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Gov. Arne Carlson on Kaler and U research ethics: ‘Where is the accountability? Where is the oversight?’

Former Gov. Arne Carlson
MinnPost file photo by James Nord
Former Gov. Arne Carlson

In an op-ed for the Star Tribune and on several recent radio and television programs, former Gov. Arne Carlson has been calling on the University of Minnesota to fire its president, Eric Kaler, for his continual “cover-up” of problems regarding research ethics in the university’s psychiatry department.

Last month, the Minnesota Office of the Legislative Auditor released a scathing report that rebuked Kaler and the U for misleading the public about serious ethical breaches in the tragic case of Dan Markingson, a young man from St. Paul who committed suicide in 2004 while enrolled in an industry-sponsored clinical trial at the U involving the anti-psychotic drug Seroquel. In the wake of the report, the U immediately suspended enrollment in any clinical drug trials being overseen by its psychiatry department until a team of independent reviewers could determine that all patients in those trials are protected.

Kaler, however, disagrees that there was any kind of cover-up going on at the U. “When I arrived in 2011, I was made aware of the [Markingson] case,” he said in an MPR interview on Friday. “It was then six years, seven years old. I reviewed the documents. I reviewed a report from the FDA, I reviewed legal findings, I reviewed a report from the Board of Medical Practice of Minnesota. And I relied on those highly credible organizations in their findings. … It’s clear, in hindsight, that those reports were not as reliable or thorough as they were represented to be. But I would argue that, presented with [that] kind of evidence from those kinds of sources, it was hard for me to believe that there was ever misconduct.”   

But the issue is not quieting down. Last week, a group of 15 U alumni who are now teachers or scholars of medical ethics joined Carlson in calling for Kaler’s firing. And on Friday, the New York Times ran an article that detailed yet another questionably run clinical trial involving the U’s psychiatry department (and Seroquel). In this 2010 study, controls were so lax that one of the enrollees — a sex offender — crushed up the drug and surreptitiously fed it to other men at his residential treatment facility.  

On Friday — before Kaler spoke on MPR and before the Times published its article — MinnPost talked with Carlson about the university’s handling of the controversies surrounding its psychiatric department and why he thinks it’s time for Kaler to step down. An edited version of that interview follows. MinnPost has requested a followup interview with Kaler, but was told he is not immediately available. 

MinnPost: Why do you believe that President Kaler should be fired? 

Arne Carlson: When [Kaler became president of the University of Minnesota in September 2011] he had already been sent materials by Dr. Carl Elliott, who’s a professor of bioethics, relative to all the dilemmas and problems and legal faults that were occurring at the university. So he was informed when he came that this problem existed. This problem had also received considerable attention from both the national media and the local media, including, by the way, the Minnesota Daily. So when he came in, he had to make a decision, and that decision was, “Do I call up Professor Elliott and sit down and find out what this is all about? Do I do some independent research and find out what this is about? Or do I simply let the past continue to roll?” He chose the latter. He made that decision.

When he made that decision he chose to consciously not obey the rules of the University of Minnesota. He deliberately made the move that he would no longer pursue the mission of the University of Minnesota, which is a search for truth. [He] became part of subverting the truth and stonewalling … and ultimately deceiving by claiming [there had been] investigations that never occurred and claiming that these were exhaustive investigations. How can you have an exhaustive investigation that was never held?

MP: In President Kaler’s response to the legislative auditor’s report he wrote that if the earlier external reviews of the Markingson case had been flawed, then he and other officials at the U had not been aware of it.

U of M President Eric Kaler
MinnPost file photo by John Noltner
U of M President Eric Kaler

AC: Bear in mind that this is the highest paid administrator in public service in Minnesota. He makes significantly more than the president of the United States, so the public has a perfect right to expect a high level of performance. So [Kaler] now says, “Gee, I did not know.” That means he paid no attention whatsoever to the materials that were sent by Professor Elliot. It means he paid no attention whatsoever to all the media reports, and he paid no attention whatsoever to the history of the program, which by that time had included six suicide deaths, the incarceration and imprisonment of a professor and the barring of research by the [U.S. Food and Drug Administration] of several of his own personnel. 

