Chapter 01: MD Anderson Presidents: Continuity and Sustained Institutional Growth
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Description
In this Chapter, Dr. Mendelsohn first talks about his predecessors, Drs. R. Lee Clark and Charles LeMaistre. He then discusses the challenges that confronted him when he took over presidency of MD Anderson and reflects on what long presidential tenures have enabled each president to accomplish.
Dr. Mendelsohn describes Dr. Clark as ambitious and anxious to create a special medical institution in Houston, given his understanding of where medical oncology was going. Dr. LeMaistre brought his strength in organizing and leading medical operations at a time when the institution needed a broader management team. Dr. Mendelsohn credits Dr. LeMaistre with expanding MD Anderson’s interactions with the community and setting up a pattern of growth that he would build on during his own presidency.
Dr. Mendelsohn says he came to MD Anderson during a “wonderful time to be president of an academic, medical institution”, because of the country’s economic strength and growing public awareness of the sophisticated measures needed to treat cancer. It was therefore ironic, he notes, that the institution was downsizing and fearful that managed care systems would not cover treatment costs at “specialty hospitals.” He says the MD Anderson faculty realized that cancer could only be pioneered at a place like MD Anderson. He also notes that the retrenchment mentality did not take account of the American public’s willingness to pay for the best treatment.
In the last minutes of this Chapter, Dr. Mendelsohn comments on the long presidential tenures at MD Anderson. Duration, he explains, gave him time to build trust within the institution so growth plans were not top-down. Growth could also go on unperturbed, evolving through a process. He notes that each MD Anderson president was fortunate to have time and resources to develop action plans that could evolve over years.
Identifier
MendelsohnJ_01_20120926_C01
Publication Date
9-26-2012
City
Houston, Texas
Interview Session
John Mendelsohn, MD, Oral History Interview, September 26, 2012
Topics Covered
The University of Texas MD Anderson Cancer Center - OverviewThe Administrator The Leader Personal Reflections on MD Anderson Portraits The Business of MD Anderson The Institution and Finances Joining MD Anderson Fiscal Realities in Healthcare The Healthcare Industry Career and Accomplishments Leadership Professional Practice The Professional at Work The Healthcare Industry
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
I’m Tacey Ann Rosolowski interviewing Dr. Mendelsohn at the University of Texas MD Anderson Cancer Center in Houston, Texas. This interview is being conducted for the Making Cancer History Voices Oral History Project run by the Historical Resources Center at MD Anderson. Dr. Mendelsohn was first interviewed in 2005 by James Olsen and Leslie Brunet. Between 1996 and 2011, Dr. Mendelsohn served as MD Anderson’s 3rd president. He continues to serve the institution as a professor of experimental therapeutics and as director of the Sheikh Halifa bin Zayed Al Nahyan Institute for Personalized Cancer Therapy. I wanted to start off with a general question before I turn to personal background. MD Anderson was founded in 1941, and it has only had 4 presidents. Ronald DePinho is still in the very early phase, just a year into his presidency, and there seems to be an unusual stability in leadership. Could you comment on how that has had an impact on the institution?
John Mendelsohn, MD:
I think the 1st leader, Lee Clark, was an exceptional pick. He was young, he was vigorous, and he was well trained at some of the top institutions in the country and very ambitious to create something special. As I remember, he was the leader of MD Anderson for 28 years. And I’m told that when he began it was a small place, that he kept all the receipts in his desk drawer. He knew everybody on a first-name basis. I think by the time he stepped down, what was needed was a broader management team, which I think Dr. Mickey LeMaistre brought in. Again, Dr. Clark was someone who knew cancer inside out, and the main treatment for cancer when he took his position was surgical. It’s still a very important treatment for cancer, and he was an excellent surgeon, but he also understood where medical oncology and radiation and science were going, and he hired some fabulous people to come here and start up the different programs that linked in with surgery. Dr. LeMaistre’s strength was more in organizing and leading a medical operation. He was not an oncologist, but he knew a lot about cancer. But he’d had a lot of experience running a hospital and running medical programs, and he greatly expanded our interactions with the community. He set up the pattern of growth which we’ve continued both in research and patient care. He stayed as president for 18 years. Now, I was the 1st outsider to be appointed; technically, Lee Clark had to be an outsider. My own interest had been focused all my adult life on taking science and bringing it to the patient. It’s called translational and clinical investigation. I was able to stand on the shoulders of these 2 individuals, and it was a wonderful time to be the president of a major medical academic institution; there was economic prosperity in our country in most of this period, the budget of the National Institutes of Health doubled, and the public awareness of the complexity and the sophistication required to manage cancer increased tremendously, so there was demand for our services. When I walked into this institution in 1996, ironically, there was a downsizing going on, in spite of what I just said. The managed care impetus in this country was taking hold, and there was great concern that specialty hospitals like a cancer hospital wouldn’t be getting patients. They would all go into managed care operations that would control their destinies. We had very strong advice from at least 2 different consultants with large notebooks of information in them suggesting that we cut back from about 450 beds to 250 beds and reduced our scope. To me and to the faculty, this didn’t make sense. We knew where cancer was going. We knew about the exciting developments that were occurring. We knew that this couldn’t be led and pioneered in an average hospital. It had to be pioneered in a place that had the kind of assets that MD Anderson had, a large faculty with protected time to do research and a total commitment to the very best standard of care. After a series of meetings with faculty and with the Board of Visitors and the regents, we decided to ignore these consultants and to take advantage of the demand for our services and to grow, and we didn’t stop.
