Houston, We Have A Problem: MD Anderson In The News

By

Leonard Zwelling

https://www.houstonchronicle.com/news/health/article/Report-MD-Anderson-deficiencies-jeopardized-14806472.php

https://www.nytimes.com/2019/11/04/health/china-nih-scientists.html

The Public Relations Department at MD Anderson must be working overtime today, November 5, as these two articles hit the Internet simultaneously.

The first was on the front page of The Chronicle above the fold on Tuesday. It describes the recent CMS audit of the cancer center and the improvements implemented since the last inspection and the areas of deficiency that remain. I did not wade through the 268 pages of the report and so have to take Todd Ackerman’s word that there are still critical parts of the MD Anderson care delivery system in need of repair. This has all been widely reported before and the article makes clear that it is not just MD Anderson that has these problems. I would like to focus on something different.

First, why have these deficiencies come to light now and have they really been present for a while? Second, why does the leadership of MD Anderson put on a sunny face about all this rather than be transparent? This is a real problem.

This latter issue also arises in relation to the second article from The New York Times and Gina Kolata about the concern of the NIH and the federal government in general that people from China, even some who are American citizens, may be sending information to China that is confidential or frankly wholly American in the form of laboratory data or the content of federal grant applications. Again, MD Anderson has a prominent role here and we finally learn what the dismissed faculty at MD Anderson did to warrant their departures. Again, not that any of this is surprising by now, but at least we learn what these people did to get themselves sent back to China.

As an outside observer with a great interest in what MD Anderson does and how it does it, I am mystified at these latest developments.

First, if there is one thing that I always took for granted about MD Anderson it was the quality of the patient care given at the center. Apparently this isn’t true and hasn’t been for some time as faculty members have been complaining about the nursing care for years now. The leadership of the clinical operation and of nursing would not hear these complaints and did nothing about them. Now the whole world knows. Anderson has a problem in nine areas of care delivery including nursing, the pharmacy and surgical services. What the heck has been going on for the past five years? Has no one been paying attention? Did no one care? As a former faculty member and current patient, I never saw any of this, but I heard about it. A lot. Many faculty felt that the standard of care being delivered was inadequate and pointed fingers particularly at nursing care, but no one listened. I guess they are listening now.

As for the Chinese issue, my guess is that the NIH and other federal agencies have a right to be concerned if intellectual property, particularly that paid for by the American tax payer, is being smuggled out to China to publish papers and start companies. However, this too was handled with a club when surgical precision was called for. This has sparked fear in the Asian community of scientists here in America, even among those who are loyal to the country and follow the rules. That’s what happens when you start rounding people up in what looks like an arbitrary fashion and keep everyone in the dark about why you are doing what you are doing.

The people in the PR Office at Anderson are probably working the phones even as I write this trying to spin these headlines in a favorable fashion. They are probably saying they have addressed all the issues that CMS found deficient and that they were bound to secrecy to protect the reputations of the Chinese being investigated. I get it. But the optics are dreadful. They appear to pit elements of the institution against other elements and certainly this spin control does not create confidence in the current leadership of MD Anderson, a crucial part of which is about to change with the appointment of Steve Hahn to head the FDA.

I think it is time for Dr. Pisters to give a state of the union address focused on the elements of trouble facing the cancer center, not a speech written by the people who scripted Mr. Rogers’ Neighborhood. Explain the problems’ origins, even if it means blaming the last guy, and outline how you will deal with these issues. Furthermore, mean what you say about transparency because right now MD Anderson looks anything but transparent. It’s opaque.

If it takes the major newspapers to get at the truth, that’s a sad day for a great institution whether it’s ranked number one or not.

The time for the core values of caring, discovery and integrity is now. Let’s hear from the top about these and how the leadership will guide the work going forward and correct the shortcomings of the past.

Leonard Zwelling