Chapter 26: Defining Operational Priorities and Preparing for Dr. Pisters to Step into the Presidency

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Chapter 26: Defining Operational Priorities and Preparing for Dr. Pisters to Step into the Presidency

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In this chapter, Dr. Hicks discusses the identification of the operational priorities [ROPR] during October and November of 2018 to manage the institution’s change process before Dr. Peter Pisters arrived to become institution president.||[The recorder is paused]||Dr. Hicks lists the Operational Priorities: patient experience; enhanced information systems; geographic expansion; discovery; education; recruitment and development; financial sustainability. He explains how this type of planning was different from what occurred prior to Dr. Ronald DePinho’s arrival and how it was managed to provide structure and also flexibility once Dr. Peter Pisters arrived.||Dr. Hicks provides a summary of what Peter Pisters brings to the institution (having worked at MD Anderson before) as well as his lack of immediate familiarity with the recent turbulence.||He comments on the selection of Dr. Pisters and how it reflected concerns that the new president have adequate familiarity with MD Anderson culture.

Identifier

HicksM_07_20190117_C26

Publication Date

1-17-2019

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; Leadership; On Leadership; MD Anderson Culture; Institutional Processes; MD Anderson Culture; Working Environment; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Understanding the Institution; The Institution and Finances

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 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

T. A. Rosolowski, PhD:

Coming out of Harvey, what were the big themes in preparation for Dr. Pisters’ arrival?

Marshall Hicks, MD:

I think really at that time, it was about three months probably, and really most of September, we were dealing with coming back from Harvey and getting things back to more normal dealings: looking at the After Action Review and the events we had. It was really, October, November, really two months I guess, before Peter started on December first. So it was --at that time, the real focus was we had gotten our operational priorities up and running and the different groups there. So we had had our—we were planning our first ROPR, or the Rolling Operating Plan Review, and really having those groups coming together at SGC to report out and plan. So it was really the culmination of all the months of work of reorganization and establishing those priorities. We didn’t call them strategies, because that was one thing we felt like we needed to wait for a new president, to really help determine what the long-term strategy is going to be. But through our process of working with the McChrystal Group, and the engagement that was had with the leaders and employees at that time, when we came up with these operating priorities. Those were ones that I think where there’s urgency around making progress in those areas, regardless of who was going to be coming in.

T. A. Rosolowski, PhD:

Would you list them for the record, the ones you can recall.

Marshall Hicks, MD:

Well you know it was—I can get them. Let me see if I can grab them real quick. [The recorder is paused.]

T. A. Rosolowski, PhD:

Okay, we’re back after a brief pause.

Marshall Hicks, MD:

The operational priorities that we listed coming out of our work with the McChrystal Group in the retreat that we had were: patient experience, enhanced information systems, geographic expansion, achieving decisive discoveries, education, recruitment, retention and development, and financial sustainability. So seven.

T. A. Rosolowski, PhD:

Now how did this, to your knowledge, look different from any preparation that had been made for Dr. DePinho’s [oral history interview] arrival?

Marshall Hicks, MD:

That’s a good question. Part of when he came, we had been coming out of the recession. So a lot of the efforts at that time, that I remember being involved with, were more about cost reduction. Trying to really recover from that, and so it was really more about the institution getting back to more normalcy, about it if you will. I don’t remember there being anything in preparation, but I may not have been privy to some of the things that were going on. I know it was—he came in ’11, the fall of 2011, I guess. The recession really was dragging on probably through ’09, so probably a couple years there, I know one of the major things I was leading was the clinical cost reduction group. There was a number of them Dr. Burke [oral history interview] was leading, so it was really trying to manage expenses and be disciplined as we came through the recovery if you will: to resist our temptation that we usually have trouble resisting, which is just hiring and spending and doing the things that kind of get us in trouble on a cyclical basis. So yeah, I think that was, it was really more just trying to get back to more normalcy of operations.

T. A. Rosolowski, PhD:

Well I’m, I’m just really struck, because having recently interviewed Raymond DuBois [oral history interview], he really stressed how there was a great functioning executive team before Dr. DePinho’s arrival. I mean he talked over and over about how efficiently he felt they managed recovery from the recession. Now, in the situation with Dr. DePinho, in transition to the next president, you had a broken executive team under him, or one that was not functioning.

Marshall Hicks, MD:

Right.

T. A. Rosolowski, PhD:

It had serious dysfunctions. So you had a totally different context, and I’m just very impressed with how you’re describing the intentionality of this process. I mean you couldn’t rely on existing structures because they hadn’t been working, so you had to make new things. So it’s just, it’s very cool that that’s in place.

