Dr. Stoll: Dr. Ransom’s inappropriate leadership and the resultant negative impact on UNTHSC culture

The following  memorandum transmitted to the UNT Board of Regents and Chancellor, on November 20, 2009 by Scott Stoll, DO, PhD.
                   Former Chairman of Department of Osteopathic Medicine
                  Former Tenured Professor-UNTHSC
                  Former UNT Health Board Member
                 Former Director of Physical Medicine Research Institute

This memorandum is intended to accompany my testimony delivered in front of the UNT System Chancellor and Board of Regents on Friday, November 20, 2009 regarding the MD Option at UNTHSC in Fort Worth.  The existence of an MD School in Fort Worth is no threat to TCOM.  The creation of an MD School outside of UNTHSC is also welcome.  It is only the creation of an MD School at UNTHSC and the associated initial and longstanding diversion of UNTHSC resources and attention which is harmful to our institution, city, county, region, and state.

It is clear that Dr. Ransom is committed to the goal of creating an MD School within UNTHSC regardless of the costs. 

He cannot honestly justify the need for an MD Option at UNTHSC because the real impetus is his (and many other community leaders’) bias and professional prejudice against DOs and in favor of MDs.  He has used (and continues to use) every deceptive and manipulative method at his disposal to accomplish this goal.  This effort has become the epitome of the ‘ends justifying the means.’  The UNT System Chancellor and Board of Regents continue to repeat their absolute commitment that an MD School will not come at the cost of substantial damage to TCOM.  However, this damage is already underway and is more profound and widespread than they seem to understand or acknowledge.  Dr. Ransom has been serially dishonest and this has hurt UNTHSC.  The ongoing support Dr. Ransom enjoys from the Chancellor and Board of Regents is what fuels this accelerating destruction of the integrity and pride that was at the heart of TCOM’s success as the country’s best osteopathic medical school. 

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I am keenly aware of the sensitivity of this subject and do not enjoy speaking negatively about anyone.  Never-the-less, I am committed to help where I can by sharing my experiences at UNTHSC over the last three years.  As follows are examples of Dr. Ransom’s inappropriate leadership and the resultant negative impact on UNTHSC.

Incidences related to MD Option:

1.    Dr. Ransom began the MD Option debate by claiming that the issue officially came onto the table for discussion because ‘vocal DOs’ were accusing UNTHSC as trying to become allopathic.  Essentially, Dr. Ransom began the MD Option debate by blaming local DOs for the existence of the debate in the first place.  It was dishonest and inappropriate to blame others for what is now known to be an initiative of UNTHSC leadership.  (Fall 2008)

2.   Dr. Ransom initiated the MD Option debate immediately after getting Marc Hahn to resign thus ensuring that TCOM would have weak or no leadership during the critical first year of the MD Option debate.  This was inappropriate and created the perception that the process was biased against the interests of TCOM. (Fall 2008)

3.   The initial survey for input was assembled and all data collected in December 2008 (rushed over the holidays) and did not quantify responses.  This was inappropriate and left the MD Study Group to provide equal (or greater) weight to a comment from a single individual in support of the MD Option than to the collective comments of a potential majority in opposition.  (December 2008)

4.    Overall, the process of evaluating the MD Option was characterized as fair, balanced, open, and transparent without a predetermined or preferred outcome.  It is now clearly known that the official evaluation of the MD Option was rushed and orchestrated with a predetermined outcome and designed specifically to have the appearance of transparency.  (Winter 2009)

5.   While Dr. Ransom was indicating that he, the MD Study Group, the UNT Chancellor, and the UNT Board of Regents were undecided as to whether an MD school should be on the UNTHSC campus; he specifically worked the lecture circuit within UNTHSC and around the community in support of the MD Option.  He even hired Dr. Sam Buchanan to promote the concept.  No one was hired to promote keeping UNTHSC with only a DO medical school. (all of 2009)

