The Illusion Of The Second P

The Illusion Of The Second P



Leonard Zwelling

Readers of this blog or of my book Congressional Malpractice about my year on Capitol Hill remember the four P’s of effectiveness on the Hill—policy, process, politics and personality in ascending order of importance. That second P tends to trip up leaders who lean on process when forming their policy and ignoring the politics and importance of their own personal brand of salesmanship to accomplish their goals.

I think Dr. Pisters is caught in this dilemma. He is continuing to expand his organizational chart with people of minimal accomplishment in redundant jobs needing ever more administrative assistance. How much has the non-faculty number grown when compared to that of the faculty? Has Dr. Pisters hired more vice presidents or more department chairs? In lieu of having a real plan for his tenure as MD Anderson President (OK, you say he has a plan? What is it?), he rolls out process. There are hundreds of meetings of dozens of committees drifting toward nowhere, accomplishing nothing, improving little. So, what could be done to improve life for the faculty at MD Anderson?

Job one is to find a way to actually listen to faculty concerns—and I don’t mean ten minutes of pre-submitted questions at the end of an hour address by the president. I mean doing the hard work that John Mendelsohn did upon his arrival in 1996 of going to each and every department with a yellow legal pad and listening to the issues most troubling the faculty. Not the administrators. Not the nurses. The faculty. Then, do it once a year, every year. The answer is not institution-wide surveys. This is the hard part. Surveys are easier to do and even easier to ignore. Meeting with the faculty face-to-face is a lot harder.

When the FDA forced me to implement a training program for clinical research at Anderson and made every single person involved take the course, I had to go to dozens and dozens of individual department meetings explaining why the FDA had done what it did. It was a pain, but it was a necessary process that demanded sensitive politics and real concern for the personalities of the faculty, including looking them in the eye. It was hard, but it was worth it.

Second, Dr. Pisters needs to take a close look at the resumes of his executives, Division Heads and department chairs and make sure this is the best he can do. One of the reasons recruitment is such a problem is not just Covid, but the demonstrable lack of prestige of the academic leadership doing that recruiting compared to that of other cancer centers. And while he’s at it, Dr. Pisters may want to revisit the competitiveness of start-up packages and objective, quantitative measures of Anderson’s science and where that excellence is and is not.

Third, the manner with which daily business is done needs a hard look. This concept of professionalism seems to be bullying the faculty into a singular personality. I remember well that this occurred when I was in the administration as well and only INTJ’s in the Myers-Briggs survey could survive in the Mendelsohn administration. I am not an INTJ, but I tested out as one during my vice presidency actually molding my personality to that which was acceptable to the leadership. Be careful Dr. Pisters! You may be doing the same with your “One MD Anderson” trope. It’s not healthy.

In the end, process can take you just so far. You actually have to have good ideas, grasp the prevailing politics, and use the strength of your personality to make it happen. For five years, John Mendelsohn did this in a masterly fashion before he got caught up in outside business ventures that went south.

Dr. DePinho had great strength of personality and great ideas. But a strong personality is not the same as an effective one and Dr. DePinho had a poor feel for UT System politics and the sensitivities of the MD Anderson faculty.

Now it’s Dr. Pisters’ turn. He seems to be caught up in process. His solutions to problems seem stamped by the imprimatur of Harvard Management ideas, not the realpolitik of MD Anderson. He has a golden opportunity having weathered Covid well to really up the game of the institution, but he’s going to need new players and new blood. Process emanating from Human Resources will not get him there. Neither will lawyers.

Tell the faculty your plans to make the lives of each faculty member better. Make it clear. Make it brief. Make it good. Make it yours. Make it theirs.

4 thoughts on “The Illusion Of The Second P”

  1. Don’t go too hard on Harvard Management concepts! They are not the issue.
    The main problem for Dr. Pisters is probably NOT rounding daily with EVERY type of employee to hear concerns and garner ideas. He sounds out of touch with the MD Anderson culture that patients expect. And, with the physicians!

Leave a Comment

Your email address will not be published. Required fields are marked *