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Friday, 2 January 2015

Princess Health and Food Reward Friday. Princessiccia

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This week's lucky "winner"... croissants!!


Read more �

Thursday, 1 January 2015

Princess Health and2014 WINS.Princessiccia

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We are a club with a strong focus on enjoying the sport, and pursuing a high level of health.  That being said, when you put a bunch of people together who support each other and have a blast doing so, something funny happens: hard work transpires without realizing it, consistency becomes easier than a lack thereof, and before you know it, results begin to pile up.


You don't have to be treated like you are hardcore, or declare you are hardcore, to race like you are hardcore.  We tried to have fun, but in the process we also won.  Now, I'm not talking age group wins, personal bests, or all the other ways our team excelled this year.  If I were to list all of those, this blog post would be never-ending.  This is simply a list of ways our team won overall (or placed 2nd).



The following performances were not our primary goals, but they are something to look back at, reflect on, and be proud of.  If you are an H+Per who does not have a name on this list, well it may as well be on there.  The success of these individuals is a direct reflection of the massive family of support and inspiration that we have assembled.

(Did we miss you?  Send us a link to your results page and we will add you to the list)


ROAD RACING

MEN

OVERALL WINS

April 26th, 2014. Guelph Avery's Bravery 5K. Robert Brouillette (18:45)
April 26, 2014. ENDURrace 8K.  Brendan Hancock (28:32) 
April 26, 2014. ENDURrace Combined  13K.  Luke Ehgoetz (47:51)
April 27th, 2014. Guelph Billy Taylor 5K. Robert Brouillette (16:03)
May 10th, 2014.  Baden 5K.- Sean Delanghe (17:20)
July 13th, 2014. Guelph Big Little trail 5K. Robert Brouillette (16:30) 
July 28th, 2014. Waterloo H+P Summer Time Trial 2.2K. Bredan Hancock (6:28)
 August 16th, 2014.  ENDURrun 10K.  Jordan Schmidt (35.49)
August 17th, 2014. Conestogo ENDURrun Marathon. Robert Brouillette (2:41:37) 
October 13th, 2014. Guelph Thanksgiving Day 10K. Robert Brouillette (34:45)
 September 13th, 2014. Wellesley Harvest Half-Marathon. Robert Brouillette (1:15:08) 
October 19th, 2014. Battle of Waterloo 23K (total)- Sean Delanghe (1:18:40)
November 23rd, 2014. Cambridge YMCA Jingle Bell 5K. Robert Brouillette(16:21)
December 13th, 2014.  Santa PurSuit 5K- Sean Delanghe (17:35)


OVERALL RUNNER UPS

February 23rd, 2014.  Re-Fridgee-8er 8K.  Sean Delanghe (27:54)
April 26th, 2014. ENDURrace Combined  13K.  Aron Mailman (49:32)
April 26th, 2014. ENDURrace 8K.  Luke Ehgoetz (29:39)
May 10th, 2014.  Baden 7M. Luke Ehgoetz (43.52)
 July 28th, 2014. Waterloo H+P Summer Time Trial 2.2K.  Robert Brouillette (6:32)
 August 10th, 2014.  ENDURrun Half 21.1K.  Sean Delange (1:16:58)
September 13th, 2014. Wellesley Harvest Half-Marathon.  Brendan Hancock (1:15:39)
September 13th, 2014. Wellesley Harvest 1/4-Marathon. Nick Burt (40:43)
Octobeber 13th, 2014. Oktoberfest 5K.  Chris Goldsworthy (18:00)
October 19th, 2014. Battle of Waterloo 23K (total).  Brendan Hancock (1:20:53)
December 13th, 2014.  Santa PurSuit 5K.  Nick Burt (19:01) 

 



WOMEN

OVERALL RUNNERS UP

February 23rd, 2014.  Re-Fridgee-8er 8M.  Gillian Willard (55:32)
May 10th, 2014.  Baden 5K.- Kailey Haddock (21:10)
April 26, 2014. ENDURrace 8K.  Jessica Kuepfer (33:12)
May 10th, 2014.  Baden 7M.  Jessica Kuepfer (49:07)



 TRAIL RACING 

MEN


OVERALL WINS

September 6th, 2014. Haliburton Forest 26K. Dave Rutherford (2:23:30)
October 25, 2014.  Horror Hill 10K.  Aaron Mailman (43:01)

