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July 30, 2009

Frank Cerra Answers Questions About Conflict of Interest Foot Dragging and the Polly Situation

At an open forum for the AHC yesterday, the following exchange occurred between Dr. Cerra and this whining dinosaur:

"Remember, we're not violating a legal statute."



What about: "First, do no harm..." ?

There is a little more development of these ideas and two additional clips in a post on the Periodic Table.

Marcia Angell on Healthcare, Remind anyone of EFS?

M. A. is quoted on Gary Schwitzer's excellent blog:

"We are the only advanced country in the world that has chosen to leave health care to the tender mercies of a panoply of for-profit businesses, whose purpose is to maximize income and not to provide health. ...

If you leave this profit-oriented system in place, you can't both control costs and increase coverage. You inevitably, if you try to increase coverage, increase costs. The only answer, the only answer, and (the President) said it at the beginning of his press conference, is a single payer system. In his first sentence, he said, that is the only way to cover everyone.

BILL MOYERS: But he's also said, if we were starting the system from scratch, we could have single payer. But we're not starting this system from scratch.

MARCIA ANGELL: You know, you don't pour more money into a failing system. You convert."

July 29, 2009

Peter Bell Serves Ace

Tim or Bob - the ball is in your court

From the Strib:


Peter Bell: Met Council is trying to work with U

Light-rail mitigation is necessary -- within reason.
(We're on a budget.)


By PETER BELL

As a University of Minnesota regent, I was a strong supporter of the university's research mission and its job-creating potential. And as chairman of the Metropolitan Council, I share the U's concerns about the impact that light-rail transit could have on important research.

However, the real question about the Central Corridor LRT project isn't: "Should we mitigate the adverse effects of LRT?" Rather, the question is: "How do we do so in a manner that is mindful of costs?"

The benefit of a billion-dollar LRT investment to the university will be significant. The Central Corridor project will remove more than 20,000 vehicles a day from Washington Avenue and transform that thoroughfare into a world-class transit/pedestrian mall. The U will have to build fewer parking garages, and faculty, staff and students will have access to first-class transportation worth millions of dollars a year.

The university's initial request of the Met Council was to provide mitigation for vibration and electromagnet impacts for all current and "future" lab equipment placed in buildings along Washington Avenue.

This would have required the council to cover costs into the indefinite future. A consultant for the university, at a recent meeting, wanted mitigation efforts to have a safety cushion of 50 percent beyond what is necessary -- with a potential cost of millions of dollars.

The reality is that there is a limited pool of dollars for the Central Corridor project.
The university's demands on this budget exceed available funds and would provide more mitigation than is necessary. This would make fewer resources available for other important needs on the corridor.

The Met Council already has committed more than $11 million to redesign the Washington Avenue transit mall in a manner that accommodates the university's concerns, and the mitigation steps we have proposed would cost taxpayers another $7.3 million.

Our staff and consultants believe these measures will allow the U's research facilities to function as well in the future as they do today. In fact, in many locations the project will significantly improve research conditions along Washington Avenue by removing thousands of heavy trucks and reducing the number of buses that now rumble along that street every day.

In a recent guest commentary ("Sleepless in Minneapolis," July 27), University Vice President Tim Mulcahy used the University of Washington as a model for us to follow.

The LRT project there is significantly different
in many important ways. That project requires the use of a tunnel-boring machine that will drill underneath sensitive labs, with trains eventually operating in the tubes. Construction will last for several years in an area of campus not previously affected by vibration sources like those that already exist on Washington Avenue.

Also, transit leaders in Seattle are having a very difficult time keeping the extraordinary commitments they made to their university.

Mulcahy also accused the Met Council of showing "indifference" to the university's concerns. This charge is incredible in light of the fact that the council has spent literally thousands of staff hours on this issue and has hired two internationally known consultants to help design mitigation strategy.

The university has been indifferent to our efforts and to the cost constraints under which we are operating.

Perhaps most frustrating was the fact that Mulcahy chaired a faculty group to assess the problems caused by LRT and develop conclusions for University President Robert Bruininks. This analysis took place without talking to the experts in our Central Corridor project office or to our consultants, instead relying on incomplete written information from their work.

Finally, there should be no mistaking the point that the Met Council is firmly committed to mitigating the problems caused by the Central Corridor project so that existing lab equipment will be fully functional after the line is open.

We ask the University of Minnesota to join us in working to develop a cost-effective mitigation strategy that will allow this vital transit improvement project to move forward on time and within our very real budget constraints.

Game, set...

Further Consequences of Footdragging - We Make the New York Times

I've got a post up on the Strib's article this morning on Medtronic related activities of my colleague at the University of Minnesota medical school, Dr. David Polly.

There's also an article in the New York Times:

2nd Medtronic Consultant Draws Senate's Scrutiny
By BARRY MEIER Published: July 28, 2009

A Senate investigation of ties between doctors and the medical device maker Medtronic is putting a spotlight on another of the company's consultants.

That physician, Dr. David W. Polly Jr., urged members of a Senate panel in 2006 to continue paying for Defense Department medical research into combat-related injuries. But Dr. Polly did not disclose during his testimony that he was a Medtronic consultant and was billing the company $6,000 for his appearance, according to documents released Tuesday. Instead, he told lawmakers that he was representing a professional medical association of orthopedic surgeons, according to the documents.

Dr. Polly, who is a medical professor at the University of Minnesota,
subsequently received some of the Defense Department research funds, to head an animal study involving a Medtronic bone growth product called Infuse, according to the documents.

Dr. Polly is the latest academic researcher to come under scrutiny in the Senate investigation, which is being conducted by Charles E. Grassley of Iowa, the ranking Republican member of the Senate Finance Committee.

Senator Grassley publicly released a number of documents, including Dr. Polly's bills to Medtronic, as part of a continuing investigation into the company's marketing of Infuse, a bioengineered bone growth product.

Between 2003 and 2007, Dr. Polly received more than $1.14 million in fees and expenses from Medtronic, those records show.
And the extent of his financial entanglements with the company, as detailed by those records, could raise questions about the ability of academic medical centers to manage potential conflicts of interest by faculty members who are also highly paid consultants to medical product companies.

In late 2006, university officials allowed him to work on the Defense Department-financed study of Infuse. The medical school knew he was a company consultant, but under the school's rules Dr. Polly had to acknowledge only that he received more than $10,000 annually. Medtronic paid him about $350,000 that year alone in expenses and fees, the records show.

In an interview and subsequent e-mail messages this week, Dr. Polly said that he had done nothing wrong in connection with his 2006 appearance at the hearing, which was conducted by the Defense Subcommittee of the Senate Appropriations Committee. A transcript of that hearing shows that he identified himself at the hearing as a representative of a professional medical group, the American Academy of Orthopedic Surgeons. He did not note his ties to Medtronic, according to the transcript.

The documents released Tuesday also indicate that for his appearance at the hearing, Dr. Polly billed Medtronic $6,000.

Dr. Polly said this week that he could not address specific questions about charges to Medtronic because his billing records were not immediately available. "If I billed Medtronic for services that were inappropriate I would be happy to refund that money," he said in the interview. "My relationship with the company has always been on the up-and-up."

Dr. Polly's study, which the Defense Department paid over $466,000 to support, involved laboratory animals and was intended to show whether the use of various antibiotics in combination with Infuse could speed the healing of badly fractured shin bones that were also deeply infected. Such trauma injuries are common in soldiers wounded in Iraq by roadside bombs and other explosive devices.

Until 2003, Dr. Polly was the head of the orthopedics department at Walter Reed Army Medical Center in Washington.

He is the second former Walter Reed doctor to come under scrutiny by Senator Grassley. The other, Dr. Timothy R. Kuklo, published a study of Infuse's use on Walter Reed patients that a British medical journal retracted in March after an Army investigation concluded that he had falsified its results.

Dr. Polly is an author on an influential Medtronic-sponsored study that found that the use of Infuse, a bioengineered protein that stimulates bone growth, was cost-effective in spinal fusions when compared with using bone grafts, the traditional material.

While he was still in the military, Medtronic paid his traveling expenses for medical meetings in this country and abroad.

The general counsel of the University of Minnesota, Mark Rotenberg, said that the medical school had allowed Dr. Polly to work on the Defense Department study despite his ties to Medtronic because the study involved laboratory rats, rather than people, and because Dr. Polly had said that it was not of economic significance to the company. The medical school instructed him not to disclose any data from the study to Medtronic before its public release.

Asked about Dr. Polly's testimony, Medtronic said it believed that he should have disclosed that the company had paid him for his preparation for the 2006 hearing and his travel. Late Tuesday, Medtronic said it plans to conduct an internal inquiry of Dr. Polly's activities and would soon announce new policies regarding consultants that covered disclosure-related issues.

A lawyer for Dr. Polly, John Lundquist, said the physician will review any concerns about how he tracked and billed for consulting activities.

Dr. Cerra and Dr. Bruininks, when will the footdragging over conflict-of-interest in the medical school stop? Dr. Bruininks, recall your statement:

"I think we need to put ourselves in the position of acting according to the highest ethical principles. I believe our people do that now and I believe our people will be doing that in the future as well." President Bruininks (Daily: 6-18-08)

And note the date. It is long past time to do something about this.

July 28, 2009

First, Do No Harm - But Only If My Ox Is Being Gored?

It is ironic to have the University of Minnesota using this phrase to support its opposition to the light rail project on campus. They are asking that the Metropolitan Transit Commission keep things as they are now, because to do otherwise would cause harm - according to them.

The depressing thing is that the University of Minnesota does not seem to think that the original application of the Do No Harm meme - the Hippocratic Oath - applies to them. Thus the "don't worry, be happy" attitude that has accompanied the two year and growing period of time spent foot-dragging on a badly needed reform of conflict of interest policies at the U of M medical school.

As Dr. Dan Carlat has recently put it in his excellent blog - The Carlat Psychiatry Blog -Supporting the search for honesty in medical education:

It was only a matter of time before the U.S. Senate decided to shine a national spotlight on one of the more corrupt sectors of the nation's economy: industry-sponsored continuing medical education (CME).

Senator Herb Kohl (D-Wis) has just issued this press release announcing a hearing entitled "Medical Research and Education: Higher Learning or Higher Earning?" It will take place Wednesday, July 29, at 2 p.m., at 562 Dirksen Senate Office Building in Washington DC. You can view it live on the web by going to the Special Committee on Aging's website.

I think it is safe to say that there will be some very strong testimony about the plethora of sham "educational" programs that are in reality marketing exercises for the drug companies.

I encourage all of you to take some time out of your schedules tomorrow to watch the webcast (hey, it's summer--just cut out of work early). I anticipate that this will be a historic event in the world of medical education.

Hospital Performance? Show Me Some Data!

Jeremy Olson has another excellent health-related piece in the Pioneer-Press:

How good is a hospital? A fresh gauge may offer some insight Medicare casts a public spotlight on select death and readmission rates

Medicare took a significant step in health care's so-called transparency movement this month by publishing death and readmission rates for all U.S. hospitals treating patients for heart failure, heart attacks or pneumonia.

While the data is mostly favorable for Minnesota -- only four hospitals in the state had rates below national averages on any of the measures -- its publication pushes many hospital officials beyond their comfort zone when it comes to public scrutiny of their performances.

It's one thing to publicly report "process" measures, such as how often hospitals prescribe aspirin to heart attack patients upon discharge. It's another to report the actual percentage of patients who die or return to the hospital within 30 days, an indicator the facility did not do a good enough job the first time.