So either it’s a case of profound ignorance or he’s simply being untruthful. 

MP: Why would he choose to ignore that information?

AC: I think that’s a question he has to answer. … I think President Kaler owes it to the public to set in motion a whole independent review of his role, as well as [the role] of his vice president, the [university’s] legal department and the Board of Regents. They’re all complicit in the cover-up, and it requires an independent review. But he is absolutely adamantly opposed to any such review.

MP: In the wake of the legislative auditor’s report, the university has created two new committees to develop and implement reforms to its human research programs. Leigh Turner [a bioethics professor at the U] and others have criticized the university for appointing to those committees people who either ignored or dismissed earlier calls to investigate the Markingson case. Do you share those concerns? 

AC: What’s interesting here is for 10 years you’ve had people waving the red flag and saying, “Gee, this is wrong, this is wrong, this is wrong.” Not one of those people has been put on any committee. Not one. But all the people who were either part or acquiesced in the cover-up, they’re all on the committee. … Then they bring in a doctor [to head one of the committees], and he’s packed with financial conflicts of interest. … We have 80,000 doctors in America, and we can’t find one without a conflict of interest?  [The U has appointed Dr. William Tremaine, a gastroenterologist who is director of the Mayo Foundation Office of Human Research Protection, to head one of the new committees. Tremaine has received funding from many pharmaceutical companies, including AstraZeneca, the company that funded the U study that Dan Markingson was in when he committed suicide.]

Somebody tell me that that is what we teach our students at the University of Minnesota school of business. Everything that’s being taught there is practiced in the opposite fashion at Morrill Hall. It’s stunning. Where is the transparency? Where is the accountability? Where is the oversight? …

Fundamentally, colleges and universities are in the business of integrity. They are in the mission of searching for the truth. And in the process of searching for the truth, you have tremendous respect for dissent. That’s what you expect on a college campus. Here we have the practice of the exact opposite. Submerge the truth at all costs. Deceive the public. Deceive the faculty. Deceive the legislature. Deceive the media. But the operative word is deceive. That doesn’t represent a very healthy search for the truth.

The second thing is the governance at the University of Minnesota. The president basically runs everything. I met with a member of the Board of Regents, and she told me in no uncertain terms that it was her feeling that the board feels that they are subservient to the president, and everything I’ve seen verifies that. I think the board feels they work for the president. The faculty Senate has very, very little power. Everything is concentrated in the office of the president, so he is completely and totally responsible for this whole scandal. His defense is ignorance. That’s a stunning defense. Somebody tell me the virtue of ignorance. 

MP: What is your reaction to the announcement that Dr. Charles Schulz is stepping down as head of the university’s Department of Psychiatry? [Schulz was co-investigator, along with U psychiatrist Dr. Stephen Olson, of the drug trial in which Markingson died.]

AC: First of all, when you lose your moral authority, which President Kaler has, and when you’re complicit in the cover-up, as President Kaler is — and as the Board of Regents is — then how can you punish anybody? You can’t because you’re not willing to punish yourself. So they arrange the softest of soft landings they possibly could. He still retains his position as medical director, and he retains his tenure in his professorship and his pension and everything else.

What you basically have at the University of Minnesota now is two different sets of laws. You have the people on top, the Board of Regents, the president and his top officers — they made the rules and the regulations, but they don’t have to obey them. They’re exempt from that. It’s only the faculty and the students and the employees who have to obey the rules and regulations. I don’t know how you can have a bifurcated system of justice and have it operating. 

MP: The CAFE drug study that Dan Markingson was enrolled in when he killed himself was not a study designed to come up with a new breakthrough drug to help people experiencing psychotic episodes. It was designed to compare three competing drugs that were already on the market. Should the U or any other university be involved in drug-company studies like that — ones that are primarily about building market share?

