Regression Revisited

Regression Revisited


Leonard Zwelling

In February of 2015, I wrote this blog about regression to the mean. This is the statistical phenomenon that describes what happens when you test a large number of people for a trait and get a mean, standard deviation and Gaussian distribution. IQ is a good example. But if you take the top 10% of IQ scorers and retest them, you will get the standard distribution again. That group of high achievers when retested will tend to regress to the mean of the previously tested group.

I suggested that this phenomenon occurs in academic centers as well. The best in quality will regress to the mean of them all unless that institution makes a concerted effort and pumps in a ton of energy (and money) to stay number one. Examples that suggest that this continuous excellence is possible include the New England Patriots, the Duke men’s basketball team and Harvard. Another was MD Anderson. Was.

In 2015 I wrote of how seemingly lavish spending on the drive for new drug development and commercialization of science in search of more money was undermining the long history of clinical research excellence. Individuals and groups were part of that excellence that set MD Anderson apart for years and now it was being lost. I had seen it happen at the NCI in Bethesda once the Vietnam War ended and the best and the brightest of American academic medicine no longer opted to be “yellow berets” in Maryland. The NCI intramural program has not been the same since in innovation or discovery.

I return to the topic of regression to the mean at Anderson because, I thought that with new leadership, the institution could shake off the bad habits of the past several years and reassume its rightful place at the leading edge of American cancer research. I was wrong.

In fact, the leadership is demanding a uniformity of behavior of a Stepford-like nature thinking that some ideal of “professionalism” can be defined by only one form of faculty member. The basic sciences have suffered significant losses of talent of late, particularly losing those of Chinese backgrounds. Then there was the wholesale loss of Jewish faculty a few years back that has seen no rebound in leadership roles at Anderson. Department chairmen, Division Heads and Vice Presidents, more than enough for a minyan, were purged from the ranks of leadership at MD Anderson in a fashion and using technologies being used again against the Chinese. Who’s next?

The only remaining question is can MD Anderson recover its true core values of Discovery, Caring and Integrity. Somewhere along the line they were lost. Many have suffered and continue to suffer because of the actions of some very powerful forces, not the least of which was money—from overseas and from the NIH. Or maybe the real force was the threat of the loss of money.

It may not be too late for a resurgence of MD Anderson’s greatness although the latest selections for leadership suggest that the horse may be out of the barn already.

To those of us who were able to catch the tail end of Anderson’s golden era, this latest iteration of Anderson with sights set on commercialization of discovery, routinizing “caring” behavior and franchising of the MD Anderson name until the integrity of the uniqueness can no longer be possible, is most alarming. It has been going on for 18 years now.

I never thought I would see the day when MD Anderson would fall victim of regression to the mean. And once I did, four years ago, I had hoped new leadership would return Anderson to its glory.

Let me be optimistic and say—not yet!

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