Whether the public uses this information, it captures the attention of hospital leaders, said Dr. David Abelson, president of Park Nicollet Health Services. "It is highly motivating to us and to other health care organizations," he said.

Ten Minnesota hospitals reported death or readmission rates that were better than national averages. Methodist Hospital in St. Louis Park had low death rates for all three conditions and a low readmission rate for heart failure. The Park Nicollet affiliate was one of 10 U.S. hospitals to be above average in four of the six Medicare measures of mortality and readmission.

For now, the publication of these results only affects a hospital's reputation, but it may soon affect a hospital's finances, too. While much of the health care reform debate in Washington focuses on expanding coverage to the nation's uninsured, lawmakers also want to encourage better care overall.



Search the U.S. Hospital Death and Readmission Rates database here.

Example of the kind of data that can be retrieved:

Screenshot.png

July 27, 2009

Exactly the Wrong Thing to Say, At the Wrong Time?

hook.jpg

OurCEO has another op-ed....

Commentary: Exactly the wrong time to cut funds for U of M

by Robert Bruininks

July 27, 2009

In many ways, the university is Minnesota's economic engine, and the value we provide to the state continues to increase. So it's no secret that I've been disappointed to see higher education sink lower and lower on the list of state budget priorities.

[You have heard of this budget deficit thing, Bob?]

Many experts agree that research universities, and the educational, research and creative opportunities they provide, are essential to economic growth and prosperity. If that's true, Minnesota is disinvesting at the exact wrong moment.

[Disinvesting? Hardly. What is this thing called The House That Bob Built? What are these new buildings that are going up? What are you thinking saying such a thing?]

For the second time in six years, our state funding has been cut deeply, requiring difficult decisions about which academic programs and initiatives must expand, which should be maintained, which should be substantially reduced or consolidated and which eliminated.

[Difficult decisions that must be made by highly compensated administrators, such as yourself?]

Such decisions are made more difficult by two factors:

First: The significant cut to our state funding in 2003, followed closely by the development and implementation of our strategic plan, transformed the way we deliver on our public mission. The more obvious changes have been exhausted. The decisions we face now cannot be easily done or undone, and will have lasting effects on the university, our students and the state.

[Perhaps some elements of the strategic plan were/are a mistake and should be modified. The sacred strategic plan is not exactly in the same category as the Ten Commandments, last I checked..]

Second: The national economy and the state's budget woes do not correspond to the health of the university. Most of the university's key indicators are up, students value our degrees, and employers want our graduates. We are being pushed to downsize despite growing demand.

[Ah, excuse me... Where are you coming from with the statement that employers want our graduates? What percent of our graduates this year are unable to find jobs? Presumably students do value our degrees since undergrads leave the U of M carrying the highest debt load in the BigTen.]

I believe that reduced public funding constitutes the "new normal" for public universities. This represents one of several new realities we face, including an aging population, a diminishing workforce, increasing diversity, intense competition for resources and students, and growing demands for additional accountability.

[Yes, Bob, it is a new reality. And people like you had better learn how to deal with it.]

As a result, we will need to become more nimble and responsive, more productive and efficient, more service-oriented and competitive, in order to generate new sources of revenue, recruit and retain talented students, and attract and compensate high-performing faculty and staff.

[And perhaps return to the priorities of a land-grant institution?]

We've made substantial progress on each of those goals, and we have a long-term vision for the University of Minnesota system that goes well beyond the next budget cycle.

[Do you mean that we should trust you, because you have a plan? Another president in another time had a plan and it was disastrous.]

Groucho Marx once famously remarked, "Those are my principles, and if you don't like them ... well, I have others." Our principles don't change in response to short-term pressures, because they are the right principles: academic quality, affordable access, unparalleled service, groundbreaking innovation and responsible stewardship.

[Those are our principles? All of these matters are debatable, but so far such debates have not occurred. Claims, however, have been made. The results of a lack of consensus building on who we are and where we want to go have been painfully obvious. Consensus building is what good leaders do.]

We are educating students to meet the long-term human capital needs of the state, and generating new knowledge and ideas to solve many of society's most pressing problems. I believe these goals transcend hard times and should not be abandoned lightly.

[Human capital? George Orwell would be pleased. Let me just say: Regents scholarship.]

The University of Minnesota was founded before Minnesota became a state, by visionary leaders who saw an abiding public good in the advancement of knowledge. Setting public priorities demands such strong leadership.

[Cough, cough. I could say something here, but I won't.]

Clearly, we must continue to do more on our own to realize our vision -- to improve academic quality, reduce costs and increase productivity. But it is also time for a serious discussion about Minnesota's vision for higher education.

[And when is this discussion going to occur, Dr. Bruininks? Will it be a conversation along the lines of that offered by Provost Sullivan?]

A world-class land grant and research university costs money, but the cost of mediocrity will be even greater.

Bob, you need to stop using straw man arguments. This type of rhetoric is disturbing to anyone who wants to have a serious discussion. It is not a question of either a world-class university or mediocrity. Let's aim to be one of the best schools in the BigTen. And please stop dismissing those who aim for this as "doubters."

Finally-

In two years we will be going over Niagra Falls in a rowboat. OurCEO and many members of the OldGuard will not be in the boat when this happens. It would be prudent to start looking for a new president sooner, rather than later, so that he or she has a chance to learn how to navigate. It would be best for the University if President Bruininks were to ask that a search for his successor commence immediately. The Regents who will be responsible for the search are on board and they are starting to think long term about how to deal with economic reality and priorities given our resources, something President Bruininks appears to find difficult, witness this piece. If the president is truly interested in the long term good of the University, he should take this suggestion.

Repeating the same tired phrases in this opinion piece is not an example of the type of leadership that will be needed at the University of Minnesota in the very near future.

July 26, 2009

Light Rail and the U, A Modest Proposal

Both the Minneapolis Star-Tribune and the St. Paul Pioneer Press have editorials in the Sunday paper today about the latest news on the proposed light rail line.

From the Strib:


Editorial: Rail planners, U need to compromise

It should be possible to stay on schedule and protect research.

In the 14 months since the new rail line was officially routed through the heart of campus, on Washington Avenue, university leaders have been saying that it spelled trouble for the research housed in 17 buildings on or near that street. Noise would present minor difficulty, they said. The real problems would be vibration and electromagnetic interference with highly sensitive equipment, such as the nuclear magnetic resonance spectrometer in Hasselmo Hall.

The Metropolitan Council, the agency in charge of the project, responded by hiring consultants, running tests, creating models and proposing a mitigation plan that keeps all of the university's existing research equipment functional. Council chair Peter Bell has also said he's willing to pledge in writing that any future unforeseen problems would be corrected without cost to the university.

The university in turn hired its own consultants. A faculty panel did its own analysis. It reported to President Robert Bruininks last week: "The Metropolitan Council's proposed mitigation strategies for vibration and electromagnetic interference have not been shown to be effective under the unique circumstances associated with the proposed siting of the light rail line, that is, within 70 feet of highly sensitive research facilities."

The panel urged the university to hold out for a more costly mitigation plan
that maintains vibration and electromagnetic interference levels at their ambient levels. The cost of those measures is not known, but is bound to be in excess of $10 million.

Bell countered that the project cannot afford "over-mitigation."
That word had university officials girding for a fight last week. They were preparing to take their complaint about inadequacies in the Central Corridor's proposed environmental impact statement to the Federal Transit Administration, the expected source of half of the $914 million the project requires.

It should not have come to this, especially not so late in the game.
By taking its fight to the feds, the university risks delaying construction of the linchpin of the 21st-century transit system planned for this region. A year's delay will add an estimated $35 million to Central Corridor's costs, postpone the economic stimulus of the largest public works project in state history and damage Minnesota's chances of landing federal support for future projects.

Delay is much to be avoided -- but so is damage to research that generates more than $100 million a year and holds forth the promise of a better life for Minnesotans. That research is crucial to Minnesota's future.

This is a situation that cries out for compromise
-- not unlike the deal struck earlier this year between Central Corridor's planners and Minnesota Public Radio. High-level negotiations, perhaps mediated by one or more of this state's political leaders, are urgently needed. The talks will have to get past fairly deep mutual mistrust, some of it residual to last year's tiff over where to route the rail line through campus, and go to the heart of the matter. The right legal assurances and some degree of financial flexibility should make it possible to keep research whole and build this railroad on schedule. The public interest demands both.

And from the Pioneer Press:


Light rail hits yet another bump at the U

We stand for the propositions that the Central Corridor light-rail transit project from St. Paul to Minneapolis is a great opportunity for our region and that it will also open a grand new gateway to the University of Minnesota.

So the rumbles of vibration problems and electromagnetic freakouts that we are feeling along Washington Avenue near the U appear to us as an opportunity rather than a barrier. The Central Corridor ride is going to get bumpy before it smooths out and this is another of the bumps that wise officials must chip away at.

It is a major change in our geography and landscape and there is an understandable freakout factor all along the line. The university freaked out because the line will run through the heart of the Twin Cities campus.

The Metropolitan Council, which will build and run the line, proposed an attractive, car-free transit mall on Washington Avenue. While the U has never been wild about the idea -- never as wild as we think they should be -- the Board of Regents did agree to pursue the mall routing. The Met Council agreed to address concerns that vibrations and electromagnetic mojo from the trains could mess up nearby laboratory equipment.

That understanding is now a cause of dispute.

A statement from Tim Mulcahy, vice president for research at the U, said "our concerns have not been adequately addressed.'' He added, "We can't accept a solution for mass transit that puts at risk one of the fundamental elements of our mission."

Peter Bell, the Met Council chairman, said the council will guarantee enough vibe-damping equipment so existing technology at U research labs will function as it does now. "We are committed to addressing both the vibrations and the electromagnetic interference issue so that existing equipment can be used, after the line goes in, as it was used before the line was put in,'' he said. "We are willing to guarantee that, and to take corrective action afterward if that is not the case.''

He said he feels the university wanted the Met Council to pay for an extra margin of safety. "Every dime we spend on mitigation at the U is a dime I can't spend on University Avenue, addressing some of the legitimate issues there,'' he said.

Kathleen O'Brien, vice president for University Services, said the U and Central Corridor planners have worked on the problem for more than a year but have not yet agreed on an acceptable solution. "The University's position is to do no harm," she said, and that may mean lower limits on interference than the Met Council is proposing.

She added that it may be necessary for elected officials to help resolve the issue. "We don't want to go to combat,'' she said.

The university is right to stand up for its interests. These are tough technical issues that affect important, high-level research. No one wants a successful train at the cost of a diminished research capacity for a great university.

But the Met Council is taking the concerns seriously, is devoting considerable resources to addressing them, and is willing to fix problems that arise after the train is running. As with concerns expressed about the train by Minnesota Public Radio and University Avenue residents, the solution to the U's problem need not jeopardize the greater good of the entire line.

This is a major improvement for the U, paid for out of the train project budget, that will be a great benefit for the university community and those of us who know how hard it is to drive a vehicle to a lecture or a concert or a game.

The Washington Avenue mall is the place where the proverbial "golden spike" will be driven in the rail bed, making the entire circuit possible. Let's get our heads together and turn the rumbling of the train into good vibes for all.



A modest proposal

The U has reported, elsewhere, that they are seeking funding from NIH to move the NMR lab to the currently unused Mayo Garage. Presumably this location would take care of problems due to the light rail?