OVERALL RUNNERS UP

July 5th, 2014. Creemore Vertical Challenge trail 25K.  Robert Brouillette (1:47:03)
September 13th, 2014. Muppuppy 8K.  Greg Dyce (31:54) 
October 25, 2014.  Horror Hill 25K.  Dave Rutherford (1:49:26)

 
WOMEN

 OVERALL WINS

June 8th, 2014.  Yankee Springs Trail Half. Jessica Kuepfer (1:50:08) 
July 5th, 2014. Creemore Vertical Challenge 25K. Jessica Kuepfer (2:20:20)
October 25th, 2014.  Horror Hill Trail Run 6 hour. Vicki Zandbergen (61.04K)

OVERALL RUNNER UPS

July 5th, 2014. Creemore Vertical Challenge 25K. Vicki Zandbergen (2:20:56)
July 6th, 2014.  Dirty Dash 8K. Vicki Zandbergen (40:57)




ULTRA RACING 

MEN


OVERALL WINS

January 18th, 2014.  Beast of Burden 100M. Steven Parke (17:40:35)
September 20th, 2014. That Dam Hill 12H. Steven Parke (122.047K)

OVERALL RUNNERS UP

Janurary 6th, 2014.  Run4Kids 6 Hr.  Steven Parke (64.64K)
May 24th, 2014.  Sulpher Springs 100M.  Steven Park (18:07)


  WOMEN

 OVERALL WINS

May 7-13th, 2014.  EMU 6 DAY Ultra.  Charlotte Vasarhelyi. (734K- New Canadian Record)
July 26-27th, 2014.  Montour 24 Hour Ultra.  Charlotte Vasarhelyi (170K)
August 2nd, 2014.  Epic 8 Hour Adventure Race. Jessica Kuepfer.

 CYCLING

MEN
 OVERALL WINS

March 23th, 2014.  Runny Nose 34K.  Bill Frier (1:28:22)

OVERALL RUNNER UPS

September 14th, 2014.  Centurtion C50 90K.  Sean Delanghe (2:23:27)


TEAM WINS


February 23rd, 2014.  Re-Fridgee-8er 8M Open (Ahmed, Luke, Aaron, Nick, Gill)
Feburary 23rd, 2014.  Re-Fridgee-8er 8K Open (Sean, Dave, Brendan, Greg, Mike)
April 12th, 2014.  ENDURrace 5K Open (Luke, Mike, Aaron, Holger, Nick)
April 13th, 2014.  Toronto Yonge Street 10K Open (Sean, Rob, Brendan, Ahmed, Jordan)
April 26th, 2014.  ENDURrace Combined (Luke, Aaron, Nick, Vicki, Dan)
April 26th, 2014.  ENDURrace 8K Open (Brendan, Luke, Nick, Aaron, Jessica)
June 15th, 2014.  Waterloo Classic 5K Open (Aaron, Steph, Kailey, Gill, Holger)
June 15th, 2014.  Waterloo Classic 10K Open (Rob,Greg, Ahmed, Chris, Dave)
August 17th, 2014. ENDURrun Relay (Sean, Ahmed, Jordan, Brendan, Greg, Rob, Luke)
October 19th, 2014.  Oktoberfest 5K Open (Ahmed, Jordan, Greg, Dave, Gill)
October 19th, 2014.  Oktoberfest 10K Open (Nick, Aaron, Emily, Sam, Speedy)
December 13th, 2014.  Santa PurSuit 5K Open (Sean, Nick, Aaron Vicki, Mike)




The win is not why we do it.  We do it to enjoy the hunt.  And enjoy it we did.  See ya in 2015 other guys.  The hunt is on!

 #cantwontstop


Monday, 29 December 2014

Princess Health and How the Anechoic Effect Persists: The Case of the Continued Punishment of Dr Elliott . Princessiccia

Princess Health and How the Anechoic Effect Persists: The Case of the Continued Punishment of Dr Elliott . Princessiccia

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We have frequently discussed the anechoic effect, how evidence and opinions that challenge the dysfunctional status quo in health care, and that might discomfit those in power in benefit from it, have few echoes.  One major reason for the anechoic effect is that people are afraid to speak up because thus disturbing the powers that be may have bad consequences for the speakers.   

A December 21, 2014 article in the Minneapolis Star-Tribune updated an ongoing example of how the leaders of health care may seek to silence their critics.  The article updated the career trajectory of Dr Carl Elliott, a psychiatrist physician and bioethicist at the University of Minnesota who dared challenge the university's handling of the untimely death of a patient in a university run clinical trial.

