Deseret News composite photo
Top left: Chairman H. David Burton, University of Utah President David Pershing. Right: Jon Huntsman Sr., Huntsman Cancer Institute CEO Mary Beckerle. Bottom left: Peter Huntsman, University of Utah Health CEO Dr. Vivian Lee.

SALT LAKE CITY — On March 2, a seven-page confidential document was prepared and signed by two members of the Huntsman family seeking to give total control of the University of Utah’s cancer program to the Huntsman Cancer Institute’s CEO.

The document, which both the Huntsmans and the university refused to release, was at the heart of accusations on both sides of a power play for control of the institute’s finances and staff — a struggle that has played out publicly for the past two weeks.

As a result, Huntsman Cancer Institute CEO Mary Beckerle was dismissed and rehired under the threat of millions of dollars in financial losses by Jon Huntsman Sr. The university’s health care CEO, Dr. Vivian Lee, who had fired Beckerle, resigned three days later following the reversal.

And Monday, University of Utah President David Pershing announced he would be retiring, throwing the future of the university and the cancer institute into uncertainty at a critical juncture.

The memorandum, obtained by the Deseret News, reveals that the Huntsman Cancer Foundation asked Pershing to cede extraordinary powers to Beckerle. More specifically, the memorandum proposed:

  • That Beckerle, as CEO, report directly to Pershing and informally to Lee and the chairman of the board of the Huntsman Cancer Foundation — Jon Huntsman Sr.
  • That Beckerle be given authority over the “full spectrum” of the cancer program at the U., including all of its "financial resources generated from clinical revenues, philanthropy, legislative initiatives and other sources," and all of the academic, research and clinical programs.
  • And that Beckerle be given the authority to hire “critical faculty” for the cancer program with or without the approval of academic departments.

The document, which was not signed by Pershing, set the stage for the power struggle that ensued over the next six weeks. Pershing and Lee gained the backing of board of trustees Chairman H. David Burton and Beckerle was released from her position.

Huntsman called Beckerle’s firing a “power grab” by Lee. Faculty and staff demanded transparency from administrators. And the university, staying largely silent about the controversy, said only that Beckerle was let go due to personnel issues they could not discuss.

In dozens of interviews, high-ranking leaders at the U., Huntsman Cancer Foundation and other people familiar with the events leading up to Beckerle’s dismissal described a battle for control over one of the state’s most prized institutions — and the $2.4 billion health system that oversees it.

Complicated history

Tensions have simmered between the Huntsman Cancer Institute and the U. for years.

Founded in 1993 with the help of the Huntsman family, the cancer center has long operated semi-autonomously from the wider university health system.

Tensions in the relationship became more palpable after Lee arrived in 2011 with a vision to integrate the health system to create more efficient and cheaper care for patients.

Huntsman said Lee’s efforts were not appreciated by him or faculty at the institute. He said Lee had been discussing more and more openly her plan to “withdraw the medical side from Huntsman,” something he said went against the institute’s three-fold mission: research, medical services and education.

“It was extremely discouraging to the doctors, the medical and clinical staff at Huntsman Cancer Institute to keep hearing from Dr. Lee that she wanted the institute to just be a research institute without medical and clinical help for our patients,” Huntsman said.

He added that the Huntsman Cancer Institute is “a multibillion dollar operation that isn’t about to change its course because (Lee) has different feelings one way or another — because she wants to consolidate all the medical under her power.”

According to Huntsman, the family’s foundation asked for just three things in the memorandum: that Beckerle report directly to Pershing instead of Lee, that the U. health sciences pay back several million dollars owed to Huntsman Cancer Institute, and that the U. agree to a plan for the Huntsmans to contribute around $250 million to the institute over eight years.

“By the time Vivian heard about it, she pushed the panic button and fired Mary,” Huntsman said. “Vivian decided to change the rules unilaterally — that’s the whole cause of it.”

Multiple high-ranking leaders at the university briefed on the negotiations contested Huntsman’s claims.

They said Lee wasn’t trying to separate the clinical side of the institute from its research side. Instead, they said, Lee and other senior leaders at the health care system had envisioned bringing cancer care out into the community by creating satellite cancer centers at the South Jordan and Farmington health centers.

Lee and other leaders also wanted to break down barriers between specialized departments — including the cancer department — and reorganize them around patient needs, much like the fully integrated Cleveland Clinic in Ohio.

They also said the changes proposed by Huntsman and his son Peter Huntsman would have dramatically altered the way the institution functioned and stripped the medical school of one of its most prized possessions: control over academic appointments.

The memorandum appears to back up those claims.

Among other things, the document also proposed changing the revenue sharing agreement between the institute and the university by increasing the amount given to the Huntsman Cancer Institute by 50 percent — totaling an estimated $48 million per year for three years.

Also, as written, the contract would not have obliged the Huntsmans to donate $250 million to the institute, a figure that Jon Huntsman Sr. has cited to the Deseret News.

Instead, it would make the Huntsman foundation responsible to “raise or provide” that amount, either through its own contribution or through other sources.

More issues

More incidents continued to strain the relationship between the institute and the University of Utah after the document was prepared, according to multiple high-ranking leaders in the university with knowledge of the deliberations.

Eleven days after the proposed memorandum was prepared, Beckerle announced that she had hired prominent cancer researcher Dr. Sunil Sharma into a newly created position: deputy center director at Huntsman Cancer Institute.

Huntsman Cancer Institute spokeswoman Ashlee Bright said Sharma, who joined the U. in 2009, was considering a position at another institution when Beckerle offered him the new title with the endorsement of the institute’s external advisory board.

“As CEO and director, she has full authority to make decisions about all leadership positions within the cancer center,” Bright said Monday in a statement to the Deseret News.

But sources say Beckerle did not inform senior leaders at the university about her actions and that they went directly against the instructions of Lee and the chairwoman of the department of medicine, Dr. Kathleen Cooney.

Sharma, when reached Monday evening, declined to comment. Attempts to reach Beckerle were not successful.

The incident was also investigated by members of the board of trustees and ultimately contributed to their endorsement of Beckerle’s firing, sources with knowledge of the incident said.

One month later, Lee and Pershing informed Beckerle through an email that she was being relieved of her duties as director and CEO. Pershing, who was scheduled to meet with Peter Huntsman in Houston the next day, did not arrive.

Breakdown

With Beckerle reinstated and both Lee and Pershing on their way out, it’s unclear who will renegotiate the memorandum of understanding with the Huntsmans and what the structure of the university health system will ultimately be.

Academic appointments, hundreds of millions of dollars and the decision-making capability of both the Huntsman Cancer Institute and the university are at stake.

At a weekly meeting of the faculty senate Monday, Pershing promised that administrators would be more transparent and vowed against making any "sudden administrative decisions" in the future. That extended to the new memorandums of understanding that are being reviewed, he said.

The university is left to negotiate the future of the Huntsman Cancer Institute with questions lingering about who actually controls the institute and the university.

In the meantime, Pershing said an attorney was consulting department chairs with regard to their concerns about those memorandums.

Some faculty members still expressed reservations that the transparency from the administration would be directed more at pleasing large donors than to keeping faculty in the loop.

But Pershing said he wanted to involve department chairs in adequately understanding and nurturing the ideal relationship between Huntsman Cancer Institute and the university's health sciences.

"The process of developing the agreement will be transparent — completely transparent," Pershing promised. "Everyone will have an opportunity to see what we’re doing."

Contributing: Ben Lockhart