If funding does not come through, could the U please get a hard number for the cost of moving the NMR lab to one of the new biomedical research buildings?

Perhaps then the Met Council might be willing to include this cost as mitigation?

To ask the Met Council to provide an open checkbook, makes it appear that the U has still not gotten over their unhappiness with the route and is willing to stop the project by making unreasonable financial demands.

( Please note the word appear. )

July 24, 2009

Budget Jihad at U of M ?

From Thomas Lee's outstanding blog, Patent Pending:


"Budget jihad"

By Thomas Lee

If you need to know how much is riding on the new Dr. Doris Taylor company the University of Minnesota plans to spin out later this year, consider the following story, confirmed by several sources.

About four months ago, Matt Kramer, Gov. Tim Pawlenty's chief of staff, summons Taylor and Jay Schrankler, who run's the university's Office of Technology Commercialization, to a meeting to discuss the yet-to-be named spin off company. Taylor, you may remember, gained international fame last year when she successfully grew a beating rat's heart in the jar.

U officials believe Taylor's work in regenerative medicine will do for the school what the pacemaker did for Medtronic. By the end of this year, the U hopes to spin out the first of what they hope to be many lucrative start-ups based on Taylor's work: a company that helps drug companies test their therapies on human tissue.

Kramer was certainly impressed, as was Dan McElroy, the commissioner of the state Department of Economic Development (DEED) who attended the meeting. But things took a turn for the worst when Schrankler told McElroy, correctly, that the company might not stay in Minnesota if it couldn't find local investors.

The prospect of losing one of the most promising companies to emerge out of the U in decades did not sit well with McElroy, who threatened to "wage budget jihad" on the U if the start-up left Minnesota.

Yowzers! (Apparently, the term jihad is a popular word these days for both Muslim extremists and state economic development officials.)

McElroy was traveling Thursday and not available to comment. When asked about the incident, Schrankler, perhaps channeling his inner Hillary Clinton, smiled and replied "Let me put to you this way: we had a good, no-holds bar discussion," sounding more like he was negotiating a nuclear arms treaty with the Russians than staring down the DEED commissioner.

Is it my imagination or is McElroy getting a little grumpy lately? Just a few weeks ago, the DEED commissioner chewed out U vice president of research Tim Mulchay for some seemingly innocent remarks Schrankler made to this reporter about nanotechnology. I guess giving press conferences each month about the state's rising unemployment numbers is testing McElroy's patience.

Sadly, this episode represents the state of political leadership in Minnesota. Maybe the Pawlenty Administration should do something useful and pass an angel investment tax credit instead of making useless threats against U officials. You can't scream at U officials for moving a company out of Minnesota if you do nothing to keep them here.

In any case, Schrankler and Doug Johnson, who heads the U's Venture Center, say while they hope the company remains in Minnesota, they will do what's best for the start-up.

"We don't want to screw this one up," Schrankler said.

Unable to find the right talent in Minnesota, the U recently hired a headhunter to launch a nationwide search for a CEO. The school is raising $1 million from angel investors and local wealthy families, most notably the Pohlads.

The U has also assembled an all-star cast to advise the start-up, including AppTec founder and former CEO Bonnie Baskin, John McDonald, former vice president of research for MGI Pharma, and Kathleen Tune, a principal with local VC firm Thomas, McNerney & Partners.


July 23, 2009

Nightmare at Eastcliff - Tom Rukavina files for governor

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Batten down the cases of chardonnay!

Our favorite populist, the Iron Ranger, state representative Tom Rukavina has filed for the governor's race in Minnesota.

From the Minnesota Progressive Project:

Rukavina's filing gives the DFL two candidates from the Iron Range; State Sen. Tom Bakk of Cook is already in the race. It also brings the number of DFL candidates either actively running or considering an entrance into the race to approximately 12.

We'll touch base with Rukavina at some point in the next day or so and have more information for you then.

July 22, 2009

Light Rail and the U, The Continuing Saga

U Admin: Cross my palm with (a lot of) silver...

From 'CCO:

A University of Minnesota report questions the consequences of running a light rail line through the Minneapolis campus, citing concerns that vibration and electromagnetic interference from the line could damage sensitive research equipment at the school.

The report, finished this week and written by professors of engineering and medical science, noted there are more than 80 laboratories with fragile equipment in 17 buildings near Washington Avenue, the proposed light rail line route.

The report urges university administration to insist the light rail builders limit vibration and electromagnetic interference to current levels. That could be made possible by techniques that include building on a special cushioned slab of concrete or running the trains on batteries when on campus, the report said.

"The university cannot acquiesce to mitigation strategies that compromise its research mission," the report said.

The university has previously raised electromagnetic radiation concerns, as well as traffic and safety worries, about the proposed Washington Ave. route.

Peter Bell, the chairman of the Metropolitan Council, which is overseeing the light rail project, said he believed the current mitigation measures were sufficient.

"We remain hopeful that university officials will join us in working to achieve an agreement that will allow this vital regional transit improvement to go forward," he said in a prepared statement. "Their continued resistance has the very real potential to delay the project and increase its cost."



[It is pretty clear what is going on here, all the U Admin is doing now is haggling over the price.]

How to Decrease the Cost of Medical Care? Haggle with the Hospital!

The University of Minnesota hospital is mentioned in Forbes:

Eight Ways To Cut Your Doctor's Bill

...Remjeske, a financial planner, returned home to Minneapolis for surgery and set out to trim his costs. He got quotes from three different surgeons at three hospitals and tried to anticipate related expenses, like anesthesia and physical therapy. The estimates ranged from $14,000 to $18,000. He picked the University of Minnesota's hospital, which had the lowest estimate.

After the successful surgery, the bills arrived, totaling $16,000--more than what he'd expected. Remjeske fought back, objecting to specific hospital charges. The hospital agreed to strike a $500 charge for time in the recovery room, $200 for a leg-lifting device that Remjeske claims wasn't used and $800 in other charges, including the cost of physical therapy sessions that never happened. Remjeske says he missed out on the opportunity to get a deal on his sedation medicine because the anesthesiologist wasn't able to tell him the price ahead of time.

"If you go in unknowing and come out unknowing, you could end up with an unbelievable bill," Remjeske says. As for the hospital, "We think we give the best care," says spokeswoman Jennifer Amundson, "so it's nice to know that we're also competitive."

Haggle with your doctor and hospital? These days you'd be crazy not to.

{Competitive? At gouging?}

July 21, 2009

President Bruininks - Nailed!

From the Daily:

A president's address

To be read at convocation by University President Robert H. Bruininks.

Hello everybody and welcome to your new home at the University of Minnesota, where we are all Driven to Discover! Looks like we have about 5,400 of you freshmen this year, about 200 more than last, securing our position as the second or third biggest campus in America or whatever. What an exciting place!

Now before we get much further into the pomp and pageantry of the day, I know that many of you are worried about the cost of college. You are worried about a multi-billion dollar shortfall in state budget, you are worried about the debt of our graduating students (which is highest in the Big Ten), you are worried about how that must balance with the apparent explosion of construction around campus and you are worried at what that all means for the quality of education you came here to receive.

But really, you have no reason to fear.

Let me tell you why, my children. When you have the mind of a shrewd businessman such as myself, you know that a decisive hand and a sharp axe are needed in the path ahead. As a newly minted Executive of the Year, I'd like to apply some of that executive capital and make some responses to the budget cuts.

We're going to be doing the old chop and raise drill as a result; that is, chopping programs and staff and raising tuition, a task becoming more and more common across the country.

But don't worry; you all should be able to absorb the deficit without too much problem.

What? It is under 10 percent.

Some call me foolhardy
for pushing this University to become a top public research institution, often at the expense of non-research producing departments. But let me say to those doubting losers that we are on track to do so, and that's despite the budget.

We don't have it bad at all. Consider this, you guys: The University of California system is losing more than $800 million, more than five times greater than our $150 million loss. And I say let's take advantage of this! In business you need men with loyalty, and Mark G. Yudof is one of them.

Throwing himself and his university on the grenade to save the California state budget is courageous, and as UC's quality of service is blown to bits, our ranking on the public research institution is surely set to jump up at least two or three ranks!

We are going to be making sure that what money we do have left will be spent wisely and with the best interests of the educational standards of this University in mind.

There are many myths spread around this University that are especially directed at you. But have no fear, freshmen. There is no such thing as a gophelope, the Superblock smell is not vomit, none of you will be sacrificed to the Tin Man and finally our ability to provide the same quality offering of higher education will not be affected by the budget deficit.

Without further ado, I want you all to take out those little envelopes you were given and open them, as per my instructions. (Pause for collective gasp.) Inside, you will find a five dollar bill voucher that you may use anyway you would like. The vice-provost of student perceptions and the vice-provost of budget and finance both agreed with the vice-provost of sage advice that this was the best way to not only illustrate the University's budgetary strength, but to stimulate the local economy.

Now let's all head over to the TCF Bank Stadium where those crisp new vouchers will work on the food and merchandise.

Say it isn't so, Dr. Bruininks.

Boilermakers Pile It On...

Having recruited away Jeff Roberts, our chem dept chair, to be a dean at Purdue, those Boilers now seem intent on taking away our supercomputer crown:

From the Chicago Tribune:


Purdue to build new supercomputer


WEST LAFAYETTE, Ind. - More than 200 information technology staffers will gather Tuesday at Purdue University to build a room-sized supercomputer that is expected to be the largest campus computer in the Big Ten.

The new supercomputer, called "Coates," will be built from more than 10,000 computer processors. Purdue's previous supercomputer, "Steele," had 6,500 when it was built last year.

The new computer is expected to be up and working by the end of the day.

Coates is expected to rank in the top 50 supercomputers worldwide when the next ranking is published in November.

The Big Ten's largest campus computer is currently at the University of Minnesota's Supercomputing Institute. That machine is ranked 59th.

July 20, 2009

How to beat the higher cost of co-pays for non-generics? Rebates!

Hmm... It used to be the claim of some drug manufacturers that generic drugs were evil or inferior to the real thing. Now some of them are selling generics. Of course the co-pay for the higher-priced spread is higher, too. How to get around this?

From the WSJ


Here's how a co-pay for a medicine is supposed to work: Insurers set up a tiered system where patients fork over a smaller co-pay for cheaper drugs and a higher one for more expensive, brand-name drugs. The setup is supposed to encourage patients to use cheaper generics.

But the drug makers are disrupting that system, according to the WSJ. Increasingly, they are paying part of patient co-pays for brand-name drugs, forcing insurers to ante up for these pricer drugs.

"Initially, we did it quite honestly because we were facing a generic presence in the marketplace," Jim Sage, who manages marketing for Pfizer's cardiovascular drugs, told the WSJ. "We also did it because prescribing decisions were being based not just on clinical factors, but also cost."

Insurers say that the result is cost-shifting from patients to the insurance plan, which results in raised premiums for everyone. Drug makers counter that more expensive co-pays imposed by health plans are making brand-name medicines unaffordable for patients. The WSJ notes that the average co-pay jumped 44% for preferred branded drugs to $26 a prescription between 2002 and 2008, but the overall cost of the same drugs during that period skyrocketed 64%.

That leads some insurers to say that if the drug companies really wanted to help patients, they should just lower the cost of drugs.

Exactly...

July 19, 2009

The Check Is Not In The Mail...

The Minneapolis-St. Paul Business Journal Reports:

Burrill seeking $1B for Elk Run, but 'no checks yet'

Biotech investor Steve Burrill is out raising a $1 billion fund to support the massive bioscience project planned for Elk Run, near Rochester, though he said he has "no checks yet."

