Chapter 17: MD Anderson and the Texas Medical Center
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Description
In this Chapter, Dr. Mendelsohn clarifies the relationship between MD Anderson and the Texas Medical Center, beginning with a brief sketch of the history of the TMC. He points out that the TMC is run by a not-for-profit board that controls the use of land originally donated by George Hermann. Some MD Anderson land is leased from the TMC. Dr. Mendelsohn reviews the regulations for use of the land and lists the institutions within its limits, noting that it is a mixture of groups related to care delivery. Dr. Mendelsohn explains that he met with the leadership of the TMC fifteen years ago to create more collaboration between the institutions within the TMC, raising its profile as the largest medical center in the world. He offers an example of collaboration between neurosurgery at Baylor and MD Anderson (for five years the two institutions have shared a chair of neurosurgery) and explains the advantages of collaboration.
Identifier
MendelsohnJ_03_20121017_C17
Publication Date
10-17-2012
City
Houston, Texas
Interview Session
John Mendelsohn, MD, Oral History Interview, October 17, 2012
Topics Covered
The Interview Subject's Story - OverviewMD Anderson History Institutional Processes Beyond the Institution Building/Transforming the Institution Multi-disciplinary Approaches
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:
We were talking about the way a lot of people are confused or mystified about the relationship between MD Anderson and the Texas Medical Center, the Health Science Center, and the Graduate School of Biomedical Sciences. Can you demystify that a bit and talk about what comes up in decision making at MD Anderson, taking into account its relationship with those other institutions?
John Mendelsohn, MD:
The Texas Medical Center was formed when the land was deeded to the city by Mr. Hermann, and probably a little additional land, to create a medical center. It is an organization that is run by a private, non-for-profit, self-perpetuating board. It hires a president, and the president has a staff. The enabling documents that set it up created it in order to parcel out the land and control the use of the land, and really that’s what it does. So the land we’re on is rented from the Texas Medical Center, as I understand it. There’s a covenant that there’s nothing for profit that can be in the Texas Medical Center. When St. Luke’s Hospital, 10 years ago, thought of selling itself to a for-profit hospital chain, it was stopped by the Texas Medical Center, so they enforced their covenant. The roads and the garages are all under their purview, and every time you want to build a new building, first of all, you have to get the land. Second of all, you have to go through a rigorous review by a subcommittee of the board of the Texas Medical Center, which is assuring standards and assuring compliance. The Texas Medical Center has not, as an entity, spent much of its time during the past 15 years developing programs. It’s proud that there are an incredible number of institutions that are excellent that are part of it. Methodist Hospital, Hermann Memorial, St. Luke’s, ourselves, and Children’s are all run by independent boards, all competing and collaborating on our own terms, with the Texas Medical Center not taking a part in that. Then there are 5 universities. There’s Baylor College of Medicine, MD Anderson and the Health Science Center, both branches of University of Texas, Rice University, and a pharmacy school here that’s a part of the University of Houston. There was a center on ethics. I don’t know if it’s still here. So it’s a wonderful mixture of groups that are relevant to medical care delivery, and it’s not just doctors. The Texas Medical Center is the umbrella. Now, about 15 years ago, when MD Anderson was planning growth, we had a hotel, the Rotary House, across Holcombe, not on Texas Medical Center property, and the School of Public Health of the University of Texas Health Science Center also had a building across south of Holcombe, which is not part of the Texas Medical Center. We began to build on property south of Holcombe, which technically is not part of the Texas Medical Center, and then we started building mid-campus. I have to take that back. It’s possible that the area between Holcombe Boulevard and Brays Bayou is part of Texas Medical Center, so that has to be checked. But then we started building south of Brays Bayou, and we started building on the south campus, which is land that is owned by the University of Texas. The Texas Medical Center has no jurisdiction over those lands. For a while, their attitude was very much hands-off. That’s your business. I think lately they’re becoming interested in trying to be a coordinator.
Tacey Ann Rosolowski, PhD:
Are you friends with the University of Texas or Texas Medical Center?
