Chapter 07: Building a Clinical Nuclear Medicine Program
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Description
In this segment, Dr. Podoloff sketches the roles he served once he came to MD Anderson as Deputy Chairman of the Department of Nuclear Medicine. He explains that he ran a small clinical operation that generated income and explains how the system of keeping physicians on salary at MD Anderson leads to good medical practice. He talks about the impact of this shifted role on his own career and how he developed the clinical operation.
Identifier
PodoloffD_01_20150402_C07
Publication Date
4-2-2015
City
Houston, Texas
Interview Session
Tacey A. Rosolowski, PhD, Oral History Interview, April 02, 2015
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Professional Path; MD Anderson History; MD Anderson Culture
Creative Commons 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:
Amazing. So when you arrived at MD Anderson what were your roles? And what were the challenges you set yourself?
Donald A. Podoloff, MD:
So I came here to be the deputy chairman of the Department of Nuclear Medicine. And Tom basically turned the entire clinical operation over to me. So I was responsible for the day-to-day scanning, for the development of new techniques, for the eighty bone scans that we did every day. I had to make sure that they started and stopped on time, and was basically running a small clinical operation.
Tacey A. Rosolowski, PhD:
Now just a technical detail. Were these functions, the radiology functions, an income-generating stream for the institution at the time? Or was it a service, internal service?
Donald A. Podoloff, MD:
It was an income-generating stream. But it wasn’t the biggest income. It was pathology, and first was pharmacy I guess. And then internal medicine or cancer medicine at that time was so big compared to radiology. I think when I first came we had twenty radiologists. We have 173 now.
Tacey A. Rosolowski, PhD:
Oh my God, that’s enormous growth. I mean I asked about the income piece because I imagine at certain times that becomes a factor.
Donald A. Podoloff, MD:
Not at MD Anderson. No. Well, it does, but it’s like we’re all in the same boat. So we’re all on salary. I don’t make one dime more because I did more scans or I did another operation today. And very few patients come here to see a doctor. They come here to be at MD Anderson. And we do our care in multidisciplinary care groups. Well, you can only do that if your income stream is not affected by the volume of patients that you see. Now that’s the way it was then. It’s changing, because the world is changing. But my daily challenge was running a clinical nuclear medicine department, make sure that the wheels stayed on. And it was fun. It was a lot—and then I started an academic career. So I started to write. I started to do research. I started to consult for drug companies. Nobody ever asked me to go anywhere when I was at Diagnostic Clinic. And now all of a sudden everybody was asking me to go everywhere.
Tacey A. Rosolowski, PhD:
I wanted to get some more detail though about how you developed the clinical operations. I mean what was the situation?
Donald A. Podoloff, MD:
Well, it was pretty well developed. It was a pretty efficient machine when I got here. What I basically did is I modernized it.
Tacey A. Rosolowski, PhD:
And what did that entail?
Donald A. Podoloff, MD:
It meant getting newer equipment. It meant getting additional resources, staff, and personnel. And I got a lot of support from both Tom and Jerry to do that. So that was my job.
Tacey A. Rosolowski, PhD:
Now I mean just so I understand. Were you beginning to focus much more on the imaging of tumors? Or were you doing a full palette for patients that had comorbidities?
Donald A. Podoloff, MD:
Mostly all tumor.
Tacey A. Rosolowski, PhD:
OK. And was that a new area? Was there a learning curve for you?
Donald A. Podoloff, MD:
Oh yeah.
Tacey A. Rosolowski, PhD:
OK. Well, tell me about that.
Donald A. Podoloff, MD:
There were some scans that I’d never done before. I’d never done a venogram when I was in private practice. There’s no reason to. And they don’t do them anymore anyhow. Now you use ultrasound for it. But we used to do a fair amount of radionuclide venograms looking for thrombosis because of the catheters and stuff. I did do MUGA scans. They were not doing any thallium scans when I got here and I started that here.
Tacey A. Rosolowski, PhD:
What’s the advantage of a thallium scan?
Donald A. Podoloff, MD:
Well, it looks at your heart at rest and stress. So it’s like a nuclear stress test. Whereas with the MUGA studies all you get was a fixed number that’s the amount of blood you’re ejecting with each beat of the heart. Should be somewhere between fifty and seventy-five percent. If it’s less than that it’s—and why was that important? Because we were giving Adriamycin. And Adriamycin is cardiotoxic. So this was a wonderful way to look at that.
Tacey A. Rosolowski, PhD:
So I mean I’m getting an impression that this was immersion really into a very unfamiliar territory in a sense.
Donald A. Podoloff, MD:
No.
Tacey A. Rosolowski, PhD:
No?
Donald A. Podoloff, MD:
The disease that I was studying was different. The people were all the same. The same skills that got me wherever I’d got, because of my ability to interact with other human beings, was still there. And like everything else if you can’t get along with people, you can’t be successful anymore, because now we’re all about team science. Well, that was not true in the ’70s. We still had superstars. So it didn’t seem like such a big change to me. I was always very good at developing the technical aspects of a scan and reading them. They weren’t so hard to read. They were blobs, remember. It’s either present or not. The biggest difference in my day-to-day life was that I spent a lot more time at work here than I did at private practice, because there was a lot more to do. I had to write. One of the interviews that I had with Gerry Dodd when we were talking about taking the job, I said, “Well, right now I only have two publications. Is that a problem?” He said, “No, but if you’re here for five years and you still only have two that’ll be a problem.” So I spent time doing that.
Recommended Citation
Podoloff, Donald A. PhD and Rosolowski, Tacey A. PhD, "Chapter 07: Building a Clinical Nuclear Medicine Program" (2015). Interview Chapters. 735.
https://openworks.mdanderson.org/mchv_interviewchapters/735
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