6.    As soon as TOMA came out in open opposition to the MD Option, UNTHSC (under the direction of Dr. Ransom) suddenly determined that TOMA dues could no longer be paid by UNTHSC state funds.  UNTHSC had used state funds to support faculty membership dues in a wide variety of professional organizations (including TOMA) for over 30 years. This type of action contributed to an atmosphere within UNTHSC that if you are not in support of the president’s initiatives that you would somehow feel retribution. (Spring 2009)

7.    Dr. Ransom claims that the UNTHSC Foundation Board approved funding of $100,000 for the Price Waterhouse Coopers (PWC) MD Option feasibility analysis.  Dr. David Garza is on this board and was not ever informed of a meeting, discussion, or vote related to this funding. This was an inappropriate, opaque process by which UNTHSC Foundation funds were directed toward the first phase of this costly analysis.  (2009)

8.    Dr. Ransom claims that the $100,000 spent by the UNTHSC Foundation in support of the PWC analysis was not money that came from TCOM funds nor was ever intended for use to support TCOM.  This is highly deceptive.  How were these funds raised and from whom?  This type of unrestricted Foundation funding is one of the most valuable resources available to our campus.  This is just one of the first in a soon to be long line of expenditures in support of the MD school that will be funding that could have been used to support TCOM, but instead is diverted to support the MD School. (2009)

9.   We were told by Dr. Ransom that the UNT Board of Regents came to UNTHSC Campus to publicly hear input concerning the MD Option so that they could decide whether to proceed with further analysis of this option.  In front of everyone present, after all public comments were complete, the UNT Board of Regents officially decided to proceed with an analysis of feasibility without a single word of discussion among the board members.  This is proof of the predetermined outcome which is different than the publicized purpose of this public forum. (Spring 2009)

10. Dr. Ransom proceeded to perform a feasibility analysis of the MD Option by hiring PWC to produce a document that is actually the documentation officially required by LCME in order to approve the creation of an MD school.  This was never explained publicly or to UNTHSC leadership that this was the dual intent of this feasibility analysis and is further evidence of an ongoing manipulation of the truth and intent to deceive in pursuit of the goal of starting an MD school. (Spring and Summer 2009)

11. The Commission of Osteopathic College Accreditation (COCA) re-reviewed the UNTHSC-TCOM in the summer of 2009 because of inconsistency in the official position of UNTHSC administration.  In the Fall of 2008, COCA approved an expansion of the TCOM medical school class to 250 students based in part on the adequacy of our clinical training sites.  Within a month or so of their granting approval to grow to 250, the TCOM dean was pressed to resign and Dr. Ransom was testifying in front of the Texas Senate Finance Committee that we needed an MD school because we needed more local training sites and that the local hospitals were refusing to partner with the TCOM unless UNTHSC also had an MD school.  At the COCA repeat review meeting in the Summer of 2009, UNTHSC-TCOM administration again, officially stated and demonstrated our ample capacity of clinical training sites for a class size of 250. Dr. Ransom misled the Finance Committee and many groups regarding our need for clinical training sites. (2009)

12.  Dr. Ransom testified in front of the Texas Senate Finance Committee that the local hospitals were refusing to partner with the TCOM unless UNTHSC also had an MD school.  Dr. Ransom repeated this claim in many forums over many months.  The representative of Texas Health Resources (largest local hospital system) who attended and spoke when the UNT System Board of Regents received public input into the MD Option stated directly and repeatedly that this was not true.  (Spring 2009)

13. Out of growing concern for a lack of transparency in this MD Option decision making process (despite assertions of complete transparency), The American Osteopathic Association (AOA) and the Texas Osteopathic Medical Association (TOMA) asked, through the Texas Freedom of Information Act, for copies of all documents that UNTHSC possessed that contained information associated with the MD Option.  The first response was to claim that over 1,000 pages of documents were protected from being released because they contained ‘industry secrets.’  Soon thereafter, Dr. Ransom declined to release any documents on the basis of a technicality.  These maneuvers are not those of a transparent administration and further demonstrate that Dr. Ransom’s actions are in fact more secretive and manipulative than he is willing to admit. (Spring and Summer 2009)

