An Admission Of Error: The Regents Blink


Leonard Zwelling

If there is one thing that I have learned over my 33 years in Texas, it is that the Board of Regents of the UT System makes no mistakes. Chancellors do. Vice Chancellors do. Presidents do, but Regents, not so much. Until now.

There is no doubt that the naming of Peter Pisters to be the new president of MD Anderson is a major positive step toward the return of the number one hospital for cancer care to its rightful place in the galaxy of academia. Dr. Pisters is accomplished, experienced, and knowledgeable of the MD Anderson culture. These are all aspects of his resume that make him an excellent choice for this position.

But there is one other thing the naming of a trained hospital manager and surgical oncologist means. It means that the Regents have finally acknowledged the mistakes of the past twenty years. It appears that this current group of Regents gets MD Anderson.

Dr. Pisters will only be the fifth president of MD Anderson. R. Lee Clark, a surgeon, really started the place and was followed by Mickey LeMaistre, an internist without oncology training who was an expert in cancer prevention and university management—exactly what was needed in 1978.

When Dr. LeMaistre retired in 1996, John Mendelsohn became president. It is reasonably safe to say this was a change in the character of the leadership of MD Anderson to a more classic academic clinical-investigator model. Dr. Mendelsohn made it clear early on that he wanted the research at MD Anderson to improve. In my opinion, the research at MD Anderson was good in 1996 and stayed good. It did not ascend to stratospheric Ivy League levels as Dr. Mendelsohn had hoped and he ran into some ethical quandaries in 2001 that tended to blunt his future effectiveness.

Dr. DePinho was another notch up in the research world. He was a major player in molecular biology without any formal oncology training or even a medical background of significance. He was going to crush cancer into stardust using the moon shot approach of massive expenditures on science and technology while alienating any and all of those faculty who might actually have been willing to help him succeed. He didn’t need anyone else’s help. That approach failed quickly along with his ethical standing as a leader.

In the wake of that failure was the loss of many highly accomplished senior faculty leaders in clinical and basic research. That is most unfortunate because a level of institutional memory and competence was lost simply because the Regents made such a poor choice in DePinho.

In both the case of Dr. Mendelsohn and Dr. DePinho, the Regents were trying to stretch the academic and research credibility of an institution the major function of which is patient care and whose faculty was far more devoted to clinical work than bench research. Both Mendelsohn and DePinho were enamored of commercialization as a means of making progress in academia. At least Mendelsohn did finally get a drug to market. DePinho was far less successful.

Now MD Anderson has a president more in line with its mission and its true function—patient care. That’s also where most of the revenue is generated—in the hospital and clinics. I feel quite confident that Dr. Pisters understands that and will emphasize high quality cancer care in his efforts to return MD Anderson to cancer care excellence. Research will still be a major part of the portfolio, but for academic and patient care reasons, not to make money.

But let’s not lose sight of the current Regents eclipsing the decision of the past Board with the selection of Pisters. This eclipse is a good sign!

Regents are human, too. They can make mistakes. And they can correct those errors. Good for them. Good for MD Anderson.

Leonard Zwelling