AC: You’re raising a very valid question. … When a company contracts with a university for a drug test, that test is more likely to be favorable than if it were conducted neutrally. So there’s a built-in bias. … There’s also a financial incentive [for the university]: For if you flavor, if you will, the results towards one company, they’re going to come back and give you more contracts. That means that if you’re a hard nose, you’re going to have a tough time getting those contracts. 

The very integrity of the FDA process is really at issue here. … I think that all these contracts should go through the National Institutes of Health, and they should disperse them out. There should be a neutral governing body that decides who gets what. Right now what you have is an endless array of conflicts of interest. You [the university researchers] get paid whatever it is — $15,000 — for every person you enroll. [For the CAFE study, AstraZeneca paid the U’s Department of Psychiatry $15,648 per enrollee.] You know as well as I do that there will be a temptation to go kind of easy on the [enrollment] restrictions.

MP: Particularly if you’re having trouble enrolling people.

AC: Of course. And your pool tends to be mentally impaired, so it’s a dreadful situation — it truly is — for universities. Nevertheless, [if you’re going to do the research] you want to make it as loaded with integrity and protection for the enrollee as is humanly possible.  

MP: Has the U’s reputation been tarnished by this?

AC: Very much so, and it continues to be tarnished. 

MP: Have you heard from people outside the university on that? 

AC: I’ve gotten a lot of emails. … I’ve got a good friend who’s on the review board at Massachusetts General [Hospital]. He’s stunned by this because just from an institutional perspective you want to do everything you possibly can to protect the integrity of your brand.  That’s what’s so stunning. All these news articles come out, and it doesn’t move President Kaler. When I showed him all these headlines [last June], he didn’t have any reaction whatsoever. And then, when I got into a debate with [Richard Beeson, chair of the Board of Regents,] about the brand — because Beeson sits on a bank board — I repeatedly asked him, “Do you mean to tell me if all these negative stories appeared about your bank, your bank board would have absolutely no concern?” His answer was, “You’re comparing apples and oranges.” I said, “No, I’m not. I have sat on corporate boards, and I know something about brand protection. Are you telling me that your bank board would ignore all this bad publicity and do nothing about it?” 

MP: What would you like to see done?

AC: The Legislature has been amazingly passive. That’s been a huge disappointment. There isn’t a single legislator who has stepped forth and said, “You know what? This scandal is serious. It imperils the virtues of a very fine university, and we’re the ones who appoint the Board of Regents. We have to assume responsibility. Let’s drill down and find out exactly what happened.”

There should be an investigation into the cover-up. It should be public. President Kaler, his vice president, his legal staff, [and] the Board of Regents should all be called in to testify and to be held accountable for the very rules and regulations that they themselves promulgate.  That has not happened — and apparently is not going to happen. … I think that’s appalling. I’m stunned, absolutely stunned. …

The issue here is not only the reputation of the University of Minnesota, but also the reputation of Minnesota as a state. I think this state celebrates people who have integrity, who are willing to be open, who are willing to care, who are willing to acknowledge when they make mistakes  — and who are willing to be held accountable. But I don’t believe the Board of Regents, President Kaler or his management staff reflect any of those virtues.    

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Comments (17)

  1. Submitted by Ray Schoch on 04/20/2015 - 10:48 am.

    A return to the Medieval

    I’ll start with a disclaimer. I’ve never been a university president, so it’s entirely possible that I’m led astray here because of my own lack of relevant experience. Nonetheless…

    I’d argue that the first and most important point here is that Universities all over the country, including the U, have adopted a corporate model. The reasons for that are various, but primarily center around money, in the form of financial support from either/both the public and private sector. Surely Mr. Carlson understands this. That the University President is paid more than the Governor of the state supports that corporate-model contention. Boards of Regents and legislatures usually have very positive feelings for the corporate model, since most (not all, but typically sizable numbers) Regents and legislators are, or have been, corporate executives, or have worked in that environment.

