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Throwing Fitz

The move to Fitzsimons was supposed to send CU's Health Sciences Center sailing into the 21st century. So why are so many doctors jumping ship?

University officials hailed the deal as a remarkable piece of synergy. But many faculty members felt left out of the decision process and were alarmed by its implications.

"People were aghast," recalls Ferric Fang. "We knew this was a medical school that barely had enough money to keep its own physical plant going. The idea of moving everything seemed preposterous to us. How were we going to afford it?"

Some doctors wondered how the new synergy would affect the existing relationships forged between the medical school and Denver Health, Children's Hospital, the National Jewish Medical and Research Center and the Veterans Affairs hospital. (Children's and the VA have since decided to move to Fitzsimons as well.) Others questioned the need to abandon some of the buildings on the Denver campus, such as the Skaggs School of Pharmacy and the Biomedical Research Building, which were practically new and still being paid for.

Faculty leaders pushed for a moratorium on the move until it could be further studied, to no avail. The debate intensified, as did suspicions that some influential division heads had been wooed to join the bandwagon with promises of extra goodies on the new campus. Fang, who worked in Schooley's division for nine years and ran University Hospital's clinical microlab, found the atmosphere at the medical center growing increasingly toxic.

"This was really dividing the faculty," he says. "Every day, you would come to work and people wanted to know what side you were on. This was very unpleasant, and it went on for years. The dean, who'd initially been opposed, became an advocate of the move. Anybody opposed to the move was seen as being disloyal."

Fang finally decided to move to Washington after learning that he was expected to divide his time for several years between his research duties on the new campus -- his area of expertise involves studying resistance to infection on the molecular level -- and the clinical lab in Denver. "It was a no-win situation," he says. "One of the activities I was involved in was going to be compromised. Other people I knew were already looking around or leaving. Without the move and the way it was handled, I would certainly still be in Colorado."

Several observers say the heavy-handed push for Fitzsimons is part of an ongoing problem in the "governance" of CU's Health Sciences Center. Although its $600 million budget makes the campus a major force in the university system, it's overseen by an elected board of regents and a university president in Boulder, who have no background in medicine and are often preoccupied with matters such as the football program's recruiting scandal. Consequently, much of the decision-making power rests with Fulginetti's successor, HSC chancellor James Shore, and Richard Krugman, the long-entrenched dean of the School of Medicine.

"The administration treated faculty as a bunch of second-class citizens who were merely transient presences at the school," says Daniel Kuritzkes, who left his position in Schooley's division two years ago to become director of AIDS research at Brigham and Women's Hospital and principal investigator at Harvard's clinical-trials unit in Boston. "The planning proceeded initially without any faculty input and included a variety of financial projections that seemed completely unrealistic."

Kuritzkes believes that the center's upper administration was never sufficiently supportive of a strong AIDS research program or of research in general, despite the fact that research programs fund almost half of the HSC's operating budget. (Tuition and state funds, by contrast, amount to less than 15 percent of the total.)

"To be working in an environment where you're clearly not valued became increasingly uncomfortable," he says. "In the twelve years I was there, from the day I arrived, I raised not only my entire salary and my benefits [from research grants], but salaries for an increasing group of people in my department. By the time I left, it was easily over a million dollars. They need a culture based on faculty governance, one that recognizes that the faculty make the place run."

Clashes between faculty and Shore and Krugman are nothing new; at times they've led to purges affecting entire divisions and embarrassingly high-profile lawsuits ("The Strange Case of Dr. Schmidt," September 20, 2001). But the most damaging controversies in recent years, from an FDA shutdown of human research studies to the firing of Robert Schrier to the Fitzsimons move itself, have all involved battles over how research funds are used.

A typical National Institutes of Health research grant takes into account not only the direct costs of the research, but associated expenses, such as lab space and support staff; for example, a grant to fund a $100,000 study would include an additional $54,000 in "indirect cost recovery" (ICR) funds. HSC administration takes a cut of the ICR money, and another portion goes to the department for research-related expenses, such as equipment, renovation, recruiting efforts and so on. But researchers claim that the state's skimpy funding of the medical school, along with shortsighted decisions of administrators, have led to an increasing drain on ICR funds, with disastrous results.

In 1999, the FDA suspended thousands of clinical trials at the HSC for months after finding that the studies had been inadequately monitored and evaluated. Several former faculty members, including Kuritzkes and Roy Jones, say they'd warned Krugman and other officials that the review board that supervised the studies was badly understaffed. "We warned them they would get shut down if they didn't do something," Kuritzkes recalls. "It was no surprise when they did get shut down."

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