Say. Do. Feel.

By

Leonard Zwelling

         I have heard about emails from the MD Anderson leadership.
They are quasi-motivational messages asserting concepts like transparency,
teamwork and quality as the bedrock of MD Anderson’s excellence. These
qualities are also the keys to restoring the admittedly poor morale that even
the most rose-spectacled optimist concedes is plaguing the faculty.

And
the leadership is correct.

Greater
transparency about decision-making (like decisions about tenure renewal or the lack thereof), a
more collegial team-like environment (and every team does not need to be on the
rocket to the moon), and an emphasis on and reward for measurable clinical
quality (that would be outcomes not box checking) would alleviate much of what
ails Anderson. So what’s the problem? 

The
problem is these platitudes are simply platitudes. They are what gets said, but
bear no resemblance to what gets done by these very same leaders. The
leadership believes that this language of the New Age will succeed in exhorting
and energizing the troops and by inference the institution to greatness. But saying
and doing are not the same.

Doing
is an entirely different matter. Faculty members come and go as do prominent
non-faculty personnel. No one seems to be sure why. Not only does this belie
transparency, it generates fear as no one is really sure what he or she is
supposed to do and what will become of him or her if they err let alone speak
up. The most frequent question I hear is, “am I next?”

Shooting
the Chief of Surgery in the courtyard makes a point, but it is not perhaps the
one that will lead to institutional harmony.

The
leadership speaks of teamwork yet every evaluation is made of individuals not
teams. Departments compete with one another for patients and patient care
dollars not to mention space and slots. You can’t have teamwork without a team
and a team requires agreement that everyone on it is playing the same game with
the same goal. Wait, they are. The game is competitive academia and the goal is
getting resources for your own program. Now what kind of teamwork is that?

The old MD Anderson was the old Yankees (Ruth and
Gehrig were played by Frei and Freireich). The new MD Anderson is like the new
Yankees with A-Ron as A-Rod.

Finally,
as for quality, what is it? Is it checking all the right boxes (from hand
washing to signing your verbal orders) or is it actually altering the natural
history of a malignant disease? If all your time is taken up checking the
boxes, when will you have time for great thoughts?

As
I have said before in this blog, leadership is the combination of vision and
will (e.g., Bush 41 had the Gulf War will, but no vision for the economy a year
later; Bill Clinton had the vision, but didn’t have the will to keep his pants
on or tell the truth; W. had a vision in Iraq that was more an hallucination;
and ran out of will on immigration and the budget; you gotta have both).

Managing
is resourcing and mentoring. Which one of the “leaders” of MD Anderson uses any
of their skills in these areas to create the morale climate they claim to want?
Which one is a good mentor in leadership and who gets all the resources?

Lastly,
there’s the matter of feeling.

It
was Maya Angelou who said:

“I’ve learned that people will
forget what you said, people will forget what you did, but people will never
forget how you made them feel.”

This is the most critical lesson
that needs to be learned by the leadership of MD Anderson. When I first came
here, it was very surely the case that those around me and leading me did all
in their power to make me feel a part of something great and much bigger than
myself. They succeeded. Today’s leaders at Anderson behave like the world
revolves around them and the rules that rein in everyone else do not apply to
them (e.g., conflict of interest rules). Such behavior is not conducive to good
feelings.

So memo (or email) to the
leadership:

1.               
Stop writing emails extolling the faculty to keep their
sunny sides up. Morale is poor and it is at least partially your fault. Own it.

2.               
Stop
talking like you are giving a self-help seminar. None of you guys (all guys, I
might add) are Joel Osteen. You ain’t even close.

3.               
Do
something concrete that actually improves the lives of the faculty. How about
acting like you actually care about other people beside yourselves?

4.               
Go get
some help. Your personalities are not meshing with those of your constituents
right now and that needs to occur if the feelings part is to improve. Trust is based on feelings and right now, there is no trust in the leadership.

In
the end, the people have to feel like you care about them, to do
what you say you want them to do.

Leonard Zwelling