    In the corporate model, the CEO is essentially just as Mr. Carlson has described Mr. Kaler’s role. While the university president may not rule by “divine right,” it’s not at all unusual for him (or, in rare cases, her) to rule absolutely. Corporations are the antithesis of democracy. In terms of their internal political operation, they generally follow the Medieval pattern. Power is absolute, and is concentrated at the top,. The CEO’s opinions are the only ones that count, at least in terms of how the corporation operates, spends its money, deals with the public’s perception of its mission, etc. Lesser officials (e.g., Deans at the university level) fill the roles of vassals. Regents typically have full-time jobs elsewhere, and have neither the time nor inclination to be nit-pickers, whether financial, ethical or instructional. Faculty are minor role-players, and students…? Well, they’re students. What do they know?

    I’ve never met Mr. Kaler, and don’t know him at all, but his public utterances certainly fit the stereotype of the corporate CEO. When he says he “reviewed” previous reports, for example, does that mean he read them in detail, asked probing questions about their conclusions, talked to the people involved? Or does it mean he glanced at the reports, or, at most, read the “executive summary?” His point is not without merit when he asserts that he had no reason to doubt the integrity of the reports submitted to him, but with someone’s death involved, his attention to the matter ought to be more than superficial. If the claim is made, as it often is in the context of executive salaries, that higher pay is merited because of the higher level of responsibility, then that level of responsibility implies a level of oversight and integrity that seems to be lacking in this case. It’s a public university, is it not? As a public institution, its officers, regardless of specific titles, ought to be answerable to the public.

    • Submitted by Robert Gauthier on 04/20/2015 - 09:53 pm.

      you have never met him

      But are quick to judge him, apparently. I have met the man twice, he is nothing you describe. Actually a good guy and very committed to fixing the U. Some of the rot began under Arne Carlson and I do not recall him in there trying to help. And I like Arne, but he is way off base here.
      And let’s not forget the axes Republicans have for the U ever since Sviggum got kicked off the Regents, that dog still is barking. Ever wonder how the WSJ seems to get so concerned about UM? Think that is no coincidence?

      • Submitted by Bill Gleason on 04/21/2015 - 09:20 am.

        You meet someone twice, Dr. Gauthier

        and you know all about him? You know that he is a good guy?

        This reminds me of Bush’s assertion that Putin was a good man because he could tell by looking into his eyes …

  2. Submitted by David Markle on 04/20/2015 - 11:44 am.

    Time to clean house.

    Arne is right, I think, and this matter points to the overgrown nature of the University bureaucracy, a very big, top heavy corporate structure accountable only to the legislature. And if legislators don’t diligently exercise oversight, it’s a bad deal–and expensive–for the public (including students).

  3. Submitted by Alan Muller on 04/20/2015 - 11:59 am.

    Thanks for this compelling interview

    Thank you for this very compelling interview. Assuming Arne Carlson is right in what he’s saying, previous reports on this scandal that I’ve read have been in the nature of coverups.

    The public utterances that I’ve heard from Mr. Kaler paint him, in my eyes, as a shallow promoter/fundraiser with nothing substantial to say. Unimpressive, at best.

    Truth is that US academia, if the word still applies, is in a state of moral crisis as well as various other sorts of crisis. Minnesota would be better off with a smaller U, but one less self-serving and characterized by more independence and integrity.

  4. Submitted by Peter Mikkalson on 04/20/2015 - 01:46 pm.

    Re: Thanks…

    It’s not often I find myself in admiration of former Gov. Carlson, but he got this snafu exactly right. It’s high time Minnesota leaders stopped patting themselves on the back (and the resultant pay raise) and long overdue for an honest assesment of morally deficient failure(s). Plural.

