD quotes the Daily)

Gov. Tim Pawlenty signed the omnibus liquor bill on May 20 , which in part mandates that alcohol be available to all legal-age buyers in the TCF Bank Stadium — not just those in premium seats, as previously planned.

… In the University’s original plans for the stadium, alcohol would have been sold to ticket holders in premium seating areas: suites, indoor and outdoor club seats and loge boxes.

… Rep. Tom Rukavina , DFL-Virginia, wrote the preliminary legislation that became the omnibus liquor bill.

“There was an overwhelming feeling in the Legislature that what the Board of Regents did was elitist,” Rukavina said. “If you can afford to sit in the premium seats, you can drink chardonnay, and if you sit in the cheap seats, you get water or pop … We didn’t think that was right.”

… An incident last fall in which a couple had sex in a Metrodome bathroom stall is an example of the kind of situation that could be avoided by not selling alcohol, [a policeman] said.

“It probably would not have occurred if those individuals were sober,” he said. “Those were both of-age individuals with alcohol that was legally purchased at the stadium or elsewhere … Generally, we don’t have problems with people in a sporting environment who are sober.”

[He] said, however, that there is a problem with people who drink before going to sporting events.

“The flip side is: The alcohol-related issues we dealt with were probably individuals who drank alcohol prior to even coming to the stadium,” he said.

Men and women are equal contributors to alcohol-related incidents at the Metrodome, [he] has found. Typically, intoxicated people are found vomiting in restroom stalls…

(Back to herself)

Well, we never said big time football games were pretty. There’s the budget-busting stadium. The bad boys on the team. The zillion-dollar coach about to quit for a better job and sue the university for an extra eight million on his way out. The drunk students. The drunk swells.

Tenure and the University: The Sins of the Past and Present Will Not Be Quickly Absolved

The old tenure topic comes up in the pages of the august journal Science. (Actually it is from the May issue of the august journal...)

OurLeader and OurProvost, especially, should take note.

Just as the tenure wars gave us a continuing black-eye, the abuse of due process, lack of required faculty consultation, and general cowboy behavior by the administration is going to further damage our university.

From Science:

The fundamental rationale for the tenure system has been to promote the long-term development of new ideas and to challenge students' thinking. Proponents argued more than 60 years ago that tenure is needed to provide faculty the freedom to pursue long-term risky research agendas and to challenge conventional wisdom (1). Those arguments are still being made today (2) and are still valid. However, a 30-year trend toward privatization is creating a pseudo–market environment within public universities that marginalizes the tenure system. A pseudo–market environment is one in which no actual market is possible, but market-like mechanisms (such as benchmarking and rankings based on research dollars, student evaluations, or similar attributes) are used to approximate a market.

The arguments against tenure are compelling to those who support a world where university "presidents have become CEOs" and "the administration has become management," as described by Richard Chait, professor of higher education at Harvard University (9). He was an adviser to Minnesota's Board of Regents in what Chait reports was "widely construed as an initiative to eliminate tenure" (9) ...

The top-down business model of the university presents the need to cut costs as the primary reason to hire part-time and non–tenure-track faculty. This is, however, misplaced: The dramatic increase in tuition and fees is not driven by an increase in the costs of full-time faculty. Since 1970, after adjusting for inflation, real full-time faculty salaries have increased by 5.0%, almost all of that rise due to the aging of the faculty (salaries went down for assistant and associate professors, and went up only 2.8% for full professors, but there are now more full professors). Tuition and fees, however, rose by 125% at public institutions and 253% at private institutions, in real (inflation-adjusted) dollars (13). Tenure is not what is driving rising costs.

The average tenure of a provost is 5.2 years and of a president 8.5 years (18), but many faculty stay at one institution through their entire careers. Just as the business model of recent years focused on short-term profits and stock prices and just as executives made huge bonuses based on illusory success, so too administrators may be concerned with being able to show a short-run accomplishment that will help them get the next job at some other institution, even if their actions undermine the long-run values and strengths of the university.

