Are You As Confused As I Am?


Leonard Zwelling

This blog has been writing about the persecution of Chinese faculty members, even faculty members who are naturalized American citizens, for weeks now. The blog has recently also focused on the CMS action against MD Anderson which appears to be connected to the administration of contaminated blood and a lack of monitoring and acquiring consent on the part of those doing the administration on multiple occasions.

The first article above goes further than any other I have read to identifying the source of the Chinese issue. It’s the NIH and the review the agency undertook that unearthed many instances of faculty having way more than one hundred percent of their time allocated to research grants. Some were NIH grants; some were from China. There is also a problem with many of these double dippers not disclosing the full extent of their conflicts of interest to the agencies from which they were taking money. According to my reading of the article, there have actually been more than a few people dismissed from positions at American universities. Only MD Anderson and Emory have owned up to this action thus far, but the clear implication is that several more institutions have done the same only surreptitiously. If the latter is the case, shame on them. If there is a serious incursion into U.S. security, intellectual property and the confidentiality of government grant documents, let’s hear about it. It sounds to me from the article that NIH was ahead of the institutions in realizing the extent of the problem and that many institutions still are unwilling to acknowledge the laxity of their oversight of faculty research and time allocation activities. Of course, if we knew exactly why people were fired, that would clarify the issue a great deal.

The third article denotes the transfusion error in greater detail and suggests that the nursing at MD Anderson has left a lot to be desired. Why this is so interesting is that many faculty have been complaining about the quality of the nursing at Anderson for a while, but to no avail. Nursing has been insulated from accountability for mishaps. Until now. There simply is no way that nurses should be hanging blood for patients without fresh consent documents that explain the risks and benefits of what is not a benign procedure although usually safe and surely the nurses learned in nursing school the needs of patients receiving blood products for careful vital sign monitoring. Patients do not monitor their own adverse events as was implied in a quote in the article.

Why this is all so serious is that MD Anderson is ranked number one in cancer patient care and has a long history of trying to oversee the integrity of the grants process as well as that of conflict of interest. Unfortunately, the latter has been shredded by two past presidents of MD Anderson and so perhaps it is no surprise that now rank-and-file faculty members are emulating the past leadership.

As for the current MD Anderson leadership, Dr. Pisters was just named a top performer among CEOs. (See second article). This is commendable, but a little premature it seems given his short tenure on the job and current series of multiple crises. It’s like giving Barack Obama the Nobel Prize for getting elected. Nonsense.

As an ex-MD Anderson employee and executive, I find what has happened surrounding the Chinese faculty very concerning, but if it is true and these folks were breaking the rules, let’s hear what rules they broke and how that was determined. Right now this all appears cloaked in secrecy. If faculty members were sending NIH grant applications that they were confidentially charged with reviewing outside the country, no one would object to their dismissal. If.

Finally, there is nothing that is better administered at MD Anderson than clinical care, but of late that is fraying due largely to unreasonable demands being made of the faculty, especially surrounding the electronic medical record, and a sense that nursing is a world unto itself, separate from the care the faculty members were trying to deliver.

Everyone must be accountable. Every investigator must respect the conflict of interest rules and the rules governing the NIH grant process. Nurses and the clinical laboratory personnel must adhere to the strictest of patient care standards and be held accountable if they do not.

I just cannot believe this is happening at MD Anderson. It’s all so unaccountable and strange.

Leonard Zwelling