  5. Submitted by Dimitri Drekonja on 04/20/2015 - 02:50 pm.

    Thanks for a very good interview. Having followed this case closely over the past several years, it’s my opinion that Gov. Carlson is absolutely correct when he points out that even a cursory review of the material in the popular press raised enough issues to cast doubt on the prior reports that “cleared” the University. Even if one took the view of being skeptical of the popular press, and thought that they were over-sensationalizing things, Dr. Elliott had been clearly laying out the issues for years. Scores of academics (many internationally known) signed onto petitions asking for greater investigation of how this study was run, and thus clearly saw that all was not well. If they could tell this from afar, it’s odd that it took the recent reports to get this sort of attention in house.

  6. Submitted by Robert Gauthier on 04/20/2015 - 09:41 pm.

    Not so fast there Arne….

    Usually I like Arne’s commentary and insights, but I think he is a bit misguided on this one. And some of it happened on his watch. This is not a pan- U problem, it is an issue of the medical school, which went off the tracks back in the Hasselmo era and has never gotten straightened out. The regents- Kefler in particular- interfered in the medical school to impose a solution without understanding the problem- money. The medical school was and largely is funded by NIH and clinical revenues, not significant state or legacy support. The Najarian witch hunt set in motion a series of bad decisions, most made by Kefler, Marc Rotenberg and Hasselmo, which simultaneously broke the morale and killed a major funding source without replacement. The solution? Revenue sharing, conveniently proposed and championed by heads of departments that never had financially balanced departments.

    This instability led to an ill advised sale of the hospital to a private chain that had no clue, and still doesn’t, how to run an academic center. At the sale of the hospital, $40M in funds from insurance pools was GIVEN to Fairview, by MISTAKE because no one from central admin was at the sale, I know, i was watching from the next room. The U had made a decision to cut and run and they sold one of the major funding sources from the medical school- the hospital foundation and funds. Without medical school support, the hospital was actually quite profitable. But no one listened, they just supported the mob roaring for blood and change- led by the Strib.

    This killing of the existing leadership structure by the weaker departments, losing funding and a whole series of poor management choices at the medical school, UMP and the University have led to a weak, demoralized, poorly funded, underpaid faculty that depends too much on industry revenue to subsidize a lack of ancillary funding from the tests and procedures at the hospital. The facility and procedural fees are now taken by Fairview to support their failing system, make the U hospital the trough they all drink at and scorn. And Governor Carlson, all of this happened on your watch as governor, so let’s have some historical perspective here. You did not fire Hasselmo or Rotenberg, did you? And Najarian was not convicted, nor fired nor run out of town on a rail. HE was judged innocent of all charges by a jury of his peers. He had never received the apology he deserved from the state for this sideshow.

    So we end up with weak deans, weak underfunded departments and everyone just trying to survive. Does this excuse this fiasco with Psych? Not at all, but the solution suggested is an axe where a scalpel is needed.

    The fault from this lies on the previous Dean, the department chair, the ethics group, led by Leo Furcht, and UMP for its poor management. If you want some heads, there are plenty there.

    Kaler is a good President, he acquired a hornets nest of trouble, tried to help but was undermined by the medical school when he tried to finance or work with the sale of the hospital. Now we still have the same problems, no money, no effective internal leadership and a corrupt system that led to the death of the poor patient headed by the same corrupt leaders.

    You can’t just hammer a medical school, they all have pretty good talents and can walk, further crippling the institution and complicating enforcing a solution. Many times you hope your leaders can implement good solutions. I sat in the presidents office discussing this with friends of the medical school and President Kaler ruefully said a medical school is a president’s biggest headache- not just here, everywhere. I agree.

    I say Governor Carlson is wrong and is letting his maroon and gold bleed too much here. Kaler is making a number of good changes, but this one had defied easy fixes- it started twenty years ago and has been slowly deteriorating since. And he was misled by the office of legal council and the medical school committees that reviewed this initially. Start there, we have replaced the legal council, now time to clean house at the medical school. Start with the ethics committee, demand accountability from UMP and its leaderships and the deans of ALL of the departments, who sit and cluck their tongues but do nothing of any consequence.

