Cleveland, OH - Dr Eric Topol may no longer be the provost of the medical college he helped establish and has lost his title as chief academic officer at the Cleveland Clinic, a result of institutional "reorganization," the renowned cardiologist was told one week ago today. Topol was informed that the change was "effective immediately," despite the fact that the board of trustees will only today be voting on the restructuring plan; the clinic is refusing to issue a formal statement until the trustees have voted.

Conspicuously, Topol's ostensible loss of authority—staff and researchers at the college will now report directly to the CEO—came days after a federal jury heard Topol's videotaped deposition in the latest Vioxx lawsuit. In it, Topol accused Merck of "scientific misconduct" and testified that Merck's former chair, Raymond Gilmartin, had in the past called fellow Harvard MBA alumnus Malachi Mixon, the chair of the clinic's board of trustees, to complain about Topol's vocal anti-Vioxx stance.

Topol received word of the "administrative streamlining" after details of his testimony appeared in the Wall Street Journal [1].

"It's a little hard to believe it was a coincidence, " Topol told heartwire. "I'm not trying to say that the Vioxx/Merck thing was the only reason this occurred; I'm just saying it contributed and certainly the timing of it had to play a role, unquestionably."

With the change, Topol will no longer oversee the Lerner College of Medicine or be the primary contact for the relationship he established between Lerner College and Case Western Reserve University. He is still chief of cardiovascular medicine for the Cleveland Clinic and remains a professor of medicine at the college and a professor of genetics at Case Western. (Topol is also editor-in-chief of theheart.org.)

It's a little hard to believe it was a coincidence.

Topol first heard that his provost and chief academic officer positions were being dissolved early on the morning of December 5, 2005. At the same time, he was told not to attend an 8 AM board of governors meeting that day, since he was no longer on the board, his appointment there being a function of his five years as chief academic officer. An official statement to professional staff at the Cleveland Clinic explaining the restructuring plan was drawn up on Tuesday, December 6, 2005 and approved by Topol but has still not been circulated. Ultimately, details of the news were leaked to the Cleveland Plain Dealer [2] and picked up by other news media, including the New York Times [3], which ran the story on Saturday, December 10.

In it, Eileen Sheil, a spokesperson for the Cleveland Clinic, is quoted as saying that Topol was not being punished for his Vioxx testimony but rather lost his title as part of a broader administrative reorganization. "The organization made the decision that that position was no longer needed," Sheil is quoted in the Times. The Plain Dealer refers to "tension" between Topol and Cleveland Clinic CEO Dr Toby Cosgrove, who won the CEO position sought by both men last year.

If the board hadn't approved the darn thing, they shouldn't have told me it was effective immediately.

Topol questions why the change had to be made so urgently. "All I can say is, if you have a table of organization changed, it doesn't need to be done on an immediate basis like this. My appointment naturally would have run out at the end of the calendar year, so it could have been set up that, in January, we'd start off with this different configuration. . . . The emergency action is very peculiar, and the fact that it was not even approved first by the board of trustees—you'd have thought that this would have been approved before they told me. If the board hadn't approved the darn thing, they shouldn't have told me it was effective immediately. So this is what's troubling about this whole thing: why did this have to be such a rush?"

Topol told heartwire he is getting a lot of support from colleagues and students. "I've been here almost 15 years and there are a lot of tight relationships and a lot of big projects. The flagship NIH grant on the genomics of heart disease is here, and I've just recruited 25 cardiologists," bringing the number of faculty on staff to more than 95.

For now, Topol could not say what his future holds. "At the moment I'm a little stunned, and it will take a little bit of time to figure out what to do."