Leonard Zwelling

It may be among the commonest words in pop music after “love.” Even the Beatles used it.

It has also got to be one of the most frustrating words in the English language. Very few people I know like to wait.

It implies patience, but it may be the opposite of patience.

A patient person is one comfortable with allowing time to pass in pursuit of a desired goal. We tend to wait impatiently. Patiently waiting is an oxymoron.

Over the past weeks residents of Houston and Florida had to wait to find out whether or not their homes would be destroyed by nature. Some got lucky. Some did not. We all had to wait to find out.

MD Anderson is waiting. It is waiting for its new president to begin his tenure and waiting to see what changes are in store with a new administration.

I think there are some choices that will be very hard especially around strategy and money, but there are also some choices that are straight forward and the new president shouldn’t wait too long to address them.

Issue number one is faculty morale. This has already improved. It started improving the day Dr. DePinho stepped down and only got better when his three Executive Vice Presidents were shunted aside as they should have been. Kudos to Hicks and Hahn. While the acting president and COO have done a lot of good things from making shared governance a reality to trying to place reasonable people in positions of responsibility, the faculty will be forever in their debt for the simple act of following the resignation of the last president with the firing of the three executives.

But this is not enough, even if it is more than enough for the acting crew to have accomplished.

The new president cannot maintain the ten or so boxes reporting up to him. This blog has already suggested a CMO, CAO, CFO, COO, IS leader and legal counsel as sufficient to run the institution. The organizational chart of MD Anderson needs flattening and the number of vice presidents and assorted administrators needs trimming. Task number one, and no waiting is needed, redo the org chart.

Task number two, and this will take some waiting, is to fill that org chart with the best possible people whether from within the current organization or not.

The CMO should be an ace clinician and clinical investigator familiar with regulatory aspects of clinical research and modern health care reform and delivery.

The COO should be a seasoned manager of large groups of people in the health care field including doctors, nurses, and technical personnel. It is imperative that the new COO has run a hospital and a cancer clinic.

The CAO should be both a researcher and an educator of national standing who no longer needs to use the resources of the institution to further his or her own academic career.

The CFO must be someone from academia who understands the nuances of grant funding, state funding, the movement of patient care dollars appropriately and with ethics beyond reproach.

The IS leader must know cancer and know academia. But more than anything, he or she must understand that it is the provision of the service of information technology to the faculty and staff that is his or her prime job.

And perhaps most importantly, the lawyer needs to know how to say no to everyone else. No conflicts of interest. No self-dealing. No nepotism. No preening. No talking down to the faculty and staff. This person too must be in service to the institution and not use that institution to enlarge his or her power base.

Redoing the org chart should not take a lot of waiting.

Filling it with the best possible people should be a slow process worthy of patience, But I am like everyone else. I don’t like to wait and my patience is limited as the faculty’s ought to be. Nonetheless, getting this right is worthy of a wait.

Leonard Zwelling