Taking Back the TMC

By

Leonard Zwelling

(Dedicated to my new
friend of vast experience, wisdom, and knowledge)

         It has become increasingly clear that many people in
positions of great responsibility in the Texas Medical Center have forgotten
what the TMC is all about. In a word, it’s about patients! 

         The TMC, academic medicine, and academia as a whole are
supposed to foster benevolent activities that serve the needs of mankind not
the pocketbooks of wealthy investors or so called academic entrepreneurs who
are nothing of the sort. A real entrepreneur risks his or her own money on a
business venture. The nouveau scientific elite like the new TMC President and
CEO, who began TMCx

(http://www.houstonchronicle.com/business/medical/article/Medical-Center-s-TMCx-introduces-first-startup-6124683.php)

as a biotech incubator
where public money can be commercialized into private wealth, have lost track
of the purpose of medicine. In a head first plunge into the pursuit of more money
using the shrinking NIH budget and economically pressured patient revenues as an
excuse, these leaders have promoted the importance of new inventions and drugs,
many of which will be priced so high that the American public whose tax money
supported the early discovery research through NIH grants, can no longer afford
the potentially life-saving therapy to which these federal grants gave birth.

         The usual excuse for this nonsense is that if academia does
not pursue commercialization, no actual patients will benefit from novel
discoveries. Give me a break. This is all a by-product of the 1980 Bayh-Dole
legislation that encouraged academic institutions to commercialize the
inventions of their faculties plus the extra special ingredient—greed. Every
dean began looking for the next Gatorade.

Those
of us who have elected to follow careers in academia did not do so with the
hope of making a fortune. Most of my former colleagues did it for one of
several reasons. They sincerely wanted to help patients with cancer, teach
younger budding physicians and investigators, make new discoveries and prevent
cancer if at all possible. It is the rare medical academic, MD or PhD, who
trained to be a businessperson. Most of the young students have not even considered
such a career course. But then they become Assistant Professors and are
informed by their department chairs and deans that a short cut to tenure is the
development of patents. Scientific papers only seem to impress Promotion and
Tenure Committees who, we all know, can have their decisions reversed by
autocratic leaders. It is not uncommon any more to have a graduate student have
to give up a project on which she was working for two years because the sponsor
of the project has proprietary interest in the results and refuses to allow
their publication until the patents are in place. This is a shame, but you
can’t get a PhD without a publicly reviewable thesis.

         I believe that MD Anderson’s current President was hired
expressly because he promised the UT Regents an alternative revenue stream
through his drug development efforts. The fact that his first try with Aveo was
a complete bust has not seemed to deter the support he gets from the
Chancellor.

http://www.houstonchronicle.com/news/health/article/UT-chancellor-vows-to-repair-connection-between-6146328.php?cmpid=gsa-chron-result

         Frankly, this ought to stop.

         As the Wall Street Journal pointed out on March 20, drug
development and its attendant costs and benefits should be in the realm of the
drug companies, not academia.

(http://www.wsj.com/articles/gary-pisano-big-pharma-needs-to-get-busy-in-the-lab-1426805547).

         Academia needs to get busy caring for the sick, doing publishable
rather than patentable research, and teaching the physicians and investigators
of the future. Profit and loss statements have taken the place of publication
lists as measures of productivity and the cars in the parking lot of academic
institutions are getting fancier, the private schools pricier and the
neighborhoods where faculty live are more upscale.

         We need to get back to first principles. Patients first.
Science next. Teaching, too. Patents, stock options and venture capital should
be left at home to be done on one’s own time. At MD Anderson the State of Texas
is paying the faculty to do clinical care, research, teaching and prevention
not entrepreneurship.

That
Dr. Robbins and Dr. DePinho have confused their purpose is most unfortunate,
but this can be corrected. Let’s do just that. All we need to do is follow the
dreams we had when we began the journey.

With
all this entrepreneurship going on, you would think conflict of interest would
raise its ugly head. Nope. Why not? Because these guys aren’t conflicted. They
just want your money.

Leonard Zwelling