Background - the Dan Markingson Case

We first blogged about this case in 2011.  The case itself dates from 2003, and first got media attention in 2008.  A good quick summary appeared in the Center for Law and Bioscience blog out of the Stanford Law School. 
Dan Markingson � a vulnerable, psychotic young man � was forced to choose between enrolling in a Pharma-funded drug study or being involuntarily committed (in other words, locked up).  A UMN [University of Minnesota]  doctor enrolled him in the study despite having just determined that Dan 'lack[ed] the capacity to make decisions regarding [his] treatment,' rendering it highly unlikely that Dan could have given valid informed consent to participate.  As Dan's mother, Mary Weiss, observed his mental condition deteriorating, she repeatedly tried to have Dan removed from the trial � at one point asking  'Do we have to wait until he kills himself or someone else before anyone does anything?'  But the UMN co-investigators in the drug study refused to terminate his participation.  Shortly after Ms. Weiss made her desperate plea, Dan Markingson killed himself by cutting his own throat.
Dr Elliott, an expert in bioethics who had concentrated on issues such as the effect of conflicts of interest and commercial influences on clinical research, started probing the death of Mr Markingson after the 2008 media reports.

Some of what Dr Elliott found appeared in a May 23, 2014 article in Science. He concluded that previous efforts to investigate the death of Mr Markingson were flawed.

 Elliott came to believe that every investigation�not only by FDA but also by the Minnesota Board of Medical Practice, the university's IRB, and its general counsel's office�had been flawed or incomplete. FDA did not seek Weiss's perspective, the views of Markingson's caseworker, or interview staff at the halfway house who had interacted with Markingson, for instance. (FDA would not comment on the Markingson case for this story.) Nor did the agency examine conflicts of interest. Weiss's lawsuit was dismissed not on its merits, but because the university's IRB and Board of Regents were deemed immune from liability thanks their role as state employees. (The judge did argue that informed consent was obtained appropriately, because Markingson had signed the consent form and had not been declared mentally incompetent by a court.)

Furthermore, he found reasons to think that the problems with the trial in which Mr Markingson died were not unique.  He and a colleague

heard from other individuals who insisted that they had been harmed in UMN psychiatric drug trials or had witnessed others' mistreatment. One man said he had worked in the psychiatric units of the hospital where Markingson was treated. Another identified herself as a counselor for teenagers. Elliott heard from parents, who said their son or daughter had enrolled in a study under pressure.

Thus, Dr Elliott and others concluded that the university should do a thorough investigation of the case,

In November 2010, eight faculty members, including Elliott and [McGill University bioethicist Leigh] Turner, wrote a letter to the university's Board of Regents, requesting an independent, university-commissioned investigation into the Markingson case.

The Punishment of a Dissident

As the Science article noted, former Minnesota Governor Arne Carlson said that the

university hired Elliott because it 'found him to be one of America's most outstanding bioethicists. The moment he comes up with something that is sensitive to them, he becomes the village idiot.'

In fact, as we noted in 2013, in a 2012 post in the Center for Law and Bioscience blog, not only did university officials rebuff the call for a new, thorough investigation of the untimely death of Mr Markingson, but the university general counsel, who had been operating at the heart of this case, appeared to threaten the leading bioethicist dissident, Dr Carl Elliott:


 After Carl Elliott, the University of Minnesota bioethicist, refused to drop the matter, [university chief counsel] Rotenberg asked the university�s Academic Freedom and Tenure Committee to take up the question of '[w]hat is the faculty[�s] collective role in addressing factually incorrect attacks on particular university faculty research activities?' � a question that appeared both to accuse Elliott of 'factually incorrect attacks' and to call for some unspecified action to 'address' them.  Other faculty, including the president of the Minnesota chapter of the American Association of University Professors, viewed this as an attempt to intimidate Elliott into silence.  If so, it backfired.  The story ended up in the press, putting the Markingson case back in the public eye and once again making the University of Minnesota look really bad.
The December 21, 2014 Star-Tribune article reported that university administrators seem to be out to get Dr Elliott once again. First, it interviewed the university's chair of psychiatry,

[Dr S Charles] Schulz, the department chair, says he can�t even bear to read Elliott�s published accounts anymore. 'It�s too painful,' he said.

Both he and Olson say that Elliott gives only one side of the story and that he ignores the facts that don�t support his case.

'I think [people] believe that because Carl Elliott is a professor of bioethics and a member of the Center for Bioethics, that he must be telling the truth,' said Olson. But 'he�s not pursuing this in an academic way. I don�t think it�s conduct that becomes a faculty member and a peer.'