14. When UNTHSC did not receive Special Funding from the Texas Legislature, Dr. Ransom presented to many internal and external groups that the DOs who were in opposition to the MD Option were to blame.  Not only was this an inappropriate and obvious deflection of blame from his own failure, but lack of Special Funding to North Texas higher education institutions is actually known to be the historical norm.  Along this same line, one particular unfunded $4 million (over the biennium) Special Funding request that Dr. Ransom repetitively blamed on the DOs actually appeared in the budget of proposed new UNT Law School at the same time that it disappeared from the UNT Medical School (TCOM) budget.  In the midst of high emotion and high stakes finances, Dr. Ransom inappropriately chose to spread misinformation about these unsuccessful Special Funding requests in an effort to demonize the DOs lobbying against the MD option. (Spring 2009)

15. In the days following the close of the 2009 Texas Legislature’s budget votes, Dr. Ransom also disseminated another deception in an effort to alienate and demonize the DOs in opposition to the MD Option.  Dr. Ransom repeated to a wide internal and external audience that a few DOs were so irrationally apposed to the MD Option that they would rather see the entire institution close than to have an MD school.  Dr. Ransom told everyone that DOs had been behind a last minute legislative bill that would have closed the school (UNTHSC).  He did not explain that this bill actually proposed that all state funding intended for TCOM actually be spent in support of TCOM.  Clearly it was inappropriate to purposely deceive so many as to the true intent of the proposed legislation.  (Spring 2009)

16. Dr. Ransom appointed Dr. Alan Podawiltz as Interim-Dean of TCOM at the same time that he announced the ‘resignation’ of Dr. Hahn.  The AOA indicated to UNTHSC administration that Dr. Podawiltz did not have the credentials to be TCOM Dean because he lacked AOA Board Certification.  Dr. Ransom then appointed Dr. Bruce Dubin as the Interim-Dean of TCOM and gave Dr. Podawiltz an alternative administrative title.  Dr. Podawiltz was directed to continue functioning as the TCOM Dean which he proceeded to do in every meaningful capacity.  Dr. Dubin readily acknowledged he was Dean in name only.  However, on the one day that COCA was on campus, Dr. Podawiltz was nowhere to be seen and Dr. Dubin was present at all required meeting of the TCOM Dean.  This is just another example of Dr. Ransom inappropriately manipulating UNTHSC to meet the letter, but not the spirit of rules and regulations.  (Summer 2009)

17. By state statute, UNTHSC must be lead by a DO.  The intent of this was to keep a clinician (a DO) in charge of TCOM.   Dr. Ransom named Dr. Thomas Yorio as Provost without a search which placed Dr. Yorio (a PhD) directly in control of the osteopathic medical school.  Of note is that Dr. Yorio has promoted the placement of an MD school on campus for years.  Dr. Yorio has spent much of his time over many years as Graduate School Dean to find ways to shift increasing resources from the medical school to the graduate school.  He is now in the position to do exactly that.  As one example, when PWC came to campus to determine the costs and feasibility of creating an MD school, Dr. Yorio had guided the Graduate School Dean and Chairmen to be prepared to present to PWC exactly what the graduate school would need to support this new MD school.  This included new research space, new faculty lines, new graduate student stipends, new staff etc.  This is exactly as it should be.  The problem is that this same guidance was not provided to TCOM or the clinical department chairmen.  So, without a TCOM dean and with the Provost and the Graduate School Dean looking out primarily for the Graduate School, TCOM was further compromised.  It is through this type of leadership lapse that Dr. Ransom and his appointees are failing and damaging TCOM.  This is only expected to continue if an MD school is created on the UNTHSC campus under this leadership. (Spring and Summer 2009)

