Chapter 16: Preserving the MD Anderson Brand Despite Global Growth
Files
Description
In this chapter, Dr. Hill discusses financial challenges that MD Anderson currently faces: challenges in expanding the MD Anderson culture beyond Houston while preserving the culture of care; competition between service providers. He also speaks about the new president, Dr. Ronald DePinho –what he appears to offer and also his lack of experience in the operation of clinical services.
Identifier
HillCS_03_20120220_C016
Publication Date
2-20-2012
City
Houston, Texas
Interview Session
C. Stratton Hill, MD, Oral History Interview, February 20, 2012
Topics Covered
The University of Texas MD Anderson Cancer Center - Institutional Change; Beyond the Institution; MD Anderson Culture; Building/Transforming the Institution; Growth and/or Change; The Business of MD Anderson; The MD Anderson Brand, Reputation; Portraits
Transcript
Tacey Ann Rosolowski, PhD:
I was going to ask you a related question about that because certainly under Dr. Mendelsohn there’s this move toward global oncology and just the expansion of MD Anderson through outposts. I was wondering what your view of that was and what happens to standard of care with growth and if an institution like MD Anderson can become too large.
C. Stratton Hill, MD:
Well, I think that’s a good question. The model is not confined to MD Anderson. The Cleveland Clinic has operations in Fort Lauderdale. The Mayo Clinic has it in Jacksonville, Florida, and Scottsdale, Arizona, and I think maybe other places now. And other clinics have metastasized to different places. I don’t know how people feel about that at the local level. In other words, “Oh, yeah, I’m going to MD Anderson, but I’m in Madrid, Spain.” The culture has a lot to do with it, and so I don’t think that changes the culture at all. You can have standards that you meet, but whether or not you have the warm and fuzzies, let’s say, I don’t know. I doubt that, depending on the culture that you’re in. I know that, for instance, I gave a talk in Jacksonville one time, and I had to give two talks. One was for the Mayo Clinic people, and the other was the non-Mayo Clinic people, and never the twain shall meet. Well, what they had was they had a hospital that was down there that was not doing well. When the Mayo Clinic moved in there, they said, “Hey, we’ve got a hospital here for you. You want to run it?” “We’ll run it, but you staff it.” That’s the way they do up in Rochester, so they said, “Sure, we will.” The local docs then say, “Hey, we don’t like this competition,” so you get that. I’ve had that happen up here in Lufkin, Texas, where a group of doctors don’t speak to the other group of doctors in the same town in Lufkin, Texas.
Tacey Ann Rosolowski, PhD:
And it’s all about competition for a limited pool of patients.
C. Stratton Hill, MD:
Yeah, it is, and UTMB has that big time now because Galveston—the population in Galveston is 65,000 and the state gives them very little money. When I interned there, we would go down and get a list of cases that people were referring in from all over the state. That was practically the only state hospital that took charity patients at that time. Now they practically don’t take any charity patients because the state doesn’t pay for it, and so they’ve got to get out and scrounge up patients for their doctors, their teaching doctors, to make money so they can compete to bring in people like that. You have that part of it. The other part, as I see it, is just the culture. I don’t know whether the people who, say, go to the Mayo Clinic in Scottsdale, Arizona, feel the same way if they went to the Mayo Clinic in Rochester, New York, or not, the top clinic or something like that. I think it’s good. If you don’t have some control over the quality of the product, then you’re going to have a problem because your reputation is going down. Now, they’ve had one, an Anderson in Orlando, Florida, for a long time, and as far as I know, that’s doing okay. But again, it’s just competition. The local docs are going to say, “We can do anything they can do.” And that’s true. That person may be able to do it, but whether or not they can do the coordinated thing— I’ve got to tell everybody that’s coming— I say, “Look, the only real advantage of a specialty hospital is that we’re going to do all of it. We’re going to do the surgery, radiation, chemotherapy, biological modifiers, immunotherapy or anything, and we’ve got control of all of that.” The surgeon may be the greatest surgeon in the world over here, but he knows his friend is in radiotherapy, and he’s not too good, but he’s his friend, so he’s going to say, “Yeah, go over there to Dr. Smith to get radiation therapy.” He convinces himself it’s okay because he’ll get just as good as he would anywhere else or something like that. There are a lot of factors that go into that. I don’t think it detracts from the quality at Anderson per se, but it’s a question of how much control they may have over the various disciplines that are needed to treat that person.
Tacey Ann Rosolowski, PhD:
I was curious, looking ahead. MD Anderson now has a new president, and what are your observations? I know you’re no longer there as you’re retired, so your relationship is not quite as direct as it was, but what are your observations about Dr. [Ronald] DePinho?
C. Stratton Hill, MD:
Well, the only time I’ve ever seen him was when he threw the baseball out at the baseball game. That’s all. I have only the opinion of one of my colleagues, Dick Wainerdi, who runs the whole Texas Medical Center. He’s high on Dr. DePinho, and he thinks he’s going to be great. The only thing that makes me have any kind of questions is the fact that he doesn’t have a lot of experience in the operational clinical side, but that’s no judgment on whether or not he’s going to emphasize the basic science over the clinical. You’re concerned that that might get the bigger piece of pie as opposed to the clinical. However, from what I hear from him is that he understands that he doesn’t have that bit, shall we say, but he wants to not let that slip. I think he’s smart enough, from what I hear, if he just looks at the bottom line to see where most of the money comes from. You’re generating 65, 75, 85 percent of your revenue for operations from clinical stuff that you better pay good attention to that, and I think he will. I just think from what I’ve heard about him that he’ll do that, and that’s just a matter of organizational skills. He can come in there and say, “These are the parameters we’re going to be looking at, and I’m going to put you in charge of it, and we’ll look at that.” And too, one of the things that happens in academia is that you have auditors by your peers, and depending on how those peers are selected, you could possibly say, “I’m going to get Joe Dokes over here,” and he’s your buddy. He’s going to come in and say, “Oh, he runs this place just great.” But on the other hand, most of the time it’s not that, and so you have people who look at your program, and I think that management consultants, Anderson has matured enough that they do that. They’ve got the budget and funds to continue to do that. When I first came there, we had to shut parts of the hospital down because we didn’t have enough money to operate.
Tacey Ann Rosolowski, PhD:
I didn’t know that.
C. Stratton Hill, MD:
Yeah, we’d have to close—at the end of the fiscal year—close down a few floors because we didn’t have enough money to pay everybody, and that didn’t last long, but it did that.
Tacey Ann Rosolowski, PhD:
Not in that position anymore.
C. Stratton Hill, MD:
Not in that position anymore, and then, too, there’s no question but that Anderson is on the map in terms of just about anywhere. I just saw, two or three days ago, an article by Andy von Eschenbach in the Wall Street Journal about the FDA. He was commissioner of the FDA, but he was head of the National Cancer Institute before that. He operated on me. I had prostate cancer, so he operated on me 15 years ago. Everybody knows he comes from MD Anderson, and so there’s a lot of difference than what it used to be.
Recommended Citation
Hill, C. Stratton Jr. MD and Rosolowski, Tacey A. PhD, "Chapter 16: Preserving the MD Anderson Brand Despite Global Growth" (2012). Interview Chapters. 1055.
https://openworks.mdanderson.org/mchv_interviewchapters/1055
Conditions Governing Access
Open