Is MD Anderson In Austin A Good Idea?
On August 14, at a star-studded press conference, the UT System announced the construction of two hospitals on the UT Austin campus to be associated with the UT Medical School in Austin. One of those hospitals will be the first free-standing, MD Anderson location outside of Houston that is not a product of buying an existing entity (e.g., Orlando, Banner, San Diego, the HALs, etc.) Dr. Pisters claims that the care and the research will be just like that at 1515 Holcombe as will be the faculty. So, the real question is, can the care, the prevention, the research, and the teaching at the mother ship be exported to Austin? Can MD Anderson be franchised?
This question has been around for years as various presidents from Dr. LeMaistre on have tried to find a way to increase a revenue stream for the cancer center by explanting what is unique in all the world from Houston to somewhere else. Can it really be done? When I was involved in these discussions, I thought then, and I think now that the answer is no. Can one build a good cancer care delivery system in Austin? Sure. Will it be what took 80 years to develop in the Texas Medical Center? No way. Why?
First, Let’s start with the most important element, the faculty.
No one will want to be a faculty member in Austin if they are good enough to be a faculty member in Houston unless they have an overwhelming desire to live in the Texas capital. Maybe they are married to a country singer.
Second, clinical trials are not easily exportable to sites without deep infrastructure to support the trials which I have grave doubts can be done at a distance. When I was the one overseeing clinical research infrastructure, I was very reluctant to use our IRB and clinical research committee to oversee research not being done at 1515. I was always worried that something would go wrong out there and we would not be able to answer to the federal authorities as to why the mistake occurred. It was hard enough herding mountain lions at the main campus. Keeping an eye on compliance at a distance was more than I was willing to take on.
Now perhaps the practice that has been obtained at LBJ may serve the clinical trials infrastructure well if it has to watch over Austin. Far more likely will be the need for Austin to have its own IRB and infrastructure which is costly, but not impossible. It will take a true believer to man or woman the helm of that ship.
Finally, there is something unique about 1515 Holcombe. The ability to care for cancer patients with great efficiency due to consummate skill and an unequalled degree of specialization will not be easy to reproduce in Austin.
I am not saying that it can’t be done. If MD Anderson was built once, it can be built again, but assuming the new locale will be the same as the established one when it opens sounds like a little pie in the sky to me. Now I doubt that Dr. Pisters had a choice as to whether or not he would agree to this plan. My guess is that the political pressure in Austin to have its own MD Anderson was intense. After all, the members of the legislature and their families would like their cancer care to be more convenient and Austin is surely a growing market.
It will be many years before the first cancer patient is seen at MD Anderson Austin, but the question remains. Can a facility unique in all the world for its best-in-class patient care and huge clinical trial portfolio really be cloned 150 miles away? I may not live long enough to know the answer, but it’s a real big ($2.5 B) gamble and one that MD Anderson has never really been able to do thus far on a far smaller scale.
I give Dr. Pisters a lot of credit whether or not he had a choice in the matter or not. He took on the challenge with a smile. Maybe he’s smiling because the time lines are so long this may not be his problem in the end.
Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:
on amazon if you search using the title and subtitle,
directly from the publisher Dorrance at: https://bookstore.dorrancepublishing.com/conflict-of-interest-money-drives-medicine-and-people-die-pb/m