A Messy Exit Leaves Planned Parenthood at a Philosophical Crossroads

WASHINGTON — Leana Wen had already made a name for herself as Baltimore’s health commissioner when Planned Parenthood hired her as its new president last fall.

Dr. Wen, a 36-year-old physician, had used innovative policies to combat the opioid epidemic and delivered a widely watched TED Talk. She regularly appeared on lists of the most influential health care leaders and government officials.

But Dr. Wen’s tenure at Planned Parenthood was rocky and short, ending after eight months on Tuesday when the board of directors ousted her following several weeks of tense and sometimes acrimonious negotiations.

Current and former Planned Parenthood officials describe Dr. Wen as a smart but alienating manager who wanted to significantly reorient the group’s focus away from the abortion wars and more toward its role as a women’s health provider.

Early in her tenure, for instance, Dr. Wen directed her staff to add new pages to the Planned Parenthood website about topics like asthma and the common cold — conditions that its clinics do not typically treat. One of her first major campaigns was simply called “This is health care.”

But as states began to pass ever more restrictive laws on abortion, and with the addition of a conservative justice to the Supreme Court — endangering Roe v. Wade — Planned Parenthood’s leaders felt they needed a more politically invested advocate in the battle over abortion access, according to people familiar with the matter.

The internal turmoil underscores one of the group’s central tensions: Is it a political organization or a health organization first? And can it be both at a time when abortion has been elevated to a prominent and incendiary issue in the 2020 presidential election — and where a middle ground has all but disappeared?

“Planned Parenthood occupies a unique position as both a health care provider and an advocate, which nobody else needs to do,” said Jess McIntosh, a Democratic strategist who has consulted with reproductive rights groups including Naral and Emily’s List. “Because they have such an outsized share of market attention, they don’t have the luxury of letting go of the advocacy piece.”

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Interviews with nearly a dozen current and former employees and officials — who spoke on the condition of anonymity to discuss internal matters — portrayed Dr. Wen as a leader viewed by many as a poor manager, perhaps unprepared to lead a nationwide organization with more than 600 health centers. Some employees chafed at a handbook for special assistants that circulated after she arrived, which featured one top bullet point reading, “All emails from Dr. Wen sent the night before should be answered immediately before anything else is done.”

Dr. Wen’s departure throws Planned Parenthood, the nation’s leading women’s health organization, into a state of uncertainty. Some of Planned Parenthood’s most senior and experienced political hands had departed during Dr. Wen’s brief tenure, and on Tuesday five of her top lieutenants whom she had brought in were fired. There were fears of lawsuits to come.

Through an associate, Dr. Wen has declined to be interviewed. In a statement Tuesday, she said she was leaving because of philosophical differences and hinted at her preference for viewing the organization through the prism of public health.

“The best way to protect abortion,” she wrote, “is to be clear that it is not a political issue but a health care one.”

Many strategists who work with abortion rights activists believe Planned Parenthood was caught off guard and ill prepared to deal with the recent attacks from President Trump and Republicans, who spread misinformation about Democratic-led efforts in states like New York to expand abortion access later in pregnancy. Instead of aggressively refuting the claims that Democrats were legalizing “infanticide,” Planned Parenthood and other abortion rights groups were slow to form a cohesive and effective response.

Planned Parenthood’s inner turmoil also distracted from those efforts at the time, people close to the organization said.

In an interview with The New York Times in May, Dr. Wen acknowledged that the slowness to respond hurt their cause. “Sometimes there is a temptation to let the absurdity stand on its own, but we have to recognize that this is a different time,” she said.

[Here’s how limits on abortion have changed across the states this year.]

According to people who worked with her, Dr. Wen pushed for changes that some employees felt were not in sync with the sensibilities of a progressive organization like Planned Parenthood. One current employee said people chafed at having years of work on “the future of abortion access” suddenly replaced with different priorities.

Dr. Wen’s public comments also caused some frustration internally, the current and former officials said. In late May, the Washington Post Fact Checker column wrote an article about her repeated claim that “thousands of women died every year pre-Roe” from a lack of legal abortion care. The column rated her statement as “false,” something a former employee said she had been told repeatedly by her staff but disregarded.

Other, newer employees, however, described a positive working relationship with Dr. Wen. One recalled a standing ovation she received when she spoke at the group’s national meeting in the spring. These employees, who also spoke anonymously to discuss internal matters, felt that the organization’s leadership was resistant to Dr. Wen’s vision for providing additional services such as mental health and substance abuse resources, seeing this type of treatment as “mission creep.”

Other employees were concerned when Dr. Wen asked that the Planned Parenthood website be updated to include new sections on chronic health conditions like diabetes, asthma and the common cold.

Planned Parenthood allies had already come under attack in 2015 for suggesting that the organization provides mammogram screenings, which it does not (the organization refers people to other providers for the service). Staff members worried that Dr. Wen’s request could lead to a similar controversy.

One email from a Planned Parenthood employee, viewed by The New York Times, warned that the new pages would be “risky for the brand” because it often “gets dinged in the press when we suggest that we provide services we don’t.”

The new pages were posted despite these objections, and some remain live on the Planned Parenthood website today.

The handbook that was distributed to some employees — a 177-page manual titled the “Special Assistant Guide,” created when Dr. Wen served as Baltimore’s health commissioner — also generated skepticism. The manual, first reported by Buzzfeed, includes instructions about how to act when she delivered public remarks — “Make sure to frequently look up (from Twitter)” — and how to handle their inboxes, noting, “Try not to look at emails more than once.”

The process of replacing Dr. Wen began in late June, when the chairs of Planned Parenthood’s two boards asked her to resign, according to people familiar with the matter.

The request set off intense negotiations involving lawyers on both sides over the terms of her departure. Her exit was assured; the one question was whether it would be done peacefully and quietly, or loudly and acrimoniously.

But at about the same time, Dr. Wen was facing down a much more personal challenge: She had suffered a miscarriage. She wrote about the experience in an op-ed for The Washington Post.

“Just as suddenly as they’d come on, my nausea, exhaustion and other symptoms went away,” Dr. Wen wrote in a searing essay. “I knew even before I went to my doctor that I’d had a pregnancy loss.”

The op-ed published on July 6 — after she had been asked to resign — surprising and frustrating senior officials and board members, who had not been informed of the article in advance.

On July 10, the board issued a notice for an emergency meeting on July 16 at which time Dr. Wen would be terminated. The board did not inform her of the meeting, according to a person close to her, though she found out soon afterward.

On Tuesday, the board voted unanimously for her replacement, the board member Alexis McGill Johnson. Lawyers continued to negotiate Dr. Wen’s departure, but talks collapsed in the later afternoon. After the news broke, Dr. Wen accused Planned Parenthood of engineering her ouster in a “secret” meeting.

“The new board leadership has determined that the priority of Planned Parenthood moving forward is to double down on abortion rights advocacy,” Dr. Wen wrote to the staff in a departure memo.

Early Wednesday evening, Ms. McGill Johnson put up a lengthy Facebook post about the organization’s next steps.

“Our work and our mission isn’t about one person or even one organization,” she wrote. “Our work is about the millions of people who need access to affordable and comprehensive health care.”