Professor was harassed by his university after criticising routine prostate cancer screening, inquiry finds

A prominent medical school professor has been subjected by his university to “egregious” harassment after he wrote an editorial critical of routine prostate cancer screening, according to an internal investigation at the university.

Michael Wilkes, former vice dean for medical education and now director of Global Health, a research and policy institute, and professor of medicine at the University of California Davis, co-wrote an editorial published in the San Francisco Chronicle on 30 September 2010, with Jerome R Hoffman, emeritus professor of medicine at the University of California Los Angeles.

Wilkes and Hoffman, who were serving as researchers/consultants to the US Centers for Disease Control and Prevention, wrote that routine prostate cancer screening “can cause more harm than good” and said that men should be full participants in the decision to be screened through a process of “shared decision making.”

Wilkes told the BMJ that he was moved to write the editorial after some of his students told him in mid September 2010 about a free university seminar for the public on “men’s health” to be held at the end of the month.

The seminar featured a “special guest,” three time Super Bowl Champion, Guy McGuire. An advertisement for the event stated that “Prostate Defense Begins at 40” and “Know Your Stats About Prostate Cancer.” The event was supported by Intuitive Surgical, manufacturer of the da Vinci robot used to perform prostatectomies.

Wilkes and Hoffman opined in the editorial that “We can’t know why UC Davis offers this course that ignores scientific evidence, but we wonder whether it just might have to do with money.”

On the morning the editorial was published, the executive associate dean at the medical school wrote an email to Wilkes and school officials stating that Wilkes would not be invited to continue as instructor of record for the third year “doctoring” course at the university after the end of the academic year.

Wilkes was threatened later with other punishments and the university’s legal counsel wrote to Wilkes alleging that there were “numerous errors of fact” in the editorial that were “injurious to the university interests,” which could lead to a lawsuit against Wilkes for “defamation.”

After mediation talks failed, Wilkes contacted the university’s Committee on Academic Freedom and Responsibility about the threats. The six member committee investigated Wilkes’s concerns and on 8 June, issued its findings that the university’s actions had the “strong appearance of impropriety on the basis of several lines of evidence” and that Wilkes was the target of “egregious harassment,” causing him to fear for his job and career.1

The university’s representative assembly issued a statement saying that it “condemns [the] Health System and Campus Legal Counsel for drafting inappropriate and apparently threatening letters that violated a faculty member’s right to academic freedom.”

The assembly unanimously passed resolutions calling on the university to apologise to Wilkes and to “rescind in writing all disciplinary actions that have been stated, proposed or taken against Professor Wilkes.”

UC Davis provost and executive vice chancellor Ralph Hexter responded to the resolutions, stating, “Academic freedom is sacrosanct at UC Davis, and the underlying assertions in this matter are deeply troubling. My office will review this case and take appropriate actions.”

Gregory Pasternak, chair of the investigating committee, told the BMJ that university officials said the dispute should have been handled internally and that Wilkes should not have published his concerns in a public forum.

Wilkes told the BMJ that he tried to reach out to the seminar organisers but was rebuffed. He said that keeping concerns about the university out of the public eye is the wrong model for academics and for the public’s health. He told the BMJ, “If we can’t challenge the organisation we work for, who will stand up and point out when something is wrong?”

The medical school issued a news release stating, “We deeply regret that the handling of this particular personnel matter [is] perceived by some as a violation of academic freedom. Academic freedom is fundamental to the discovery and dissemination of knowledge, and we are personally and professionally committed to upholding that freedom within our institution.

“We respect and protect the rights of our faculty to pursue their research and teaching as they wish, so long as it is in a manner that is consistent with professional standards. It would be inappropriate to comment publicly on specific personnel matters and on Academic Senate recommendations under review.”

The faculty resolutions are not binding and currently none of the threats against Wilkes have been withdrawn. The dean’s office did not say when it would conclude its review.

Wilkes’s co-author, Hoffman, told the BMJ that the decision to go after Wilkes “doesn’t really seem to be about PSA screening, or about purported inaccuracies in what we wrote,” since the university did not send him or the publisher a letter intended to “set the record straight.” The investigating committee made a similar point stating that the university’s failure to write to either Hoffman or the newspaper suggested that their intent was “precisely to stifle legitimate public debate and impinge on Professor Wilkes’ academic freedom.”

Hoffman said “I don’t want to speculate about what was in the minds of the UC Davis administration. But I do believe this episode should get us thinking about the core mission of a medical university. Irreconcilable contradictions can arise when health care tries to maximise health but also to maximise profit, and a similar tension seems inevitable when an institution tries to reconcile prioritising the promotion of science and of the public health with the alternate notion that its existence depends first and foremost upon its ability to succeed in the marketplace as a money making venture.”

This is not the first time Wilkes has come under attack for his views on routine prostate cancer screening. In 2003, a laymen’s group, US Too! International launched a letter writing campaign to the medical school dean demanding that Wilkes be fired for his “terrorist journalistic tactics” after he wrote an earlier editorial in the San Francisco Chronicle. US Too! told BMJ in 2003 that 95% of its $799 012 (£513 869; €634 113) budget in 2000, came from drug and device manufacturers.2