'Malaise' besets medical school at U, panel says

  • Article by: JENNA ROSS
  • Star Tribune
  • December 17, 2012 - 8:49 PM

A "malaise" has infected the University of Minnesota's medical school, a special panel appointed by U President Eric Kaler has found.

Its prescription? Pick an organizational structure, then quit fretting over it. Inspire faculty with clear goals. Seize the "golden opportunity" of the new Biomedical Discovery District.

The panel's long-awaited report, released Monday, offers few dramatic fixes for the school's national rankings, which have fallen, or its relationship with Fairview Health Services, the source of "a great deal of concern."

"The review does not provide a road map, but rather a calibration," Kaler said in an e-mail to faculty.

In a written response to the report, Kaler announced that a faculty-led group would fashion a strategic plan by next summer. He also said he would stick with the school's current leadership structure, in which the dean of the medical school also acts as vice president of health sciences. Dr. Aaron Friedman currently serves in that role. The report studied the university's entire Academic Health Center (AHC), an amalgam of six schools, the largest being the medical school.

"I hope the community can take this and move forward," Kaler said in a telephone interview, "and stop spending time worrying about what the structure is going to be."

Kaler announced the outside review almost a year ago, responding to blowback over an earlier, internal review, which one faculty committee called "an uncritical acceptance of the status quo."

He picked a former colleague to lead the review: Dr. Kenneth Kaushansky, a senior vice president and dean of the School of Medicine at Stony Brook University in New York, where Kaler was provost. The panel of three surveyed and interviewed faculty and staff.

The report twice calls the university's health enterprise "strong." But of the medical school, it says "there is a great deal of work that needs to be done."

Some of the U's health sciences schools, including the School of Public Health, rank among the best in the country. But the medical school placed 29th in National Institutes of Health funding in 2011.

Relations with Fairview

Any changes to the medical school are complicated by its relationship with Fairview Health Services, which bought the university's struggling hospital in 1997. The U and its physician group, University of Minnesota Physicians, are fashioning a new agreement with Fairview that they hope will bring more revenue and authority for the university and its physicians.

Kaler said negotiations with Fairview, which "frankly, have taken longer than I expected," delayed the report's release.

The external review found "a great deal of concern'' about Fairview, including "discordance in fundamental values and missions, challenges with clinical training sites ... as well as problems with funding for the medical school."

Many of the faculty members surveyed said they are concerned about their "ability to feel that their contributions ... benefit the university -- and not just the broader Fairview system," Kaler said.

Over many years and several reviews, the Academic Health Center has grappled with its structure. The outside panel found that, "first and foremost, an imbalanced amount of energy is being spent on organizational issues ... that appear to be affecting the quality of the work and environment in the AHC."

The group noted that "greater transparency about the cost and function of the AHC structure would be welcomed."

The structure has been controversial, reviews of the internal review made clear.

"Many believe that the dual role of vice president for health sciences and dean of the medical school can be a conflict of interest and/or that the job is too big for one person," the new review says. The group offered three models, noting "there is no right answer."

"I think this is a model that can work," Kaler said.

Some faculty members were skeptical.

Carl Elliott, a bioethics professor in the medical school, called the review and its response "utterly vacuous."

He disagrees with Kaler's statement that the health center serves as "the national model of interdisciplinary education." Its structure "forces departments and centers to compete against each other for tuition revenue," Elliott said by e-mail. "I've never worked at a university that made interdisciplinary education harder."

Elliott, who has been a vocal critic of ethical conflicts at the school, said he was discouraged to find not one mention of them in the review. "Don't these problems merit just a little attention?" he said.

The panel expressed high hopes for the university's Biomedical Discovery District, a complex of buildings the U touts as an incubator for new ideas and products, saying it "is a golden opportunity to improve research funding and rankings."

Given the university's strengths, the review says, "the critical components exist to reverse the negative reputational trajectory and feelings of malaise that exist."

Jenna Ross • 612-673-7168 Twitter: @ByJenna

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