... a university is not supposed to be a business; viewing it as one shows not hard-headed realism but a failure to understand what gives the university its strength and potential. Tenure-system faculty are a problem to administrators and trustees precisely because tenure-system faculty have an alternative vision of the university and the power to act on that vision.

When administrators respond to trustee and larger societal pressures to cut costs, it typically involves a model in which most faculty engage in "content delivery," not education. If faculty are teaching to the test, delivering a standard curriculum determined from above, with little or no ability to explore alternatives or to respond to student interests, then a de-skilled and vulnerable workforce has important advantages. This may help to explain why tenure is weakest at community colleges and virtually nonexistent at for-profit institutions (9, 19). A market-style model works less well if a university's goals are free speech, creativity, research, and student exploration of alternatives.

Tenure-system faculty produce better outcomes: A study, based on 30,000 student transcripts, found that first-year students were less likely to return for their sophomore year if their large introductory classes were taught by part-time faculty (20). A study of community colleges found that students were 4% more likely to transfer to a 4-year institution for each 10% increase in the share of tenured faculty (21). Although contingent faculty may be excellent teachers, typically they do not have the continuity and institutional supports that enable them to provide mentoring. If contingent faculty do not have offices, it is hard for them to hold office hours; if they are gone a year later, students have trouble getting letters of recommendation.

Certainly the situation is a complex one, and it would be naïve to say that the current tenure system is perfect in all ways. However, despite the best efforts of administrators and trustees, tenure remains a crucial part of any attempt to have a first-rate college or university.

The decision about tenure is also a decision about two visions of a university. A university can be seen as a business with a "product" whose offerings should be driven by student "demand," a business that should rely on contingent faculty combined with highly paid administrators committed to "the bottom line." Alternatively, it can be seen as a center of knowledge where students are educated (not just trained), that should be governed in significant part by tenure-system faculty with a long-term commitment to the institution and to knowledge.


President Bruininks? Provost Sullivan?

June 1, 2009

The fish rots from the head: conflicts of interest at Partners and Harvard Medical School

One of my favorite sayings is: "The fish rots from the head."

This is because leadership is important and a bad leader inevitably leads to rot throughout the corpus of an institution.

Allison Bass has an interesting post:

Much has been written about prominent doctors who fail to disclose their lucrative financial ties with pharmaceutical and medical device companies. Yet there has been less focus on hospitals and other leading institutions who have similar conflicts of interest -- until now. In The Boston Globe Sunday, long-time investigative reporter Steve Kurkjian turns the spotlight on the enmeshed relationships between the long-time chairman of Partners, New England largest health-care company, and the pharmaceutical industry.

Kurkjian's eye-opening account reveals that Partners failed to disclose that its long-time chairman, Jack Connors, has owned several lucrative businesses that profited from their close ties both to Partners' teaching hospitals and Harvard Medical School, which provides the faculty and residents that staff Partners hospitals

Indeed, as Kurkjian notes, Connors' company, M/C Communications, "profited hugely from an exclusive commercial relationship it maintained with Harvard Medical School." But Partners didn't think it important to disclose that enormous conflict of interest to its own board or the public. Nor did Partners disclose the fact that Connors (after he sold M/C Communications in 2004 for a whopping $450 million) founded another for-profit home-care company that has solicited business from Partners hospitals.

If that's not a conflict, I don't know what it is.

In this case, Connors' undisclosed conflicts of interest are emblematic of the larger flaws that exist in health care today. The kind of profitable and conflicted relationships that he symbolizes go a long way toward explaining why both Partners (which owns Mass. General Hospital) and Harvard Medical School have been so loathe to strengthen their own conflict of interest policies and take action against compromised doctors like Joseph Biederman (a big gun at MGH), despite pressure from students and some faculty.

After all, if Partners' own chairman is allowed to get away with undisclosed conflicts of interest, how honest can the folks at the helm of either institution be?

Who was it that said the fish rots from the head?

[Any resemblance to other institutions, living or dead, is purely coincidental.]