Father Knows Best

Lawrence Biondi radically remakes St. Louis University, leaving resentment in his wake

A professor closes the door to his office. Piles of books and papers have not yet found their way into boxes. He pulls out stacks of memos and clippings from newspapers that relate to the president of St. Louis University.

The prof leaves in a few weeks to teach at another school, yet he still asks for his name to be withheld.

"They do hear everything," he says.

Although this sounds like a line from The X-Files, he doesn't display the nervous tics of a paranoiac.

"We're losing good faculty. I'm telling people who I like that they should leave. If I thought the administration would listen, I would be more inclined to stay. There would be progress here. But the last couple of years," he sighs, "it's been living without hope."

Outside his office, the SLU campus looks anything but hopeless, a charming greenspace surrounded by old and new architecture.

St. Louis University's stature has risen significantly since the Reverend Lawrence Biondi became president fifteen years ago. The campus has grown. New construction and renovation of old facilities continues. What was once a small oasis in Midtown's urban wasteland has been transformed into an attractive, pleasing campus that has helped revive, however gradually, the neighborhoods surrounding it.

The endowment has increased, as has enrollment. SLU attracts better students, with incoming freshmen brandishing higher test scores. A more ambitious faculty teaches those students. This faculty is involved in significant research and publishes in respected journals. Fifteen years earlier, this wasn't necessarily the case.

There are abundant reasons to celebrate SLU's achievements and to praise Biondi's leadership.

Biondi's oft-stated goal, his vision, is an ambitious one: for the Jesuit institution to become the greatest Catholic university in America.

Yet after numerous interviews with senior and junior faculty, tenured and nontenured, with administrators and former administrators, it appears the drive toward Biondi's goal has stalled.

A Faculty Senate report has emerged that is highly critical of Biondi's autocratic leadership style. Members of the Faculty Senate are beginning to consider a no-confidence vote on the president.

More buildings are going up, but the educational environment is diminishing. Esteemed faculty members have left and are leaving. At the School of Medicine, according to the Faculty Senate report and interviews with senior professors, morale is at an all-time low. The Faculty Senate study reports that 100 physicians and researchers have resigned in the last two years.

The sale of St. Louis University Hospital to Tenet Healthcare four years ago, a sale designed to secure the quality of the med school, was disastrous, according to the teachers who work there. Profits that once went to the university now go to Tenet. Those who work for the medical-practice arm of the school, the University Medical Group (a.k.a. SLUCare), must devote more time to their practice to pay the bills of their various departments, resulting in less time to teach.

In 2000, the Health Sciences department lost $12 million dollars.

The med school once prided itself on its students' success rate on national board exams. At most, one or two students would fail each year. Last year, 20 percent of the class failed.

The Faculty Senate report, delivered to Biondi in April, documents many of these problems. The most resounding phrase from that study ("Shared Governance at St. Louis University: Reality or Myth?") comes near its conclusion: "St. Louis University continues to be governed in a top-down manner that emphasizes centralization and micro-management and minimizes faculty voice. The consequence is an atmosphere of fear."

The professor packing up his office is not alone in his anxieties. The signs of fear are revealed by others who request that their names not be used for this article. "Biondi can get very, very nasty if someone criticizes him," says one longtime member of the faculty, not for attribution.

"I can't afford to retire yet," one senior professor jokes.

"There is, unfortunately, a feeling that there is a certain vindictive quality to things. That's unfortunate, very unfortunate," says another faculty veteran.

"The operating mantra of the president is 'power, money and control,'" says a professor who has been on the Biondi watch at SLU for many years. "I would say any number of people have heard him say that time and again, and it's absolutely true. He runs the place with that operating principle: power, money and control. If you are functioning that way, it's going to lead you to behave in certain kinds of ways, because you're driven by that particular motto.

"So many gifted people -- senior people -- are fearful of what he will do," the veteran adds. "That in itself is a powerful story."

