A Scorecard for the
Factions: How to Explain What Is Going on at MD Anderson To Your Friends

(With thanks to the Cancer
Letter of February 20, 2015)

By

Leonard Zwelling

         The Chronicle is no help and neither is the rumor mill.

         For several years now, at an ever-intensifying rate, the
public is hearing about incidents of turmoil and embarrassment emanating from
the halls of what was once the number one place for cancer care in the country.
Patients I have spoken with and their families have noted no decrease in the
excellence of the care they are receiving at Anderson, yet the media is full of
stories of faculty discontent and a lack of agreement on strategy, direction,
leadership and oversight from Austin on the part of that faculty and its chosen
local leaders.

         As a public service, I will try to develop a scorecard, so
everyone can be on the same page with regard to who the factions are that appear
to be pitted against one another and what each wants.

1.  Executive Leadership: This is essentially 5
individuals, the President Ron DePinho, Ethan Dmitrovsky, the Provost, Tom
Buchholz, the Chief Medical Officer and the administrative side of Dan Fontaine
and Leon Leach. They would like quiet. The turmoil that characterized the last
10 years of the prior administration that all factions hoped would be dampened
with the coming of the new president in 2011, has only intensified during the
DePinho years. Dr. DePinho’s main focus seems to be research and drug
development that may de facto convert Anderson from an academic cancer center
to a drug company. The wisdom of this strategy is, as yet, unclear but to be
fair, it hasn’t had sufficient time to prove itself. The Moon Shots are the embodiment
of this strategy. How the strategy integrates with Anderson’s 75 year legacy of
clinical care and clinical research being at the center of its strategy is
unknown.

2.  The Faculty Senate consists of elected representatives
of the faculty. They would like a say in their own professional lives,
something they feel they lack now. The Senate sent a letter to the UT
leadership in Austin asking for “guidance” with regard to the repeated
demonstrations of discontent via surveys of low morale in the faculty. A resolution of the
Senate’s position was distributed to the faculty at-large on February 16.

3.  UT System is the Chancellor, Executive Vice Chancellor
for Health Affairs and the Board of Regents. It is most unclear what the
positions of these individuals are with regard to their perception of the
situation at 1515 Holcombe or whether or not the current state of affairs
requires their intervention. The UT System claims to be “working closely with
both the Executive Committee of the Faculty Senate and the executive leadership
team,” but you could have fooled me as to whether the close relationship Austin
is claiming to have with Houston is leading to improvements in morale or
operations at the center.

4.  The Division Heads are the leaders of the various
clinical services at Anderson. They too would like quiet so they can get back
to work. They have recently supported the executive leadership at Anderson in
contradistinction to the position of the Faculty Senate.

5.  Anderson’s top administrators joined with the Division
Heads on February 17 in responding to the Cancer Letter with support for the
executive leadership in Houston.

6.  Former chairs of the Faculty Senate have started their
own petition that differs in perspective from the position of the current
Senate leadership in being far more supportive of the executive leadership and
seeks signatures from the faculty at-large. I do not know what precipitated
this latest maneuver except to say that knowing the three leaders of this
latest movement, they are going to try to inject reason into the debate. They always
do and are usually pretty good at it. This may, however, be too little, too
late. The success of this effort to recruit signatures from the faculty rank
and file is unknown at present.

To
summarize, most of those on top think the problems identified by the various
poor morale surveys are being addressed. The current Faculty Senate seems less
sanguine about cooling its heels any longer and wants help from Austin.

I
have no idea what is really happening so I cannot imagine that the greater
public can either and that’s the real problem.

MD
Anderson is a jewel in the Texas Medical Center and its one that the people of
Houston, Texas, and the country count on to provide care at their time of
greatest need. This continuing flow of turbulence that is emanating from the
center needs to end and each of these groups is seeking to do just that in its
own way. The problem, of course, is that they don’t agree on a solution. Trust
between them has broken down due to a spate of firings, the whiff of corruption
that has only become more noticeable since the DePinhos arrived and the general
state of medicine and academic medicine of being under fire from an economic
environment that does not favor high cost, high priced research-intensive
medical care that is the core competence of academia.

     I think that should get you up to date on
all the players. You can decide for yourselves where it goes from here, but in
the end, the onus is on the leaders in Austin to improve the lot of the faculty
and its local leaders and the relationship between them. Either they believe
that the current executive leadership team at Anderson can deliver what it is
they expect (and I don’t know what THAT is either) or they don’t and they require
a change.

In
the end, it comes down to that. It will be an early test of the new Chancellor.
Will he ring the Navy SEAL bell and allow the Anderson to drown in its own
turmoil or will he attempt to bring some order to Anderson by demanding some
accountability of the local leadership and some shared governance with the
faculty?

Stay
tuned…

Leonard Zwelling