50,000

By

Leonard Zwelling

            This
is a simple heartfelt thanks to each and every one of you who have read any of
the postings on the blog.

            Today
we have surpassed 50,000 pageviews since our beginnings in March. I guess this
internet thing is here to stay.

            I
hope I have helped the debate at Anderson with regard to what I consider some
outrageous behavior on the part of our new leadership. In my opinion the
current problems, financial and otherwise, facing MD Anderson did not start in
September of 2011. To my mind, this all began in 2001 when some additional bad
behavior took place without consequence and unleashed a culture of rapacious
ego wars, competition among departments that were formerly collaborative, and
as Mr. Leach called it “weapons of mass construction” (some built with
ethically questionable dollars) that have only worsened to this day.

            MD
Anderson has always had its clashes and surely had its egos. Nonetheless, the
Presidency of Anderson, was always considered a place where civil behavior and
high ethics were the norm. At least I believed that it was, but perhaps it is I
who is naïve.

            Once
conflict-of-interest, service on corporate boards of rogue companies, nepotism,
self-dealing and all around self-protection of personal wealth became the norm
in the offices of the leadership, the culture dissolved.

            If
our core values are to mean anything again, we need to turn our attention to
all of them.

            Discovery
can come from anywhere and we need to entertain the possibility that many different
approaches are needed to improve the treatment and prevention of cancer. One
shot to the moon won’t do it and neither will the wholesale chopping up and
sequencing of human cancer DNA alone. This technology may prove fruitful, but
it also may prove to be like discerning what kind of car a pile of iron filings
had previously represented.

            Whatever
progress we have made against this disease to date did not require such
technology. It’s a fine idea, but it is research like all the rest of what we
do beyond standard care is. It is not ready to be standard of care and surely
not ready for reimbursement by insurers. On the contrary, we should be far more
rigorous about what we call standard of care and use both comparative
effectiveness research and prospective trials to prove that what we do matters
to the quality and/or quantity of a patient’s life. It is possible, in fact it
is likely, that a fair percentage of what is considered standard of care is
neither effective nor of any clinical value. Much of it has never been
objectively tested. So as we discern which of the new technologies are
effective, we might also take a hard look at the other, more established things
that we do, especially the costly things, to make sure we are providing value
for patients and payers alike. Could you imagine how insurers would send
patients to us if we LOWERED our charges by not doing things that don’t
contribute to patient well-being?

            Caring
cannot be a word in the dark. It must be the walk we walk, not just the talk we
talk. And it cannot be just about patients. It must include everyone, faculty
and classified staff alike. That a bullying seminar should outdraw the
President’s town hall makes a heck of a statement about the culture problem.
You in charge at all levels, vice presidents and above, department chairs and
division heads, wake up. Whatever it is you think that you are doing to improve
life around here isn’t working. Furthermore, you cannot improve things working
alone simply because you are not being led, organized or treated well. It is
time to rise to the occasion. The faculty, the staff, the patients and the
institution need your COLLECTIVE wisdom.

            As
for integrity, we have a long, long way to go to return to even a modicum of
this. If we are not led by those with integrity, and right now it appears for
all the world that we are not, this is going to be a slow and painful journey
back. But, it took Odysseus 10 years to get back to Ithaca and then he still
had a lot of cleaning up to do, so maybe we are right on time.

            Either
it is up to those with fiduciary roles in the running of MD Anderson in Austin,
those overseeing the financial markets and securities rules in Washington, or
the faculty that continues against all odds to represent the best of Anderson
as its most critical and valuable asset to act in a coordinated fashion to
begin the tough road back.

            As
I said in another blog: “What are you prepared to do Mr. Ness?”

Comment from Mike Siciliano:

Denying tenure renewal to those who have fulfilled their obligation to the University, and who have been so recognized by the appropriate faculty review committee by receiving an overwhelming vote for tenure renewal, does more than lower morale.  It crushes hope.

mike

1 thought on “”

  1. Thank you, Dr. Zwelling. For many of us, you have become our voice.

    There are many of us who are saddened by the metastasis of this insidious cancer within the institution and yearn for the days before the so-called leaders began to run it like a private corporation. We yearn for the days when the focus was quality and integrity instead of metrics.

    I hope those in Austin realize this, before it's too late.

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