Inside state Surgeon General Joseph Ladapo's rocky tenure at University of Florida

Miami Herald

02-04-2025

When Gov. Ron DeSantis hand-picked Joseph Ladapo as Florida's surgeon general in September 2021, the role came with a second high-profile appointment: a tenured faculty position at UF.
But Ladapo's colleagues still aren't sure what he does to earn his salary at the university. Some say not much.
UF fast-tracked Ladapo into a $337,000-a-year contract as part of his role as the state's top medical official, charging him with launching an internal medicine research program, taking on a part-time teaching role and leading an administrative team.
A rising star among conservatives opposing pandemic-era safety measures, Ladapo dazzled UF's top brass with his Ivy League credentials and multi-million-dollar research portfolio. After reviewing his résumé, the medical school's dean said he looked 'fabulous.'
Now, more than three years into his tenure, internal records and interviews with more than a dozen professors and administrators raise questions about whether Ladapo is meeting UF's expectations.
Ladapo's work calendar shows monthslong stretches with little or no activity. Instead of attaining grants and conducting research, he spent his first year revising manuscripts and writing his memoir, 'Transcend Fear,' which details his skepticism of vaccines.
He also promised to bring hundreds of thousands in research dollars from the University of California at Los Angeles, his previous employer. That never happened. He blamed his former boss, claiming she withheld the funds over disagreements about COVID-19 policies. A review of internal reports and public directories indicate Ladapo hasn't secured any research grants for UF.
His classroom contributions are similarly sparse. Ladapo agreed to dedicate 20% of his time to teaching; so far, that's amounted to a handful of seminars and guest lectures. A proposed course on 'critical evaluation of scientific evidence' has yet to materialize.
Meanwhile, he collects $75,000 a year leading what his contract described as an administrative team addressing healthcare disparities within UF's hospital system. Yet records requests yielded little evidence of the team's work.
Ladapo didn't respond to an emailed list of questions about his time at UF. Spokespeople for the university and UF Health declined to answer specific questions about his tenure.
Ladapo's dual appointment is one of the most prominent examples of Florida Republicans installing party officials into lucrative posts at state universities with questionable results. State auditors recently dinged UF for continuing to pay former President Ben Sasse — previously a Republican U.S. Senator — $1 million a year to co-teach a course after his resignation.
Although UF leaders initially welcomed Ladapo, issues with absenteeism, funding shortfalls and clashes with colleagues quickly emerged. Professors also questioned the speed at which the university awarded Ladapo tenure — academia's most coveted status, offering effectively permanent job security to carefully vetted scholars. The process usually takes months or even years; a Faculty Senate report released months after his hiring found administrators approved Ladapo in less than three weeks.
'This was definitely a pressure hire,' said one professor with intimate knowledge of the process. The professor, who was granted anonymity to freely discuss details that could reflect poorly on their employer and one of the state's top public officials, described Ladapo's position at UF as a 'cushy job here to fill out the remainder of his paycheck.'
Faculty members also raised concerns that Ladapo's contentious scientific beliefs would erode UF's credibility as one of the nation's top research institutions.
Like DeSantis, Ladapo gained national attention during the COVID-19 pandemic for defying mainstream medical guidance. As surgeon general, he's opposed vaccine recommendations from the Centers for Disease Control — and UF — and, most recently, embarked on a statewide tour urging counties to remove fluoride from drinking water, despite evidence of its dental health benefits.
Ladapo has faced multiple research integrity complaints from his colleagues at UF regarding a study he personally altered to suggest that certain vaccines are harmful to young men. The university's top research officer has declined to investigate the study, reasoning Ladapo performed the analysis as surgeon general — not as a UF professor.
In November, the medicine college's faculty council formally rebuked him for 'promoting health misinformation and for 'breaching the trust placed in him as a faculty member,' urging the dean to 'publicly and unequivocally denounce Dr. Ladapo's misinformation campaigns.'
At UF's medicine college in Jacksonville, pediatrics professor Jeffrey Goldhagen filed a similar resolution with the faculty council in December calling on Ladapo's firing. The resolution accused Ladapo of leveraging his tenured role for 'personal and political gain,' leading to 'disastrous consequences for the health and well-being of thousands of Floridians and the future of higher education.'
'Ladapo's a charlatan,' said Goldhagen, the former director of the Duval County Health Department. 'It completely decimates the reputation of the University of Florida.'
The Alligator's reporting on Ladapo's rocky tenure comes as Tallahassee scrutinizes state university budgets for wasteful spending and unproductive staff. The GOP-dominated Legislature has also pushed through a law requiring tenured faculty to undergo high-stakes post-tenure review every five years — a measure DeSantis said was necessary to get rid of 'unproductive' professors who were the 'most significant deadweight cost' facing universities.
For Ladapo to meet the medicine college's post-tenure review standards, he'll need to secure at least $500,000 in outside research funding and 10 publications in peer-reviewed journals during the five-year review period.
Asked how the university would handle Ladapo's case, UF Health spokesperson Melanie Ross said the institution will 'adhere to all relevant university and state policies and requirements regarding evaluation of and post-tenure review for all faculty members.' She declined to comment further, saying the university doesn't discuss personnel matters with the press.
The DeSantis administration redirected The Alligator's questions regarding Ladapo's tenured faculty position to the Florida Department of Health, which didn't respond in time for publication.
A balancing act
Balancing a faculty position with running the nation's third-largest state health department is a daunting job.
'It was grueling,' said Scott Rivkees, Ladapo's predecessor in the surgeon general role and the former chair of UF's pediatrics department. He worked 12-hour weekdays in Tallahassee and spent weekends in Gainesville catching up on research.