    Moral culture cannot be imposed, it is an internal value. Canning the President will not change a thing, start with the real culprits. That is where firings should occur, then hold the new leaders accountable. Take all the tenured faculty who participated in this mess and revoke their tenure for failure to perform in an ethical fashion. Take all remaining administrators involved with this and either retire or dismiss them. Hold UMP leadership accountable for patient safety, something they should be overseeing. That is where the rot is.

    Roll some heads there and you will see some long overdue changes.

    • Submitted by Bill Gleason on 04/21/2015 - 09:27 am.

      You make many good points, Dr. Gauthier

      And in fact your last comment – roll some heads – is what Arne is calling for. Will it happen under President Kaler? And will improvements at the U result by simply putting those at fault in charge of changing things? This is apparently President Kaler’s plan. Let’s just put the foxes in charge of the hen house, again?

      Your thoughts?

      And some of your suggestions to curing the problem at the U are simply laughable. “Take all the tenured faculty who participated in this mess and revoke their tenure for failure to perform in an ehtical fashion.”

      Trying to do this would result in a witch hunt such as the one in the Crucible, currently under performance at the Guthrie.

      William B. Gleason, Ph.D.
      retired med school faculty and alum of the University of Minnesota

    • Submitted by Dimitri Drekonja on 04/21/2015 - 10:01 am.

      Robert– you have a longer personal history here, so your insights are interesting to read. I certainly agree with many; the only major point of disagreement I have is that I think the record shows that President Kaler has been slow to address this fairly major problem– again, until the recent reports by the legislative auditor and the outside bioethics review, the public pronouncements were that the U had been fully investigated and cleared. He has himself acknowledged this (to his credit), but I think to many this is a case of “too little, too late.” I agree that the problems clearly pre-dated his arrival, the trouble many people have is that the response until recently was various versions of “nothing to see here.”

      “Kaler acknowledges U misstatements on drug study”

      — Minneapolis Star Tribune, March 28 2015

      “Kaler, meeting with reporters, acknowledged that the public may have been misled by the university’s repeated claims that it had been investigated, and cleared, by the state attorney general.”

      http://www.startribune.com/lifestyle/health/297799831.html

  7. Submitted by Mark Rose on 04/21/2015 - 06:07 am.

    the Dept. of Psychiatry

    I’m quite glad that Shultz is no longer head of Psychiatry at the U of M. From talking to friends and colleagues, he has ran the dept. with sole concern over the bottom line. His ruthless approach to management has had a demoralizing effect on staff. There are many psychiatrists and psychologist in the dept. doing excellent work in patient care and research, but they need supportive leadership instead of an environment where they feel constantly squeezed and expendable.

  8. Submitted by Robert Gauthier on 04/21/2015 - 01:21 pm.

    Actually

    The idea of removing tenure along with employment is not laughable, in fact your response makes my point. It is a nuclear option, and what is wrong with a little witch hunt, there are plenty of witches there.

    Where Arnie Carlson is completely off-base is that sacking the lead man will change anything. It will actually reinforce the inertia and the resistance to any external change by the lower faculty. Think of it for a second, you have someone leading and ethics committee who has been brought under scrutiny multiple times for ethics violations.I can think of no clearer evidence of putting the fox in the hen house. How did he get this position? Because he has been there long enough, it’s survived enough change, and had enough political friends to essentially put himself in a position to judge others and protect himself. Do you really think firing the President of the university is going to change that?

    Going back to Dean Brody, who was probably the most astute and forward-looking Dean in the medical schools had in the last 30 years, anyone with a vision or wanting to implement significant change at the medical school is usually forced out. During the turbulent times of the mid to late 90s, one thing I heard repeatedly from chairman was “thank God they picked X, he won’t change anything”. I always privately thought that’s exactly what the place needed Americans, lots of change.

