Part X – Silencing Faculty Voice

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Slamming the Door

Part X – Silencing Faculty Voice

In the fall of 2012, just before Al Gilman’s departure, MD Anderson officials cracked down on internal critics.

On Sept. 26, 2012, Raphael Pollock, head of MD Anderson’s Division of Surgery, was summoned to the office of Thomas Burke, then the executive vice president and physician-in-chief, and was relieved of his duties.

Pollock, who is Jewish, was fired on Yom Kippur, the Day of Atonement.

Sources told me that Pollock was told he was fired because his division was inconsistent in meeting financial targets. Indeed, MD Anderson financial data showed that surgery produced revenues that were $5 million below budgetary projections, underperforming by 33.2 percent.

This financial performance was caused in part by changes in CPT codes for surgery, which were published in November 2011, three months after MD Anderson finalized its budget, sources said.

Surgical facilities at the institution were running at full capacity—additional operating rooms would be required to add revenues.

“I’m grateful for Dr. Pollock’s commitment to leading the division for the last 15 years, and I’m pleased that he will continue making contributions as a professor with joint appointments in the departments of Surgical Oncology and Molecular and Cellular Oncology,” Burke wrote in an Oct. 1 email to the MD Anderson staff.

The word of the incident spread immediately.

People I talk with often were recruiting members of MD Anderson’s faculty, and Pollock was one of the biggest stars out there.

Starting immediately, many of the top academic cancer centers started putting together proposals to lure Pollock, who is also the program director and principal investigator of an $11.5 million five-year Specialized Program of Research Excellence grant for translational research in sarcoma. The grant is held by the Sarcoma Alliance for Research Through Collaboration, which meant that the money would move with him.

Indeed, after 31 years at MD Anderson, Pollock landed on his feet, becoming a professor and the director of the division of surgical oncology at The Ohio State University Wexner Medical Center College of Medicine’s department of surgery. Pollock also serves as the chief of surgical services of the Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. He has since become the surgeon-in-chief at James Comprehensive Cancer Center and surgeon-in-chief for the Ohio State University Health System.

***

A month after Pollock’s firing, the volunteer publishers of Faculty Voice, the MD Anderson faculty blog, were told that anonymous bloggers would henceforth need to submit their names to the blog administrator, who would keep them on file.

The blog allowed faculty members to say exactly what they wanted without fear of retaliation. Many posts focused on the faculty’s quality of life—working too hard to meet the quotas. There were also complaints about the style of new management.

The faculty used it to share news and opinions—and to blow off steam. It made for entertaining reading for insiders—and for reporters. Besides, some executives at MD Anderson regarded Faculty Voice as a great resource. The blog made it possible to keep an eye on the mood of the faculty.

When I called the press office, I was told that the administration was enforcing an existing MD Anderson policy, which required that the blog contributors identify themselves to the blog administrator, who would then be able to post the contributions anonymously. I was told that this is done to ensure safety. Imagine if someone posts a bomb threat—but also so that people who represent themselves as faculty members actually are.

By that time, Len Zwelling was taking it for granted that his career at MD Anderson was over, and with his posts on the blog, he was likely speeding up the process. Some of his zingers were published on the blog pseudonymously, i.e. as Moonshot Marvin, but increasingly Zwelling signed his own name, and he was not at all reticent to be quoted in the Houston Chronicle and The Cancer Letter. Prior to him being quoted, I administered something similar to informed consent, reminding him that this can’t possibly help his career.

“Obviously, my posts are usually not anonymous, but I have sought the ambiguity of anonymity on occasions when I felt the opinions I expressed might be offensive to some folks with power over me. This is in spite of the fact that I believe the most important American right of all is the power to offend others,” Zwelling wrote in a post Oct. 29, 2012. “We would be a lesser country without the Will Rogers, George Carlins, Shelly Bermans, Lenny Bruces, Richard Pryors and Sara Silvermans of the world and MD Anderson would be a lesser place without strong, opinionated people expressing their outrage at the behavior of their colleagues or their unease with wrongs being perpetrated upon them. To me, these people are what make MD Anderson and the United States great and we will all be less for the loss of a forum for their expressing their opinions, even if they are anonymous. I am not sure what the administration fears about anonymous expressions of feelings or thoughts, but clearly these are a threat when reduced to an internal blog.