What is not academic or unbecoming about investigating the death of a vulnerable psychiatric patient during a clinical trial is not clear. Then,


University officials have not been amused. They accuse Elliott of whipping up hysteria with 'false and unfounded' allegations, and undermining research efforts in the process. And while the university hasn�t tried to fire him, it has reprimanded him for 'unprofessional conduct,' a move that he�s now challenging under the tenure code.

Again, rather than investigating the death of Mr Markingson, or at least responding to specific allegations, university administrators have set about to punish their own distinguished faculty member who wondered why a vulnerable patient died during a university run clinical trial. 

Finally,


So far, academic freedom has protected Elliott�s job. But last winter, the university claims, he crossed a line. It accused him of using a 'fabricated letter' in a speech about the Markingson case at Hamline University and demanded that he issue a retraction.

The 2004 letter, addressed to Weiss, Markingson�s mother, appears to be from a university lawyer disputing her right to her son�s medical records. The U says it�s a forgery; Elliott says he doesn�t believe it, and he refused to issue a retraction. He called it an attempt to discredit Weiss, adding: 'I won�t be part of it.'

Elliott received a letter of reprimand in August from Dr. Brooks Jackson, the current dean of the Medical School, citing him for 'significant acts of unprofessional conduct.' The reprimand is on appeal.

The evidence that the letter was a forgery was not apparent.  Yet while they pursue their own faculty member for his investigation of Mr Markingson's death, university managers still apparently have not addressed the many problems in the university's version of the story of Mr Markingson's death, from the fragmentary nature of previous investigations to the problems just revealed in a Scientific American blog with the knowledge of an expert witness for the university in the lawsuit brought by Mr Markingson's mother against it.  

Summary

Dr Carl Elliott is a respected physician bioethicist who has uncovered problems with commercial contract research organizations doing human research (see our blog posts here and here), and has written a critically acclaimed book, White Coat, Black Hat (reviewed here by Dr Howard Brody on his blog.)  Yet his previous work counted for naught when he dared look into possibly unethical clinical research done at his own university.  As noted in the Star-Tribune article,

Within the U�s Center for Bioethics, where he has worked since 1997, he says the tension is so palpable that he dreads setting foot in his office. He does most of his work from coffee shops.

In my humble opinion, it appears that top university managers have put their personal interests ahead of the mission of their university, the role of their faculty members in upholding that mission, and even the welfare of patients who put their trust in the university's academic medical center.  The hard life that Dr Elliott has lead since he started to challenge his own university's administrators show how the anechoic effect is generated.  As long as leaders of academic medical institutions, and other health care organizations can put their own interests ahead of the mission, health care professionals and other academics who object are likely to have their lives made miserable, possibly lose their jobs, or worse.  How many will have both the courage, and the resources to stand up for what is right under such a threat.

True health care reform would turn leadership of health care organizations over the people who understand and are willing to uphold the mission of health care, and particularly willing to put patients' and the public's health, and the integrity of medical education and research when applicable, ahead of the leaders' personal interests and financial gain.

ADDENDUM (30 December, 2014) - Post corrected.  Dr Elliott trained as a physician but is not a psychiatrist.

ADDENDUM (30 December, 2014) - also see comments on the 1BoringOldMan blog. 

Friday, 26 December 2014

Monday, 22 December 2014

Princess Health and Guest Post: Scholarly Mad Libs and Peer-less Reviews. Princessiccia

Princess Health and Guest Post: Scholarly Mad Libs and Peer-less Reviews. Princessiccia

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Health Care Renewal presents a guest post by Marjorie Lazoff, MD, a Board certified internist with a clinical background in academic emergency medicine.  She is currently a full time freelance editor and independent consultant specializing in evidence-based clinical content and medical informatics.

On December 17, 2014, Scientific American published an investigative report by journalist Charles Seife documenting a new and curious form of scholarly publication fraud, For Sale: �Your Name Here� in a Prestigious Science Journal. As an editor and supporter of evidence-based medicine I am both appalled by, and sympathetic to, how such widespread fraud could take place unnoticed.