"The esprit de corps of the faculty is at rock bottom," says one senior professor at the School of Medicine. "We've lost a lot of people. We have lost a lot of very good clinicians. The number of clinical faculty is down tremendously."

The loss of 100 physicians and researchers in two years is an underestimation, says a senior faculty member: "If anything, that's a conservative figure."

Former provost Sandra Johnson, speaking for the administration, asserts that such losses are in line with the national average. (The dean of the medical school, Patricia Monteleone, was unavailable for an interview.) Johnson, whose expertise is health law, says, "This is the toughest time I've seen for academic medicine." She cites as examples increased competition within the health-care market, as well as "the pullback from Medicare reimbursement, managed care, lack of support for medical education from insurers and from the government. It's tough."

Quality doctors can leave universities and make a lot more money in private practice. Among medical schools, competition is fierce for those physicians serious about teaching, research and clinical practice.

Med schools are costly to run, making it essential to land physicians who can bring money into the school to help pay the bills.

SLU has been losing these doctors, say professors who've been attentive to the changes at the med school.

Monteleone has given the "national average" response to her faculty, as well. But, one senior professor counters, "I think it is a very naïve way of looking at it, because on the national scene, yes, there might be people who leave, but they are usually junior people who are moving to another institution to move up.

"But here, if you look at who left, they are heads of departments, people who are heads of programs, and as a result of their leaving, the program fell flat on its face."

In a medical school, an entire department may diminish, or fold, with the loss of one exemplary doctor. Those who have been at the school long enough to watch the exodus tally some of the most serious losses.

· Larry McBride, former chief cardiovascular surgeon, who moved to the Mayo Clinic in Jacksonville, Florida: Says one senior professor, "St. Louis University was the cardiovascular center in the Midwest, far better known than Washington University as far as cardiovascular surgery was concerned. Now we almost don't do any compared to them. It's been markedly reduced."

· Tom Miller, former head of surgery: Since Miller left SLU for the Veterans Affairs medical center in Richmond, Virginia, says one senior professor, "The surgery department is having a hard time attracting good surgeons."

· Virginia Herrmann, an esteemed breast surgeon who left for Washington University: According to a former SLU colleague, Helman is "nationally recognized in her field, a very prominent person."

· Doug McDonald, an orthopedic surgeon who also went to Wash. U.: One professor blames the current status of the department on the loss of McDonald, saying, "We have a very squalid orthopedic department that used to be very good."

Senior faculty members also refer to the decline of the school's nuclear-medicine division. The department had grown into "one of the best in the country" under the leadership of Robert Donati, says one senior professor. Donati went on to administration and has since resigned. Now, continues the professor, "in nuclear medicine, they can't offer the services because they're down to one half-time person. They can't offer services on various days because they don't have the people to do it."

With both Biondi and Monteleone unavailable for comment, SLU's media-relations department responds in an unsigned e-mail to RFT queries, stating, "Turnover at academic medical centers is a national issue." The faculty-turnover rate at SLU has increased slightly, according the media-relations report, but "the university continues to have excellent success in recruiting faculty to fill vacancies and has hired 48 new faculty last year and 44 this year."

A senior professor isn't impressed with the new hires, who, he claims, are "without academic credentials and academic interests."

The School of Medicine was once "the mecca of research at St. Louis University," says this senior professor.

The med school still receives 88 percent of the research funding that goes to the entire university. But, in recent years, SLU's national ranking, in terms of funding from the National Institutes of Health, has dropped markedly.

In 1996, according to the NIH Web site, SLU ranked 71st in the nation.

This year, it ranks 81st.

Many senior professors pin the plight of the School of Medicine not on national trends but on the sale of St. Louis University Hospital to Tenet in 1998.

"The hospital should never have been sold. A lot of us feel selling the hospital was a disastrous move," says one professor who's experienced the former years of plenty and the current drought.