Burrill is partnering with Woodland, Calif.-based Tower Investments, the real estate developer behind the project. Tower Investments has several times declined to comment on to what extent the project is already financed.

Both Tower and Burrill are expecting to lure startups working on technology developed at Mayo Clinic and the University of Minnesota to their development. Burrill also said he envisions the project drawing attention from institutions in neighboring states, such as the University of Wisconsin-Madison.

"If I stand on a street corner at Elk Run and wave around $500 million, people will come," he said.

Still, Burrill acknowledged that raising a venture fund is difficult in the current economy, saying he's received some "push back" from the pension funds, companies, and other organizations he's approached. "There are a lot of questions, 'why Elk Run?' and 'why life sciences?' It's difficult, but this is a good opportunity."

Burrill said he met Tower Investment's leaders through a mutual contact at Mayo Clinic. However, Elk Run's backers do not have a formal agreement with the clinic. "I would put us in the best-friends category. There are no formal secret society or legal agreements."

Mayo has long had its own approach to spinning off startups that are developing its technology. Mayo has a $10 million venture fund and an active office of intellectual property. Over the years, however, the majority of those startups have moved out of Minnesota. Out of Mayo's 35 spinoffs, only three have remained based in Minnesota, a Mayo official told the Business Journal in 2007.

And many of the companies that have stayed in the state, such as NeoChord, Torax Medical Inc. and Muve Inc., are based in the Twin Cities metro area -- not in Rochester.

"At a 30,000-foot level, Minnesota is the world headquarters for med-tech. Tower is a world-class real estate company. We are a world class venture capital firm. There's no shortage of opportunities."



Maybe Bob Bruininks, Frank Cerra, and Deborah Powell should join the board of this operation - when they retire? They've had a lot of experience with world class operations...

July 16, 2009

The Next Mayo Clinic?

While much gnashing and thrashing has been going on at the AHC/U of M med school, the barbarians are at the gates, figuratively speaking.

From Dave Durenberger's newsletter:

MASSIVE HEALTH CARE VENTURE POTENTIAL FOR THE DAKOTAS, WESTERN MINNESOTA

Sanford Health of Sioux Falls, SD, is talking to MeritCare in Fargo, ND, about creating a new medical presence in the five states of SD, ND, MN, NE, and IA. Sanford has 23 hospitals and 128 clinics plus ancillary services, a health plan and 9,200 employees. MeritCare operates 583 beds in two Fargo hospitals, 20 other facilities in the Fargo-Moorhead area and a regional hospital in Thief River Falls, MN. It has eight medical clinics in ND, 19 in MN and 7,131 employees.

MeritCare competes with Innovis Health -a hospital and multi-specialty group practice part of the Essentia System out of Duluth in the Fargo-Moorhead area. Sanford Health's principal competitor is Avera Health System, headquartered in Sioux Falls as well. Since banker and philanthropist T. Denny Sanford made a $400 million gift to Sioux Valley System to change its name and focus on research, hospital campus redesign, and children's health, Sanford has been well on its way to giving CEO Kelby Krabbenhoft potential for his bragging rights as the next "Mayo Clinic."

You remember good 'ole Denny? An alumn and a potential donor to the House that Bob Built? He did finally give about six million to the stadium fund lately after the initial fumble over naming rights. He's also given some big bucks to Mayo.

It's an old story - but still illustrates why a new COI policy at the U of M med school is needed urgently

Quoted in University Diaries:

Last spring a small group of first-year medical students at the University of Minnesota spoke to me about a lecture on erectile dysfunction that had just been given by a member of the urology department.

The doctor's Power-Point slides had a large, watermarked logo in the corner. At one point during the lecture a student raised his hand and, somewhat disingenuously, asked the urologist to explain the logo.

The urologist, caught off guard, stumbled for a moment and then said that it was the logo for Cialis, a drug for erectile dysfunction that is manufactured by Eli Lilly.

Another student asked if he had a special relationship with Eli Lilly. The urologist replied that yes, he was on the advisory board for the company, which had supplied the slides.

But he quickly added that nobody needed to worry about the objectivity of his lecture, because he was also on the advisory boards of the makers of the competing drugs Viagra and Levitra.

The second student told me, "A lot of people agreed that it was a pharm lecture and that we should have gotten a free breakfast."

And so it goes, Frank?

Would any Aussie switch health care systems with the US - not on your nellie!

From the comments section of an article in the NYT entitled:

Health Care's Historic Moment

Reader Comment

"Changing the current U.S. system isn't really all that risky, because every other developed nation has already done it, successfully -- gotten rid of job lock, to the benefit of small businesses and employees; brought down the cost of health care; and provided cover for everyone. I now live in Australia, and I urge all Americans to take a look at the Aussie system. Is it perfect? No, nothing is. Are there people with gripes? Of course! But would any Australian swap with any American? As we say down under, not on your nellie. . . ." - Posted by Lisa, July 16, 1:14 a.m.

Priced Out of the American Dream?

from EJ Dionne's piece in the Strib:

It's the silent education crisis, the one we don't talk about much because its existence undermines the story we like to tell about our country.

...we rarely confront how badly we're faring when it comes to educating our people after high school. That silent education crisis belies our claim that no nation comes close to us in guaranteeing that anyone can work hard, get a great education, and soar.

Judge Sonia Sotomayor honored this national article of faith in a lovely tribute to her mother at her confirmation hearings. "She taught us that the key to success in America is a good education," Sotomayor said.

"And she set the example, studying alongside my brother and me at our kitchen table so that she could become a registered nurse."

In 1976, the year Sotomayor graduated from Princeton, federal Pell Grants for low-income students covered 72 percent of the average cost of a four-year state institution. An excellent education (if not necessarily at Princeton) was, in principle, within reach of most Americans. But by 2003, Pell Grants covered only 38 percent of the cost of attending a state university.

Today, the United States stands 10th in the percentage of 25- to-34-year-olds who have earned a postsecondary degree.

The information I've just offered comes from an important article by Andrew Delbanco, a professor at Columbia University, published this spring in the New York Review of Books. Delbanco concludes that "a great many gifted and motivated young people are excluded from college for no other reason than their inability to pay."

...remarkable finding of Donald E. Heller, the director of Penn State's Center for the Study of Higher Education, that "the college-going rates of the highest-socioeconomic-status students with the lowest achievement levels is the same level as the poorest students with the highest achievement levels." I added the italics to underscore the not-so-hidden injuries of class.

All this is why President Obama went to Michigan on Tuesday to announce a plan to spend $12 billion over 10 years to strengthen our community colleges and "help an additional 5 million Americans earn degrees and certificates in the next decade."

But his proposal should be seen only as a first step. The community colleges are in crisis because they are being flooded with students who cannot afford four-year schools, and also with unemployed workers seeking training for new jobs.

Obama is on the right track. But we'll need to do much more than he's proposing if we want the story of Sonia Sotomayor and her mom to define a realistic aspiration for the next American generation.


Ah, the a-word. Everyone is using it... To some, it means something. To others, is it just empty sloganeering?

July 15, 2009

Hilarious Meeting At The U - Newt And TeePaw Talk Healthcare

From the Daily:

Gov. Tim Pawlenty and former House Speaker Newt Gingrich talked about the future of healthcare Wednesday at the University of Minnesota's McNamara Alumni Center.

They spoke to an audience of about 150 at a workshop titled "Creating a 21st Century Intelligent Health System in Minnesota," hosted by the Center for Health Information.

Pawlenty called the nation's healthcare system "fundamentally broken," and said reform should come through consumers paying for quality of care, and correcting medical malpractice.


[What a crock. Medical malpractice is a tiny part of the cost of healthcare. And the problem is easily rectified - see Texas.]

Both speakers critiqued the 1,000 page proposal released by the Obama Administration Tuesday, which would reduce the number of uninsured by 37 million and cost about $1 trillion dollars over 10 years.

Pawlenty said if national reform is centered on price, Minnesota would get the short end of the stick because it has one of the most efficient systems in the nation.



[No, Tim, that isn't how it is going to work if done right. Incentivizing efficient care should be to our advantage.]

Gingrich said the number one word to describe the proposal is "disappointing." He called it a "1970 socialized medical model brought up 30 years later." He said the proposal was all about control, and the bill created 31 new agencies, but lacked innovation.

[Ah Newt, you're so sixties, not even seventies. Will these people never get over the idea that all they have to say is "socialism" and everyone will drop an idea like a hot potato. Not anymore, pal.]

Both speakers said Obama's reform bill should be stalled. Gingrich said as time goes on it would be tougher to pass it through the Legislature.

Gingrich also shared Pawlenty's motto that it is unnecessary to raise taxes. He said if healthcare payments were aligned with value and "we go after the crooks" (people committing medical malpractice), there would be almost enough money to pay for universal coverage.

He gave the example of five pizza parlors that were claiming to treat HIV/AIDS to collect coverage as an example of people abusing the system.


[Yeah, that happens all the time. That damned Campus Pizza. Why pretty soon McDonalds will get into the racket.]

Frank Cerra, senior vice president for health sciences and dean of the Medical School, also said there is no need for new money to enter the healthcare system.
He said the way doctors are paid needs to change and nurses could be better utilized. Eliminating fraud in service programs like Medicare and Medicaid could also save money, Cerra said.


[Oh, Frank, puh-leeze. Stop the pandering and remember what you said at the Board of Regents meeting on July 8: "I would add parenthetically, where the president was, I think they should give us a little more money to do it with."]

Human service programs were also criticized at the state level, as Pawlenty said programs like General Assistance Medical Care were "designed on the heels of others," and are "now imploding."
[Pawlenty's position on GAMC has been outrageous. To quote only one outraged group, the socially conscious Catholic clergy: Archbishop John Nienstedt and the state's other bishops sent a letter to legislators last month encouraging them to balance the budget with a mix of revenue increases and cuts. "We believe that resolving the budget deficit through spending cuts alone will do great harm to Minnesotans and our economy," they wrote. "We urge you to support raising sufficient revenue as part of a comprehensive approach to resolving."

The bishops said that cuts to health and human services should spare the poor. "Catholic social teaching upholds the role of government to assist individuals and communities when they cannot help themselves. In performing this role, the state is fulfilling its moral responsibility to promote the common good."]

Transparency and Medtronic's $800,000 Doctor

Yet more from the Wall Street Journal:

Remember that former Army doctor accused of faking data in a published study that found positive results for a Medtronic product?

Turns out, Medtronic paid him nearly $800,000 over the past three years. Here's the report from this morning's WSJ.

Medtronic says it paid Timothy Kuklo (pictured) for developing products for the company, training doctors and speaking at company events, and that Medtronic wasn't connected to the study or journal article in any way. Kuklo hasn't publicly commented and didn't return a message left by the WSJ.

There are plenty of valid reasons for medical device makers to pay physicians -- for one thing, practicing doctors need to be involved in the development of new devices. But there's also been a push for public disclosure of these payments, and today's report does make us wonder how much Medtronic pays other doctors. We'll be able to find out -- but not for a while.

The company, like several other drug and device makers including Pfizer, Eli Lilly and Merck, has promised that it will start publicly disclosing payments to doctors. But the first Medtronic report, which will be on payments made in 2010, isn't due out until March 2011.

Beer outside the stadium?