Seife describes how he discovered the doctored writings:

The dubious papers aren't easy to spot. Taken individually each research article seems legitimate. But in an investigation by Scientific American that analyzed the language used in more than 100 scientific articles we found evidence of some worrisome patterns�signs of what appears to be an attempt to game the peer-review system on an industrial scale�

�This is not a simple case of plagiarism. Many seemingly independent research teams have been plagiarizing the same passage. An article in PLOS ONE may eventually lead to 'our better, comprehensive understanding' of the association between mutations in the XRCC1 gene and thyroid cancer risk. Another in the International Journal of Cancer (published by Wiley) might eventually lead to 'our better, comprehensive understanding' of the association between mutations in the XPA gene and cancer risk�and so on. Sometimes there are minor variations in the wording but in more than a dozen articles we found almost identical language with different genes and diseases seemingly plunked into the paragraph, like an esoteric version of Mad Libs, the parlor game in which participants fill in missing words in a passage.

Another example virtually eliminates the likelihood of coincidence:

There is no such thing as a 'Beggers funnel plot'�the proliferation of 'Begger's' tests [were discovered] by accident. While looking for trends in medical journal articles, papers [were found] that had almost identical titles, similar choices in graphics and the same quirky errors, such as 'Begger's funnel plot.'

Seife�s investigative reporting revealed that China was the source of most of his �fill-in-the-blanks� research. Further,

Much of the funding for these suspect papers comes from the Chinese government. Of the first 100 papers identified by Scientific American [and listed at the close of his article], 24 had received funding from the National Natural Science Foundation of China (NSFC), a governmental funding agency roughly equivalent to the U.S.'s National Science Foundation. Another 17 acknowledged grants from other government sources.

Seife suspects that most research probably began as legitimate work without intent to deceive, but somewhere an author or service was added to help ensure publication through the necessarily arduous manuscript review process.

The culprit?

A quick Internet search uncovers outfits that offer to arrange, for a fee, authorship of papers to be published in peer-reviewed outlets. They seem to cater to researchers looking for a quick and dirty way of getting a publication in a prestigious international scientific journal.

Seife�s investigation goes undercover, 60 Minutes style:

In November Scientific American asked a Chinese-speaking reporter to contact MedChina, which offers dozens of scientific 'topics for sale' and scientific journal 'article transfer' agreements. Posing as a person shopping for a scientific authorship, the reporter spoke with a MedChina representative who explained that the papers were already more or less accepted to peer-reviewed journals; apparently, all that was needed was a little editing and revising. The price depends, in part, on the impact factor of the target journal and whether the paper is experimental or meta-analytic. In this case, the MedChina rep offered authorship of a meta-analysis linking a protein to papillary thyroid cancer slated to be published in a journal with an impact factor of 3.353. The cost: 93,000 RMB�about $15,000.

Finally, the corrosive effect of this particular fraud on scientific and medical publication is real:

Publishers at the moment are fighting an uphill battle. 'Without insider information it's very difficult to police this,' Clinical Endocrinology's Bevan says. CE and its publisher, Wiley, are trying to close loopholes in the editorial process to flag suspicious late changes in authorship and other irregularities. 'You have to accept that people are submitting things in good faith and honesty,' Bevan says.

That is the essential threat. Now that a number of companies have figured out how to make money off of scientific misconduct, that presumption of honesty is in danger of becoming an anachronism.

Were this the only threat currently facing research journals today! Last month, Retraction Watch published an article describing a known and partially-related problem: fake peer reviews, in this case involving 50 BioMed Central papers. In the above-described article, Seife referred to this BioMed Central discovery; he was able to examine 6 of these titles and found that all were from Chinese authors, and shared style and subject matter to other �paper mill-written� meta-analyses.

Retraction Watch agrees:

It would seem that a third party, perhaps marketing services helping authors have papers accepted, was involved.

Problems with peer review are longstanding editorial fodder. For a description of another recent peer review scam, this one involving authors hijacking researchers� identities, see the article also written by Retraction Watch editors and published last month in Nature.

On Friday, in response to requests by several publishers, The Committee on Publication Ethics (COPE) posted a statement on inappropriate manipulation of peer review processes 

While there are a number of well-established reputable agencies offering manuscript-preparation services to authors, investigations at several journals suggests that some agencies are selling services, ranging from authorship of pre-written manuscripts to providing fabricated contact details for peer reviewers during the submission process and then supplying reviews from these fabricated addresses. Some of these peer reviewer accounts have the names of seemingly real researchers but with email addresses that differ from those from their institutions or associated with their previous publications, others appear to be completely fictitious.

COPE recommends, among other things, the retraction of articles based solely on fraudulent reviews. Retraction Watch�s announcement earlier today of a MacArthur Foundation grant to help fund a comprehensive and freely available database of retractions could not have come at a better time!

