One Small Step For Faculty, One Giant Leap For MD Anderson

By

Leonard Zwelling

I was gratified to learn on Friday afternoon, February 3, that the Chancellor and Board of Regents persuaded Dr. DePinho to bring in a Chief Operating Officer who, I assume, will be running the day-to-day operations of MD Anderson. Someone needs to.

I believe Steve Hahn was selected for this role. He has our prayers and sympathies because the elephant in the room is still in the room—Dr. DePinho. It is a beginning, however, of ACA, Administrative Change at Anderson.

This is what I have been waiting for. When a similar problem arose (i.e., lack of money) at the Health Sciences Center under Dr. Willerson about 10 or so years ago, a similar solution was found and soon enough, so was a new president. I suspect the same will happen here.

There are three problems that need to be surmounted.

First, can the damage be repaired?

I am going to give this one a not yet, because as long as Dr. DePinho is on site, the needed adjustment, better morale, will not be possible. Doubts surrounding his possible resurrection will haunt the halls and clinics.

I am going to be very surprised if Dr. Hahn and Dr. DePinho can co-exist without permanent refereeing by Chancellor McRaven and I cannot imagine Dr. DePinho tolerating that very long. Either he will find a new job (Director of the NCI?) or Chancellor McRaven will have to supplant him by force just as Dr. DePinho did to a number of high ranking academic appointees. Ron only responds to power greater than his own. There is no more a chance of peace at Anderson with him in place than there was when the Arabs held the Western Wall. So this is step one and a good one. Then what?

Second, ad interim presidency. This can provide stability, but no progress.

This will probably be needed as I am sure that the forces in Austin have made it clear to Dr. DePinho the sooner he is gone the better and he must no longer be suffering from mural dyslexia. He can read the handwriting on the wall. I suspect he will find a place in the private sector somewhere, but leave the Regents looking for his successor. This period too will not be characterized by recovery, but it should stop the bleeding. That bleeding is EPIC, and poor morale, and insurers holding back payments for over-priced services and a general uncertainty in the health care sector given the wrangling in Washington. The one thing an acting president won’t be able to do is act.

Third will come the recovery if the new president is named and realizes that re-engineering of the entire institution is what is necessary to save it. It must return to a strategy of small elegance, the Tiffany of cancer care. It cannot compete with the Cancer Treatment Centers of America that must have lower overhead than Anderson being a cancer treatment and clinical research only organization. Ditto Texas Oncology, and Kelsey.

Anderson needs to return to a strategy of specialized cancer surgery, elegant radiotherapy, and the best in experimental systemic therapy. That means fewer patients in total, but most of whom will stay at 1515 for care. If the outlying Anderson clinics are to be kept, they need to be high volume providers of routine cancer care and ought to have a very different business strategy than the one guiding 1515.

So let’s call Friday what 1000 lawyers at the bottom of the sea is—A Start! There is one lawyer and two executive physicians who appear to have been demoted as Dr. Hahn will stand between them and Dr. DePinho. Good luck, Steve! Beware of SEALS bearing gifts and Executive Vice Presidents newly scorned.

The sooner the DePinho show leaves Houston the better. Some of us have been saying this since the circus arrived in town. I am glad the Chancellor finally figured it out.

But you have to admit it is surprising that a guy who could spearhead the mission to kill Osama Ben Laden couldn’t get rid of DePinho.

Yet…

Leonard Zwelling