Education

Did UNC and Duke med schools have a 'no-poach' agreement? Emails give clues.

Duke University Hospital is one of two Top 20 hospitals in the Southeast, according to US News & World Report’s annual hospital rankings.
Duke University Hospital is one of two Top 20 hospitals in the Southeast, according to US News & World Report’s annual hospital rankings. N&O file photo

There are emails going back to 1998 that document the existence of a conspiracy between the Duke and UNC health systems to tamp down any intramural competition between them in faculty hiring, a former Duke radiologist's legal team says.

Former UNC Health System CEO Jeff Houpt and former Duke University Chancellor for Health Affairs Ralph Snyderman swapped messages in late October 1998, after Duke offered a UNC faculty member a $100,000 raise to jump ship, lawyers for radiologist Danielle Seaman said in a new court filing.

In an email with the subject line "raiding," Houpt pointed out to Snyderman that two could play that game.

"If this is to be our modus operendi, I'm prepared to accept it because we regularly get calls from Duke people who say they'd like to bail out," Houpt, UNC Health's chief from 1998 to 2004, told his Duke counterpart. "I think, however, we'd only be setting up a bidding war. Let me know your thoughts."

Snyderman wrote back later the same day, telling Houpt the professor in question had "not been offered a job as of now." He also said Duke officials were "very sensitive to 'raiding' UNC" and suggested that he and Houpt "talk in person" about what he called "the general topic."

"I know your frustration, but as of now, the [hiring] gradient has been DUMC to UNC," said Snyderman, Duke's health chancellor from 1989 to 2004. "I assure you, we will see eye to eye on the general principles."

Seaman and her lawyers are suing Duke because they claim a no-poach collusion agreement between Duke and UNC cost her a chance to move from her job as an assistant professor at Duke to an assistant professor's job at UNC in 2015.

Such collusion, they say, violates federal anti-trust law and depresses medical salaries. And they contend they can show there's "a much lengthier anti-trust conspiracy involving more co-conspirators than Dr. Seaman initially alleged."

From the outset, she's had an email from a UNC administrator that cited as the reason for denying her application the existence of a no-poach agreement between the then-deans of the competing medical schools, incumbent UNC Health CEO Bill Roper and former Duke School of Medicine dean Nancy Andrews.

Roper has since said he urged Snyderman's successor at Duke, former Chancellor for Health Affairs Victor Dzau, to consider formalizing "some kind of understanding" between the universities on the matter, and that he'd told his own department chiefs to be "thoughtful and smart" about how they manage hiring and other matters impinging on the school's relationship with Duke.

In a deposition, Roper further said that when he took over from Houpt in 2004, the departing CEO told him that lateral-hiring issues were "something that he had discussed" with Snyderman.

But Roper also told lawyers there's nothing actually in writing on the matter at UNC, and that there's "no need" because oral directives to key officials there would suffice.

Lateral hiring involves a job swap between the institutions that doesn't include in the bargain a promotion, say from assistant professor to associate professor.

UNC settled with Seaman out of court, pledging to avoid collusion in all future hiring decisions.

Duke, meanwhile, has signaled through its lawyers that it intends to deny the existence of any conspiracy. Andrews told lawyers involved in the case that she never tried to prevent subordinates from raiding UNC. And Roper has said Dzau, after checking with Duke's lawyers, rejected the idea of formalizing anything.

The Houpt-Snyderman emails squared not just with Roper's hearsay about the possibility of such discussions, but with a deposition from former Duke President Nan Keohane in which she told lawyers Duke in her time had a "policy of avoiding active recruitment" from UNC.

Keohane was Duke's president from 1993 to 2004.

The emails, Roper's and Keohane's depositions and Duke's denials leave Seaman and her lawyers the job of establishing that collusion occurred during former Duke President Richard Brodhead's administration, which ran from 2004 to 2017.

But other court filings indicate they're working on that, in part by trolling through emails UNC's supplying as part of its settlement and in part by asking a judge to force Duke to turn over evidence.

A March filing indicated that they're examining faculty hiring outside the medical schools, including one recruitment of a then-Duke professor that former UNC Chancellor Holden Thorp was keeping an eye on. Its sponsor told the target that Thorp had advised him that "protocol is to notify Duke that we are talking to you."

In UNC's files, there is "important evidence of the conspiracy," Seaman's lawyers told U.S. District Court Judge Catherine Eagles, who is presiding over the class-action lawsuit.

They further said they want to gather depositions from Houpt and Snyderman.

Ray Gronberg: 919-419-6648, @rcgronberg

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