One MD Anderson Unmasked

One MD Anderson Unmasked

By

Leonard Zwelling

“Fighting Cancer. Now that’s a job!”

“Making Cancer History”

“Whatever it takes”

“One MD Anderson”

These are just some of the catch phrases used by the world’s number one place for clinical cancer care, The University of Texas MD Anderson Cancer Center over the last forty or so years.

And they have been effective.

Let’s examine these.

The first dates from the mid-1980s when I first came to Houston and the phrase was on a bright red tee shirt I bought once I signed up in December of 1983. At that point, we were all soldiers in the battle against cancer with no illusions of eradicating it, despite that being the MD Anderson mission. Perhaps, we were wiser then.

The second dates from the Mendelsohn years and was the origin of the still used red line that cancels cancer. We were no longer soldiers but exterminators. We were going to cure cancer. Well, not yet, unfortunately.

The third is current and included in the recent set of television commercials and I really like this one. It puts the focus on the people of MD Anderson who will go the extra mile for the patients who come to any of the Anderson affiliates for care.

But, it’s the fourth that gives me some pause, because I am not really sure what it means and am a little concerned that it undermines both the past and current missions and the truth.

As I understand “One MD Anderson” it is the painting of a picture of a monolithic and derivative MD Anderson foot soldier (clones?) in the battle against malignant disease with an almost communistic approach of full equality among all MD Anderson employees. This is best exemplified by the recent movement of the Physicians’ Referral Service (the practice plan and its funds) to Human Resources and the refusal of management to allow the faculty to establish a dining space with food for purchase suggesting a unique place for faculty to eat is somehow elitist despite there being a doctors’ dining room in most academic hospitals in the country. Undoubtedly, faculty benefits will soon be lumped in with those of all the rest of the employees and there simply won’t be a unique dining space where great ideas can be shared as they were for so many years at the Anderson Mayfair and atop the LeMaistre Building.

But such an approach didn’t get the Soviet Union to excellence and it won’t continue MD Anderson there either.

Big organizations have a natural hierarchy and it is that hierarchy of different jobs and different responsibilities that leads to excellence. While it is just as important for all employees to be as dedicated to the MD Anderson mission as for the neurosurgeon to be, the latter is going to have a bigger impact on the survival of patients who come to Houston and there is nothing the leaders of the institution can do to alter this medical reality. The faculty are the people who draw patients to Anderson not the administrators. When I was one of those administrators, my job was to service the faculty. If you don’t get that, you don’t get modern medical care and biomedical research and I fear there are those at the highest reaches MD Anderson who don’t get that.

Anyone entering the hospital must wear a high-quality face mask given to them at the entrance. By contrast, the research faculty in the buildings on the south campus get flimsy, lower quality masks and when the research faculty and staff asked why, they were told by leadership that’s just the way it is. Is this consistent with “one MD Anderson?” It doesn’t look like it to me.

There seems to be a movement afoot at the highest reaches of the executive suite to homogenize all personnel at Anderson other than the very executives themselves who continue occupying big offices and pulling down overly large salaries while doing all in their power to undermine the autonomy of the faculty through ignoring shared governance.

MD Anderson did not become the number one place for cancer care by homogenizing the greatest cancer physicians and Nobel caliber faculty into an amalgam with everyone being exactly the same. And I have yet to meet a CFO who cured a patient with cancer. That’s not how great medical centers work.

Perhaps it’s time to go back to the old catch phrases about excellence and forget the new one about equal importance. Personally, I don’t mind an administrative assistant scheduling my surgery, but I don’t want an administrative assistant operating on my tumor. Do you?

And not to put too fine a point on it, even in the US military, where one Army or Navy is critical—the officers have their own dining room. If it’s good enough for the military, it should be good enough for MD Anderson.