Is Commercialization in the TMC Facing An Early Death? : We Can Hope, Can’t We?

Is Commercialization in
the TMC Facing An Early Death? : We Can Hope, Can’t We?


Leonard Zwelling

         Under our noses there is battle raging for the heart and
soul of the Texas Medical Center. For years the TMC has been the haven for
academic excellence and its application to patient care. Whether at Methodist,
St. Luke’s, Hermann, UT Medical School, Baylor, Texas Children’s, MD Anderson
or any of the other many associated institutions, the major product was truth.
The TMC was the largest place for the application of new biomedical science to
the improvement of life for patients from throughout the world.

         Then some things changed.

         The first thing that changed was that medicine became big
business. As the insurance system that paid for care grew and what was once an
anomaly, having someone else pay for your health care, became first a benefit during WWII wage and price controls,
then an entitlement in the mid-1960’s (Medicare and Medicaid), providers of care saw bags of money
scattered on the operating room floor and sought to pick them up as quickly as
possible. And they did. Doctors got rich as they attained god-like status
particularly with the cross-parking lot rivalry for dominance in cardiac
surgery here in Houston. The drug companies followed turning the making of
life-saving compounds into a major sector of the economy. Then came the
Bayh-Dole Amendment of 1980 and the ability to commercialize discoveries made
using taxpayer money and biotech got rolling, mostly on the Coasts. Everyone
was getting rich—until they weren’t. Payrolls swelled so revenues had to swell
to match them. As Mr. Leach so aptly put it, “weapons of mass construction” saw
building after building erected in the TMC also pressing the need for more
revenue to keep them air-conditioned. The enterprise was out of control and has
remained so.

         Another revenue stream was needed to keep up with the
spending. How about commercializing everything?

         MD Anderson, Baylor, Texas A and M and the TMC itself chose
leaders who embodied the sprit of academic entrepreneurship. Academic
entrepreneurship differs from real entrepreneurship in that the academics
developing new business initiatives never risk their own money. It’s a great
gig if you can get it and many have. Conflict of interest rules were bent and
intellectual property regulations at institutions encouraged the privatization
and patenting of discoveries that used to be first noted in scientific
journals, but now were announced in the Wall
Street Journal

         This is the TMC today. But I think the wind direction is

         The queen of privatization, Lynda Chen, wife of the king,
Ron DePinho, has been summarily shipped off to chase diabetes and obesity with
her genomic skills. Good luck with that in Texas, Lynda. Dr. Giroir thought the
need to tender his resignation for the new Texas A and M President did not
apply to him and he found out he was right when he was fired last week. Another
Harvard guy brought in to make money finds himself out on the street.

         There are only a few left to displace and my hope is that we
will see this shortly as the Regents in Austin and College Station have seen
the error of the ways of their predecessors and want to get back to
intellectual pursuits to benefit society not the faculty’s pocketbooks. Science
and medicine in the public’s interest may make a comeback.

         This may be a really good thing. Now if we can find other
things for the many employees who will no longer be needed to push all the
paper or electrons around and mothball the buildings, shrink the fixed costs
and get back to sane budgets, we might be able to make cancer, heart disease
and other oppressors of the human condition, if not history, at least more manageable,
which is all we can do. Surprise! No one lives forever no matter how many heart
transplants or cell therapies they receive.

         It is time to get back to the basics of the TMC. This is
supposed to be a non-profit zone generating discoveries to improve the human
condition, not the seed for another industrial park making people financially
wealthy but spiritually numb.

         Back to the Future at the TMC. After that we bring back the
MD Anderson prom. The first one will have as its theme, “Enchantment Under the

         MD Anderson and the TMC at-large have become addicted to
money. It’s time for their leaders all to go to rehab-No, No, No? YES!

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