“It has been fun writing these posts and especially fun hearing from you on-line or in person about what I have written. I liked those disagreeing with me the most as I learned the most from them. And those of you who have stopped me in the hall and encouraged me, I really want to thank a great deal. As a writer, I have learned that you never really know if anyone is reading what you write, so thank you so much for speaking up, even if you disagree with a position I have taken.”

“Whatever happened to academic freedom? What ever happened to freedom itself?”

Ultimately, Zwelling’s seven-year contract was not renewed the following year. He said he was offered another year of employment for signing a non-disparagement agreement, but he declined.

Now, he runs a widely read blog which focuses on MD Anderson.

***

“This isn’t just about academic freedom or freedom of speech. It’s also about freedom from fear,” Warren Holleman, the founder of Faculty Voice, posted Oct. 27, 2012. “When I came to MD Anderson three years ago, my job was to assess the health and well-being of the faculty. One of my most vivid impressions of the organizational culture was the fear factor and its impact on individual morale, job satisfaction, and the relationship between faculty and administration. I wish I could say that things are better now, but that just isn’t the case.”

Holleman, who started the blog when he arrived at the institution three years earlier, is a professor at the Department of Behavioral Science and director of the Faculty Health & Well-Being Program.

“One of my objectives in starting the Faculty Voice was to reduce this fear and thus improve faculty health, well-being, and morale by creating a safe place for conversation about faculty concerns. Call me naïve, but I believed that as we faculty expressed concerns about particular problems and issues, our friends on the administrative side would join the conversation by acknowledging our concerns, expressing empathy, presenting their perspectives, and engaging in a solution-focused dialogue. That hasn’t happened, at least here in the blog, so in that sense the Faculty Voice has failed.

“Instead, many of my friends on the administrative side view the blog as a place where a small contingent of disgruntled faculty vent, gripe, and whine. They assume that these views do not represent the ‘silent majority’ of our faculty. To those on the administrative side I would say this:

“’I believe you are wrong. I think the concerns expressed in this blog are representative of the faculty. Last year I interviewed 19 of our department chairs, most of whom sounded an alarm about low faculty morale. The recent morale survey by the Faculty Senate will be published soon, and it will offer additional insight. I think you are also wrong in another respect. Not only do you tend to caricature the faculty, but you also tend to caricature the blog. I have observed that, for many of you, your knowledge of the blog is based on reading only the most extreme posts and comments that you email to each other. If you logged onto the blog and read more representative samples, you’d see that we focus mostly on solutions, not problems. You’d see that we love this place as much as you do and are just as committed to its success—if not more so.’

“As moderator of the Faculty Voice, I wish I had done a better job of ‘selling’ the blog to the administration in general and the executive leadership in particular. This did not happen, but there are many other good ways to reduce the fear factor and to improve health, well-being, and morale.

“Let’s get together, and let’s get it done.”

***

In the fall of 2012, it was an open secret that DuBois, too, was looking for a job.

Indeed, he left MD Anderson on Dec. 31, 2012 to become the executive director of the Biodesign Institute at Arizona State University.

In a letter to the editor, which appears in this issue of The Cancer Letter, DuBois described the CPRIT controversy as a “brief, awkward blip in my career.”

“Taking the long view, it’s rare that anyone in academic medicine doesn’t hit a rough patch, and it pales in comparison to the kinds of rough spots cancer patients deal with all the time,” DuBois writes.

Later, as the CPRIT crisis continued to unfold, an effort was made to recruit DuBois to run a Texas state agency as a sideline to his job in Arizona.

***

When Gilman vacated his office Oct. 12, 2012, his departure was followed with the sort of fireworks rarely observed in science.

The Nobel laureate and his friends used the departure as a teachable moment, an opportunity to demonstrate to Texas politicos that scientists can be pushed only so far.

In the process, they demonstrated what the universe beyond the breaking point looks like.

Next Week: Gilman’s exit strategy plays out.

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