Chapter 11: Financing the Moon Shots Program and Changes to MD Anderson Structure

Chapter 11: Financing the Moon Shots Program and Changes to MD Anderson Structure

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Description

Dr. Leach begins with general comments on Dr. Ronald DePinho’s Moon Shots Program –a speculative and expensive initiative, he says, designed to move the bar. He notes his belief that the most exciting developments in cancer will be coming in the next four to five years.

Dr. Leach then explains that, with the complexity of research today, a new framework is needed to think about conflict of interest. He then notes that the Moon Shots will reorganize all of MD Anderson, moving the institution to more efficient structures that free faculty members’ time so they focus on what they do best.

Identifier

LeachL_02_20121127_ C11

Publication Date

11-27-2012

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - MDACC in the Future; The Administrator; Building/Transforming the Institution; Multi-disciplinary Approaches; Business of Research; Healing, Hope, and the Promise of Research; On Research and Researchers; Philanthropy, Fundraising, Donations, Volunteers; Understanding the Institution; Ethics

Transcript

Tacey Ann Rosolowski, PhD:

Tell me a bit now about the Moon Shots and how that whole balance of research and funding is going to work with these huge initiatives. Leon Leach, MBA, PhD Well, I think we’re in the process of modeling it out now, so anything I tell you at this point is more speculation than it is history. So I just want to be clear about that. The history of this is Ron [Ronald DePinho, MD] getting together our scientists and saying, “If we focus our efforts, where could we truly move the bar getting us back to moving the bar and making that difference? And we identified several opportunities where we thought—or the MD Anderson scientists think—that there is enough in place that with enough focus, we could reduce a disease to something that is manageable over a reasonable amount of time. So if we put the money into doing that—focus translates into dollars—and it could be pretty expensive to do that. We’re talking 3 billion dollars over I think a ten-year period, or a six-year period—I think it was a six-year period. But part of it is, if we commit to Moon Shots in various disease areas, as the world starts learning about what we’re doing, we’re going to have more and more people with those diseases that want to come here, because if we’re making that effort to push this disease into the manageable category and you’ve got that disease, what better place would there be to go to?

Tacey Ann Rosolowski, PhD:

Right.

Leon Leach, MBA, PhD :

So I think some of the funding will come from people coming here from not only Texas but the nation and the world, and I think that will help with some of the funding. But I think the initial funding is going to come from philanthropy, people who are excited about what we’re doing, and different grants and contracts we may be able to obtain with industry, and I think some of it will be from our own reserves just to get it up and kick-started, but I think it will over time. And like I said, we are in the process of modeling that out now, what does that look like? But over time, I think it will be self-sustaining as more people come in for care for those particular types of cancers where we’ve made progress.

Tacey Ann Rosolowski, PhD:

Let me just read them for the record—acute myeloid leukemia, myelodysplastic syndrome, chronic lymphocytic leukemia, melanoma, lung cancer, prostate cancer, the type of breast cancer known as triple negative, and ovarian cancer. So that’s quite the list. In terms of the modeling, what can you tell me about what that looks like in terms of needs for new faculty, buildings—what is it looking like? Is there more growth that we’re looking at?

Leon Leach, MBA, PhD :

Well, there is certainly going to be more growth. You can’t do this without growing. We’re using the Economic Forecasting Model that I just described. It’s flexible enough that we can plug in different components, if you will, different modules for the different Moon Shots. I could only speculate at this point. We haven’t presented it to the Executive Committee. I have seen it. It is very much a work in progress, and I’d rather not speculate. But I can tell you that it does need more growth—that’s clear.

Tacey Ann Rosolowski, PhD:

Does that just jazz you?

Leon Leach, MBA, PhD :

Well yeah, and there’s a lot of things that have me jazzed because, in the years I’ve worked in healthcare, the most exciting years are going to be the next probably four or five because of what’s happening environmentally. We’ve got incredible pressures and changes that are happening environmentally. Then because of our strategy, the Moon Shots, we’ve got a chance to cure—cure is a big word—but we’ve got a chance to reduce some cancers to a lesser stage of disease to something that is manageable. We’re probably the only folks on the face of the planet that can bring all those things together to make that happen. And we can’t do it singularly. We’re going to have to enlist others in this crusade. So it’s a very exciting time. I don’t see in my crystal ball anything more exciting or a more exciting place to be. But it’s going to be exciting, and it’s going to be a bit tumultuous because we are going to have to deal with the external environment while we’re trying to cure cancer here in a bubble.

Tacey Ann Rosolowski, PhD:

Are there some internal challenges that you foresee as well instituting— Leon Leach, MBA, PhD Oh absolutely. It gets back to academic medical centers are not, by their nature, nimble creatures. Forgetting about the Moon Shots and just looking at the external pressures, that’s going to force us to be much more nimble, and that’s not a natural thing in academic medical centers. Add in the Moon Shots where we’re going to have to be much more decisive about what science works, what science doesn’t work, get it in the right orders, and move ahead and drop those that aren’t getting us there, that’s a real challenge in itself, too, because that’s not—again, the nature of academia isn’t to move through these things. What Ron brings to the party is that he’s done this at Dana-Farber. He’s gotten cures out there in the forms of companies. All the rhetoric that you read in the paper about the conflict of interest, that’s because he’s on the board of companies he started with his science to cure cancer. So we’re looking at progress through an archaic lens. We’ve got to have a different framework for looking at progress and accepting progress and managing the conflicts. There is a general assumption that conflict is conflict and you can’t manage it. Well, that’s not necessarily true.

Tacey Ann Rosolowski, PhD:

What would that new system look like? What would that new framework look like from your perspective?

Leon Leach, MBA, PhD :

I think it’s going to be much more nimble. It’ll be more overtly data driven. The facts are going to be important, and there will be more clarity around the facts. It’ll be harder to argue the numbers, and I think there will be more real-time data. Information systems and information technologies will play a big role in that. It’s going to be well informed and better informed on a more timely basis—the decisions that will be made. A lot of that will be because of the power of the computer, but what we have to rely on is the power of mankind to respond to it, and that means stepping away from the old and stepping into the new and our willingness to do that on a fairly responsive and fairly quick basis.

Tacey Ann Rosolowski, PhD:

To what extent do you think these Moon Shot initiatives will reorganize MD Anderson? Do you think that it’s coming, that it will take a different structure?

Leon Leach, MBA, PhD :

Yeah, I think first of all, organizations aren’t a static thing—they’re constantly changing. You’ve got the formal organization, and you’ve got the informal organization. The formal organization is what you see on a piece of paper. The informal organization is how it really works. Oftentimes if you try to diagram out how it really works, it’s not worth putting it on paper because it’s based on interpersonal relationships, trust, years of working together, and a whole bunch of other factors. So yes, organizations are living, breathing, dynamic things. They are going to change. I think part of what you’re going to see at MD Anderson is a move towards more efficient organizational structures that basically free up people’s time to do what they do best. If we have that physician scientist who really is better at being the scientist than the doctor, hopefully we can free up his time to follow what he’s best at, or her time to follow what she’s best at. I think that’s the optimum. The same thing can be said on the business side. We’ve got business people embedded in clinical operations because they have business functions there. At times they may report directly to the clinical function. They may not have as much of an appreciation for what the business needs are or may have greater appreciation for the needs are. They are first stymied by a bureaucracy that is not responsive to them. So we’ve got to create more responsive structures, and I’ll think you’ll see changes in that regard.

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Chapter 11: Financing the Moon Shots Program and Changes to MD Anderson Structure

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