18. I resigned my tenured faculty position at UNTHSC after 20 years of service.  I gave my UNTHSC employers 5 months notice in order to assist the TCOM OMM Department in its transition to a new Chairman.  In retaliation for my vocal opposition to Dr. Ransom’s policies, within two weeks of my resignation announcement, the Provost, Dr. Yorio, threatened to reduce my pay by 40% throughout my remaining 5 months.  It was only after I threatened to sue that this pay reduction was for the most part prevented.  I can provide documentation of this upon request.  No other longstanding faculty in good standing has ever been treated in this manner.  Dr. Ransom’s direct reports may have learned from his example how to abuse power and inappropriately manipulate faculty. (Fall 2009)

19. When Randy Jones, previous President of UNTHealth, resigned (was pushed out) in 2008; he also gave many months of notice to assist UNTHealth in transition and to ensure that UNTHealth completed FY2008 successfully.  At that time, UNTHealth had an established Executive Compensation Plan which included bonuses for executives if UNTHealth met predetermined benchmarks.  Although Mr. Jones last day was after the end of the fiscal year and his transition assistance ensured that UNTHealth met the productivity benchmarks required to fulfill this element of his contractual compensation plan, Dr. Ransom would not pay him his rightfully earned bonus pay.  After six months of effort, I was finally able to get Dr. Ransom as Chairman of the UNTHealth Board of Directors to address this unethical action in front of the whole board.  The justification Dr. Ransom gave for withholding the earned bonus from Mr. Jones was that by precedent, bonuses were only given if the employee was present at the date that bonuses were dispersed (October 2008) and not if they were just present throughout the period the bonuses were earned (August 31, 2008). (Fall 2008)

20. Dr. Kathleen Forbes, President of UNTHealth (also a direct report to Dr. Ransom) also retaliated against me for my vocal opposition to Dr. Ransom’s policies.  By almost any measure, I had a phenomenally successful clinical year in FY09 ending 8/31/09.  I significantly surpassed all of my projected productivity targets.  After all expenses were accounted for including my budgeted fund balance contributions, as an individual faculty; I ended the year with surplus funds (in the black) by $181,000.  I can provide documentation of this upon request.  This is the best I have ever done at UNTHSC and I suspect this ranks among the highest surplus productivity ever seen at year end for any faculty.  However, despite clear rules to the contrary, Dr. Forbes in closed session and with no explanation authorized the bare minimum in bonus compensation even with $80,000 designated bonus money left unspent in the UNTHealth budget.  In contrast to Dr. Ransom’s stated policy as it applied to the resignation of the past President of UNTHealth, Mr. Randy Jones, even though I was present when the UNTHealth bonus was earned (August 2009) and also when the bonuses were dispersed (November 2009); no fair bonus was allowed.  Again, Dr. Ransom’s direct reports may have learned from his example how to abuse power and inappropriately manipulate faculty. (Fall 2009)

21. Over the last three years, this drive toward an MD Option has had a significant impact on the makeup of faculty at UNTHSC.  It has made an even greater impact on the makeup of the leadership team on campus.  Dr. Ransom has hired, promoted and placed as committee chairs those individuals who are in support of the MD Option.  He has alienated, marginalized, and run off many who are not supportive of the MD Option.  As the years pass with Dr. Ransom as President, the number of MD Option supporters in key positions grows. These individuals have many varied qualities; however a common thread is a bias in favor of MDs over DOs.  These individuals in turn also hire and place similar minded individuals into key roles in their departments, institutes, and divisions.  The consequence is a growing and expanding contingency of such individuals throughout UNTHSC and the UNT System.  The longer Dr. Ransom is at UNTHSC, the greater will be this insidious and unfortunate influence at an institution which is in existence and predominantly needed for its osteopathic medical school. (2006-2009)

Miscellaneous Incidences:

22. UNTHealth Board (Clinical Department Chairs) collectively agreed to keep UNTHealth President Randy Jones.  Dr. Ransom proceeded to force Jones out in favor of his predetermined choice Kathleen Forbes, MD.  This occurred despite the advice of the search committee against Dr. Forbes.  Dr. Palmarrozi’s activity on this committee likely positioned her in opposition to Dr. Ransom on this issue and contributed to her dismissal as Chair of Family Medicine.  (2007-2008)

