Listen, Learn, Act

Listen, Learn, Act


Leonard Zwelling

It’s that time of year again. Yes, kids, it’s the Big Survey now called MD Anderson Listens, Learns, and Acts. Just color me skeptical.

The last time an MD Anderson president actually listened to anyone besides his superiors in Austin was when John Mendelsohn first began his tenure in 1996 and went to every department with his yellow pad and listened to what the rank-and-file faculty had on its collective mind. That translated into a new chief of pathology and a new leader in biostatistics. I am not sure any MD Anderson president ever did so much so fast as Dr. Mendelsohn did in his first year and he did it by listening, learning, and acting. He removed vice presidents and other academic leaders who were not effective. He installed a chief academic officer and did it again when the first one didn’t work out. He got the hospital a real chief operating officer, hired a chief of marketing who was fantastic (“Making Cancer History”), and got us some real financial leadership. Dr. Mendelsohn’s first five years (pre-Enron, pre-ImClone) were the exemplification of listening, learning, and acting. It all ended in 2001 never to be seen again.

Flash forward to 2023.

If there is one organ that Dr. Pisters seems unable to gain function of it is his ears. He cannot hear the moans from the clinics about understaffing, the electronic medical record, and inadequate time to see patients. Vacancies are everywhere in the hierarchy of the academic programs. There still is no permanent Division Head in Cancer Medicine. How many years has it been this way?

And the fear. Oh, the fear of being labeled unprofessional and being shown the door. It’s happened more than once.

Pisters seems to put a greater premium on winning awards for diversity than actually advancing the diagnosis and treatment of malignant diseases. Hey Peter, that’s the mission, man.

His hires have been lackluster at best and absent at worst.

The only real question is why anyone would think this time and this survey will be any different. Now, after five years, President Pisters is going to listen and learn and most of all act? I doubt it. His only actions seem to be using professionalism as a weapon to rid the institution of those with whom he does not agree and to use the rest of his time to surround himself with people who will agree with him, do his bidding, and certainly ask no questions.

The other thing about these large surveys is that they will never get to the heart of the matter which is that the needs of the staff, the nurses, and the faculty are not identical and cannot be captured in some third-party invented nonsense questionnaire that tends to homogenize the data and allow the leaders to use it any way they wish. If Dr. Pisters really wants to know what the faculty think, read the survey of over 900 faculty showing the high burn-out rates.

There is a small technique I used when I was in positions of leadership that Dr. Pisters might employ. It’s called managing by walking around. You actually have to get on the ground and talk to individuals to really understand what their professional lives are like and how you can make those lives better. When I was the ad interim department chair in Smithville, I spent an afternoon every week just walking the entire campus, lab to lab, office to office to hear how the faculty and staff were doing. They had been traumatized when their long-time chairman was fired and I was stepping into a hornets’ nest when I went to Smithville to live five days a week. It was hostile territory and I couldn’t wait for some survey instrument to help me calm the hurt feelings and shock. I had to listen to the faculty and staff, learn what they did, and make the changes that would get us through to the time when a real chairman could be appointed. It got done.

Broad-based survey instruments are fine for assessing how restaurants are doing, not how an academic cancer center’s faculty and staff are handling the tough, post-Covid world.

If Dr. Pisters wants to know how he’s doing, don’t ask US News and World Report or the Board of Regents. Ask the faculty and staff. And do it face-to-face without prepared questions. I dare him.


Did you know? Dr. Zwelling’s new book “Conflict of Interest” becomes available Spring 2023. Check for the latest on this book and information on how you can purchase a copy.

2 thoughts on “Listen, Learn, Act”

  1. When I was asked to create and lead the Heart and Vascular Center at Roper St Francis Healthcare in Charleston, SC, my hospital CEO was Matt Severance. Quickly, he mentored me on the importance of your message: rounding daily in one’s institution to not only listen but also to thank working colleagues for their daily efforts.
    After adopting “daily rounding” in the Heart and Vascular Center, I learned what EACH person needed to optimize their day. With this information, I structured my leadership and priorities.
    The result was NOT only better patient care but also better “scores” in every survey internally and externally.
    Thanks for this insightful reflection.

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