What’s the Plan?

By

Leonard Zwelling

            From
the very beginning of my days as an administrator here (1993) I have been
asking that question. Does MD Anderson have a strategic plan? For the most
part, this refers to clinical activity as that is the major driver of revenue,
but it applies equally to the other mission areas. In fact, since the other
mission areas require resources—space, slots, money—and those resources are
largely dependent on the clinical revenue, the plan ought to encompass all of
the four mission areas in an integrated fashion.

            As
a new affiliation is announced with a hospital group over 1000 miles away in
New Jersey, one has to pause for a second and ask why this is a good idea,
especially at a time when resources are strained here in Houston. One has to
assume there is money in this somewhere, but the actual financial arrangements
(who gets what for how much) were not announced at the press conference with
Governor Christie. My assumption is always that we are selling one of our two
major assets, our name or our faculty’s expertise, and it sounds like none of
the faculty will travel to New Jersey to work, so I am guessing they will get
to put our name on the side of a new building and will pay us for the
privilege. I also suspect that some form of clinical research will take place
there. I wouldn’t be surprised if they did this because protocols can be
approved faster in New Jersey than here on Holcombe.

            The
article in the Chronicle also referred to the affiliations we have in Orlando,
Spain and Arizona. We are told these are all productive but the numbers somehow
never appear.

            My
concern is quite simple. MD Anderson has always behaved like an entity with a
product differentiation, niche strategy. We were high priced, high cost, cancer
only and purported to be of high quality. The latter has never objectively been
proven compared to any other cancer care provider, but no one really uses that
kind of data to market to patients or insurers anyway. Lately, with the all out
push to see more and more patients, we are not acting like the Whole Food
market but more like WalMart. It seems logical then that we should go into the
franchising business, opening mini-MD Andersons (although a 600 bed hospital
and 100 different offices does not sound mini to me).

            So
once again I ask the perennial question. What’s the plan? How will we know if
we are successful? What are the metrics of accomplishment? Money? Patient
numbers? Outcomes? I just want to know what we are trying to do besides
“eradicate cancer”.

            I
suspect that we will know when we eradicate cancer. That will be clear. Until
that time, it would be beneficial to have intermediate end-points of success or
failure as tools for management and productive resource distribution. At this
point, I can come to only one of two conclusions: (1) we have a plan and the associated
key metrics but we rank and file cannot know it or (2) there is no plan and we
are just bumping along making it up as we go.

            Is
there a plan? Pretty straight-forward question. What’s the answer?