Chapter 07: Major Roles Building Translational Research

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Chapter 07: Major Roles Building Translational Research

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In this chapter, Dr. Mills begins sketching his approach to rebuilding the Department of Systems Biology. He discusses problems that departments have when they are built around "a cult of personality." Next he talks about his work as Deputy Head of the Division of Research, tasked with building and improving translational research across the institution. Next he talks about his work on the Clinical Cancer Genetics Program, which he took on just as work on BRCA-1 and -2 was emerging. (He notes that he helped write the Texas Genetic Confidentiality Bill.) He was asked to put together a vison for the future of research, which presaged his current role of assessing what is going on in cancer research to make strategic decisions about next directions.

Identifier

Mills,GB_01_20160505_C07

Publication Date

5-23-2016

Publisher

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

City

Houston, Texas

Topics Covered

The Interview Subject's Story - The Administrator; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges; Critical Perspectives on MD Anderson; On the Nature of Institutions; Leadership; On Leadership

Transcript

Tacey Ann Rosolowski, PhD:

I'd like to return to this question about the leadership a little bit later, maybe after we've talked about some of your roles, but I wanted to talk a little bit about what happened when you first got here, you know how you began to fit into the institution, what you saw, how you proceeded, because this was a new role for you. What were your goals?

Gordon B. Mills, MD, PhD :

I had two major, or I guess three major roles, when I came to the institution. One was to take what had been a very long-term department and rebuild it, and indeed, of all of the people that were in the department when I came, none of them are in the department now. That process happened fairly quickly, with one exception, and that is the ex-department chair of the department did stay in the department, which is already an administrative challenge that worked. Most of the people with a lot of work and evaluation, we helped find positions that were much better suited for their skillsets, usually elsewhere.

Tacey Ann Rosolowski, PhD:

Now what was the issue there? What were the skillsets? How were the skillsets defining the department and how did you want the department to change?

Gordon B. Mills, MD, PhD :

To a degree it was one of excellence. I think that because the department chair had been in place for a long period of time, that some of the turnover that needs to happen. The recruitment of bright, new faculty, I tend to call them kids, I shouldn't, but bright new faculty who will drive a much more active vision of the future, had not happened in that department, and I think to a degree had not happened across MD Anderson. I also think it was a time when we were switching from, as I mentioned, this idea of an insular basic research program, into a translational research program that would make a difference, and very much my vision and I think the vision of many people in the institution, of the future at that time. That meant that we needed to help people who really didn't fit into that model find positions at more classic universities, where they did fit into the model. And so it was very much a transition time.

Tacey Ann Rosolowski, PhD:

Who was the department chair?

Gordon B. Mills, MD, PhD :

Jordan Gutterman [oral history interview], and he's still here as a retired professor and I still work with him, and I will meet with him again this afternoon.

Tacey Ann Rosolowski, PhD:

Well, say hello to him for me. I interviewed him a few years ago.

Gordon B. Mills, MD, PhD :

He did some incredible things, but it was time for a new chair. Actually, I think this is one of the problems at MD Anderson. Many of the departments, on the research side in particular, are cults of personality, driven by a very dominant department chair. Actually, I shouldn't say that, that's across the institution. And we see, as many of these department chairs are stepping down, great challenges in trying to rebuild the departments around a new leader. And so the strong leadership, the cowboy attitude, the cults of personality, are very much there. And do we need a Department of Cancer Systems Biology if I wasn't here, would clearly be a question that I would expect to be asked. It's one that my vision and the vision of the people I've recruited have driven. Is it an institutional vision? Not as clear. And I think that applies to every single department that we have. The way in which they are molded and directed has been very much dependent on the department chairs.

Tacey Ann Rosolowski, PhD:

Well and also, to be fair, dependent on department chairs who are reacting to a particular moment in history, in their fields and at the institution.

Gordon B. Mills, MD, PhD :

And also as part of retention. These are incredible people that we are trying to retain, because they really do make a difference, and so part of that, in many cases, is building a department around them. So, all of those statements are true, but I think it really has become clearer, as a number of our department chairs have stepped down recently, just how powerful the leaders of a number of departments have been in setting vision and managing people, and how much of a challenge that can be after they leave. We really don't do a very good job of recruiting our successors, recruiting, retaining and growing them. Now, one of those is, is that most of them get recruited elsewhere, and it actually is good if your best people are not being offered jobs that are unbelievably good elsewhere, you're not doing a good job. I recently had a faculty member who came to me with a job offer and said well, aren't you going to retain me? And I said well, there are two reasons; one, you've already signed. If you wanted me to retain you, you would have had to come to me before you did. I will not let you renege, because that is not going to look good in your career. Second; this is an unbelievable offer, go. I mean, you're going from being an assistant professor, to being head of an institute and being deputy director of research in the hospital. Go. I mean, this is what I want to see. But, that means he's not going to be here as a successor, but again, that's a wonderful choice and chance, and we do have many of our best people being recruited away, but if you don't, you're in much worse shape. The challenge is, is then what do you do with the ones who don't get the job offers, and that was a little bit of what I talked about in the turnover that was necessary in the department or at least the part of the department that I inherited.

