Posted on: Saturday, December 15, 2001

Medical leaders at UH in turf war

By Alice Keesing
Advertiser Health Writer

A turf war between two of the key players in the University of Hawai'i medical school development in Kaka'ako is testing the UH president's new administration.

For months, medical school Dean Edwin Cadman and Cancer Research Center Director Carl-Wilhelm Vogel have been at odds over the $300 million development.

Now Vogel says he has been cut out of the decision- making for the Kaka'ako development, and the center has been pushed into a second phase that has yet to be paid for. That jeopardizes the center's coveted national standing as well as the $20 million of federal research money it brings into the state every year, he said.

The disagreement has left President Evan Dobelle caught between the warring views of two of his highest-paid employees.

"This tests the (mettle) of the president as well as the board, because clearly the rising stars at the university — it is the Cancer Research Center, it is the medical school and the whole biotech movement that both of them can do to drive Hawai'i," said Joseph Blanco, a former Board of Regents chairman who is familiar with the Kaka'ako project as the governor's special adviser for technology development. "Can the two co-exist? I certainly hope so."

Interim Chancellor Deane Neubauer said he has been aware of the problem since he stepped into office in July.

"Of course, anytime you have two people who are important to you who have a disagreement you're concerned about it, and we're working to try to get something sorted out that will meet both of their needs," he said. "I have never seen a university in which strong deans don't have disagreements. It's kind of what you inherit with the turf. What we do insist upon is people can't get onto each other so that the core business doesn't get done, and the core business is moving the project forward and getting the research done."

Vogel and Cadman were hired within four months of each other in 1999 as part of the university's drive to become a first-class institution by attracting world-class leaders. Both brought with them big reputations.

Cadman arrived from his job as chief of staff at Yale-New Haven Hospital. At the helm of UH's recently resuscitated medical school, he is part of the charge to grow Hawai'i's economy by specializing in fields such as biomedicine and biotechnology.

Vogel arrived at UH several months earlier to take over the helm of the Cancer Research Center, one of 60 facilities in the nation that has the prestigious National Cancer Institute designation. The center turns out nationally recognized work and is among the university's top dollar earners. Vogel was previously chairman of the Department of Biochemistry and Molecular Biology at the University of Hamburg in Germany.

From the time he arrived, Vogel said his biggest challenge was finding more room for his staff of 250, who are crammed onto three floors. And from the beginning, he has said the center must control its own destiny and remain administratively independent from other university programs.

University officials see the two working on a common goal. But the pair has not seen eye-to-eye from the beginning, according to Cadman.

Part of the disagreement appears to stem from a proposal Cadman made to the newly arriving Dobelle in May that would place the Cancer Research Center under the dean of the medical school as part of a new college of biomedicine and research. Such a move would cut off Vogel's direct line of communication to the president — a valued channel in the university's power structure.

Cadman says the idea of bringing the two under the same umbrella "was in the works before I got here."

Blanco said the regents and then-president Kenneth Mortimer wanted to consolidate the two to maximize their potential. Cadman believes the two would work well together, but said he's not pursuing the idea.

"(Vogel) didn't want to join the medical school, it was quite clear, and I didn't want to push it," he said. "It wasn't my agenda; my agenda was getting the new medical school."

However, Neubauer said the proposal is still alive as part of Dobelle's "everything's-on-the-table" strategy to overhaul the university.

Meanwhile, the disagreement has simmered and is now playing out over the Kaka'ako development.

The Legislature provided $150 million for Kaka'ako during the special session. The project is set to break ground in the spring and Vogel has become concerned that the cancer center has taken second place in the development, pushed into a later phase for which the university still must raise another $150 million.

A delay in getting new cancer center facilities could jeopardize the center's National Cancer Institute-designation, Vogel said. The last NCI review of the center noted its problem with overcrowding.

"If the university expends lots of money on biomedical research and does not include the Cancer Research Center, this is going to be viewed by the NCI as a lack of institutional support," he said.

He also argues that if the Legislature's intent in supporting the project was to bring research money into Hawai'i, it would make more sense to include the cancer center in the first phase, rather than an education building serving 60 students per year that won't bring in money. With the new expanded facilities at Kaka'ako, Vogel estimates the center could bring in $40 million a year.

Cadman replies that more than two-thirds of the current plan for the medical school and Pacific Biomedical Research Center is research space, which should generate as much as $100 million.

"We've got two strong leaders here and it's important to listen to both of them," Neubauer said. The university will begin work on the medical school building first, but he explained the choice as a matter of practicalities.

"I know that Carl's preferred position is to build two separate research buildings simultaneously — it can't happen given what we have been told by our technical people," he said. "My great fear is that if we don't do this right, we would end up with two substandard research buildings, which would be too small and the next thing we would hear from folks is 'We've outgrown our building.' "

Planning for the cancer center will begin in January, he said, and the administration is taking seriously Vogel's concerns about an impact on the center's NCI designation.