From Charley Walters:

The University of Minnesota has opted for a no-alcohol policy for Gophers football games inside TCF Bank this season. But for those of appropriate age who want to enjoy a beer at the games this season, athletic director Joel Maturi said today, there will be tailgating right outside TCF Bank Stadium, as well as other nearby venues, including the University's McNamara Alumni Center.

"It's only in the stadium that the policy exists," Maturi said.

It's also possible beer might be available, albeit at private parties, at the Mariucci and Williams arenas across the street.

Some questions:

And just how much will those tailgating parking places cost?
I've heard some rather high numbers...

And the obvious question, the answer to which has lead to the U's no alcohol IN the stadium policy: How are "mixed" age groups going to be controlled? Will the cops stroll 'mongst the tailgaters asking for ID?

Private parties in Maruch and Williams? I don't think I'd try that. Seems to be in direct contradiction of what's been said before? Maybe OurCEO could have a chardonnay party over at Eastcliff before/after the game?

Can anyone say hypocrisy.

Beer outside the stadium?

From Charley Walters:

The University of Minnesota has opted for a no-alcohol policy for Gophers football games inside TCF Bank this season. But for those of appropriate age who want to enjoy a beer at the games this season, athletic director Joel Maturi said today, there will be tailgating right outside TCF Bank Stadium, as well as other nearby venues, including the University's McNamara Alumni Center.

"It's only in the stadium that the policy exists," Maturi said.

It's also possible beer might be available, albeit at private parties, at the Mariucci and Williams arenas across the street.

Some questions:

And just how much will those tailgating parking places cost?
I've heard some rather high numbers...

And the obvious question, the answer to which has lead to the U's no alcohol IN the stadium policy: How are "mixed" age groups going to be controlled? Will the cops stroll 'mongst the tailgaters asking for ID?

Private parties in Maruch and Williams? I don't think I'd try that. Seems to be in direct contradiction of what's been said before? Maybe OurCEO could have a chardonnay party over at Eastcliff before/after the game?

Can anyone say hypocrisy.

Are Campus Tweets Being Filtered in Some Way?

Added at 12:25

Latest tweet accepted:

wbgleason: Don't know what the problem was. Whether someone intervened or there was a glitch. Latest post up at #UMN

I'm not sure whether it was a twitter glitch or some intervention. But the latest post was accepted.

[Added at 11:48 AM, Wednesday July 15: Apparently they are being filtered - I hesitate to say the word censored. I put this up as a test:

wbgleason RT @UMNews Online exhibit - U of M's Memorial Stadium http://brickhouse.lib.umn.edu/ #UMN We gave up this for TCF Stadium? a test

The tweet showed up immediately on #UMN on twitter - using the search function. It has yet to show up on the Daily campus tweets site. Interesting...

A final experiment:

Further experiments http://bit.ly/OnrkQ Appears that not all posts including #UMN show up as U. of Minnesota Daily campus tweets?

This hasn't shown up either, so I think it is safe to assume that whatever is going on is deliberate.]

From Twitters list of #UMN

wyffels RT: @UMNews: Online, interactive exhibit illustrates the history of U of M's Memorial Stadium http://brickhouse.lib.umn.edu/ #umn

wbgleason wbgleason RT @UMNews Online exhibit - U of M's Memorial Stadium http://brickhouse.lib.umn.edu/ #UMN We gave up this for TCF Stadium?

wbgleason RT @ByJenna It actually happens regularly - click on #UMN then go to the Daily and look at #UMN there. Notice anything funny?

wbgleason RT @UMNews Online exhibit illustrates U of M's Memorial Stadium http://brickhouse.lib.umn.edu/ #UMN We gave up this for House That Bob Built

--------------------from campus tweets--------------------

# wbgleason: RT @ByJenna It actually happens regularly - click on #UMN then go to the Daily and look at #UMN there. Notice anything funny?

# ByJennaByJenna: RT @MarloWelshons Lose yourself poring over the history of Minnesota's Memorial Stadium http://brickhouse.lib.umn.edu/ #umn

# MarloWelshonsMarloWelshons: Lose yourself poring over the history of Minnesota's Memorial Stadium, and then share your own memories! http://brickhouse.lib.umn.edu/ #umn

# UMNewsUMNews: Online, interactive exhibit illustrates the history of U of M's Memorial Stadium http://brickhouse.lib.umn.edu/ #umn

----------------------

At first I thought this might be a mistake. So I modified the post and put it up again. Neither one of the #UMN flagged posts has shown up on the Daily Campus Tweets site.

According to the description of Campus Tweets:

As members of the University of Minnesota community, you also will be able to contribute tweets of news, happenings, events and observations of things on campus. When you come across something newsworthy or worth comment on campus, just tweet it with #umn at the end of it.

If there are exceptions to this, perhaps it would be a good idea to explicitly state them?

Central Corridor - Another example of the long term consequences of lack of leadership?

Although I have a lot of sympathy for the bad position in which my fellow scientists have been placed vis-a-vis relocation of sensitive instruments...

Once again we see the consequences of poor leadership on the matter. Rather than fighting tooth and nail against the Central Corridor proposal, the university should have been working all along, in cooperation with the Met Council, to try to solve these issues.

Although moving sensitive instruments to the Mayo garage at first seemed like a good idea, it would probably be a good idea to talk to all of the major players to see whether, ultimately, a better move would be to one of the new buildings under construction.

From the latest on the matter from the Daily:

Even as orange barrels and multi colored paint were placed in downtown St. Paul last week, marking some of the first visible work on the Central Corridor light rail line, the University of Minnesota is not yet ready to have construction begin on campus.

In the next few weeks, a University team led by Timothy Mulcahy, vice president for research, will present recommendations to President Bob Bruininks on how to proceed with mitigating the impacts of the Central Corridor.

The report will combine the expert opinions of both the Metropolitan Council and the University on how to alleviate vibrations and noise from the line that could impact 80 research labs in 17 buildings along Washington Avenue.

The University, in conjunction with the Met Council and surrounding cities and counties, published a memorandum of understanding last summer which forged an agreement on issues such as traffic and parking solutions, the location of light rail stations and the design of the pedestrian mall. However, the agreement came only after losing a battle to have the line run in a tunnel directly underneath Washington Avenue.

From hiring experts, consultants and putting in faculty hours and services, O'Brien said the University has spent nearly $2 million on the Central Corridor over the last several years.

That doesn't include the cost of moving the University's Nuclear Magnetic Resonance lab, which officials say cannot stay near the line as it will impact the facilities sensitive research equipment.

Estimates for moving the facility are anywhere between $10 and $20 million, Beverly Ostrowski, facilities manager at the NMR lab, said.

Lab officials are seeking funds from the National Institutes of Health (NIH) to move the lab to either the Mayo Memorial Building parking garage or to the new biomedical sciences buildings.

Ostrowski said she expects a decision from NIH in October, but even if the funds come through, she said it's still important that the University and the Central Corridor come up with a working mitigation plan.

While the University has been in these negotiations for about 14 months, the University's President of Parking and Transportation Services, Bob Baker, who is also chair of the University's work group with the Central Corridor, said that other universities have taken much longer to negotiate light rail lines, including the four-year mitigation of a light rail line at the University of Washington.

Second Ward councilman Cam Gordon said that he was initially disappointed that the University decided to seek mitigation plans so late, and said he wishes the University, city and county could have worked together earlier to prevent these negotiations from stalling the project.

Time is money for the Met Council, which fears a large inflationary price tag could come along with delaying the project.

Met Council spokesman Steve Dornfeld , said he understands the University's concerns for their research institutions, but there is not much "give" in the projects schedule.

If you draw a line in the sand - as the university did - and then something is forced down your unwilling throat, this is the result. It is time for the university to start learning how to make contingency plans for worst case scenarios. Perhaps we can learn something from this situation?

July 14, 2009

House Bill Provides for Full Disclosure of Physician Payments

If you can't make them do the right thing for the right reasons...

From Goozner's Blog on Health:


Bill Includes Full Disclosure of Physician Payments


The House bill would create an internet accessible database that includes all health-related payments to physicians by corporations including gifts, food, or entertainment; travel or trips; honoraria; research funding or grants; education or conference funding; consulting fees; ownership or investment interests; and royalties or license fees. If I'm reading the bill correctly, it says anything over $5 must be reported. (From pg. 635 of the bill.)


Ethics? What me worry?

Dr. Kuklo, who has been mentioned here several times, appears to be in deep doo-doo.

From the Wall Street Journal:

JULY 14, 2009, 5:13 P.M. ET
School Says Surgeon Failed to Disclose Medtronic Deal

Washington University said a surgeon accused by the U.S. Army of falsifying a study favorable to Medtronic Inc. failed to tell the school he had a paid consulting arrangement with the medical-device maker.

Surgeon Timothy Kuklo is on paid personal leave at the request of the St. Louis school, where he is a member of the medical faculty. The allegation that he failed to properly disclose his financial relationship with Medtronic was made in a June 23 letter from Washington University medical-school Dean Larry J. Shapiro to Sen. Charles Grassley (R., Iowa), who is investigating the Kuklo matter.


It gets, unbelievably, worse...

From the Wall Street Journal Health Blog:

July 14, 2009, 5:25 PM ET


Doctor Accused of Falsifying Studies Gave Ethics Talk

The former Army surgeon at the heart of a scandal over allegedly falsified research gave a lecture last December on "ethical business practices."

Copies of slides used in the Dec. 13 presentation by surgeon Timothy Kuklo were included in a packet of information sent by Washington University to U.S. Sen. Charles Grassley. Kuklo started at the university in August 2006 and is currently on paid leave.

The university says Kuklo failed to inform it of his financial relationship with Medtronic in 2007 when he was conducting research on one of the company's big-selling spine products, the WSJ is reporting this afternoon. Kuklo has not responded to calls for comment.

The Army, meanwhile, says Kuklo falsified data in a study published last year on the use of Medtronic's Infuse bone-growth product in injured soldiers.

The December presentation on ethics was given in Chicago, but the slides do not indicate who was being lectured to. Also, many of the slides are hard to read.

One slide titled "Importance of Ethical Business Practices," indicates that "trust is fundamental to the doctor-patient relationship" and that "conflict of interest concerns will erode this foundation." Another slide includes the recommendations "avoid unethical conflicts of interest" and "avoid the perception of problematic COI."

If course before anyone in Minnesota goes into finger-pointing mode, it should be noted that we have had similar problems at our own place that surfaced last December. For further information, please see:

Going Green At The U?

green.jpg

Trust Me, I'm a Med School Dean

From the excellent blog of Dr. Carlat:

Everybody's buzzing about the new organization and website, ACRE, whose purpose is to stem the tide of legislation that is rehabilitating the ethics of physicians. The trouble is, there is some confusion about which is the true ACRE website. Is it this one, which calls itself the "Association of Clinical Researchers and Educators"? Or is it this one, which calls itself "Academics Craving Reimbursement for Everything"? It's devilishly hard to distinguish the two, because their messages are identical.

At any rate, either ACRE 1 or Acre 2 is hosting this fancy conference to convince everyone that doctors should be giving more, rather than fewer, promotional talks for drug companies. Incredibly enough, one of the scheduled speakers is Dr. Jeffrey Flier, the dean of Harvard Medical School. I guess we now know where Dr. Flier stands on the issue!

Seems that the U of M med school would be a fertile recruiting ground for ACRE membership. Maybe we could hire the Harvard dean the next time the job opens up? He seems to have his goals aligned with that of our institution. Goal alignment, isn't that the latest in adminspeak around here?

Perhaps ACRE should make Chuck Grassley an honorary member and invite him to speak at their function?