Seife and Retraction Watch have documented new forms of published research fraud among third world researchers. Certainly the solution is not for editors and readers to suspect all papers from specific countries; there are ample instances of research fraud emanating from English-speaking researchers and top U.S. institutions. Research from around the world is critically important, particularly although not exclusively in the basic sciences, emerging infectious disease, and public health/epidemiology. Now that it has been identified, a common screening procedure for manuscripts at a journal can be adjusted to filter out this new form of plagiarism.

Sadly, it seems to me that fraudulent research of all types can flourish within a perfect storm of circumstances and factors: the globalization of science and medicine encourages non-or-limited English-speaking researchers to publish (or perish) in the highest impact English language journals; the proliferation of open-access wannabes, hybrids of every color and degree of sincerity, and other money-over-science journals and companies that rip off desperate and na�ve researchers; a complicated, time-consuming and often author-unfriendly manuscript submission process; and journal editors who struggle with limited staffing and resources, necessarily arduous editorial processes, and the pressure of increasing numbers of worthy manuscripts deserving to reach the scientific and medical communities in near-real time. Research fraud is particularly destructive given traditional publishing�s ongoing struggle to survive the transformational Electronic Age; the pervasive if not perverse marketing of pharma, medical device companies, and self-promoting individuals and institutions using �unbiased� research; and today�s bizarrely anti-science culture.

Health Care Renewal is wonderful at calling out intentionally perpetrated health care events whose importance and implications can be debated, depending on one�s perspective and personal values. Here, I think, we have the reverse: there is near unanimity over the need to prevent fraudulent papers of any type from contaminating our research databases, as best as is humanly and technologically possible. There is also near unanimity among quality medical journals throughout the world, and internationally respected editor and publisher groups, to confront and solve these problems. The enemy identified by HCR is not always unrestrained greed or maliciousness. Sometimes, as in this case, the enemy is a cacophony of small circumstances and extraneous factors that could, if left unattended, invisibly erode something we all hold dear.

Without ongoing attention and support from the entire medical and science communities, we risk the progressive erosion of our essential, venerable research database, until it finally becomes too contaminated for even our most talented editors to heal.

Dr Marjorie Lazoff

ADDENDUM (30 December, 2014) - This post was reposted on the Naked Capitalism blog on 24 December, 2014.

ADDENDUM (7 January, 2015) - See also comments on DSHR's Blog.  

ADDENDUM (19 January, 2015) - This post was reposted by TruthOut on 10 January, 2015.

Sunday, 21 December 2014

Princess Health and2014 Santa PurSuit.Princessiccia

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Well, the 2014 season has come to a close for the team!  We finished it off with a bang at the 2014 Santa PurSuit.  Here's how the team did:



Team Results:

H+P ended ended up winning the event by over 7 minutes average/5K.  RESULTS.

Individual Results (CLICK):

Sean won the race in 17:35

Nick Burt battled hard, and placed comfortably in 2nd place OA with a time of 19:01

Aaron Mailman had a strong race for the team, placing 4th OA, winning his AG with a time of just under 20 minutes

Vicki was the first female in for the team, placing 4th out of all H+P-ers, and 3rd OA for women in a time of 22:18

Michelle and Nicole were in next for the teams with very solid finishes well under 26 minutes

Mike Hewitson was 5th for the team in the official results, finishing in 26:36.

Laura Hewitson was chasing her husband down, finishing in 26:45 and winning her category!

Jessica came in just behind Laura, placing 4th in her category!

Despite not running very much at all in the last few months, Will still managed a Santa PB of 34 minutes!

Andrew and Heather Heij both ran together and had a blast coming in 8th and 9th officially for the team.

Cari and Sam both ran with their kids in the 3K run!  They also both managed 2nd place in their category, nice work!

Onwards to 2015!  

Wednesday, 17 December 2014

Princess Health and The Medical School as Hereditary Plutocracy - Retiring Board Chair Sanford Weill of Cornell Weill Medical School Names His Own Daughter as New Chair. Princessiccia

Princess Health and The Medical School as Hereditary Plutocracy - Retiring Board Chair Sanford Weill of Cornell Weill Medical School Names His Own Daughter as New Chair. Princessiccia

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As I have written before, sometimes you just could not have made this stuff up.

The Retiring Board Chairman Appoints His Own Daughter to Succeed Him

The most even handed reporting on this story was in Inside Higher Ed,


Leadership of the board that oversees Cornell University�s medical college is passing from father to daughter, an unusual transition of power for a higher education board.

