A national academic organization is charging that the University of Texas MD Anderson Cancer Center disregarded accepted standards for academic freedom, faculty tenure and shared governance when it chose not to renew the appointments of two professors who received unanimous endorsements from a faculty panel.
The controversy has grown from an internal family dispute to one of regional and national concern as each new angle has been reported on by the Cancer Letter, an industry publication founded in 1973, and the Houston Chronicle, which reported on worries that the infighting could knock MD Anderson off its national pedestal.
Evidence that the feud had grown beyond its institutional walls was provided last month when the University of Texas System's new chancellor, Adm. William McRaven, vowed to rebuild the trust that had been broken at the institution.
The April 8 report by the American Association of University Professors, a Washington-based organization with chapters on 450 campuses, assesses the cases of professors Kapil Mehta and Zhengxin Wang, whose applications to renew their seven-year appointments were denied in 2013 despite unanimous recommendations from the faculty Promotion and Tenure Committee. MD Anderson has disputed the professors' claims that they never received explanations for the decision. But faculty leaders argue that the real issue is that their recommendations were ignored, illuminating how little professors share in the governance of the institution.
“For faculty receiving a unanimous vote in favor of renewal by their PTC, the applicant should be confident of tenure renewal barring egregious actions such as criminal activity,” professor Douglas Boyd, who chaired the 27-member promotion- and tenure-review panel, wrote in a March 2014 blog post. “What this ultimately boils down to is shared governance. Instead it seems that a semi-dictatorial system is in effect at our University of Texas institution where the decision for tenure renewal can amount to an arbitrary process decided by one person. The latter for sure must be a morale buster for faculty.”
The reappointment dispute was followed by a series of accusations that Dr. Ronald DePinho, who took over as president of the institution in September 2011, shifted MD Anderson's focus without faculty input.
According to the AAUP report, faculty members are concerned that DePinho, formerly at the Harvard-affiliated Dana-Farber Cancer Institute, took MD Anderson's emphasis off investigator-initiated basic research and put it on drug development instead. This shift, the critics say, was infused with conflicts of interest and favoritism as faculty members were cast off to make room for DePinho's fellow “Harvard expatriates," according to the report.
The national professors association became involved in the dispute last April after Boyd requested the organization conduct a formal investigation. The report concludes that MD Anderson violated the standards by requiring professors to seek reappointment every seven years instead of granting indefinite tenure and disregarded principles of shared governance with its “general failure to involve faculty meaningfully in academic decisions.”
“It's a principle of ours that sound academic governance requires participation by all the major components of the institution: administration, faculty—and students, to some extent,” Greg Scholtz, AAUP associate secretary and director, said. “The report concedes, to some extent, that MD Anderson is a special institution in that it is more hospital than school.”
MD Anderson had almost 1.4 million outpatient visits, nearly 28,000 hospital admissions and $4.4 billion in revenue in fiscal 2014. It employs 20,000 people, including 1,700 faculty members who oversee more than 6,300 trainees. This includes 1,276 clinical residents and fellows, 1,238 nurses in training and 318 School of Health Professions students.
Since 2009, the institution has had a policy that faculty members whose primary responsibility is research must obtain 40% of their salary from outside grants. DePinho and other MD Anderson leaders told Scholtz in a May 23, 2014 letter that Mehta did not meet this requirement and that Wang “abandoned his appeal before exhausting all steps of the faculty appeal process” when he instigated legal action.
The letter also states that the faculty renewal rate has been 92% over the past three years. In the report, however, the professors association argues that a “deferral” mechanism has been used to “camouflage the actual number denials” and it puts the renewal rate at 81%.
In February, the association sent MD Anderson a draft of its report to review and marked it “confidential.” MD Anderson posted the draft online and released a response on March 13 that was signed by the “Executive Leadership” without any names listed. It mocked the report as a “biased editorial” containing “clumsy misstatements and malicious false statements.” The letter also claimed that there were “legally actionable” statements made in the draft about how DePinho's wife, Dr. Lynda Chin, came to be founding director of MD Anderson's newly created Institute for Applied Cancer Science.
It was announced April 2, however, that Chin would step down from that position. Days later she became associate vice chancellor for health transformation and chief innovation officer for health affairs of the University of Texas System, an entity that includes nine universities and six related healthcare institutions.
“If we want to transform the way healthcare is delivered, then we need bold and innovative solutions,” McRaven, the university's chancellor, said in a news release. “Dr. Chin is a very talented physician scientist who has the vision and the ability to get it done.”
McRaven has vowed to put an end to the squabbling without taking sides. At a March 18 meeting, he gave the faculty senate his e-mail address and cellphone number and let professors know they can contact him personally with their concerns.
McRaven is an imposing figure. He graduated from the University of Texas at Austin in 1977 with a journalism degree before entering Navy SEAL training. He planned the 2011 raid that killed Osama bin Laden in Pakistan and his 2014 commencement address at his alma mater has been watched more than 2.9 million times on YouTube.
McRaven told Modern Healthcare that he's “fully committed to safeguarding the future continued success” of MD Anderson, which he described as a phenomenal institution “where countless lives are saved and improved” through the research and patient care conducted and delivered there.
“I have visited MD Anderson twice in my first three months as chancellor, and I will continue to visit as often as necessary to make things right,” McRaven said. “While there are clearly differences of opinion, it is essential for MD Anderson's executives and faculty to share the responsibility of working together to focus on solutions.”
The faculty has been asked to develop a list of actions needed to improve the MD Anderson work environment, and DePinho has been informed of expectations “to improve morale and functionality,” McRaven said.
“Dr. DePinho has offered assurances to improve communications and transparency and to bring faculty representation into his decisionmaking process,” McRaven added. “I remain supportive of him as we move forward for the benefit of our patients and the institution as a whole.”