    So what is left behind? People who don’t want change in her very comfortable with the status quo. Many of them have risen to the top by the Peter principle. They are not good, they are political.

    So you want to make a significant change at the medical school? Make some significant changes! Fire some people, not only fire them to remove their tenure and remove them from positions at the University of Minnesota.

    Remember the bottom line in this whole sad affair, somebody died. And tell me how that fits the basic vision and mission of the medical school. Easy answer, it doesn’t. Quit pussyfooting around, cut out the disease and get started on the real change

    • Submitted by Bill Gleason on 04/21/2015 - 03:31 pm.

      A few corrections, Dr. Gauthier

      1. Brody was not the dean of the medical school but rather the Provost of the Academic Health Center. Until Frank Cerra did an end-run around the medical school faculty (in collusion with then President Bruininks) and took over both the position of Dean and Provost. This, after he forced medical school Dean Deborah Powell out.

      Given the complexities of medical school administration this is an easy mistake to make.

      2. Brody did not last long at Minnesota, only two years. And his attempt to re-engineer faculty tenure was one of the most disastrous things ever to occur at the U.

      Readers who wish to see some actual facts of the matter, rather than the recollections of us oldsters, may wish to read the excellent summary:

      Destroying the University to Save the University
      link: http://bit.ly/1yMMR1G

      I think we have the same goals, Dr. Gauthier. I just don’t believe you understand how to achieve them given the reality that is the tenure code. It is not a simple matter to take away someone’s tenure and fire them.

      Now there are some people who actually might have been fired. I think of Leo Furcht. But the University and the Medical School chose not to do this.

      See:

      U Doctor on Ethics Panel Was Disciplined
      http://bit.ly/1bqLOun

  9. Submitted by Robert Gauthier on 04/21/2015 - 05:08 pm.

    Wow

    That city pages article sure brought back memories! One thing to remember about reforming tenure at the University of Minnesota medical school is that it is a school that does not run on any sort of foundation monies. If you are tenured and semi retired, people who are working hard paying for your tenure. And I’m not talking taxpayer. all you had to do is go down to the doctors lounge at the Fairview hospital on any morning and see you a number of faculty sitting around drinking coffee who haven’t seen patients in years.Brody was trying to address some of these issues.
    To call his efforts those of the slick salesman or shyster really gets to the heart of the problem. The culture of Minnesota, and the medical school in particular, was and is very resistant to change and outside influences. We can argue till we are blue in the face about what is wrong with University, but the reality is that Bill Brody is now the chancellor one of the top universities in the world, major medical industry such as Medtronic and Saint Jude do not invest as much time and effort at the University As they did in the “Good old days”.

    Minnesota does not have a strong culture of leadership, in my personal observation. Medtronic didn’t become an international leading corporation until management outside of Minnesota took over. The same can be said of target, 3M, UnitedHealth group and many other corporations that are based here. It seems that our Lake Wobegone mentality of just good enough really is a key staple of the Minnesota personality.

    Kale r needs time to execute his vision and the new Dean seems decent. The trick will be getting the deeply entrenched rot out of the medical school. When things have been bad for a long time, two types stay, the self motivated who want things to be better and the larger group of those who could not get a job elsewhere. That group is the senior group and they currently control a lot of the reins of power and will fight to the death to avert change. Or I this case, the patients death.

    • Submitted by Bill Gleason on 04/21/2015 - 08:24 pm.

      More corrections, Dr. Gauthier

      “One thing to remember about reforming tenure at the University of Minnesota medical school is that it is a school that does not run on any sort of foundation monies.”

      Until very recently, for reasons of efficiency, there was a foundation called “The Minnesota Medical Foundation.” It was recently folded into the Minnesota Foundation. These organizations raise monies that are provided to the Medical School.

      Your statement is inaccurate.