Weill Cornell Medical College�s Board of Overseers has been chaired for the past two decades by its namesake and major donor, Sandy Weill, the former CEO of Citigroup.

His daughter, Jessica Bibliowicz, is now set to take over Weill's role. She is the founder and former CEO of a major insurance brokerage, and has also been on the board for a decade.

Let me just dissect this a bit.  Weill Cornell Medical College is a large, prestigious medical school located in New York City, and part of Cornell University.  The chair of its Board of Overseers for the last two decades as been one Sanford I Weill.  Mr Weill is a famous finance executive, formerly CEO of Citigroup from 1998 - 2003, remained chairman of the board of Citigroup through 2006, and is now chairman emeritus (look here). 

According to a Cornell press release, the new chairperson, ms Jessica Bibliowicz, is a

Cornell University graduate in 1981 and after working 18 years in financial services, Ms. Bibliowicz became CEO of National Financial Partners in 1999, a financial services firm that specializes in benefits and wealth management. The company went public in 2003 and was sold to Madison Dearborn in 2013.

 Currently,

Ms. Bibliowicz is a senior advisor at Bridge Growth Partners and serves on the board of directors of Sotheby's(NYSE: BID); Realogy (NYSE: RLGY); and the Asia Pacific Fund (NYSE: APB). She is a board director/trustee of Prudential Insurance Funds....

The Inside Higher Ed article noted that

In a statement, Cornell said, Weill Cornell Medical College engaged in a comprehensive process to select its chair of the Board of Overseers by canvassing multiple members of the board in full consultation with senior leadership. The search was headed by a group of senior trustee overseers with extensive knowledge of the institution and Weill Cornell firmly believes it has selected the best choice as chair.'

The New York Times reporting of the succession, oddly in the Dealbook blog, which is focused on finance and Wall Street, not medicine, made it seem, however, that Mr Weill handpicked his daughter to succeed him,

he increasingly felt that the time was nearing to appoint a successor.

'I felt like it was a good time for younger blood,' he said.

Ultimately, he decided upon his daughter,

The Cornell press release lauded Mr Weill, the retiring chair as providing "bold and visionary leadership," having "enduring dedication," exemplifying "benevolence and unwavering resolve to ensure a healthier future," etc, etc.  It called him a "self-made man who exemplifies the philosophy of leading by example."  It quoted the current dean of the medical school, Dr Laurie Glimcher, (whose apparent conflict of interest as a board member of Bristol-Myers-Squibb we discussed here and here) calling his accomplishments "breathtaking."  It quoted the university president, David Skorton, calling him again a "visionary."

In the Dealbook article, Dr Glimcher further praised the chairperson designate, Ms Bibliowicz, as "a person of enormous energy and passion," who will "bring her energy, her connections and her passion for medicine and medical research and education to the role."


The Inside Higher Ed article noted some vague questions about the position of chair of the board of trustees of an important medical school being passed from father to daughter,

'On the other side of the coin, within-family succession planning adds complexity to the issue -- it just raises certain questions,' [former vice president for programs and research at the Association of Governing Boards of Universities and Colleges Peter] Eckel said.

However, Mr Eckel did not really list these questions.

Later, the article referred to "nepotistic arrangements," presumably in part referring to this father - daughter transition, but then found someone to defend them. 

The Real Questions

Weill Cornell Medical College is part of a non-profit organization.  Nonprofit organizations have no owners. Non-profit organizations are formed to support particular missions, under the stewardship of boards of trustees (or directors or overseers).  These boards have three basic duties [italics added]

 Duty of care: Board members are expected to actively participate in organizational planning and decision-making and to make sound and informed judgments.
Duty of loyalty: When acting on behalf of the organization, board members must put the interests of the nonprofit before any personal or professional concerns and avoid potential conflicts of interest.
Duty of obedience: Board members must ensure that the organization complies with all applicable federal, state, and local laws and regulations, and that it remains committed to its established mission.

Thus, the transfer of the position of chair of the board from parent to offspring, apparently directly under the control of the parent, is questionable on its face, suggesting that family interests came before the "interests of the nonprofit."  Such transfers may commonly occur on the boards of privately family held for-profit companies, but are basically unheard of for medical schools or other large academic medical nonprofit organizations, where they certainly could appear nepotistic.

That concern is amplified when neither parent or child have any appreciable background or training in the work of the nonprofit.  Neither Mr Weill nor Ms Bibliowicz seem to have any training or background in health care, biomedical research, or specifically medicine.  Yet Weill Cornell Medical School's basic mission is to train students to be physicians.  So how well either or their personal judgments about the policy and operations of a medical school are "informed" is not exactly clear.  