Tacey Ann Rosolowski, PhD:
Did you feel that the management team that was giving you that advice was erring on the side of caution, because they didn’t understand the science or where the science was going? What was the reason for their advice?
John Mendelsohn, MD:
I really can’t say. Like today, there was a lot of uproar in this country about how healthcare should be handled, and managed care was the big buzzword then in 1993. There were large insurance plans that were enrolling doctors and enrolling patients and setting controls and limits. It’s a good thing to remember today as we go through a similar exercise. What wasn’t realized is the American public, when they get a disease like cancer, want to go to the best, and they’re willing to pay and co-pay, and they pushed these plans to allow for access to MD Anderson. They had to pay a little more to do that, but there were enough people that wanted that. This fear that everybody would be locked into a plan and go to their hospital because their plan was going to legislate that was not well founded, because it wasn’t accepted. That’s my explanation for it.
Tacey Ann Rosolowski, PhD:
Is there anything more you’d like to say about that now before we turn to more general background issues or this particular issue of the stability of leadership? You were here for 15 years, and you had your vision. What did that stability allow you to achieve?
John Mendelsohn, MD:
When you take over leadership of an organization this size, it takes a year or so to figure out what makes it special and where to grow and to enlist the trust and the vision and the counsel of the people here so that when you plan growth, it’s not a top-down thing. It’s an institution planning its growth, and I spent a lot of time doing that. There was a period of over a decade when growth went on just in a phenomenally unperturbed way, again, because of some of these circumstances, like the demand and the excellent state of the economy and the availability of research grants from the government plus tremendous philanthropy from the community in Texas. That all takes time, and I think the institution was fortunate. I don’t think it was planned that we’d only have 3 presidents in our first 70 years, but the institution was fortunate that each president had the energy and the ambition, had the teamwork of the people with whom they were working at MD Anderson and could develop action plans that didn’t have to be executed in a few years. They could have a 5- and 10-year span. When you build a new building, it takes 4 years. You decide you want to expand something; you can’t do it tomorrow. We doubled the size of our patient base, so we had to have twice as many doctors and twice as many nurses and twice as many X-ray machines. You’ve got to design the plans to accommodate, recruit, and put in place all those people. That takes time.
Tacey Ann Rosolowski, PhD:
The early leaders of MD Anderson certainly were smart to buy as much space.
John Mendelsohn, MD:
We’re blessed with access to space, and we really used it the past 15 years.
Tacey Ann Rosolowski, PhD:
I’d like to turn now to some questions about personal background. I wanted to do this from the perspective of looking at your own mission of institution building. As I was reading background, it began to strike me that you almost approach cancer research and leadership in a cancer institute as a public service. Am I on track with that at all?
John Mendelsohn, MD:
That’s an interesting way to put it. I think you are on track. I think everybody has different goals in life and different things that they do that give them satisfaction. I certainly enjoy science, and I certainly enjoy working one-on-one with people as a physician. Equally exciting to me is the opportunity to create new programs and take a vision and put it into practice. I’ve had opportunities now 3 different times in my life to do that, so I’ve been very fortunate.
Recommended Citation
Mendelsohn, John MD and Rosolowski, Tacey A. PhD, "Chapter 01: MD Anderson Presidents: Continuity and Sustained Institutional Growth" (2012). Interview Chapters. 1417.
https://openworks.mdanderson.org/mchv_interviewchapters/1417
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