Leonard Zwelling

         I have written about relationships a great deal. It’s a
major theme of the book I am about to publish for it is relationships, or the
lack thereof, that are so crippling the federal government and, in particular,
the ability of the Congress and the President to cooperatively deal with the
problem of health care.

         Early in my fellowship in DC, we fellows learned about the 4
Ps: policy, process, politics and personality. These are the four drivers of
legislative action on Capitol Hill.  They
are listed in ascending order of importance.

         Every congressional office knows its position on every
policy issue. The process of legislation is well described in the Constitution
and by the rules of the House and Senate. The politics really is about group
activities. How do the Dems vs. the GOP plan to deal with a specific issue? But
the personalities are the most critical aspect of the legislative dance for the
“common ground” I wrote about in the last blog may have its foundation in
politics (both parties agree that immigration reform is needed), but the “compromise”
rests squarely with two people agreeing that they disagree, that the problem
needing a solution is too important to ignore, and that each party will give up
something to get something (and make no mistake about it; immigration is about
the economy and the electorate—money, jobs and votes). That activity, called
compromise, is promulgated through relationships and trust.

         In Washington now, those relationships and trust are
missing. Mr. McConnell and Mr. Reid clearly do not like one another and hold
each other in contempt. Speaker Boehner has just thrown the gauntlet down to
President Obama in his first news conference since Tuesday’s election and told
him that the President will “get burned” if he tries to go it alone on
immigration or any other big issue. I think it is safe to say that these
professional relationships are poor at best and are in need of some repair if
the American people are to prosper.

         The recent faculty survey results would suggest a similar
set of problems plague Anderson. In essence, the faculty does not trust the
leadership and some of that leadership holds much of the faculty in contempt.
This is not healthy either.

         So to all of you out there who have positions of
responsibility and/or leadership within the Anderson clinical and research
faculty and can possibly effect positive change, I suggest you take an
executive to lunch and try to explain why there is such poison in the
atmosphere. Try to develop a relationship. I will not write your words for you
although feel free to use anything I have ever written in the blog. Just
explain what life is like in the clinics, labs and classrooms that you occupy
trying to make change for the good for your patients, your students, and your
colleagues. Explain that seeing more and more patients who you cannot help, is
not really resonant with why you came to Houston. Sacrificing more and more of
your personal time to write grants because they are so hard to obtain while much
of the research in other parts of the institution are receiving internal and
state funds is not helpful or conducive to a happy workplace. Many of you have
little if any time to teach and aren’t rewarded for it any way. Once you do all
that explaining, then you have to suggest what you want to make it better.
What’s the deal you are willing to cut, the compromise you are willing to come
to for the “ask” to make your life and the life of everyone at MD Anderson
better? What are you willing to give the leadership to get what you want? On
Capitol Hill, the “ask” is everything for any lobbyists worth their salt.  It is the same on Holcombe and especially in
the upper reaches of Pickens Tower where they are trying to figure out what
they can do to get better scores on Executive Vice Chancellor’s surveys and
keep their jobs.

         You need to develop relationships with Ron, Ethan, Tom, Dan,
and Leon and they need to know you on a first name basis as well. That’s their
job and that’s yours, too.

         I cannot assure you this will work. I cannot know because I
was really bad at it when I was in your place (as a VP) and was trying to get
things done that the President didn’t like. (You can read in my book all about
that). I am no poster boy for compromise, of course that wasn’t my job as the
Institutional Official for Human Subjects Research, Animal Care and Use, and
the Research Integrity Officer. Nonetheless, had I been more conciliatory, I
might still have a job. Ya never know.

         Hell, try it. What have you got to lose that you haven’t
already lost?

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