Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care

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Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care

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Dr. Rodriguez states that MD Anderson has shifted away from its mission as a care facility since Ronald DePinho assume the institution’s presidency in 2011, moving toward a research-generating facility. She sets context by discussing the growth of research under Dr. John Mendelsohn, noting that research still served patient care despite accelerated industry-sponsored research. She next talks about MD Anderson’s focus on new drug development and the implications, specifically in the demand for financial and intellectual resources this requires.

Identifier

RodriguezA_04_20150605_C25

Publication Date

6-5-2015

Publisher

The Historical Resources Center, Research Medical Library, The University of Texas Cancer Center

City

Houston, Texas

Topics Covered

Institutional Change; Critical Perspectives on MD Anderson; MD Anderson History; Institutional Mission and Values; MD Anderson Culture; Growth and/or Change; Industry Partnerships; The Business of MD Anderson; The Institution and Finances; Research, Care, and Education; Business of Research

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

Tacey A. Rosolowski, PhD:

What’s—is there—what’s been preserved? I mean, you’re alluding to things that have been lost, are there things that have been preserved throughout that growth?

Alma Rodriguez, MD:

Well, I would like to say—I would like to believe, and I think from being in the role that I currently perform, I can see, or I can speak to this, I think the one thing that has been preserved is that the physicians are truly dedicated to doing their best for the patients. I mean, people are very proud of being good doctors. And that’s—and they want to be good doctors, and they want to do their best for the patients. That I don’t think has changed. I think the nursing staff continues to be excellent and compassionate and dedicated to doing this very difficult task as well. That, I think, has been preserved. I think something that is changing very radically, or that has changed very radically as I said, has been this shifting away from—well, to some degree, shifting away from the missing of the organization as a cancer care facility. To some degree, shifting from that to a research-generating facility. And it’s not that research hasn’t been part of our DNA before, but that it had always been superseded by the clinical mission. I really don’t think that’s true today, at least I don’t—that’s not the messaging that we receive, and it’s not what is rewarded or recognized.

Tacey A. Rosolowski, PhD:

Is that part of the change that’s occurred since 2011? Or did that begin under Dr. [John] Mendelsohn?

Alma Rodriguez, MD:

Well, it began to some degree under Dr. Mendelsohn, although I have to say that Dr. Mendelsohn repeatedly made his message, that the research mission was to personalize cancer care. For him, that was truly the research mission; to personalize cancer care, to make the treatment meaningful to every patient, or to make it relevant to every patient for their own particular disease. The degree to which industry-sponsored research was promoted did accelerate under Dr. Mendelsohn. That definitely was one of the changes.

Tacey A. Rosolowski, PhD:

And why was that important?

Alma Rodriguez, MD:

Well, the importance of pharmaceutically-sponsored research was that we, ourselves, were not—we, ourselves, did not have, if you will, a pharmaceutically-produced, or a pipeline that was producing new drugs. We were not creating the new drugs. But we had the patient populations in which we could test and formulate the most appropriate—or investigate the most appropriate application for these new drugs. And so it was, in a sense, a symbiotic relationship. We have the patients, they have the drugs, why not work together? In addition, of course, the pharmaceutical industry had the resources, the financial resources, to support the research infrastructure that would be required to do those kinds of tests, in the scope that would be necessary. And, for example, one of the departments that became very prominent, very large, as a result of the drug, the pharmaceutical research interaction was a Leukemia Department.

Tacey A. Rosolowski, PhD:

Right. Now, the way you shaped that statement, I’m assuming that there’s been a change in that with indus—there is a different field to industry-sponsored research now?

Alma Rodriguez, MD:

Well, not really, I mean, it’s still there, and it’s still very present. What has shifted is that we now have said, or Dr. DePinho’s vision is that we will be the new pharmaceutical drug pipeline producer, or that from the research that is conducted at MD Anderson, from the basic laboratory research conducted at MD Anderson, there will be new drug products that will be placed in the market. So we no longer are simply the testers of the drugs, but we will be the producers of the drugs, or the initiators of the drugs that would then be put into production. So do you see that—

Tacey A. Rosolowski, PhD:

I do.

Alma Rodriguez, MD:

—shift in the—

Tacey A. Rosolowski, PhD:

And what do you feel are the implications of that shift?

Alma Rodriguez, MD:

Well, the implications of that shirt are that that’s really—to be the pipeline producers of drugs requires enormous financial resources, number one. It also requires top-tier intellectual resources, which again is a financial resource requirement. I mean, great minds don’t come cheaply.

Tacey A. Rosolowski, PhD:

Yeah.

Alma Rodriguez, MD:

And so that degree of financial infrastructure really requires big money investment. You have to have a pipeline of investors, of entrepreneurs who want to do that. They’ve never had, if you will, the know-how. We don’t have the skillsets to do that. And also being a state-funded organization, there probably are even legal ramifications to doing that. That’s outside of my scope of knowledge, I really don’t understand the complexities of all of that. But I’m certain that there likely are complexities to that, and barriers to that. So I see it as a challenge; clearly not an impossible one since we’ve embarked on it, and hopefully we will succeed at it. But there are enormous problems with taking that on as a new initiative. There are, of course, potential benefits, huge benefits in the future. Like all investment enterprises, if the investment pays off, the payoff could be huge for us, as well. It could, perhaps, lead to self-sustaining, a self-sustaining research infrastructure. I can tell you that at the present time, we do not have a self-sustaining research infrastructure that, you know, there is a significant proportion of the funds that are generated from the clinical side of the house that do go to support the research infrastructure.

Tacey A. Rosolowski, PhD:

Right. There’s also a lot of philanthropic support for it.

Alma Rodriguez, MD:

And there’s a lot of philanthropic support for it. So whether we will—as one of the threats that we see to that is that, of course, we know for sure, given the national imperative to cut down on healthcare costs, we know for sure that the degree to which we will be able to support research in the future from the clinical side of the enterprise is going to diminish very significantly. Sooner rather than later. I mean, everyone is anticipating very late, but we know that by 2019, we already have very significant likely reduction in the reimbursement for healthcare in general, but for cancer care specifically. We are one of the biggest cost items on the Medicare bill, and so we will be a target. And by “we,” I don’t mean just MD Anderson. I mean cancer care in general.

Tacey A. Rosolowski, PhD:

Cancer care in general, yeah.

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Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care

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