Marshall Hicks, MD:

Yeah, and I think that was the urgency we felt. We knew it wasn’t working. Or it was --you know I think dysfunctional is a good way to describe it for a number of different reasons, and it was also in a little bit of a transition. Even at that level, there had been some shifts in the EVPs before. We knew, as I mentioned before, we knew Dan [Fontaine] was retiring. There was a whole piece, a big piece of the organization that needed to be moved forward, and provide some certainty there, and make sure that we had some continuity in leadership. But how that could best be structured. So it was a combination of both things. Structure as well as what are we focusing on operationally and prioritizing. I think that was what led to that: we wanted to have priorities where we all knew, we were all clear, and we came to the consensus on what those were. What do we need to be focusing on regardless of how the presidential search comes out? That leader is going to want to come in with us stronger and with a focus on priorities that we know we need to be executing on.

T. A. Rosolowski, PhD:

Now once Dr. Pisters was named, what was the process to communicate with him prior to his arrival? I mean was there an attempt to dovetail what was going on here with the vision he was bringing?

Marshall Hicks, MD:

He had a couple times, when he came down, we talked on the phone several times, I think he was—we had briefings about sort of what we were doing, what the priorities were. I think individually, sort of the president’s team, leadership team at the time, had interactions with him. I know he came and we met once as a group and kind of went around the table and talked about what we thought were the challenges and also the things that we were prioritizing. So I think the prep work and the prep material had a lot—you know, fortunately with the roadwork kind of coming together, it really was ideal briefing material to put things together of where we were. He had witnessed from afar, the whole Harvey incident, and was contacting, texting. We were keeping in touch on how things were going there. So I think he was aware of that. Aware that coming out of that was an historic event that we kind of weathered, and that financially, we had gotten back on solid footing. We’re starting off the next year, despite Harvey, started to get into October, November financials that were extremely strong. So I think there was a sense that we had turned the corner. Now it was, how do we continue to sustain it and have—as we talked before, the structure that we put in place? There was intended flexibility there, because there were some interim roles that were put in, knowing that this probably was going to change, but trying to do something that would be the least disruptive as part of that transition. So then it became really transitioning to understanding that roles may change and the structure may change, but that we needed something to be able to sustain us through the next few months. Peter, he knew the organization. It wasn’t like there was a lot of—I mean he had been gone, I guess three years, something like that, three and a half or something. So it was not like he was—and he had been here 20 years before that. So it was, the familiarity was there. It was really just —he wasn’t here during the Epic installation and some of the experiences there. To some extent probably, there’s a disadvantage of not understanding some of the context around what happened with the White Paper and the shared governance creation and things like that. But I think we all did our best to try to bring him up to speed on that. But it’s hard, not having gone through it, to really understand it to the depth that it was sort of shaking the foundation of the institution at the time, that required the chancellor to step in and make changes, significant changes to the organizational structure, including the Shared Governance Committee creation and appointment of a COO, and then ultimately having the president step down. That happened for a reason and as I mentioned, some of the dysfunction. He was not here during all of that. It’s part of our history, but there’s a longer history than that. He’s pretty familiar with the culture.

T. A. Rosolowski, PhD:

Absolutely.

Marshall Hicks, MD:

It wasn’t like you were trying to educate him about the culture of the place, I think he understood that. It was really more about putting things into context recently, to understand why we had done things a certain way, or were structured a certain way, or set things up.

T. A. Rosolowski, PhD:

I’m wondering how much his familiarity with the culture fed into his selection.

Marshall Hicks, MD:

I’m sure it did, yeah. My understanding, from comments that were made, I think at the Regents levels and other discussions, there was a real concern about having someone come in that didn’t really have a familiarity with the culture of the place, because of the issues that we’d had before. It is a unique place, and I think that people, most of the Regents, most of the leadership in Austin, probably a number of them had had experiences here. Personal experiences either with family or friends or themselves. They understand the uniqueness of the place and I think they didn’t want that to be lost, and so there was a real concern, I think about trying to find someone who was a good fit, who understood the culture, could come in and build on the greatness that’s here. [background noise] That’s the windows.

T. A. Rosolowski, PhD:

Oh wow, I’ve never heard that before.

Marshall Hicks, MD:

Yeah, they crack, I guess as they heat up.

Chapter 26: Defining Operational Priorities and Preparing for Dr. Pisters to Step into the Presidency

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