Biondi and his advisers promoted the sale of the hospital, even though it was making millions for the university. There was enough money to pay for the School of Medicine, enough money to fund programs on North Campus, enough money to cover up Biondi's blunders.

For example, Biondi opened the Anheuser-Busch Eye Institute in 1993, against the advice of a number of ophthalmologists. It lost millions. However, says one senior professor, "the losses were obscured by the budget because the hospital made so much money."

SLU media relations says these figures are not available.

In 1997, Biondi, his advisers and his board of trustees foresaw disaster for SLU Hospital. Other university hospitals had begun losing money, so much so that those universities (Loyola of Chicago and Georgetown, for example) were dipping into their endowments to cover the deficits incurred by their medical facilities.

SLU Hospital was sold to Tenet Healthcare for $300 million. Of that money, $261 million went into an endowment for the health sciences.

"We blazed a trail," says Sandra Johnson. "Thank God we sold the hospital when it was sold, because that gave us an endowment to support the medical school. If we had kept the hospital, we would be in the position of Loyola, Georgetown -- who lost tremendous amounts of endowments to their hospital. We didn't have to go through that."

A senior professor at the School of Medicine responds skeptically to Johnson's position. "The proof of the pudding is in the eating. What has happened to Tenet? Have they lost money? They took over the hospital. Correct? They have not lost money yet. They've made nothing but profits. What was wrong before? If [SLU administration] thought they were going to lose money, they probably had bad business practices they needed to work on, rather than sell the hospital. Here somebody else has come in, taken over and made a profit of it.

"As far as I know, the hospital up to [the point of its sale] had never lost money. It had always had a profit before the sale to Tenet. What has now happened is that profit -- which is to help the university and the medical school -- has gone over to Tenet. Both the university and the medical school are hurting as a result of that. That's a very bad decision."

Johnson argues that such comparisons are apples and oranges: "Is Tenet able to show a margin in that hospital because it is a national system that gets a lot of savings off of bulk purchasing of everything from professional services to toilet paper? Is it making money because it has a four- or five-hospital system in St. Louis? Is it making money because it runs it differently than an academic practice would? I don't think it's at all fair to say it would have been profitable or produced a margin if we had continued to run it."

The wisdom of the sale of the hospital is open to debate.

Yet four years after that sale, even SLU's own self-study -- prepared for the recent visit of a national accreditation committee -- acknowledges that times are tough, even though the sale of the hospital was to secure the quality of the health-sciences program.

Under the heading "Challenges," the self-study reads, "Faculty physicians find that they must increase their clinical practice to maintain their previous level of compensation, at the expense of time otherwise devoted to teaching."

"Biondi cut deals with Tenet, selling UMG services well below market rate," says another professor who has observed Biondi's business deals over the years. "They're performing various physician services for the hospital, but they're getting reimbursed well below what market should be. As a consequence, they're having financial problems with the UMG."

SLU media relations, by e-mail, replies: "The hospital contracts with the university only for physician services that the hospital requests and needs. Those contracts are developed through arm's-length negotiations between the parties. The chair of each department is informed of annual payments by the hospital for those services in their departments and is responsible for the distribution of these resources."

Physicians have not been given access to those contracts and consequently have no real knowledge of how they're being served by those "arms-length negotiations." If they want a pay increase, they'll just have to work harder. The UMG doctors took a 5 percent pay cut six years ago and have not received an increase in their base salaries since. An e-mail from the media arm of the university says, "We actively encourage faculty to apply for more grants and contracts to help offset salary and unfunded research costs."

Meanwhile, students are failing.

"Last year, for the first time in the history of the school -- we never had trouble with board examinations; we had maybe one or two flunk a year -- last year we had 20 percent of the class fail," says one senior faculty member. "I'm holding my breath to find out what happens this year. They're taking [boards] now."