Tacey Ann Rosolowski, PhD:

Now you were listing a few things, a few roles that you had. One was rebuilding the department. What were some of the other tasks you took on?

Gordon B. Mills, MD, PhD :

The second role that I had was deputy head of the Division for Research, and my goal was to really help to evaluate, grow, and improve research, the translational research aspects, across the division, and I think that was one of those that worked. I think that we probably could have done a better job of it, but it was a time when that was difficult.

Tacey Ann Rosolowski, PhD:

Tell me about that process and tell me about the success and then the well, we could have done this better, just to get a portrait of what was going on at the time.

Gordon B. Mills, MD, PhD :

This was a time, again, of change. The whole concept was not so much whether team science should be the driver, but where was translational science within a clinical division and what degree of basic science should you have. Where should they live, who could you recruit to bring in bright, new blood into the system? That, as I said, needed change. Who would be willing to move to MD Anderson at that time, with its reputation, which was not one of having strong science and supporting strong science? It wasn't one where it was clear that its potential could really be fulfilled. And then, finally, in terms of recruiting family, this is not the first people think of, of moving to, and much more so when I came here, where the city was simply not as vibrant. I mean it closed down at nine o'clock, there was nothing downtown. Now there's lots of neat things going on. So, it was a very difficult environment to recruit to. And so all of those pieces were together, and at that time, it was a buyer’s market. There were more good positions than there were good people, and so there were lots of people recruiting everywhere. Part of our job was to recruit and I don't think we managed to land many of the people that we should have. And indeed, I mean I'm excited in one way, sort of the first ten people we interviewed are all leaders in institutions, many of them now cancer directors. We did a great job of identifying some incredible people that would have made a difference but landing them was hard, and so that's the strength and weakness of it. The other that I inherited shortly after I came was our Clinical Cancer Genetics Program. This was just as the opportunity to deal with BRCA-1 and 2, in terms of cancer risk and genetic counseling was coming to the fore, and I was asked to build that program. I had done some of that in Toronto, for five or six years, and then headed that program here for seven years, helped write the Texas Genetic Confidentiality Bill, which was signed there, which protects patients from discrimination based on their genetic background. All of those things were part of what I was building at that time. I was also asked to help build our breast cancer program here, which was not nearly as strong as it needed to be on a translational level. We had already built an incredible ovarian cancer program, which continues, and so those are sort of the early things that I was asked to take on, in addition.

Tacey Ann Rosolowski, PhD:

Now what was your personal vision, you know, what did you want to accomplish when you came here?

Gordon B. Mills, MD, PhD :

You know, one of the things of having a computer is that every once in a while, you come up with old files when you're looking for something else, and one of the things that I was asked to do when I came, was to put together a vision for the future. That vision for the future is very much what I am doing now. It really was to take our absolutely rapidly burgeoning knowledge of why cancer was occurring, and build programs that would implement that into patient care. So, that sort of evolution came with my being requested to head the Kleberg Center for Molecular Markers, or actually more specifically, building it based on a donation that we arranged from the Kleberg family, of that eventually becoming the Khalifa Institute for Personalized Cancer Therapy, and then evolving a little bit further.

Tacey Ann Rosolowski, PhD:

Oh, okay.

Gordon B. Mills, MD, PhD :

But really, these were sort of step-by-step programs of going from identification of what was happening in tumors, the basic biology and genetics of cancer, through to molecular markers, which was the Kleberg Center, through to implementation in patient care, which is the Institute for Personalized Cancer Therapy.

Tacey Ann Rosolowski, PhD:

Wow, interesting. Well, we're almost at eleven o'clock, and this sounds like a preview of coming attractions to me. Would it be okay if we sit another session?

Gordon B. Mills, MD, PhD :

Sure. I'm not sure I'm the right person but I'm glad to do this.

Tacey Ann Rosolowski, PhD:

Listen. I would just say all of this is gold, from my perspective, so if you're willing, I'd be --

Gordon B. Mills, MD, PhD :

Sure.

Tacey Ann Rosolowski, PhD:

That would be great. Well, thank you very much for your time this morning and I'm going to be turning off the recorder now, at about ten fifty-four.

Chapter 07: Major Roles Building Translational Research

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