      The new Dean (and Academic Health Center Provost, again contrary to the wishes of the faculty) had this to say about our friend Dr. Schulz, the head of psychiatry stepping down:

      “Dr. Schulz is an excellent clinician. He has saved hundreds if not thousands of lives.”

      and further (link http://bit.ly/1J8J6Ya )

      If you want to know why families of research subjects who have been injured or mistreated in psychiatric studies will never trust the University of Minnesota, you don’t need to look much further than this statement by Brooks Jackson, the VP for Health Sciences, on last night’s edition of Almanac: “Dr. Schulz is an excellent clinician. He has saved hundreds if not thousands of lives.

      It is not enough for Jackson to dodge questions and evade any admission of wrongdoing. Heaping this kind of effusive praise on the man most responsible for the “culture of fear” and “intimidation” in the Department of Psychiatry is an intentional poke in the eye of anyone who might speak up on behalf of vulnerable patients.

      Fortunately, Leigh Turner. a professor in the Center for Bioethics, was also on Almanac. His response to Jackson: “I’m astonished to hear those remarks. Frankly, I’m surprised that Dr. Schulz still has a medical license.”

      You can watch the entire program at this link. [ http://bit.ly/1EdpkcF ] ”

  10. Submitted by Robert Gauthier on 04/21/2015 - 05:31 pm.

    One last comment

    Sometimes I think these discussions become echo chambers for a few interested folks an little else. Better to meet at a brew pub and discuss.This Psych issue was terrible as a death resulted. But that is not a single episode.

    Recently, another former faculty member of the same department i was in, took his mother in for emergency care while visiting from out of town. The care suggested was inappropriate and sloppy. The person who should have come in and done the case did not want to and lied about doing the case that night to my friend. His mother was septic and very ill with a surgical wound infection around a major artery in her neck. hit the room and demanded the person came in. When the attending came in he said to the friend “I hear you are difficult.”

    The person he was speaking to just left a prestigious NY training hospital, where he was offered an assistant chair or section head and had worked for 9 years after 14 years working at FUMC, was two time winner of the most prestigious award for teaching at this center, one of the major teaching centers in the world. Once this rude attending, a radiologist, was taken down a notch, he apologized as did the other two attending physicians and admitted they were ashamed, as UMP physicians for this type of care. The took full responsibility

    As a favor, I passed this on to the QA department at the U. Their response? “Tell them to call if they have any issues”. Not, sorry, Oh my god what can i do or anything in that vein. The rot is deep and endemic to the place. Firing the president will not do anything. Widespread changes and restructuring is. New buildings don’t do anything but distract from the real issue. Poor people make for a poor medical school. And the infrastructure is shot through with mediocre lifers who just want to have their nice high paying jobs.

    Firing Kaler would do nothing for this type of situation. It literally occurs daily at that place.

  11. Submitted by Jim Million on 04/21/2015 - 09:03 pm.

    A Reasonable Resolution?

    Perhaps Eric Kaler was the wrong candidate to cleanse the various departments. Perhaps it was not fair to expect him to design and implement these corrections, but Kaler did take the job. Apparently, he has done little to nothing in the way of repairing and reinforcing the cracked foundations. So:

    1. President Kaler takes responsibility for critical executive failings and moves to re-organize areas of concern, replacing key bad actors where necessary.

    2. Mediocre Regents are replaced with independent and strong leaders resolved to produce excellence. The Board must be prompted by internal peer pressure to properly perform its statutory oversight responsibilities.

    3. President Kaler is unequivocally ordered to clean the slate, as it were. Given specific directives, he must then perform or also be fired. He likely is not suited to such tasks. We must remember that Gov. Dayton had to intervene directly with him to stop something as fundamentally wrong-headed as the proposed student sports ticketing scheme. That should have blown any cover Kaler then had. Only after this cleanse/purge/re-organization/whatever is at least clearly placed in process, will a truly competent leader consider taking the job.

    4. A new President is eventually hired to take the institution forward with a bold and creative agenda. Excellent candidates may then be interested in coming to Minnesota.

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