They Say We Are #1; What Do We Say?


Leonard Zwelling

US News and World Report rankings are out. Once again MD Anderson is ranked
number one in clinical cancer care.  This is definitely a cause for
celebration, especially for the people who are our patients. But what about for
those of us who work here?

happen to agree with the rankings. When my wife Dr. Kleinerman woke me by
seizing on July 28, 2012, I called the EMTs and told them to take her to
Anderson. Why? If it was nothing I knew our ER team could handle it. If, as I
feared, it was something, as in a space-occupying lesion, I really KNEW our
team could handle it. It turned out to be a little of both as she had two
meningiomas (benign, but space-occupying) and indeed Dr. DeMonte’s team and Dr.
Conrad’s team cared for her in an exemplary fashion as indicated by her finally
breaking 100 on the Westwood golf course last week. The nursing care was great;
the clinic staff responsive and kind; the support staff wheeling her to and
from the MRI unit was considerate. I have absolutely no doubt that we are the
number one place for clinical cancer care anywhere. BUT—more importantly—I
didn’t need some magazine to tell me that.

do we wait every year with bated breath for the evaluation of our clinical excellence
by a group of people unlikely to know the first thing about what we really do
for our patients?

do we go through a song and dance every 5 years so that the National Cancer
Institute, a group that has contributed next to nothing to the understanding of
clinical cancer in its intramural program for 30 years, “approves” us as a
comprehensive cancer center and gives us some money as if anyone had a more
comprehensive cancer program anywhere?

do we judge the value of our own faculty at promotion and tenure time by
getting outside letters, quantifying the amount of money they have been able to
convince outside funding agencies to grant them or count the number of papers
others have decided were good enough to publish?

do we constantly bring in consultants to advise us who know less about cancer
than we do? We have talent to burn here. We might think about not burning it
any longer and put it to constructive and efficient use, and that is not
building a drug company staffed by high paid outsiders who have yet to share
their secret to a cancer cure with the rest of us.

are we going to grow up and decide for ourselves what quality cancer care is
and not worry about what other people think of us?

it’s about the referrals?

let’s really measure our quality by showing our outcomes are truly superior and
that we can deliver them for less money. If we do that, we will have no fear of
a diminution in referrals from other docs or from insurers paying the price we
ask them to pay for our superior services.

goodness sake, this is the MD Anderson Cancer Center. Let’s act like it and
stop worrying about our image and just present the truth—-unless we are
afraid that we can’t handle the truth. Or worse. What if the truth is not at all what
the magazine says it is? 

            Let’s find out and deal with it as opposed to marching
around with a red, Styrofoam finger in the air crossing out the word CANCER on the side of buildings housing therapies of unproven value while cheering “we’re number one” like a group of blue-painted Duke basketball fans. If we are #1,
we should know it, act like it and be humble.           

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