Everybody’s Talking

Everybody’s Talking. No
One Is Listening.


Leonard Zwelling

         Another week and another town hall at MD Anderson. As usual,
the talking heads spoke for more than 50 minutes leaving little time for
questions, none of which were spontaneous. It’s a time-honored way of seeming
to be inclusionary when in fact being the exact opposite. MD Anderson has
become a corporate autocracy run by administrative paper pushers who know
nothing of research, clinical or otherwise.

         It is quite remarkable that all of the four presidents of MD
Anderson who I have known have had unwelcome surprises upset their plans for
the institution.

         Dr. LeMaistre had to deal with the Clinton Era health care
reform, the onset of managed care, and the opening of MD Anderson to
self-referral. As much as I adored Dr. LeMaistre, this new world of MD Anderson
as a major business was not what he signed up for and eventually he gave way to
John Mendelsohn.

         Dr. Mendelsohn had a long, 5-year honeymoon of great success
and growth. As he was both a real clinical investigator and lab-based
researcher, he was able to bring great credibility to the president’s office
and a most successful five-year opening run. Then came Enron and ImClone and
the momentum he had built began to fizzle in a cloud of conflict of interest
and corporate greed from which his administration never really emerged.

         Dr. DePinho took the baton next and he faded fast when he
went into a foolish pursuit of a cancer cure running up against a doubting
faculty, many of whom he fired. Then he kept all the resources for himself
while he and his wife ran roughshod over the Houston landscape while pocketing
millions for themselves and using institutional dollars to decorate their
offices. He was not going to last long. And didn’t.

         Now Dr. Pisters, the man I call the Velvet Glove, is
corporatizing MD Anderson with principles he learned at Harvard Management
School, but he lacks the credentials to steer MD Anderson through the choppy
corona-filled waters that have washed ashore on Holcombe. Had he had more trouble-free
time at the helm, he might have learned of the sensibilities of the clinical
and basic science investigators and taken them more into account when he
planned his response to the coronavirus. He also would have leaned more on his
competent department chairs and less on his less-than vice presidents to get
him through this crisis. I believe he is so afraid of having staff contract the
virus that he has lost track of the mission of MD Anderson—eradicating cancer.
The mission requires all kinds of research and a great deal of patient care, even
if many patients cannot get to Anderson right now due to constraints on travel.
The full slate of clinical trials must be opened and lab research must start up
again if the true mission of MD Anderson is to be fulfilled. Cancer does not
stop for a coronavirus and cancer is still killing over 1600 Americans every

         I have a friend who has always said that MD Anderson has two
assets—its name and its faculty. The concept of “one MD Anderson” where the
entire staff and faculty are equal is ridiculous. Only the faculty generate the
income. They manufacture the product. Everyone else—including the high-priced
administrators—is overhead. When I was a vice president, I never lost sight
that my role was in service of the faculty. I didn’t make the surfboard. I tried
to make it better. Like BASF. I had become overhead and knew it.

         The presidents of MD Anderson I have known have all started
off well. Undoubtedly, like all leaders, they hit speed bumps. Some handled
those speed bumps better than others.

         None had a more formidable speed bump than Dr. Pisters with
the coronavirus. However, the mission has stayed the same throughout. So have
the assets. If MD Anderson is not fulfilling its mission it is not preserving
its name. If the faculty aren’t the primary drivers of the strategy of mission
fulfillment, the leadership will surely fail. History does not blink and you don’t
get a do over.

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