Vivian does not get approval from the President and the board without a valid reason. Now the board and president may not have known Huntsman was going to flip out, but Huntsman was involved in the process. The move by itself was intended to bring all health services under one roof. Huntsman decries it as a money grab, but there are a lot of good reasons to have uniform decision making throughout the organization. Such consolidation would allow for efficiencies and collaboration that is currently not taking place. It would allow departments to streamline research and focus on services that benefit overall patient care. There is a money component to it, but it is overstated because HCI cherrypicks the revenue. (Cancer treatment is lucrative, but it is a small part of overall patient care).

One rumor I have heard is that HCI requests university resources, but won't reciprocate when asked by the university. It is very hard to work with HCI unless it is consistent with their stated goals.

None of this is intended as a slam on HCI. It is an amazing institution and has helped countless people (many successful) battling cancer.