Florida law allows state agency heads like Ladapo to hold secondary jobs under two-year 'interchange agreements,' letting them collect two salaries. Between his two roles, Ladapo earns $437,000 annually — triple the governor's salary.
As part of Rivkees' surgeon general appointment in 2019, a new contract with UF made it so his state role would count as 80% of his duties, with research and teaching accounting for the remainder.
Ladapo's agreements, however, don't indicate in writing how much time he's supposed to spend on each role. His UF job letter assigns him a full-time, 12-month position, which he's allowed to keep after his interchange agreement expires at the end of his surgeon general term.
During his surgeon general confirmation hearings in early 2022, Ladapo said he couldn't answer Democratic lawmakers' questions about the amount of time he was spending at UF.
'I can tell you almost every waking hour I have I am either exercising, spending time with my family or working,' he said. 'I don't get a lot of sleep.'
By that point, Ladapo was already hitting roadblocks in his research.
Money problems
Around December 2021, Ladapo began working with administrators to carry over his research projects and grant money from UCLA, promising to secure a subcontract from at least one of the National Institutes of Health grants he'd landed there.
Ladapo's controversial stances on COVID-19 policies, however, strained his relationships with UCLA colleagues; he lamented in his memoir that 'things had deteriorated into something resembling a bad marriage' before his departure. His division chief Carol Mangione once accused him of violating the Hippocratic Oath — a code of conduct physicians are required to take pledging good ethical practice — and spent large parts of the work day dealing with complaints about his writings.
Before arriving in Florida, Mangione said UCLA wouldn't let him transfer any of the money to UF, according to emails obtained by The Alligator. She feared Ladapo's new position in a Republican administration — paired with his views on public health — would lead to clinics dropping out of the study.
Early in the transfer process for one of Ladapo's studies, the new project lead at UCLA told research administrators at UF there weren't plans to send over money from a $600,000 grant. Ladapo assured administrators in January the issue was 'actually not resolved' and followed up with UCLA in May demanding an explanation. Mangione and the new project lead said they needed to dedicate all resources toward the study's Los Angeles operations.
Ladapo didn't think so. In a complaint to the NIH's Office of Research Integrity, he alleged the decision was driven by Mangione's political bias against his position as Florida's surgeon general.
'While this type of bias may not elicit the type of response from NIH as a bias based on an investigator's race or sex, for example, it is still, in my opinion, improper,' he wrote.
According to emails, Ladapo also sought help from university officials and his legal team at the Florida Department of Health. The university's vice president of research David Norton relayed that UF's top lawyer determined UCLA had no obligation to transfer the grant money. The research integrity complaint was Ladapo's only recourse.
He spent the next five months pressing the NIH for updates, expressing frustration about the slow response and arguing UCLA's decision was hampering his ability to conduct research.
'I'm a bit nonplussed,' he wrote in a December 2022 email. 'There seems to be little deference for the professional courtesy that typically obligates a timely response to inquiries, and little concern over the implications that a potential violation of research ethics has for a researcher's career.'
It remains unclear whether the NIH or UCLA ever investigated Ladapo's claims. Mangione, reached through a UCLA spokesperson, declined to comment for this story. The NIH didn't respond in time for publication.
Three months later in March 2023, Ladapo emailed an NIH officer again — this time requesting help transferring money from another UCLA grant. They denied him.
A study in 'malfeasance'
A year into his tenure, Ladapo was defending his job to top leaders at the medicine college. In an August 2022 email to his department chair, the medicine dean and UF's vice president of health affairs, he gave a detailed list of what he'd accomplished so far.
In terms of research, he edited three manuscripts he finished before arriving at UF, co-authored a study on HIV treatments and published a critique of COVID-19 lockdown procedures. He also finished his memoir, noting it was already the top new release in Amazon's Public Affairs and Administration category.
As part of his teaching assignment, Ladapo guest lectured for an HIV course and spoke at a UF Health Cancer Center Control Working Group meeting.
'I traveled to Gainesville on both occasions,' added Ladapo, who lives in Pinellas County about 150 miles south of UF's main campus.
Ladapo also floated an idea: a new seminar — and potentially his own course — on the 'critical evaluation of scientific evidence.' For the next year and a half, he toyed around with his curricular vision in meetings with faculty and administrators, records show.
In June 2023, he pitched it as a graduate course in an email to the dean's office at the College of Public Health and Health Professions. The syllabus would draw upon the work of popular pharmaceutical company critics — like Marcia Angell's 'The Truth About the Drug Companies' — and center on how scientific evidence informs health policy, Ladapo wrote.
'Malfeasance will be a unifying theme in this course,' he told the public health dean six months later, according to meeting notes obtained from a records request. The notes included a bullet-point list of 'aspects to consider' during course development, like 'teaching students how to think, not what to think' and 'who is the right audience?'
Administrators also told Ladapo about UF's course approval process, which involves multiple layers of review by administrators and committees before instructors can begin enrolling students.
Ladapo followed up with the dean's office a month after the meeting: 'Thank you all very much for the generosity of your time and knowledge. I'm thinking through the information you shared with me.'
A search of UF's curricular approval website shows Ladapo hasn't filed any paperwork for a course yet. George Hack, an associate dean who attended the meeting, told The Alligator in an interview that the course 'never went anywhere' after the discussion in December 2023.
Ladapo's teaching activities that year included a guest lecture to graduate students in UF professor Arch Mainous' health policy class. Mainous invites a public health expert to lecture each time the course is offered, he said, 'so being the surgeon general of a large state, he fit.'
'The students were told to be respectful,' Mainous said. 'This is an outsider who's spending their time coming to do that.'
Contact Garrett Shanley at [e-mail]. Follow him on X @garrettshanley.