On top of the other changes that have taken place with the sale of the hospital, the School of Medicine has revised both its curriculum and its admissions policy. For the sake of diversity, the school has admitted students with lower entrance-exam scores than previously had been accepted. The new curriculum has not worked well for the new students, say several senior faculty members.

"Everybody's finger-pointing," says one professor. "I attribute it to the new curriculum. One of the problems was, almost no one fails anymore. No one fails our examinations or our courses. But when 20 percent flunk the boards, there's obviously something wrong with the curriculum. If 20 percent don't fail our curriculum but 20 percent fail the boards, there's something wrong."

According to SLU's self-study, an accreditation team "examined the data and concluded that the goal of enhancing diversity was lofty enough not to blame the curriculum."

Dan Zabel was executive director of the UMG. He met with physician faculty on a Wednesday evening in May.

The physicians of the UMG have a special role at the med school. The UMG is responsible not only for teaching medicine but for practicing medicine. That practice is expected to make money, money that further compensate the physicians, the departments of the med school and programs university-wide.

Zabel, according to those who met with him that night, believed the UMG was being unfairly burdened in other ways. The UMG was paying high overhead fees to SLU's North Campus for a variety of services. The costs for these services had increased remarkably, says one UMG physician, and yet the UMG did not know how those costs had been calculated.

Zabel told the physicians he was going to meet with SLU administration, including Biondi, to ask where they came up with those figures.

Two days later, the medical-school faculty was informed that Zabel had resigned, "for personal reasons."

"Of course these overhead costs have been reviewed," SLU media relations responds by e-mail. "The UMG Governing Board reviews the details of the university overhead charges to the UMG each year. Overhead expenses will continue to be examined annually and, where appropriate, will be increased or decreased."

Zabel is unavailable for comment. Those at the school who have tried to contact him have been told by his former office staff that he does not want to be reached.

"Biondi needs to get as much money as he can from various sources to allow him to do what he wants to do when he wants to do it," says a longtime Biondi watcher. "That's the key."

Biondi controls an asset unique to American university presidents. It's called the President's Opportunity Fund.

The first million dollars of unrestricted donations the school receives each year is allocated to SLU's operating fund. The rest goes to Biondi's fund, which he can tap with little oversight. He does not reveal to the university community how much is in the fund and can spend as much as $500,000 at any one time without seeking permission from the Board of Trustees.

"I don't know presidents at other institutions that have such opportunity funds," says a senior professor. "So ask yourself: Where does all the artwork come from? Is it true that he is free to go to Florida and buy artwork, or go to Oregon, or wherever he goes, and if it's below a certain amount he has the cash on hand because the Opportunity Fund's there?"

The Faculty Senate, which has grown increasingly frustrated with the president's overweening authority, questions not only where Biondi's money goes but from where it comes. In the past, Biondi has solicited trustees and staff to donate to his Opportunity Fund rather than to the school's general fund.

"Biondi builds monuments to himself," says one who has watched the buildings rise since the president's arrival on campus in 1987.

Among those monuments is the new St. Louis University Museum of Art, which illustrates Biondi's priorities, as well as his leadership style.

It's a beautiful building, but what's inside embarrasses those on campus whose expertise is art.

"His choices in art are demoralizing," says a member of the art department, "because art professionals are not being involved. We all hate the art, and it infects my teaching. I think about my teaching because there is this art on this campus and I don't know what to say about it.

"What may you talk or not talk about? Students bring it up. They want to know what I think. What do I tell them? I'm not good at dissembling. It's not appropriate in the classroom to dissemble."

Faculty are hard pressed to find ways to use the art museum as a teaching laboratory. "Biondi thinks of an art museum as a warehouse," says one art professor.

The art department learned how welcome its expertise was back when Biondi's first plans for an art museum were being developed, in 1998.

After Biondi removed the popular nightclub 20 North from the border of the SLU campus, he planned to build an art museum in its place.