And so it goes...

July 12, 2009

What does the adminspeak phrase "best practices" mean?

An illustration of the use of the phrase:

bestpractice.gif

For all practical purposes, best practices are the way things are done somewhere else that administrators would like to do here without having to provide justification.

q: Why should we do it this way?

a: Well, this is a best practice.

So, to use a completely arbitrary example, we need to re-organize the graduate school according to best practices at universities x, y, and z. [Where x, y, and z do it the way the administrator would like it done here.]

Moral: Be very suspicious when an administrator claims to be here to help you and show you best practices for how to do something.

July 11, 2009

Goldy Asleep On Small Business Biotech? Badgers Seize the Moment?

In survival mode, biotech startup VitalMedix leaves Minnesota for Wisconsin

I-love_wisconsin.jpg

It's a sign of tough times for promising technologies. The biotech startup VitalMedix, which is developing a drug to protect bodies from severe blood loss, is leaving Minnesota for Wisconsin to take advantage of a state tax-credit program.

"Any start up has to look for the most fertile ground for investment," President Jeffrey Williams said. "Right now Wisconsin has a better opportunity than does Minnesota."

But is this announcement also the sign of a bit of a border war? VitalMedix is the latest Minnesota company to move across the border to Wisconsin. Rapid Diagnostek, formerly of St. Paul, left for Wisconsin last year and other companies are considering a move, according to the Milwaukee Journal-Sentinel.

"An additional curve ball to try to hit (in Minnesota) is that we're a biotech company,"
William said. "The Twin Cities is the birthplace of medical-device technology. There have been some very successful investors in medical device technology. But they look at this ... and it's a different deal to try and understand."

The current business environment seems to be a tough one for both the State of Minnestoa and the U to figure out. My neighbor is a small business man and he informs me that IF he had the money he would expand his business and add a person.

The trick here is to figure out tax incentives that REQUIRE job creation. Giving some incentives simply puts more money in the pocket of the people running the show. This is a hard nut to crack but we really need to get on it. Minnesota jobs depend on it.

Time to get real?

July 10, 2009

Preview of Coming Attractions - Disaster at California's Public Universities

California's Public Universities to Cut Salaries and Enrollment in Budget Crunch

San Francisco -- California lawmakers are still deadlocked over a plan to close the state's $25-billion budget gap. But the state's universities released plans this week to slash faculty and staff salaries, sharply cut enrollment, and raise tuition in the expectation of the largest cut in state support in several decades.

Faculty and staff members at the University of California will be placed on furlough starting in September for seven to 26 days per year, according to a plan released today by the system's president, Mark G. Yudof. The plan, which is expected to be approved by the university's Board of Regents next week, will amount to a salary cut of 4 to 10 percent, with the highest-earning employees facing the largest cuts.

The temporary furlough will push the university's faculty compensation to about 20 percent behind comparative institutions, university officials said at a news conference. "We're going to really have to work hard to come up with creative means to retain the excellent faculty that we have now and to further recruit people," said Mary Croughan, chair of the university's Academic Senate.

Hey We've Got Plenty of Room at University Enterprise Laboratories?

I thank a friend for pointing out this disturbing article.

From the Milwaukee Sentinel-Journal:


Minneapolis biotech firm moving to Wisconsin

Posted: July 9, 2009

Lured by the state's tax credits for investments in high-growth companies, a Minneapolis biotech start-up said Thursday that it was moving to Wisconsin.

VitalMedix Inc. is developing a drug that first responders, trauma center surgeons and military medics could use. The drug, Tamiasyn, has the potential to allow humans to endure severe blood loss and inhibit organ damage during resuscitation. It has been tested in animals and could go into human trials as early as a year from now, said Jeffrey M. Williams, company president and chief executive.

"This sort of deal is better understood by investors in Wisconsin," Williams said. "Angel groups in Wisconsin are not only more aggressive, there are just a lot more of them."

The state has 22 organized angel investing groups, according to the Wisconsin Angel Network.

Despite a huge budget deficit, Gov. Jim Doyle and the Legislature expanded the state investment tax credit in February. Wisconsin doubled the cap on the amount of credits that a qualified business may use to $8 million, raised the cap on eligible angel investments to $4 million and tripled the total credits available each year to $37 million.

"Other states have incentive programs that are designed to help start-up companies, but it's fairly unusual to have a tax credit program tied to investments in tech-based companies," said Tom Still, president of the Wisconsin Technology Council.

The council gets calls nearly every week from around the countryWisconsin Technology Council, asking about the credits, Still said.

'We need to do better'

Minnesota legislators tried to create a similar program but failed.

"We are clearly aware we need to do better and have more tools in our tool belt for tech-based economic development," said Minnesota state Sen. Kathy Saltzman, who strongly supported investment tax credits. Gov. Tim Pawlenty vetoed them in May, citing opposition to tax increases in other parts of the bill.

VitalMedix's move to Wisconsin "certainly should be a wake-up call for anybody in Minnesota who questions whether these credits work," Saltzman said.

The credits had lured another biotech company. Rapid Diagnostek Inc. moved to Hudson last year from St. Paul to take advantage of the credits.

Charlie Goff, general partner of NEW Capital Fund in Appleton, the lead investor in Rapid Diagnostek, said the investment tax credits "had everything to do with" the move to Wisconsin.

The top executive at BioE Inc., a Twin Cities tech company, praised Wisconsin's embrace of tech companies and didn't rule out a move.

"If the right opportunity comes along, we definitely in a heartbeat would make a move," said Michael Haider, president and CEO of the 15-employee company.

BioE developed a system for separating stem cells from cord blood for preservation and eventual transplantation in humans.

VitalMedix has four employees and has raised $4.5 million from investors and U.S. Defense Department grants, Williams said. The company is negotiating leases in Hudson or New Richmond, he said, and expects to move within 90 days. If it is successful at developing into a large operational company, VitalMedix might move to Madison or Milwaukee, where there's more industry-specific talent, he said.

Presentation to group

Williams made a presentation this week to Successful Entrepreneur Investors, a Milwaukee angel group, said Dan Steininger, the group's co-director.

Several members are thinking of investing, enticed by the company's promise, the tax credits and the state's policy to exclude from capital gains tax up to $10 million of proceeds if they're reinvested in young, high-growth companies, Steininger said.

Two researchers at the University of Minnesota campus in Duluth, who were studying how hibernating animals and deep-diving mammals survive drops in heart rate and metabolic activity, developed the VitalMedix technology.

"The piece that is truly a stake in the heart for us is that this particular product was discovered at a University of Minnesota campus by researchers studying gophers," Saltzman said.


"How would Wisconsin feel if a company that discovered its product while studying badgers was moving here?
"

JAMA - Walking the Talk on Ethical Medical Publishing?

from CARDIOBRIEF:

Down the memory hole: JAMA editors rewrite history and remove original editorial

Posted on July 10, 2009 by Larry Husten

One of the most powerful images of modern times is of Winston Smith, the anti-hero of George Orwell's dystopian novel 1984, rewriting history for the totalitarian regime he serves by dropping original but no longer convenient documents into the "memory hole" of an incinerator.

Now the editors of JAMA appear to have adopted Winston Smith as their role model. An earlier version of an editorial that had been published online has now been removed from the JAMA website, in stark defiance of the rules and ethics of medical and scientific publishing.

First a little background (you can read about it in more detail using our chronology of the controversy): Jonathan Leo, a professor of neuro-anatomy at Lincoln Memorial University, published a letter on the BMJ website. The letter pointed out that a study on Lexapro in stroke patients published in JAMA failed to disclose a conflict of interest of one of the authors, Robert Robinson. Leo had initially reported his finding to JAMA. After waiting several months without any action from JAMA he sent his letter to BMJ. The story's focus soon shifted to the JAMA editors for their pitbull-like response to events, especially after they had a series of contentious conversations with their critics and Wall Street Journal reporter David Armstrong.

In March the JAMA editors published the original combative editorial, which took a strong stance against both conflict of interest and free speech. The editors wrote that it was acceptable to accuse JAMA authors of conflict of interest, but it was unacceptable to tell anyone except the journal editors until the editors themselves reported their final determination of guilt or innocence. The editorial also included combative remarks about Leo and denied reports by the Wall Street Journal's David Armstrong of abusive language and harrassing behavior stemming from DeAngelis.

Following a great deal of negative publicity, the AMA announced that its Journal Oversight Committee would review the affair. On Tuesday of this week JAMA published a highly edited version of the March editorial. The new version contains no direct reference to the Robinson and Leo affair, and includes no reference to the previous version. It also fails to disclose that the remaining text is almost identical to text in the previous version published online. (Most journals have explicit policies against the reuse of previously published content. But perhaps those rules don't apply to editors.) The authors also fail to disclose that the editorial is apparently a response to recommendations from the the AMA's Journal Oversight Committee.

At some point following the publication of the new editorial on Tuesday the original March version of the editorial disappeared from the JAMA website. I first learned about this on the blog of medical ethicist Udo Schuklenk. As Schuklenk wrote:

"No retraction notice was published, no erratum of any kind. As one of my colleagues pointed out: what does this mean for the substantial commentary (overhelmingly critical in nature) that was published in various fora on this now non-existent article?"

Schuklenk raised another point about the implications of removing a document with a doi number, since it should "not be changed in any print version or on-line without proper errata, withdrawal notes etc.; basically an on-line paper with a doi number ought to be treated just like one would treat a print article."


I call it the doctor mentality.

Sadly, although the majority of real doctors do not suffer from it, those running the medical schools, academic health centers, and medical journals still seem to suffer from the doctor mentality.

"Make it so, Spock" ?

July 9, 2009

MoreU Park - The Smoke Screen Continues...

But at least some faculty members can penetrate the haze...

Senate Research Committee Monday, April 27, 2009

Dr. Muscoplat said that UMore Park will be a revenue center for the University, not a cost center.

Professor Dahlberg said he would like to see a financial plan that includes the dollars invested and an estimate of when the University will start to receive money. The University has invested about $5 million and will need to put in a little more, Dr. Muscoplat said, but he expects that money will be paid back all at once because of the value of the gravel to the University's mining partner.

The University will need to spend more on real estate development, but it will make money from the gravel.

Professor Hays asked what the projected revenue from the known gravel deposits would be.

Dr. Muscoplat said that 3-5 million tons per year would be sold, over several decades, at perhaps $1 per ton. It is a big number, but it is only possible to sell so much into the local market in any one year. This will not be a windfall, he emphasized.

Professor Hays inquired if they expected to use the money for development. They do not, Dr. Muscoplat said; they expect the developers to pay all the costs of development, not the University.

[And infrastructure support, Dr. Muscoplat? Do you intend to tap the state for this?]

Will they build quickly in order get a payoff, Professor Hays then asked? The University must be careful, Dr. Muscoplat responded, and developers will be required to adopt plans that carry the University's imprimatur; the University will be in control.

[You mean the way we are in control of Fairview Hospital, Dr. Muscoplat?]

Professor Dengel commented that he would not want to live near dump trucks hauling gravel; he would want the industry cleared out, and usually the gravel is removed and only then is the land developed.

The take-home message, in his view, Professor Cohen said, is that gravel pits are a dicey business and long-term development around gravel is a leap of faith he is not willing to take.

Professor Ruggles said that aside from the research platform, the University could just sell the land on the market.

Dr. Muscoplat said they studied that alternative and concluded that developing the land with a plan would generate ten times as much money as simply selling the land.

