The Time For Another Survey Has Passed

By

Leonard Zwelling

            The
last few days at Anderson have been momentous. Starting with the Chancellor’s
visit we have learned (for the third time) that morale among the faculty is at
an all-time low and that the poor morale encompasses more employees that just
the faculty.

            We
have learned that the activity for which MD Anderson is most known and for
which it is really top ranked, patient care, is viewed as less than optimal by
those who deliver it.

            We
have also found out that at least some faculty members believe that patient
safety is being undermined by accelerating patient volumes caused by a large
institutional push to make more money, not on quality, but on quantity.

            Whether
or not this is all true, most people at Anderson, and now many in Houston and
around the country, believe it is so. Reputation is everything in our business
and ours is definitely taking some hits. Is this the best time to launch a
refined effort to quantify the degree to which that reputation has fallen as
the Chancellor suggested? I don’t think so.

            What
is called for is some definitive action that demonstrates to one and all that
the problem has been recognized and understood by the leadership and they have
a plan to deal with it. I just don’t know which leadership: departments,
Divisions, Vice Presidents, Executives, the President or the Gang of Three in
Austin.

            Many,
many years ago, on a Saturday afternoon, John Mendelsohn, Anne Mendelsohn and I
were given media training after Anne won it at a silent auction. One of the
trainers taught us that this is the most important first thing for a leader to
say when addressing those he or she leads:

1.     I
have a vision for where we are going

2.     I
have a plan to get us there

3.     It
won’t be easy

4.     It
will be worth it when we get there

            My
hypothesis is that the first person among the many leaders I listed above who
does this, wins. So far, none has.

            The
Chancellor and friends had their chance Wednesday. They dropped the ball. Even
if they step up now (and that would mean a take over of the operations of the
clinical care delivery system at Anderson by a UT-appointed outside entity), it
is not at all clear that they have the legitimacy or the know-how let alone the
person, to do this.

            What
about our executives including the President here in Houston? I think it is
safe to say, they are viewed as the problem. The fewer of them around for the
future, the brighter that future is likely to be and the more engaged the
remaining faculty will be in solving the current dilemma. All the Mendelsohn
crowd (which is most of those of high station) must go. Whether the President
himself makes this move as a way to preserve his own job or he too is
sacrificed matters little for he has no credentials or credibility in the
clinical realm and would be hard-pressed to lead such a corrective effort. Can
we really expect the current clinical, financial or administrative leadership
who brought us this mess, to now clean it up? I don’t think so.

            The
Vice Presidents? Give me a break. Next…..

            The
Division Heads? They could have saved the day and perhaps Dr. Pollack tried.
Now it is probably too late for them as well. Besides it seems many are ad
interim, or about to retire and they have not been doing so well for a long,
long time anyway.

            The
department chairs are possibilities, particularly those in the clinical
departments, but will they rally against their bosses? If so, why now?
Doubtful.

            So
who is going to be the Moses who leads us out of this land of moral relativism
and morale depression and can it be done in less than 40 years?

            I
believe that it can be done, but it will take someone who understands clinical
oncologic care in 2013, who understands clinical operations of a huge and
complex hospital, who understands the new healthcare marketplace and all of the
economic, regulatory and ObamaCare-associated nuances affecting academic
medicine and actually has a personality that is both strong and winning with a
powerful ethical streak and uncompromising honesty and humility. If the person
were independently wealthy, that would help. Then he or she could walk away if
a knucklehead or two makes his or her life difficult, which is almost
inevitable. The personal wealth would eliminate conflicts of interests as major
drivers of decision making as they have appeared to be around here for quite a
while.

            I
don’t know who the modern Anderson messiah can be. Personally, I hope he’s a
she.  What I am quite sure of is
that we need this person yesterday and we need to rid ourselves of the others
who had their shot and blew it.

            The
DePinho vision was a family portrait of the DePinhos along with bags of money
and a few prominent high prestige prizes. His plan was to spend everyone else’s
money to get it. It sure hasn’t been easy and it most definitely has not been
worth it. He’s had his chance. Next up?

            We
don’t need no stinkin’ surveys. We need a leader who cares, who has integrity
and who understands the proper balance between discovery and unwise
risk-taking. We need someone who embodies our core values. Any names?

Leonard Zwelling