Doctor Drama

Bureaucracy leads to low morale and mistrust at the UA College of Medicine

Michael Demeure: "I'm a tenured professor, which should theoretically offer me some protections. They've shown that it doesn't."
Transforming the UA into a premier research facility remains UA President Robert Shelton's goal--but he recently admitted he can't do that until fundamental changes are made to the College of Medicine.

Shelton spoke on Monday, May 5, to a standing-room-only crowd of 150 College of Medicine faculty and staff, and admitted that he and UA College of Medicine Dean Keith Joiner now realize issues of low morale and mistrust within the college need to be addressed.

These problems were made public last month with the release of a report by the Committee of 11, a faculty-led committee elected by the UA Faculty Senate. The committee led a fact-finding mission in the fall and winter of 2007 after the Faculty Senate noticed an increase in complaints from College of Medicine staff.

One issue, according to Shelton, is what he describes as the complex organizational structure between the college's dean and department heads, and how they work with the University Medical Center and the University Physicians Healthcare (UPH) organization that runs the Kino hospital.

Part of the complex structure includes a required agreement between UPH and tenured faculty in clinic and surgery programs to work primarily through UPH at Kino hospital. If a doctor refuses, according to the agreement, they can jeopardize their tenure.

To provide an example of the complexities, Shelton told the assembled faculty that he has no direct influence with UPH--though UPH has a direct influence on tenured faculty.

"I'm not on the board, and its CEO does not report to me," Shelton said.

Further, critics point out that UPH is able to make demands of the College of Medicine and its department heads--another area beyond Shelton's influence.

Shelton does serve on the UMC board, which is assembled by the Board of Regents. However, Shelton said UMC is not accountable to the UA administration, either, an independence fostered by the fact that some board members have served more than 20 years.

"But these three entities (the College of Medicine, UMC and UPH) need to come together to work better," Shelton said.

One of the first questions at Monday's meeting came from Michael Demeure, an endocrine surgeon recently fired from his position at UPH and his tenured position with the College of Medicine, because he allegedly didn't uphold the employment agreement between the College of Medicine and UPH.

Demeure asked Shelton what the UA's role is in academic freedom and research, especially when that role conflicts with UPH's wishes and the tenured-faculty-employee agreement. Shelton answered that individuals under the agreement must fulfill the contract to remain tenured.

Demeure and the UA have faced off in an ongoing series of complaints and lawsuits that began a year ago, when Demeure requested a leave of absence with his UPH supervisor while he healed from shoulder surgery. Rather than allow the leave of absence, Demeure was fired from UPH.

Demeure told the Tucson Weekly that his case highlights a number of employment-law issues, ranging from discrimination to right-to-work matters. His case is also an example of the concerns tenured staff shared with the Committee of 11 regarding UPH and the lack of security that being tenured offers faculty.

"If they can do it to me, who theoretically does everything I'm supposed to do as a tenured professor--grants, growing a national reputation, being a good clinical surgeon with no issues regarding the quality of my care--they can do it to anybody," Demeure told the Weekly. "I'm a tenured professor, which should theoretically offer me some protections. They've shown that it doesn't."

In one of Demeure's complaints, he alleges that his UPH department supervisor, Dr. Hugo Villar (who is also a UA faculty member), made untrue statements that Demeure was in agreement with his termination so he could collect disability.

After being fired by UPH, Demeure still had tenure, but the majority of his income came from his surgical and clinical work through UPH. Demeure said he continued to negotiate with UPH to get his old job back, but he needed to make a living, so he purchased malpractice insurance and notified his former supervisors he was working at UMC and other local hospitals unaffiliated with UPH. Demeure continues to work through UMC and the Arizona Cancer Center, and to conduct adrenal and pancreatic-cancer research.

In April, Demeure was fired from his tenured position, with the UA stating he did not fulfill the requirements in the UPH employee agreement he signed in 2002.

In December, Demeure turned to the faculty-led Committee on Academic Freedom and Tenure (CAFT) to appeal, which found that Demeure was not dismissed for just cause. Demeure said he felt vindicated. Shelton, however, denied Demeure's appeal in April, despite the CAFT ruling.

Meanwhile, Demeure had filed a discrimination lawsuit against UPH on Jan. 10. On May 3, Demeure filed a lawsuit against Villar for interference and defamation, claiming that Villar's statements led to his dismissal. And now, he and his attorney, Don Awerkamp, are preparing a request for judicial review in Superior Court regarding Shelton's denial.

"What I had wanted was to be a professor and for the UA to allow me to work it out with UPH. I was always open to a settlement that would get me back to my original position," Demeure says. "Now there are clear damages. People think I did something wrong. My name is mud in the eyes of the administration, not because of anything I did, but because I had the audacity to ... fight for my rights."

The Weekly contacted Shelton and Villar regarding Demeure's dismissal. Shelton responded by e-mail that he was unable to comment, because it was a personnel matter; Villar did not respond as of press time. The Weekly did ask Shelton for further comment regarding the Committee of 11 report, but he did not respond as of press time.

At the College of Medicine faculty meeting on May 5, Shelton did say changes will take place, but in baby steps.

"The UA will not realize its potential until the College of Medicine realizes its potential," Shelton said. "If we don't straighten it out, we will lose our position, and we'll never regain it as the premier health-care system in the state."