But when the initial renderings for that building were examined by the art department, they noticed that a few basics had been left out. There was space for a fountain and a restaurant, but administrative offices and load-in facilities were minimal or nonexistent. Moreover, plans for visiting artist studios included viewing areas, creating a facility that the department referred to among themselves as the "art zoo."

The University News, SLU's student newspaper, interviewed members of the art department about the proposed museum. The professors mildly suggested that the art museum deserved a little more discussion.

Soon after, Biondi called the entire department into his office. According to those who attended, Biondi berated the faculty, calling the art school inferior and weak.

"All we did in that meeting was listen to how worthless we were," says one who experienced the tongue-lashing. "We were all troublemakers. None of us was famous. Where did we come off having an opinion?"

Last spring, Biondi got his museum, without a word of dissent. SLUMA is a beautiful renovation of a St. Louis architectural treasure.

Meanwhile, the art department itself -- the one that tries to teach students -- has facilities of lesser distinction than those of many high schools. A tour of the St. Louis Community College system reveals resources of a higher caliber than those provided to students in the SLU art department.

Photography is going to be offered at SLU this fall, but, as yet, no darkroom is available.

The printmaking area, which is a harbor for toxic chemicals and fumes, has for ventilation a single fan in the corner of one window.

The studio space is overheated in the winter, so students open the windows. The pigeons that fly in leave their droppings behind.

The sculpture studio consists of one sink -- which a faculty member installed himself -- and, for now, that sink is blocked.

Former provost Johnson returns to teaching at the School of Law this fall after four years working alongside Biondi. With Biondi out of town, she speaks for the administration.

In her view, SLU's very progress has fueled faculty negativity and dissension. SLU, she says, has created a "culture of aspiration."

Johnson sees faculty frustration as a positive sign, proof that the university community has grown ambitious. When Johnson listens to a quote from SLU's own self-study -- "The perception remains ... that university governance structures are still worked by strong central control" -- she responds, "I think shared governance is always an area of tension in a university. I think it's a healthy tension.

"The reason I think it's healthy is that universities now -- and maybe it's always been the case, but certainly in the last twenty years -- are really called to preserve academic values. And this is a very traditionally oriented university in the sense of the Jesuit tradition and values of students, but we act in a competitive environment. You're called to do both things. I think that's where shared governance is at the pivot point, because to preserve academic values and respond to a competitive environment you need all the perspectives that people bring. But you're not going to run the place making every single decision by committee."

What she calls strong, vigorous leadership does not amount to "an atmosphere of fear," in Johnson's estimation. "That is something I can't relate to," she says.

Yet those interviewed for this article all use the same word to explain why they do not want their names attributed: "vindictiveness."

Johnson scrunches up her face as if trying to decipher a foreign phrase: "I worked closely with [Biondi] for four years. This position is second to the president. This is probably the closest position to him other than his board. I never saw it.

"I'm not saying he doesn't have strong reactions, but I've never seen him take an action against someone in a vengeful manner at all. Never saw it."

Three years ago, the student body held a minirevolution against Biondi after he increased parking fees. In the spring of 1999, the Student Governing Association gave the president a vote of no-confidence.

The Faculty Senate resisted such a motion because, as one former senator recalls, "We take a vote of no-confidence very seriously, and, you know, this was just parking."

But the upheaval moved Biondi to sign a peace accord with the Faculty Senate. He agreed to move toward greater shared governance of the university. Faculty, students and staff would be placed on committees where they hadn't been welcome before. The administration would be open rather than closed, providing information rather than keeping plans to itself.

"Shared Governance at St. Louis University: Reality or Myth?" is Biondi's report card, delivered to him by the Faculty Senate in April.

According to this report, Biondi pulled an end run. He allowed faculty, students and staff onto committees, then took away their power.

For example, such decisions as the moving of the School of Public Health to the Salus Center last year, the construction of the new art museum, property acquisitions -- these sorts of issues used to be dealt with by the President's Coordinating Council.