[So let's be clear about this. The bulk of the money that is waved at us by the Morrill Hall crowd is in development, not gravel. Right now the landscape is littered with developers and car salesman who have gone under. The U should stay the hell away from the development business...]

Why would the University get into the development business, Professor Ruggles asked? That is also his question, Professor Dahlberg said: is it proper for the University to do this? It would be investing for academic reasons, but only for a few faculty members. He said he did not know of any other university that has taken on a project like this.

It was agreed that the Committee would return to this subject in the fall, and would wish at that time to see financial projections.


Absolutely amazing...

There are so many holes in this plan that you could drive enough gravel trucks through to fill a football stadium.

And we have a business school at this University? What do the Carlson folks have to say?

God help us.

And let's look at the management team:


UMore Park Executive Committee

Charles C. Muscoplat, Chair, Vice President for Statewide Strategic Resource Development

Kathryn Brown, Vice President and Chief of Staff

L. Steven Goldstein, President and CEO, University of Minnesota Foundation

Robert Jones, Senior Vice President for System Academic Administration

Larry Laukka, University Distinguished Fellow and UMore Park Director of Commercial Development

Kathleen O'Brien, Vice President for University Services

Richard Pfutzenreuter, Vice President and CFO

Mark Rotenberg, General Counsel

E. Thomas Sullivan, Senior Vice President for Academic Affairs and Provost

Can you say: "The Usual Suspects?"

And who is Larry Luakka? Google pulls up:

Larry Laukka, who built Centennial Lakes and Edinborough in Edina, will take his next residential project across the border into Bloomington.

Laukka, president of Edina-based Laukka Jarvis Inc., said his firm this week purchased a research and fabrication facility at 10701 Lyndale Ave. owned by Eden Prairie-based SurModics Inc. The company plans to raze the building and build 27 acres of residential development.

Hmm...

The mess at Emory med school

From Academic Exchange - on the Emory University website:


Faculty Member Removes Emory Name from Blog

July 9, 2009

In his June 18 blog post, Doug Bremner, a professor of psychiatry and radiology at Emory, wrote that, at Emory's insistence, he had removed all mention of the university from his blog. The move didn't go unnoticed.

Bremner's sometimes-acerbic blog, "Before You Take That Pill," comments on drug and health safety news. He frequently goes after the pharmaceutical industry for, among other things, misleading claims and unseemly financial ties with academic researchers.

According to Bremner's July 1 post, Emory wanted to distance itself from his blog because of a complaint it had received about a satirical letter posted January 28. Bremner had written about mental health blogger Phillip Dawdy, who was being evicted from his Seattle apartment because he smoked on the property in violation of the lease. He wrote that Dawdy, who has bipolar disorder, should be allowed to smoke because the strain of quitting could "disrupt his mental condition in an unacceptable way" and that it was "medically contraindicated for him to stop smoking cigarettes." Emory, Bremner added, said that his blog is for personal use and therefore it is a violation to use its name or letterhead.

In separate letters, Emory's executive associate dean for administration and faculty affairs, Claudia Adkison, and the acting chair of the psychiatry and behavioral sciences department, Steven Levy, ordered Bremner to remove the Emory's name from his site because he had violated Emory policies of using its name for non-Emory Business.

"If that's the case, why doesn't Emory ask others to take their names off of work not related to Emory? It's not like I'm just blogging about what I had for breakfast or where go on weekend with kids," Bremner told the Academic Exchange. "I only write about things that are relevant to what I've carved out in my work, which is prescription medications, health care news, and mental health in general." If [Emory] is asking me to take name my name off of my blog, why not ask others to take name off work not related to Emory?"

The story was picked up by Inside Higher Ed, which said it had received the letters from Bremner:

"According to Bremner's Emory superiors, complaints they received suggested that he was making 'clinical recommendations for a patient you do not know and have never examined,' and these postings made them feel the need to tell him to stop using the Emory name."

Comments posted by on the blog and the Inside Higher Ed website have been overwhelming supportive of Bremner and generally critical of Emory. Bremner said that visits to his blog had quadrupled since the controversy broke.

Some of the comments contrast Bremner's situation with that of other medical researchers at Emory who freely identify themselves as Emory faculty when involved with outside interests. The Inside Higher Ed article noted that other Emory faculty bloggers "who blog (but not anything to do with the pharmaceutical industry) don't appear to distress the university by having their affiliations noted."

The article went on to say that Emory Health Sciences director of media relations, Sarah Goodwin, said that "Emory's objection to the use of its name in non-official places was 'across the board' and not related to the content of Bremner's blog,"

Bremner responded to Goodwin in his July 1 entry by naming other Emory faculty who write for non-Emory online publications and who "prominently display the name of our university on their blogs."

Goodwin told Inside Higher Ed that she didn't know why other Emory bloggers or Web sites who listed their Emory affiliations seemed to fall outside of the restrictions.

The Inside Higher Ed article went on to say, "Goodwin noted that Bremner has been 'blogging for some period of time,' and that "if you read it over a long period of time, you can see comments he makes that may be of concern.' She declined to identify those comments."

Cary Nelson, national president of the American Association of University Professors, told Inside Higher Ed that "he had no problem with Emory restricting the use of its logo, or even of asking professors to add a statement to a blog stating that opinions don't reflect those of the institution. But he said that it was wrong and a violation of academic freedom for Emory to tell a faculty blogger not to use the university's name in his identification or elsewhere on his blog."

Interesting.

On my PTII blog (this one) I assume everyone knows or could find out that I am a U of M faculty member. Since the avowed purpose of UThink is personal expression, I don't worry too much about what I put up here. No one has ever directly requested that I take something down or spoken to me about it. Directly is used here deliberately, because I have heard it through the grapevine that some people are not too happy about it.

My colleague PZ Myers, at the Morris campus, has taken serious flack for his blog Pharyngula. But the administration at Morris and the Twin Cities campus made it pretty clear that his head would not roll to appease the wingnuts. That is to their credit - PZ is an asset to the University community - whether or not you agree with him. I have always been a great admirer of people of conscience who do not put their finger to the wind before making a pronouncement and who do not compromise their principles for the sake of being popular.

My other site, the (original) Periodic Table, is on Google. There I can be a little more irreverent, since the blog does not depend on the U for its existence. I don't make a big deal about being a U of M faculty member and don't use U of M logos, etc., very often. And I don't feel that people should take what I say as the Gospel because I happen to be a faculty member. Obviously I don't speak for the U.

But what is going on at Emory should be disturbing to any academic who writes a blog.

July 7, 2009

Iowa Does the Right Thing on COI - They started in January of this year

We started two years ago and the foot dragging continues.

This kind of behavior has become a hallmark of our medical school. Although some of the blame can be laid at the feet of the former dean, our new dean Dr. Frank Cerra, continues in this tradition - see below.

From the Daily Iowan:

UIHC puts kibosh on freebies


Medical-industry conventions typically offer myriad goodies for attendees: dizzying displays of free pens, post-it pads, and doughnuts resting in front of panels of advertisements for new drugs or lab equipment.

Seems innocent enough? Under a new conflict-of-interest policy, they will soon become memories for staff members at the UI Hospitals and Clinic.

The new policy has been in place one week. It requires UIHC staff, faculty, and students to report any gifts they received from outside businesses, such as medical-equipment vendors or drug companies, through an online External Relationships Disclosure Form.

Furthermore, industry exhibitions and private gifts -- including travel stipends, special free meals, and product samples -- are goners.

"I think people understand the problem," said Jennifer Niebyl, UI professor of gynecology and obstetrics, who helps enforce the policy.

The goal is to reinforce "the highest possible ethical standards and to foster greater transparency," said Deborah Thoman, an assistant vice president for compliance and accreditation.

All staff, faculty, and students receiving paychecks from the hospital will need to fill out the disclosure form by Sept. 1. The collected data will be then displayed publicly online, contrary to current guidelines, which keep them confidential.

"Making the disclosure process open is a step to ensure patients can be confident their health-care providers are not influenced by any self-interest," Thoman said. "Our new, strengthened policy allows faculty and staff to advance teaching, service, and research [while] avoiding real or perceived conflicts of interest."

The UIHC began a review of its conflict-of-interest policy in January,
because of growing national attention on several reports of conflicts of interest at other universities, including a case at Stanford involving a researcher who lied about the amount of money he received from companies. While no similar cases have been discovered at UI, officials are confident the new policy will prevent any from happening in the future.

Niebyl said the staff seems to have been supportive so far.

"We have heard very, very few complaints," she said. "Nobody has [yet] criticized the policy."

Talk is a lot cheaper at the U of M, e.g.

"I think we need to put ourselves in the position of acting according to the highest ethical principles. I believe our people do that now and I believe our people will be doing that in the future as well." President Bruininks (Daily: 6-18-08)

At Minnesota we are in no hurry according to new dean, Frank Cerra.


And so what kind of timeline are you working on? Is there a goal for what Regents meeting you'd like to bring the policy to? (Daily)

Not really. I think we're more interested in a more deliberative, thorough approach where we listen to people and then take forward to the institution some recommendations, because ultimately the institution has to decide what it wants as well as everybody who works in the community. And that's the stage we're at now. (Dr. Cerra)

So there's no rush to get it done? (Daily)

No, I think it's better we get it to come out the right way than to just kind of push something through for the sake of a new policy. There are a number of very important issues that I think need to be discussed in a collegial environment. (Dr. Cerra)

I think we're also in the midst of preparing a position statement on the value added from relationships between faculty and the institution and industry where there is really clear value added. (Dr. Cerra)

First things first, Frank?

The University of Minnesota Medical School Unofficial Anthem:

July 6, 2009

The U UpNorth...

Breslin.jpg

Sad. I don't know what else to say.

So here's some recent material from the Daily Planet:

University of Minnesota, meet North Minneapolis.
Oops, try again.
And again.
It hasn't been easy for the University of Minnesota to work its way into the North Side. A child development program it originally planned to locate there brought out protesters with picket signs. Its land acquisition attempts resulted in a rift with Hennepin County.

Its efforts to study the mortgage foreclosure crisis have been criticized as too little, too late, in neighborhoods that had already been dealing first-hand with the issue for more than three years.

And a recent hiring flap outraged many neighbors and public officials, to the point where some are saying that the U just doesn't seem to get it.

When the University's Urban Research and Outreach/Engagement Center (UROC) recently hired former Jordan Area Community Council (JACC) Executive Director Jerry Moore for a short-term mortgage foreclosure research project, some community members said they were shocked. JACC had fired Moore in January after he got into a fist fight at a neighborhood meeting. He has been at the center of controversy that has included legal action and heated arguments at meetings.

Dottie Titus, former JACC executive director, wrote in a recent blog: "What I mostly feel is disappointment. There was a great deal of mistrust of the University when the [University-Northside] partnership was first proposed, but I saw an incredible potential if the University was going to bring some of its best minds to help solve the problems North Minneapolis has faced over the past two or three decades."

Hiring Moore was a betrayal of trust, she added. "In my mind, it speaks volumes about the University's real interest (or lack thereof) in the Northside Partnership. We simply cannot depend on that bright vision once held out to us."

When asked if the U did a background check on Moore before hiring him, Jones said they had not.

"I understand the community has concerns. We were not aware of any accusations when he was hired. No accusations or concerns were ever mentioned to my staff. Our goal was to hire people from the community and we tried to do that. We typically don't do background checks on casual temporary workers; you can be hired on Monday and let go on Tuesday. Because of this issue, however, I have asked staff to do background checks from now on."