John Mendelsohn, MD:
The Texas Medical Center also has interactions with 2 other entities: the DeBakey VA Hospital, which is on Federal Government land, and a mental hospital that’s about 2 miles from here. I’m not sure how that relationship works. At one point in my tenure as president of MD Anderson, I met with the leadership of the Texas Medical Center to encourage them to get involved in building more collaborative programs. Dr. Wainerdi has spoken about that. He has just retired. He was president of the Texas Medical Center for over 2 decades. Formal collaborations never became substantive, and it became too complicated. There is a lot of collaboration, organized around specific objectives or specific research scientists’ interests.
Tacey Ann Rosolowski, PhD:
What would be the advantage be of having Texas Medical Center take on more of that role?
John Mendelsohn, MD:
One advantage is that we’re the biggest medical center in the world, and people outside of Texas don’t know about us. A TMC role could be in branding and advertising. We’re all looking for patients. I think it hasn’t happened, because we’re all pretty busy, so we’re not worried about that. If it ever became important, if there was so much competition that we were anxious to attract patients, it might be that we work closer together. If all these different entities were aggressively advertising, it gets kind of complicated. If you might put it together and say this is the world’s largest medical center, you have specialists that are in the top 10 in heart and the top 10 in cancer and the top 10 in everything under 1 group of roofs, and we collaborate. But I think this is unlikely and unworkable. There have been discussions that Dr. Wainerdi has brought up about privileges crisscrossing. A number of our doctors can operate at St. Luke’s and can operate at Methodist. Over the years, I think this has gone up and down. It’s not a big part of our program or anyone else’s, but in our gynecology program we have a very strong relationship with St. Luke’s. We tried to develop a strong relationship with Texas Children’s, and it didn’t work. They were not interested, so we developed our own pediatric intensive care unit and built in some specialists to take care of the general pediatric problems of our young patients.
Tacey Ann Rosolowski, PhD:
Why do you think Children’s wasn’t interested at that time?
John Mendelsohn, MD:
You’d have to ask them. It was probably partly competition and partly internal issues. Maybe they were busy doing their thing and didn’t want to overextend. There was talk at one point of building a joint children’s hospital for cancer. It got pretty detailed. We also had talks at one point with Hermann Memorial, about having a joint children’s program. Our program remains independent.
Tacey Ann Rosolowski, PhD:
That struck my ear because when I was talking to George Stancel, he expressed the really strong opinion that given shrinking resources everywhere and the need to use everything more efficiently, that those inter-institutional collaborations can really help people leverage what they have very effectively.
John Mendelsohn, MD:
It could, and if we joined with Texas Children’s, it would be the largest children’s cancer program in the country. Right now, St. Jude’s is the largest children’s cancer program. Bigness isn’t always the best. Now, Anderson has a lot of relationships. I got a phone call from Peter Traber, who was the President/CEO of Baylor a few years ago, when Baylor was in the midst of breaking its relationship with Methodist. He needed a new head of neurosurgery. He did not have the resources to build a neurosurgery program, so he asked if he could meet with Ray Sawaya, who is the head of our neurosurgery program. I met with Ray Sawaya, and we talked it over. Ray thought that there would be advantages having a joint program because Baylor includes both Texas Children’s and what would have been Methodist and the program at Ben Taub. If physicians training in neurosurgery came to MD Anderson, they would only see cancer, but if they were in a big program, they’d see vascular disease and other types of neurosurgical problems. For at least the last 5 years, he’s been the chairman of neurosurgery, both at Baylor and here, and they pay 49% of his salary. I told him, as long as it’s advantageous to your program and MD Anderson, it’s great. I’m willing, and I think Ron DePinho is willing to consider individual collaborative efforts where there is a win-win situation. The Children’s thing could pop up again. Texas Children’s is in an even stronger position now, I think, than it was 5 years ago. They’ve done a terrific job of building. They can’t possibly have the cancer research resources available for their patients that we have. They’re a complete hospital. I think there would be advantages to them. They have tremendous expertise in taking care of very young kids. There are children that are half a year old that get cancer, and they have special needs. I can see where we could help each other, and it might come up again.
Recommended Citation
Mendelsohn, John MD and Rosolowski, Tacey A. PhD, "Chapter 17: MD Anderson and the Texas Medical Center" (2012). Interview Chapters. 1433.
https://openworks.mdanderson.org/mchv_interviewchapters/1433
Conditions Governing Access
Open
