Vision, Plan, Means, Will

Vision, Plan, Means, Will

By

Leonard Zwelling

Many years ago, then-MD Anderson president John Mendelsohn’s wife Ann won a silent auction at a charity event. Her prize was a day-long leadership training program for three. At that time, I had become the media spokesperson for the institution after a great deal of coaching from the great Steve Stuyck, our Vice President of Public Relations. Nonetheless, everyone can use more coaching, so John, Ann, and I were the students that Saturday in the president’s conference room on the eleventh floor.

Early in the training, the coach told us what every leader needs to say when addressing those he or she leads.

I have a vision for what we can be.

I have a plan to get us there.

It will not be easy.

It will be worth it when we get there.

Vision, plan, means, will.

I have thought a great deal about this sage advice, particularly of late when the leadership I see around me both close to home and in the larger world seems so inadequate, undecided, and undetermined. No vision, no plans, no will despite a wealth of means.

I have examined whether the past and current leaders of MD Anderson followed these four tenets when they were in the leadership position.

R. Lee Clark surely had a vision. That vision was MD Anderson itself, a free- standing cancer center at the edge of Houston. He had a clear plan, he had the means by recruiting the state of Texas into his vision, and no one had more will than Dr. Clark. He recruited many visionaries like himself—Frei, Freireich, Bodey, and hundreds of others. They turned his vision into the reality of the Pink Palace to which the world flocked when no one else would care for patients with malignancies. Dr. Clark epitomized the four points of leadership.

Dr. LeMaistre had already proven his capabilities when he was tapped to run Anderson. He had been the Chancellor of the University of Texas. He also had a unique vision that probably had its origins in his service on the federal committee that conclusively linked tobacco use to cancer. He wanted to prevent cancer and he devised a whole new department, Cancer Prevention and Control headed by Guy Newell. This became a division headed by Bernard Levin later and now has a prominent role in MD Anderson’s mission. Dr. LeMaistre institutionalized his vision of cancer prevention.

Dr. Mendelsohn also had a very distinct and different vision. Although Dr. LeMaistre, with the help of Vice President of Research Fred Becker, began to improve the quality of MD Anderson science, it was Dr. Mendelsohn who institutionalized scientific excellence during his tenure using the phrases “research-driven patient care” and “raising the bar.” As a physician-scientist himself, Mendelsohn was able to institutionalize the MD-investigator as the norm at MD Anderson by exemplifying the expectation that it was only through research at the bench and at the bedside that cancer could be conquered. He, too, had a vision and plan. He used the ever-growing resources of greater patient care revenues to make that vision real. Vision, plan, means, will.

Unfortunately, you need to have all four components to be a success. Ron DePinho certainly had a vision and a plan. That’s the good news. Alas, his vision of curing five cancers was ridiculous and his plan was to horde all the means for himself and those he recruited leaving the excellence created by his predecessors behind scraping for space, slots, and money. And when it came to money, DePinho used most of it on himself, his wife, and their cohort. This was not a route to success and after six years, Chancellor McRaven had had enough.

The current president, Peter Pisters, seems to have no vision at all beyond developing the means by turning philanthropy into concrete. He wants MD Anderson everywhere, even Austin. Those in the Legislature and Michael Dell will provide the means as has recently been reported. Perhaps Mr. Dell’s vision of an AI-driven medical campus in Austin will be enough to carry MD Anderson into the future, but despite the fact that MD Anderson is sitting on a gold mine of data, I see no evidence of its using AI to put that data into use helping patients as is happening at other institutions like Duke as Genie and I heard at a recent set of meetings in the Houston area led by the Duke Dean Mary Klotman. To be succinct, the only vision I see Dr. Pisters as having is that of piles of money in his own bank account.

If the UT Board of Regents had any vision, they would identify a cancer visionary to lead MD Anderson and do that tomorrow. Dr. Pisters is not that person. There is nothing in his background that would suggest he understands the future of patient care, research, education, or prevention adequately to elucidate such a vision or design such a plan. No matter how large he expands the institution, it still seems to be stuck in today and that is no place to be for a cancer center.

MD Anderson has had some truly visionary leaders. I served under two of them. It needs another. Now. With a plan, with the means, and with the will, but first, what’s the vision?