23. The UNTHealth Board was told that the costs of defending the lawsuit related to the financial losses at OMCT would be borne by UNTHealth budget.  The Board was collectively and vocally apposed to this, but was reminded that the UNTHealth Board was advisory and that this was an executive decision.  A year later it was determined that the official minutes of this Board Mtg indicated that the UNTHealth Board supported the use of UNTHealth funds to cover these legal fees. (2008)

24.  As both Chairman of the UNTHealth Board and President of UNTHSC, Dr. Ransom directed the movement of significant funds from the state side of the UNTHSC ledger to the  clinic side of the ledger in order to ensure that UNTHealth would end FY2009 in a profitable position.  It is suspected that Dr. Ransom receives bonus compensation to ensure UNTHealth meets specific financial benchmarks and that he inappropriately used surplus state funding to make sure these benchmarks were met.  I can provide documentation of this upon request.  (Spring and Summer 2009)

25. The monthly and YTD financial reports of UNTHealth list all clinical dollars that are used for faculty salaries as “Transfer to TCOM.”  Dr. Ransom directed this terminology which is clearly intended to manipulated perceptions (create misperceptions) related to the UNTHealth clinical budget and TCOM state budget.  UNTHealth and TCOM are supposed to be distinct and separate institutions without any co-mingling of funds.  For anyone not familiar with these budgets, this appears like the UNTHealth clinical practice plan is transferring significant dollars to the medical school.  It makes it seem that UNTHealth is a financial engine which supports TCOM and perhaps is even presented as part of the TCOM budget.  However, in actuality, clinicians work hard in clinic with a poor payer mix, high overhead, and high institutional taxation all while simultaneously teaching students and residents.  The dollars left after all non-salary expenses are subtracted from revenues is simply the clinicians’ salary, yet it is misrepresented as a transfer to TCOM.

Every year since Dr. Ransom arrived at UNTHSC, there have been several Leadership Development Retreats.  These have featured a variety of prominent leadership facilitators and covered a wide range of topics.  In 2007 and 2008, I attended several which emphasized team building.  It became a common occurrence that at some point during each of these meetings the program would come around to the fundamental importance of integrity and trust.  Trust was the obvious foundation to positive relationships and these positive relationships were the foundation to successful teams.  Of note, was that the UNTHSC leadership in the room (absent Dr. Ransom) would consistently (amazingly) voice their lack of trust in Scott Ransom.  Leadership meeting after meeting would emphasize the importance of trust, would acknowledge the lack of trust, and then we would be stuck.  No one in the room had the power to change Dr. Ransom’s integrity or methods.  The negative impact of this lack of trust in Dr. Ransom has lead us to where we are today.  It was not dealt with effectively when identified in these leadership forums and now there are few leaders left willing to speak out about this issue.

Over the last year, I have regularly been approached by students, staff, and faculty who express their concerns regarding Dr. Ransom.  These comments invariably come after the speaker first ensures that our conversation is private and cannot be overheard. I am commonly lauded for being willing to stand up and speak out against the obvious injustices and am told that they cannot speak up for fear of losing their jobs or student status.  The only proof I have of this pervasive concern is the attached (de-identified) emails I received after I sent out a response to Dr. Ransom’s most recent promotion of the MD Option. You may note that the authors include MDs, PhDs, DOs and students from each school on campus.  These represent a small fraction of the verbal commentary I have received.

These are actually only a few examples of Dr. Ransom’s inappropriate leadership methods.  I chose to resign rather than contribute to what has become a culture of deception, mistrust and intimidation.  Perhaps the situation can best be summarized by paraphrasing a student’s comments.  We are here to train the next generation of physicians, physician assistants, physical therapists, basic scientists, and public health professionals.  Fundamental to all of their training and professional careers is ethical behavior.  How can we as a university system, health science center, college, or school tolerate a blatant and ongoing lack of integrity in our top leadership?  These students learn by example and what we allow, we teach.  What is the UNT System Chancellor and Board of Regents allowing?