MD Anderson Is Too Big

MD Anderson Is Too Big


Leonard Zwelling

Two articles in the Houston Chronicle on February 5 make the title of this blog abundantly clear.

In the first, Ken Janda, the CEO of Community Health Choice, relates the difficulties he and his family faced navigating the health care system to care for their aging father with cancer. He writes that the triple aim of health care is to “improve health outcomes, lower costs, and improve patients’ experience.” And he’s right. Those are the goals of health care reform as well. Then why are the goals so rarely reached?

Janda basically identifies this as well. The system is simply not built around patients, but around doctors. I would add it is built by and around money. What he claims to desire, a patient “docking station,” was supposed to be the goal of the multidisciplinary clinics at Anderson, but my guess is there still is a need for patients to travel from clinic to clinic to obtain the care they are prescribed. We shall see whether the geniuses at Amazon, Berkshire Hathaway, and J. P. Morgan can come up with a better model. They may find health care a bit more challenging than marketing books.

I was surprised that Janda was serving as his father’s care coordinator and navigator as I thought that service was provided at Anderson. Clearly not to everyone.

But what if MD Anderson concentrated its attention uniquely on patients that it alone could help—those with unusual diseases or those eligible for clinical trials? Patient volumes would drop. Congestion in the clinics would abate. Navigators could steer patients and their families through the multi-clinic maze and the triple aim of health care would be met.

The second article in the Chronicle is about MD Anderson’s name being associated with a conference in India at which a yogi who believes cancer comes from bad karma will be speaking. MD Anderson’s association was attributed to the efforts of three professors there, one of whom retired under a cloud of controversy having to do with his research being supported by manipulated images.

What all this is really about is the fact that MD Anderson has reached the level of unmanageability, at least by the current leaders. There is a new president who needs to be given the time to put his own team in place to do the managing. It may come as no surprise that in the interim, difficulties will ensue, both in Houston and within the global reach that MD Anderson has attempted.

These two articles give sufficient grounds for a hard review of the operations of the clinics and the wide spread affiliations of Anderson throughout Houston and the world.

The first article suggests that the Chief Medical Officer and Chief Operating Officer have a great deal of work to do to create an efficient and negotiable system for patient care. If a knowledgeable health care consumer is struggling, what will happen to the average patient and his or her family?

The second suggests that MD Anderson has a global reach but no one is minding the store. This too is fixable, but needs immediate attention as the face of MD Anderson in other markets is being adversely affected.

For years some of us have been concerned that the unbridled growth of buildings and personnel has undermined the financial and intellectual basis of MD Anderson’s continued role as the number one place for cancer care in the country. These articles support that view. Changes are needed. Soon.

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