Further concerns are raised by the background of the father in this father daughter transaction, the part of the background that was entirely ignored by the rather fawning public discussion of the transaction in the Cornell press release, and also the NY Times Dealbook article.

In fact, Mr Weill's leadership in the past was of Citigroup during the lead up to the global financial collapse of 2008.  Citigroup, the poster child for the too big to fail bank, nearly went bankrupt, and required a huge government bailout.  Its near collapse, again apparently only prevented by government action, is widely considered to have been a major cause of the finance disaster starting in 2008.  As we noted in a 2009 blog post about Weill Cornell,   The Sellout, by Charles Gasparino, featured vivid portraits of the bad leadership that lead to the collapse, including specifically Mr Weill,

But in reality, Will never really ran anything. He was a visionary, to be sure, but one whose vision was so myopically focused on building the empire had lusted for for so long and on its share price that he ignored just about everything else. (p. 144)

Furthermore, this was Mr Weill's listing in the "key people" section of the book,

Former CEO and chairman of Citigroup, Weill created the idea of the one-stop-shopping mega-financial conglomerate, engineering a series of mergers ... and in the process created the world's largest financial company.  Famously obsessed with his firm's stock price, Weill announced his resignation in 2003 after investigators discovered he'd pressured a stock analyst, Jack Grubman, to raise his rating on AT&T, where Weill was on the board, in return for ensuring that Grubman's children got into an exclusive preschool.

Furthermore, in the Time magazine series on the "25 People to Blame for the Financial Crisis," Mr Weill is listed as  "blameworthy" because,

Who decided banks had to be all things to all customers? Weill did. Starting with a low-end lender in Baltimore, he cobbled together the first great financial supermarket, Citigroup. Along the way, Weill's acquisitions (Smith Barney, Travelers, etc.) and persistent lobbying shattered Glass-Steagall, the law that limited the investing risks banks could take. Rivals followed Citi. The swollen banks are now one of the country's major economic problems. Every major financial firm seems too big to fail, leading the government to spend hundreds of billions of dollars to keep them afloat. The biggest problem bank is Weill's Citigroup. The government has already spent $45 billion trying to fix it. 

In a post on the Baseline Scenario blog, Simon Johnson, author of another authoritative book on the financial crisis, 13 Bankers, wrote this about Citigroup leadership,

Citigroup is a very large bank that has amassed a huge amount of political power. Its current and former executives consistently push laws and regulations in the direction of allowing Citi and other megabanks to take on more risk, particularly in the form of complex highly leveraged bets. Taking these risks allows the executives and traders to get a lot of upside compensation in the form of bonuses when things go well � while the downside losses, when they materialize, become the taxpayer�s problem.

Citigroup is also, collectively, stupid on a grand scale. The supposedly smart people at the helm of Citi in the mid-2000s ran them hard around � and to the edge of bankruptcy. A series of unprecedented massive government bailouts was required in 2000-09 � and still the collateral damage to the economy has proved enormous. Give enough clever people the wrong incentives and they will destroy anything.

Physicians are supposedly rigorously trained, and tasked with upholding important ethical principles.   So did it make sense to entrust the stewardship of a premier American medical school to the man who engineered the expansion of Citigroup that turned out to be "stupid on a grand scale," in order to "get a lot of upside compensation," while leaving the "downside losses" to become "the taxpayer's problem," so that the "collateral damage to the economy has proved enormous?"   Does it make sense to allow him to choose his own daughter, who has no more medical experience than he did (which was zero), to steward the school in the future?

I wonder what Cornell medical students, or physician alumni would say, if they felt safe enough to answer the question?

As we wrote in 2009,  boards of trustees of not-for-profit health care institutions have a primary duty to uphold the institutions' missions.  Thus, one would think such boards would be selected according to their dedication to their missions.  But perhaps, in the grubby real world, there may be more important criteria, possibly such as the size of their donations to the institution.  Furthermore, those likely to donate the most  may be more likely to be richest (and perhaps most in need to making themselves appear philanthropic and public-spirited) than the most fervent upholders of patient care, teaching and research.

Maybe giving stewardship of our once proud health care institutuions to people most likely to defend their missions, rather than most likely to donate a lot of money, would result in somewhat poorer institutions which do a better job of patient care, teaching and research.

You heard it here first.  
 
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