Findings of the Administrative Organizational Review
Committee

By

Leonard Zwelling

March 27, 2013

            How’s
that for a title?

            Well,
it’s spring and we need some renewal and rebirth. The Easter bunny is coming on
Sunday, the Passover matzos were eaten last night and then there are eggs,
admittedly more colorful for the Christians than for the Jews. It must be time
for spring.

            What
better way to celebrate the season than the first signs of something that

has been gestating for 9 months—The Simone Report-aka the
title of this piece.

            For
those of you not following the saga, this was a report commissioned by the
president to evaluate MD Anderson’s administrative functions.  This report has been highly sought by
the Faculty Senate and just as equally hidden by the leadership for reasons
that had escaped one and all, and, now that it is available, the mystery only
deepens.

            What
does it say?

            Essentially
a committee of mostly, but not entirely, outside experts, led by the famous
pediatric oncologist Joe Simone, report on their findings upon reviewing data
that I have under good authority were assembled by the consulting firm McKinsey.

·     
This review was conducted from April 2012 to
July 2012, the date of the report. Thus the report has been completed for 9
months.

·     
It was focused only on the administrative
functions here, not clinical care, research, prevention or education.

·     
The group compared our practices with those of
others in our industry and even with those used outside of academic medicine by
companies with good administrative functions.

·     
Over 100 faculty were interviewed and many
administrative leaders were as well. They are not named.

·     
The big recommendations are to launch 39 new
initiatives, restructure the organization by 2013 and implement a formal
project management process to do this.

            It
turns out that these functions use about $760M per year and are supported by
almost 6000 people. The report notes that “MD Anderson trails peers in the
relative efficiency of core administrative functions such as HR, Finance, and
IT”. I guess that’s for those of you who didn’t know this already. Major shifts
that are suggested include the usual buzzword suspects of “centralization”,
“efficiency” and “streamlining”. There also must be “accountability”. The
committee expects savings to be about $130-220M per year.

            It
is very hard to argue with any of this although I am sure that the Devil will
be in the details and someone will be upset if the leadership attempts to
actually implement this plan. Then again, the leadership has had this report
for 9 months. What are they waiting for?

            The
real question behind the denial of the parenthood of this spring baby is not clear
at all. The president has been in place for 18 months. Virtually the same
leadership team has served him during this period as served his predecessor.
The turmoil on the academic side of the house exemplified by the results of the
Faculty Morale survey and the continuing water torture of leaks to the Houston
Chronicle and Cancer Letter must have the outside world scratching its
collective head as to what the heck is going on at Anderson. This report, that
the leadership has had since July 2012, suggests that what is going on at
Anderson is not all that much.

            There
are very few explanations as to why this should be the case:

1.     The
leadership disagreed with the report’s conclusions and is ignoring them,
satisfied with the status quo OR

2.     The
leadership disagrees with the report’s conclusions and is developing an alternate
administrative overhaul implementation plan of its own OR

3.     The
leadership agrees with the report and is developing an implementation plan in
line with the report’s recommendations OR

4.     The
leadership agrees with the report, wants to implement the recommendations, but
simply doesn’t have the vision or will or personnel to do so.

            Place
your bets!  

Leonard Zwelling