Chapter 22: Sister Institutions
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Description
In this Chapter, Dr. Mendelsohn talks the lessons learned by creating two sister institutions, MD Anderson Espana in Madrid (originally a for-profit institution) and Banner Arizona. He explains that it is important to select institutions that have the resources and will to operate in the “MD Anderson way,” and that it is important to visit the locations and spend the time necessary to offer on-site instruction and support. (He notes that the head nurse in leukemia spend three months in Madrid for this purpose.) Dr. Mendelsohn lists the benefits of these inter-institution relationships and explains that an aim is to raise standards at centers that may not originally offer the best quality of care.
Identifier
MendelsohnJ_03_20121017_C22
Publication Date
10-17-2012
City
Houston, Texas
Interview Session
John Mendelsohn, MD, Oral History Interview, October 17, 2012
Topics Covered
The University of Texas MD Anderson Cancer Center - Beyond the InstitutionThe Administrator Institutional Mission and Values MD Anderson Culture Beyond the Institution Building/Transforming the Institution Multi-disciplinary Approaches Professional Practice The Professional at Work
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
John Mendelsohn, MD:
I spent a lot of time in my thinking about building the image and the patient base of MD Anderson beyond Houston and beyond Texas, trying to attract patients from all over the United States and the world. Until 9/11, that was all going very well. Since 9/11, it’s harder to get patients from around the world. They’re going more frequently to Germany and England. I also spent a lot of time visiting cancer centers in other major cities around the world and setting up collaborations in research and sometimes in clinical care, and we began to experiment with putting our name up on cancer centers in other cities. There’s one in Florida that we developed that I inherited. There’s one in Spain that we started right after I came that we learned a lot from; it was painful, but what we learned is now being applied well to a number of collaborations with cancer care institutions, nationally and internationally.
Tacey Ann Rosolowski, PhD:
What was that learning process like, with the center in España?
John Mendelsohn, MD:
You have to learn who to make deals with. One thing we learned in España was you don’t make a deal with anybody unless they’ve got the resources and the commitment to create something. In Spain there was a lot of goodwill, but the people that put up the money initially were in it for profit. We were always short on money, and we were working with people that were trying to find an inexpensive way of getting things done. The current people that have taken over MD Anderson Espana are a large chain. They want this to be a jewel, and they’re putting money into it. In the long run, they’ll make money, but they’re not worried about investing. They have a different view of the investment than the original people we worked with. It was all transparent, but we learned what to look for. We learned how to set up. The faculty, the executive leadership, and I agreed we’re not putting our name up unless we think the care there is really outstanding. For a while, people here said, “This is crazy. They can’t get as good of care there as they can get here.” My point was, well, they can get a lot better care working with us than they got before we were there. We could be raising the bar. We want to be the number 1 cancer center in the world, which is the aspiration that we set up in our vision statement. I think we talked about the vision statement. We purposely said, “We want to be the premier cancer center in the world.” That was a big, hairy goal, and I think we achieved it. Let’s put it: as the premier cancer center in many people’s eyes. In any list of the top 3, we’d be on the list. That wasn’t the case. In order to merit that, you’ve got to have a presence in the world, by working with cancer centers in many states and countries and creating situations where we are contributing to their quality of care. We have a number of cancer delivery partners around the country and a few internationally without our name over the door. We’re giving advice and sharing expertise, and being paid for it. We had to set up rules. One rule we learned is don’t go unless they have the resources to do something that we’d be proud of. Another rule is that they have to agree to do things our way: our quality assurance, organizing around multidisciplinary care, our standards. I think those are the 2 main rules. We’ve learned that it’s much better if you can get people involved that were trained here. In the Spain affiliation, a lot of the people came here, got trained, sometimes for 3 months, sometimes for a year. The hardest thing is you have to go and visit, not just your business and operations experts, but your brain surgeons and your breast oncologists and your radiotherapists. You have to visit there. You don’t have to be there all the time, but in any 2-year period someone from a variety of disciplines has to go and spend a week and see what’s happening, show them what you have learned is right. I remember in Spain, when we got to leukemia, the head nurse in our leukemia program had to spend 3 months in Spain because leukemia patients are very complicated, and they take special knowledge in order to give care so they don’t die from the treatment. That’s the level of commitment you have to make, which means you don’t do a lot of these. We also learned you can’t do a lot of them because you want your people around here to be available to take care of our patients. If they’re in the airplane all the time, we can’t do our thing at home.
Tacey Ann Rosolowski, PhD:
Given the challenges with MD Anderson España, for example, what have been the benefits of that collaboration and relationship?
John Mendelsohn, MD:
Well, there have been very few referrals. There have been very few research accomplishments. If you read our mission statement, it says we want to eliminate cancer in Texas, in the country, in the world. If you read our vision statements, we want to be the premier cancer center in the world. We’ve set up something very special in Spain that we think is justifiably thought of as the best cancer program in Madrid, and that’s a part of our mission. We don’t put our financial resources into these relationships. We’re a public institution, even though the state only counts for 4% of our budget. If we went and spent money to develop a cancer program in another country or another state, we’d be in the newspapers about it. We can justify what we are doing. We’re paid for our time and effort, we’re paid for all we do, but these things we’ve done in Spain and other places, up until now, have not been major business programs. Now, what we’re doing in Banner, and what we’re starting to do now in all of our regional care centers is different. They’re part of a business plan in addition to part of the mission, and they will be margin centers. (We don’t use the word profit.)
Recommended Citation
Mendelsohn, John MD and Rosolowski, Tacey A. PhD, "Chapter 22: Sister Institutions" (2012). Interview Chapters. 1438.
https://openworks.mdanderson.org/mchv_interviewchapters/1438
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Open