But after representatives from the faculty, student body and staff joined that committee, Biondi moved the ultimate decision-making power to his executive staff.

The PCC, which formerly met every other week, began to meet once a month. Meanwhile, Biondi's staff began meeting every other week.

"They simply began to deal with the meaty issues, the juicy issues, those which would be controversial," says a former PCC member. "The [PCC] became more information-sharing than decision-making. The PCC in its earlier form actually used to vote on things on a consistent basis. In its new iteration, that rarely happens."

Sandra Johnson, who sat in on both PCC meetings and the president's closed sessions, disputes the Faculty Senate's charges. "I would have to say there was a very faithful adherence to that agreement on the part of the senior staff and the president," she says. "Whatever came up at senior staff [meetings], what was always discussed was 'Is this a PCC issue or is this a management issue?' Not every decision that's made goes through the PCC, or should. There are some things you have to do to keep the trains running. There's always going to be tension, and people are going to have different views of that. But that PCC really did operate. Things went to it in a constant fashion."

She admits that the president's staff determined who should decide what: "Sometimes the judgment was the wrong judgment. But it wasn't from lack of trying to be faithful to that agreement."

A faculty senator says Johnson is missing the point: "Suddenly, after the faculty, student and staff members were put on the PCC, the senior staff meetings increased in frequency and the PCC meetings decreased in frequency. A lot of the content of the PCC meetings turned into reports.

"From that, what can you conclude?"

The move of the School of Public Health to the Salus Center, to make room for Biondi's new art museum, says the faculty senator, "is probably the most grievous [decision made] because of what those people were put through."

The Salus Center, formerly Incarnate Word Hospital, was not yet completed when classes began in August 2001. Fumes from the tarring of the roof infiltrated the ventilation system. Those who already suffered from respiratory problems suffered even more.

"If they weren't asthmatic before," says one professor, "they're asthmatic now."

Everyone interviewed for this story praises St. Louis University. They are loyal to the institution. They are committed to its progress.

They all say that these disputes with the administration do not affect the classroom. They're too professional to allow it.

But they do talk about a reluctance for faculty to go the extra mile. One who has gone those extra miles puts it this way: "When individuals experience what we're talking about, they become demoralized. As a result of being demoralized -- what I'll call the vocation of the professorate -- becomes something that individuals will go about in a different kind of way. If individuals are unhappy and demoralized, they're not going to spend extra time on campus. They're going to do what they need to do. It's not that they're punching a clock, but they are abiding by their classes. They're abiding by their office hours, but the extra mile you want individuals to go with students -- it's different. What should be a love affair becomes much less than that.

"It begins with where you are," says the SLU veteran. "It begins with shared governance. It begins not with Biondi's vision of the institution but an institutional vision that's embraced by everybody. He keeps talking about 'It's my vision.' Frankly, who gives a shit whether it's his vision? That's part of it, but if everyone doesn't buy into it, especially the faculty, then it's going to be difficult to achieve that particular vision."

The Faculty Senate concludes its report with six modest steps toward positive change at the university. These proposals seek to decentralize the decision-making process by shifting the distribution of power from the top-down model that prevails today to one that is more inclusive. The Faculty Senate also stresses that special attention must be paid to the School of Medicine.

A committee has been set up to monitor the president's response to these recommendations.

"When do you get to the point where you no longer have confidence in this person? The answer is that if these six things are not done, it will trigger that," says a senior faculty member. "I really think that's going to happen. When do you get to the point that the faculty has enough chutzpah to be able to say, 'This is simply unacceptable. We cannot function or behave in this way. This is not the way a modern university is supposed to work'"?

He doesn't believe this is the way to becoming the greatest Catholic university in America.

"People believe we cannot get there from here unless there is a change of mind, a change of heart, and there is commitment to togetherness. That is not there at this particular time."

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