What’s The Opposite of a Team
of Rivals?: When FORDs Become Job One


Leonard Zwelling

         Lincoln is considered by most one of the two greatest
leaders to be president and the greatest to have occupied the White House given
that Washington didn’t live there. Doris Kearns Goodwin has immortalized the
term “a team of rivals” to describe the disparate group of men in Lincoln’s
cabinet who were his rivals for the presidency and competed with each other.

         One hundred years later, John F. Kennedy also assembled a
brilliant cast of men to advise him perhaps none more important than his own
brother, Robert. Admittedly, these “best and the brightest” took the steps that
started our drift to war in southeast Asia, but they were the greatest minds in
the country at the time.

Kennedy was prone to listen
to them debate before he quietly formed his own decisions.

         Whether either Lincoln’s team or Kennedy’s was a success,
the process established by these two dynamic leaders of surrounding themselves
with the finest people they could, regardless of their political affiliation or
past battles with the leader, created the environment that would be the most
likely to service the needs of the American people and their very different
belief systems and political persuasions.

         The Obama White House, from all descriptions, appears to be
quite different than Lincoln’s or Kennedy’s. Insularity characterizes Mr.
Obama’s interactions with his advisors. It’s one thing to surround yourself
with the true believers when you are trying to get elected, it’s quite another
to do so when you are trying to govern a nation as complex and diverse as our

         On my favorite subject, health care reform, some events
conspired against Mr. Obama having the right people in the right places. Senator
Ted Kennedy was terminally ill. He would have been as valuable an asset in
legislative reform as he was during the election, but he was, alas, gone.
Similarly, there could have been no better choice to head HHS and be the White
House health czar than Senator Tom Daschle, but he didn’t pay his taxes. In
lieu of replacing Kennedy or Daschle with more dynamic thinkers, Obama gave us the
enigmatic and perpetually flustered Kathleen Sebelius and Oy!

         Dr. DePinho is faced with a challenge similar to the one
facing Lincoln, Kennedy and Obama. The organization he was chosen to lead was
struggling on both the financial and morale levels. Important strategic
decisions would need to be made to shore up the shaky fiscal status while
preserving the culture of excellence of Anderson in clinical care and clinical
research that is so much a part of Anderson’s history. With many leaders on the
clinical side aging, Dr. DePinho was going to have the opportunity to replace
them as they retire and create a new team using the world-class leaders already
at Anderson and recruiting new clinical leadership from around the country.

         That is not what happened.

         The Chief Medical Officer, Head of Surgery, Head of
Radiotherapy, Chair of Melanoma-Sarcoma, Chair of Lung and Head and Neck Medical
Oncology, Department chairs in Pathology, Division Head of Quantitative
Sciences and most remarkably of all, the chair of the phase 1 program in
medicine being a surgeon, are all promotions from within. Dr. DePinho has not
been able to recruit a single clinical leader from outside of MD Anderson.
Whatever the opposite of a team of rivals is, this is it!

         There are still opportunities to optimize team performance.
Medical Breast Oncology is open as is GI Medical Oncology and NeuroOncology. Internal Medicine
will open shortly as hopefully will the Division leadership of Cancer Medicine
as the incumbent’s presence is surely part of the impediment to recruiting
department chairs. Any one taking a chair position in DoCM now would not know
who his or her boss would be in two years or even less. Would promises made now
be kept?  

us hope that some outside talent with new ideas can be found.

         The real question is why has MD Anderson failed to attract
any candidates of sufficient stature from outside Houston? Perhaps it is
because the leadership is unaware of the critical issues in clinical medicine
and clinical research facing the institution and thus doesn’t know what to look
for. Perhaps it is the fact that leaders for whom other leaders might work have
long overstayed their welcomes and need to step aside. Or worst of all, perhaps
the President wants to surround himself with those he can control and who will
do his bidding (make money; donate patient tissue to IACS) rather than
challenge him as Lincoln’s and Kennedy’s cabinet members challenged their

         The entire story of the DePinho years is far from being
written, but we do know this much. When given the chance to fill clinical
leadership openings with the best and the brightest from around the country,
Dr. DePinho chose to stay close to home. Nothing at Anderson comes close in magnitude
to the existential threats posed by the Civil War or the Cuban Missile Crisis.
That doesn’t mean Dr. DePinho couldn’t learn from Lincoln or Kennedy (someone
he is so fond of quoting).

         MD Anderson is in vital need of some new ideas. And all of
them don’t have to be Ron’s and Lynda’s or the ideas of the FORDs—the Friends
of Ron DePinho.

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