Roberta Englund, executive director of the Folwell Neighborhood Association, said, "I'm pleased with what the U will bring to North Minneapolis from their base at Plymouth and Penn. 500 Under 5 can be a meaningful, contributing program to families. The U could be a supportive partner for stabilizing and revitalizing North Minneapolis neighborhoods. But they need to come with an understanding of what their mission is and what they can contribute. I don't think that, from the very beginning, the U was in touch with the realities of North Minneapolis.

"They simply don't pay attention,"
Englund said. "They came to North Minneapolis with what I believe were good intentions, but they fell into the North Minneapolis trap of organizational self-aggrandizement. There were organizations and individuals involved with their coming who thought they would benefit.

"The voices the U listens to," Englund added, "are those most collaboratively supportive to the opinions they have already formed. They have structured outreach according to their rules, and they have imposed a structure they are comfortable with.

"This whole business of foreclosure crisis is like closing the barn door," Englund said. "It's too late. For the U to come to the table and talk about it is a waste of their time and money and will not benefit anybody.
This is not a storm that is going to regroup. If the U wanted to contribute anything meaningful, they would have looked at information from 10 years ago, including what was going on with the Federal Reserve, that contributed to the social and economic damage to the community. I don't think anybody expected the kind of financial malfeasance and exploitation that we had. I wonder if we wouldn't be better off understanding that."

Last spring (2009), the University of Minnesota hosted a foreclosure symposium and invited representatives from different cities. What city didn't get invited? Minneapolis.

Tom Streitz, director of housing for the city of Minneapolis, said, "They did not connect with either me or [foreclosure coordinator] Cherie Shoquist in an expeditious way. We were not included in an invitation to participate. It was a little bit of a disappointment to us, because the City of Minneapolis is considered a national leader in foreclosure delivery efforts. I've personally given presentations on foreclosure response in other cities."

Streitz added that the U eventually invited Minneapolis, after city officials learned about the symposium. Shoquist attended, he said, but he did not.

Louis King, CEO of Summit OIC, a Northside employment training program, said Banks had contacted him about the UROC project, but he turned it down. "This was a $2 million deal. We are involved in a $200 million project at Target and a $4 million project at the Twins stadium. I told her I was not interested in tying up my people going to those meetings for this job [to get this job], which was a relatively modest rehab over a short period. We want long term engagement, where people can launch careers. From our perspective, it was a whole bunch of talk about nothing. I told them they were putting in more hours in meetings than there were hours of work for our employees."

An initial 2005-2006 plan to partner with Hennepin County on a center for early education and child development, led by Dante Cicchetti--head professor at the U's Institute of Child Development--triggered protests from a group called Leaders of African Americans Concerned Together (LAACT).

The group accused the U of not being forthcoming about its research plans, and said it worried that it would be similar to past projects that targeted low income African Americans for mental health tests without their knowledge or consent.
The U denied that, and tried to move forward with plans to locate the child development center in one of three places: in NorthPoint's human services building at Plymouth and Penn, across the street from NorthPoint on a vacant lot, or in a strip mall at the same intersection.

Meanwhile, its partnership with Hennepin County didn't go so well, when the U decided that the rent the county proposed to charge was too high.

"It's all water under the dam as far as I'm concerned," Jones said, "But it was unfortunately framed that we were pulling out of the North Side, when we said we couldn't afford to be in the building."

Jones said they are still looking for a site for Cicchetti's program. "That's what the original partnership with the county was supposed to house. We intended to renovate the shopping center and address other critical programs the community said it wanted: early childhood education, health and nutrition, technical assistance to small businesses. The plan was to locate all of those in the shopping center, but it wasn't big enough for the Cicchetti program, so we started talking to the county."

Jones, who lived in North Minneapolis for 20 years, said that from the beginning, the U has encountered "naysayers, people who are vocally against what we're trying to do on the North Side.

"People have a right to their opinions. But UROC is a vision that [U of M] President Bruininks and I came up with. We are one of the largest, most complex universities in the world. We are a land grant U, which means that implicit in our mission is an obligation to serve the citizens in the state, and we've done that very well.

What to say, what to say? "an obligation to serve the citizens of the state, and we've done that very well."

I don't think so. Nor do the people who live UpNorth, apparently.

It is also amusing to see someone from this U admin turn on the old land grant charm.

Please don't get me wrong. What goes on UpNorth is a disgrace and the U should be doing everything in its power to assist. Unfortunately the present gang that can't shoot straight is not cut out for the job. If it comes down to spending money on MoreU park or UpNorth, what to do is clear.

Gates Foundation? Anyone with me?

July 5, 2009

Regents Meeting This Week

Plenty to talk about...

From WCCO:

U Of M Regents To Meet, Then Go On Retreat

MINNEAPOLIS (AP) ― The University of Minnesota regents are going to compress their usual two days of meetings into one this week before leaving for their annual retreat.

The regents are scheduled to meet Wednesday in both their workshop and regular meeting before going to Owatonna on Thursday and Friday.

It'll be the first meeting with Clyde Allen presiding as the new chairman. He's a former commissioner of the state Revenue Department.

Among the highlights of Wednesday's meeting will be an update on the university's new underground physics laboratory along the Ash River in northern Minnesota.

The regents retreat is at the Gainey Conference Center in Owatonna. They'll be focusing on developing broad policies for the university during a time of shrinking budgets.

The clip below indicates that some of the Regents are concerned about the small amount of time allotted to financial planning at the U. Many of these folks are successful business men and women and they are, rightfully, appalled at how things are done around here.

Let's hope that the meeting at the St. Thomas Gainey Center produces some tough questions for the administration and a lot more transparency than has been seen in the past.

Pharma's Weary Negligence in Minnesota

From the Strib:

Payment disclosures: 'Compliance in name only'
A Minnesota law requiring drugmakers to report payments to medical practitioners is generating data that is incomplete, inconsistent and hard to search.

By JANET MOORE, Star Tribune

Every spring, they trickle in: reports from dozens of drug companies disclosing how much they paid Minnesota physicians in consulting fees the previous year.

This year is no different. Some 86 drug companies made hundreds of payments totaling $13 million to Minnesota practitioners -- defined as anyone who can prescribe drugs.

But if consumers want to review the records, they will have to be patient. The Minnesota Board of Pharmacy won't post them online for a few weeks. Even then, the most dogged researcher may be flummoxed by documents that are sprawling, hard to search and often vague.

And reformers who hoped that payment disclosure would curb inappropriate ties between companies and doctors may be disappointed. The records are sometimes incomplete and inconsistent. Doctors say they are often inaccurate. Enforcement for companies that don't comply has been nonexistent, even though the law allows a fine of up to $10,000 and revocation of a company's license to sell drugs in Minnesota.

"It's like looking for a needle in a haystack,'' said Peter Lurie, deputy director of Public Citizen's Health Research Group, a Washington, D.C., consumer organization that has used the files. "It's compliance in name only.''

The Pharmacy Board requests that companies submit the records on searchable spreadsheets. But several firms, including drug giant Eli Lilly, sent their information in file attachments that cannot be searched electronically.

It isn't too hard to figure out what is going to happen here. Senator Grassley is licking his chops...

July 3, 2009

Prescription Data Mining - New Hampshire and Vermont Lead in Prohibiting

Dan Carlat writes an excellent blog - The Carlat Psychiatry Blog, which supports the search for honesty in medical education. It should be required reading for medical school deans, full- and part-time.

The blog could also be read with profit by executive vice-deans, vice deans for clinical affairs, vice deans for research, vice deans for education, associate deans for faculty affairs, and even associate vice presidents for new models of medical education. Especially the latter.

From a recent post:

Prescription data-mining is a marketing tool in which drug companies purchase information from pharmacies that allow them to spy on doctors' prescribing practices. The companies use this information in a variety of sneaky ways. Front line drug reps download this information to their laptops and use it to tailor their marketing pitches before they call on doctors. Higher level marketing executives use the data to craft targeted marketing campaigns involving everything from pseudo-journals to invitations to promotional dinner meetings.

It is a deceptive and quite nauseating marketing practice,
but it has continued through the years because it seemed for a while that everybody stood to win. Drug companies got invaluable demographic information in order to sell the newest and most expensive drugs. Data-mining firms; like IMS, built their entire lucrative business model on their new identities as information brokers; pharmacies reaped profits by selling prescription info to IMS and their ilk; the American Medical Association profits to the tune of several million per year by whoring out the organization and selling doctors' DEA numbers to data base firms; and finally, individual doctors in their offices started receiving dozens of invitations to fancy dinners by reps who wanted them to prescribe more of their drug.

But now this corrupt house of cards is tumbling down. Not all at once, but gradually, state by state, appeals court by appeals court.

Here are a couple of recent developments.

1. New Hampshire. In 2006, New Hampshire's legislature banned data-mining. In 2007, lawyers were able to convince a district court to strike down the New Hampshire law by arguing that buying and selling prescription information was protected by free speech safeguards. In 2008, the First Circuit Court of Appeals overturned the district court's decision, and unanimously upheld New Hampshire's Prescription Confidentiality Act. The forces of greed do not give up easily, and the data-firm lawyers submitted their case to the United States Supreme Court. Well, a few days ago, the Supreme Court declined to consider the case, sending a message to many other states that the ban on data-mining is, in fact, constitutional.

2. Vermont. In 2008, the Vermont legislature passed a law banning prescription data-mining unless physicians specifically opt in to their data being bought and sold. Data firm lawyers descended on the Green Mountain State, and submitted an appeal to the federal Second Circuit Court of Appeals requesting that they grant an injunction blocking the implementation of Vermont's law. Twas not to be. The Appeals courts just refused to block the law.


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There is a strange situation in Minnesota where DNA data of newborns, acquired by the state, ended up in a study in Finland. Perhaps the state legislature should look into medical and prescription data mining practices and take appropriate action?

July 2, 2009

Org Chart Madness or, How To Streamline Administraton

OrgChartMadness.jpg

If you know how to read chicken entrails, there is a lot of information here. If you have been on the South Side of Washington Avenue for very long, the message is even clearer.

How did that latest submission of the translational research grant go? Is rearranging the deck chairs really an answer to our problems? [Most of the deck chair occupants have been here for a while.]

Frankly speaking...

No man can serve two masters: for either he will hate the one, and love the other; or else he will hold to the one, and despise the other.

"One of the questions I continue to hear involves the roles and responsibilities of the Dean in contrast to that of the new Executive Vice Dean. Underlying the question, there appears to be a concern that the Medical School deserves the attention of a full-time Dean." Frank Cerra

"I think people will think what they want to think." Frank Cerra


Dr. Cerra has recently sent a blanket email:

Dear colleagues,

There is quite a bit of activity taking place in the Dean's office this morning, as computers are logging in to new servers, and we test the phone systems. As with the beginning phases of any new administration, we are working through the logistics of new protocols of scheduling regular meetings for Medical School leadership.

Beginning today, I will be spending half of my time here on the 6th floor of the Mayo Memorial Building, just down the hall from Executive Vice Dean Mark Paller's office. You will find me here on Monday and Tuesday afternoons, and in the morning on Wednesday, Thursday, and Friday. Angie Menzel will be managing my calendar and appointments as Dean, so please contact her at menzel@umn.edu for meeting requests.

And so it goes.

July 1, 2009

Alcohol Policy in the New Gopher Stadium - Let's keep our priorities in mind...

Regent Hunter admirably capsulizes this situation: