Who Owns MD Anderson?


Leonard Zwelling

         Talk about a stupid question! Everyone knows that the State
of Texas owns MD Anderson in that MD Anderson is the free-standing cancer
center of the UT System and one of two medical divisions of UT in the city of
Houston. I do not believe that these facts are up for discussion. Or are they?

         When Dr. LeMaistre was President of Anderson, this was a
non-discussion. All the patients had to be referred to Anderson by law. Any
Texan wishing to get to MD Anderson would be cared for without the need to pay.
A good chunk of the annual budget consisted of the State biennial allocation
and MD Anderson acted like the branch of the state government that it was. Dr.
LeMaistre was the conductor of a very finely tuned orchestra but the first
violin was still the UT Chancellor and the rest of the strings were the
Regents. The orchestra’s major patrons were the people of Texas.

         As Dr. Mendelsohn exponentially grew the place, a lesser and
lesser percent of the operating budget was supplied by the State to the point
where under 10% of costs were really defrayed by state funds and much of that
covered the bill for unreimbursed care. The maintenance of the operating budget
fell to the funds generated by the clinical faculty. Fortunately, just before
leaving, Dr. LeMaistre had secured the endorsement of the Legislature and the signature
of the Governor to allow self-referral to Anderson. When the revenue
constraints threatened by HillaryCare that caused Anderson to ask for this
legislative change did not materialize in Texas, MD Anderson was swimming in

Mendelsohn built with that cash, mostly buildings, and to some extent, with
himself as a model, began a more entrepreneurial view of what emerged from the
Anderson labs. Where previously the knowledge gleaned by the faculty’s research
was published as fast as possible, now a trend toward patenting and commercializing
that knowledge grew. For the most part, Dr. Mendelsohn personally did not view
the resources of MD Anderson as his to use and turn into money, although he and
I had a hell of a fight about who owned the genetic material from the patients’
cancers. (Hint: the patients do unless informed of what others wish to do with
the tissue and then give consent. Consent to bank tissue is not
consent to use it which must be obtained prospectively, independently and with
full knowledge of the patient of what is to be done with his or her tissue
unless stipulated otherwise by the IRB).

         The more traditional view of academia not being a commercial
enterprise was not held by Dr. Mendelsohn’s successor. It was evident from the
outset that Dr. DePinho viewed MD Anderson in its entirety as his laboratory
and in fact his drug factory. Anything that could be patented and commercialized
became fair game for the DePinho juggernaut to control and own, regardless of
the involvement of Dr. DePinho, his wife, or their minions in the discoveries
or resources they wished to employ to line their own pockets. There are not
just a few people on that list I published lately of the MIA of previous star
faculty who possessed resources the institution (i.e., Ron and the FORDs)
wished to employ but who had refused as it was their life’s work when Dr. DePinho
asserted his dominance over the data base, or repository or other resource of
value and would not allow anyone or anything to stand between him and his goals
of total control. And, in all fairness, he could do it because the State owned
it all.

         In a very systematic and calculated fashion, the interlopers
from the Northeast gained control of the institution and those already here who
wanted to stay gave in to their pressure and toed the party line. That would
include both faculty and administrators. MD Anderson became the cancer center
in which going along was equated with getting along and getting along was
equated with survival.

         There are only three potential days of reckoning on the
horizon. One, all of this power asserted by the FORDs works and they cure
cancer in the allotted five years.  Tick
tock. We are down to the last year. Two, they soundly fail and forces within
the institution take back control of the place and return it to its academic
roots, resecting the vestiges of the malignancy that is commercialization.
Three, the Chancellor and the Regents declare that they have had enough and
dump Ron and his crew and reinstall an academic mindset to the leadership of
the UT Cancer Center.

         Place your bets.  Guaranteed winner in Ron Roulette: Odd.

Leonard Zwelling