Pisters Out. Was It Something I Said?
By
Leonard Zwelling
Most of my readers have seen this article from the front page of the Houston Chronicle on August 27 or read the emails from the UT Chancellor or from President Pisters himself about the Pisters retirement. Forget about the PR bull for a moment. The facts seem to be that a CEO in his ninth year of leadership of the number one place for cancer care in the country and who was budgeted for a 30% raise on a $3.9 million salary is voluntarily retiring from the best job in all of oncology and doing so after having raised almost all of the money he pledged to raise. Yet he gets to see none of the buildings he planned to erect. If you believe that, I have a bridge for you to buy.
Let’s go back just a bit before we speculate on what happens next.
I have been privileged to know all of the five presidents of MD Anderson except the first, R. Lee Clark. Each was different in style, knowledge, vision, and qualifications. Some were egosyntonic with the job (it fit their personality). Some definitely were not.
When I got to Anderson in 1984, Dr. LeMaistre was our leader. He personally interviewed me during my recruitment visit. He took a genuine interest in my career. He was the president when I first became an Associate VP and he took me with him to Austin to explain to the leaders there what had happened that brought the FDA down on our heads and how we extricated ourselves from the difficulty.
Dr. LeMaistre knew everyone at UT headquarters from the board room to attendants in the parking garages. He had been the UT Chancellor before his Anderson presidency. He was quite simply the most adept politician I have ever known, and that includes many U.S. Senators. His qualifications for the Anderson job were his vast experience and knowledge from his years in Austin. He also exuded great grace. His major contribution was raising the importance of cancer prevention and making it a formal part of the cancer center’s mission. Mickey was a great president. I adored him.
John Mendelsohn was next. He has got to be the most qualified person to ever hold the job. He was a board-certified internist, oncologist, and hematologist. He started a cancer center in San Diego. He was Chief of Medicine at Sloan-Kettering. He was a real lab investigator and had developed a treatment for cancer. John was the real deal when he started in 1996.
His first five years were magical. He did everything right. He hired great people in the clinic and the lab. He improved the financial system. Lab research got better. He went out of his way to meet with the faculty and listened carefully to what the faculty told him they needed. And he responded by fulfilling those needs. He did, indeed, raise the bar for research at Anderson.
Unfortunately, he had significant flaws in judgment when it came to people and money. He got in bed with the board members of Enron and was on Enron’s board when the company collapsed. He went into business with a man who would become a felon who led the company that developed his drug. Finally, he abused his position at Anderson by promoting the performance of the clinical trials with his drug overseen by faculty who reported to him (could they really be dispassionate research investigators or trying to please the boss by making his drug look good?) and enrolling patients who had no idea that their participation could enrich him and his fellow ImClone board members.
He survived the scandal for another ten or so years, but he was never the same. Lawyers protected him personally and he gave the keys to the kingdom to other lawyers, a move from which Anderson has yet to recover. Then, all of a sudden, he stepped down without a good explanation suggesting it was not voluntary.
Ron DePinho was next. He did not have the qualifications to run a major cancer center. He had run a research institute in Boston. He was not an oncologist, but a world-class basic scientist who never really understood that MD Anderson, above all else, is a patient care facility. He had contempt for the Anderson faculty and made outrageous promises about altering the natural history of cancer by developing new drugs that would enrich the UT System and undoubtedly himself and his family.
He and his scientist wife, who turned her nose up at the faculty while purchasing expensive furniture for her office, lasted only 6 years. Admiral McRaven saw to that.
Then came the current president Peter Pisters, a former Anderson faculty member who came back from his native Canada where he ran the University of Health Network of Toronto. I believe that his major qualification for the Anderson job in 2017 was that he was the not Ron DePinho.
I have written many, many times of how bad a choice Pisters was. I met with him several times at the beginning of his tenure at his request trying to advise him on the matters of importance to the faculty. Chief among my suggestions was to get a member of the National Academy of Sciences as the leader of research, something John Mendelsohn had unsuccessfully tried to do. Instead, Pisters appointed a Ron DePinho holdover to the job and surrounded himself with a glut of unqualified executives. He also could not distinguish between the faculty and the rest of the 22,000 or so employees. Sorry Peter. There is not “ONE MD Anderson.” There’s the faculty who actually produce the work and money you build buildings with and everyone else, many of whom work from home.
I am quite certain, at our very first meeting for breakfast at Adair’s on Westheimer, I told him the two greatest assets of MD Anderson are its name and its faculty. I don’t think he ever believed that. His contempt for the faculty, especially the Faculty Senate, was palpable. He would not even go before the assembled faculty and answer questions without having them submitted beforehand. Put simply, he was not ready for prime time.
Now, according to today’s Houston Chronicle, in his ninth year, with a pending 30% salary increase, he is going to retire. Put simply, no one retires from the best job in cancer at age 66 voluntarily, especially after raising over $2 billion.
I believe there are three explanations possible:
His contract was not renewed for some reason.
He has a serious illness.
Someone close to the Texas governmental leadership wants the job and Governor Abbot is going to see that he/she gets it.
Time will sort this all out.
Looking forward, it is the hope of this blog that a professional search firm is engaged by the Board of Regents immediately since it will take 6 to 12 months to find Pisters’ successor. There are many on campus who would like the job, but there are better candidates around the country than those who will vie for it from within.
The ideal candidate would be a physician-scientist who is a real oncologist and a world-recognized investigator, clinical or basic. That person should have leadership experience running a large and successful organization, preferably an NCI-designated comprehensive cancer center. The person needs to have an international reputation for excellence and actually be good at identifying, hiring, and nurturing new faculty leaders and young faculty while being able to speak to all the employees, something Dr. LeMaistre mastered.
Finally, I would like to make a plea that serious consideration be given to having several women as candidates for the Anderson presidency. Anderson has had 25 years of destructive, ethically compromised, or down right greedy male leadership. I am not saying that women cannot embody these traits. It’s just less likely.
Finally, for goodness sakes, send someone to the current job site of any candidate being seriously considered and ask the faculty and staff there about what those people think of the proposed candidate. That small gesture might have spared the institution the misguided leadership of the past 15 years.
Despite the lousy executive leadership this century, Anderson has maintained its leadership role in cancer care. Today it has another opportunity to identify a visionary leader who understands the wise application of AI technology, the need for close working relationships with the pharmaceutical industry, the ongoing requirement for basic science excellence, and the continued value of cancer prevention, risk analysis, and population screening. It would also be helpful if the new president can answer questions spontaneously in front of the entire faculty and reconstitute something like the Faculty Senate to the extent the rules of the Texas legislature allow. A new era of true shared governance would be welcomed by one and all.
I know such a person exists. What I am less sure of is the wisdom of the current Board of Regents to initiate a process devoid of Texas politics that truly finds the best person for the job.
Hope is not a strategy. Nonetheless, I hope the process to find a new president starts immediately and that it is truly a process seeking excellence in all spheres of cancer center leadership and someone who will be a model for ethical conduct. It’s been a long 25 years of poor leadership. It’s time for a change of direction.
