Chapter 12: Views on Changes at MD Anderson
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Description
In this chapter, Dr. Ewer offers his perspective on how the institution has changed since 2011. He offers his view of Dr. Ronald DePinho’s vision for developing MD Anderson’s research capacity and the struggles the institution had implementing this during a period of financial change in healthcare. He then talks about offering his services to Dr. Peter Pisters, the new president of MD Anderson.
Identifier
EwerMS_02_20180725_C12
Publication Date
7-25-2018
City
Houston, Texas
Topics Covered
Institutional Change; The Business of MD Anderson; The Institution and Finances; Growth and/or Change; Leadership; On Leadership; Obstacles, Challenges; Controversy; Institutional Politics; MD Anderson Culture; Building/Transforming the Institution; Growth and/or Change
Transcript
Tacey A. Rosolowski, PhD:
Yeah, yeah, for sure, for sure. Would you be willing to give me your perspective on kind of transformation of the institution, you know, 2011, when Dr. DePinho [oral history interview] came in, to now, when we have a new president? What’s your perspective on that?
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
My perspective is a little bit out of touch with the institution’s perspective, and I’m not sure that I want it recorded.
Tacey A. Rosolowski, PhD:
Okay, well, I can turn off the recorder, or—
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
But I can give it to you, and you can delete it, or...
Tacey A. Rosolowski, PhD:
Or you can decide to delete it later.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Yeah. I think that Ron DePinho was a brilliant person, and probably an outstanding choice. I think Ron DePinho should have had some very, very serious discussions before he accepted the position and immediately after, of what he wanted to do, what limits would be placed on his authority, and how he was to be helped to turn this into a success. And maybe they happened, or maybe they didn’t, but it didn’t turn into a success, and the faculty was unhappy. Now, the faculty was destined to be unhappy because the timing of Dr. DePinho coincided with a change in how healthcare was financed and how it was delivered, and so our clinicians were being encouraged or pushed to have greater productivity. I believe it was Dr. DePinho’s concept that by adding to our productivity we could support higher levels of research, and I’m not sure that was totally realistic in a changing environment. And that’s where I had wished I could have helped him to say, “Hey, you know, we need to look at the reality of being out of network more, and maybe we need to balance what the institution can accomplish in patient care, and bring patient care to the highest possible level that we can, and then channel the surpluses into the most appropriate research.” And I think his philosophy was that research is what keeps us going, and we have to do it, but if the institution was going broke because we couldn’t manage, then we had a problem. And the old adage about throwing the baby out with the bathwater may apply to my own particular personal impression of that what turned out to, I guess, somebody could call a fiasco.
Tacey A. Rosolowski, PhD:
I’m not surprised that you warmed to Dr. DePinho’s vision, because of your emphasis on the importance of creativity, and making advances in cancer research. So it makes sense to me. I mean, there are a lot of people that found his vision really compelling.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Yeah, but it had to work.
Tacey A. Rosolowski, PhD:
And it had to work, exactly, and that’s where the disconnect came.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
My idea of how to make it work would have been to say, “We have now new leadership. We have to deal with the reality of the Affordable Care Act. We have to deal with the reality that insurance companies are there to make money. And how do we work within that new hostile environment, in some instances, to create the best possible situation for our present patients, and yet maintain enough so that our future patients have new and innovative ways of treating their disease?” Different approach. Whether mine would have succeeded or not, I don’t know. They never suggested I apply. (laughter) And since I had applied to other things and had been rejected, I didn’t think there was any reason in the world why I should be rejected again.
Tacey A. Rosolowski, PhD:
What was your impression of the leadership team that was appointed after Dr. DePinho resigned?
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Dr. Buchholz?
Tacey A. Rosolowski, PhD:
Mm-hmm, and Marshall Hicks [oral history interview], as interim President, and Steve Hahn as Operating Officer.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
I had very little to do with them. Dr. Buchholz, of course, was down the hall from me, and when I needed something I banged on his door, and he was receptive to what I asked, but he didn’t come to me very often asking for help. And I’m not sure that... I’m not sure what he really was supposed to do in that position. Tom Burke left. You know, that position probably needs to change from time to time so that we don’t get into a... We need new ideas in those positions. I felt I have a certain loyalty to those people, and I also had a certainly loyalty even to Karen Lu when she was there. You know, my job is to help them, to support them, but not to push myself on them. And if they didn’t need my help, then I’ll find other things to reinvent myself.
Tacey A. Rosolowski, PhD:
What assistance did you provide to Karen Lu and Tom Buchholz?
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
I don’t know. That’s a question for you to ask Karen.
Tacey A. Rosolowski, PhD:
Oh, no, I mean what were the situations where she called you in, for example.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
I’m not sure she ever called me in, but I was available to her, and she might ask her secretary, “Send that to Ewer and ask him to look into this.” But it was very unusual.
Tacey A. Rosolowski, PhD:
Okay, gotcha. Gotcha. What do you think of Dr. Pisters as the choice for, you know, kind of Ron DePinho on one hand, Peter Pisters on the other?
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
I don’t know enough about Peter. Peter immediately recognized me from his prior stay, so I knew that over the years I must have made an impression on him, but, you know, I did offer my services to him. I said, “If there’s anything I can do, you know, I have a whole big alphabet soup after my name. I am an MBA.” I don’t know why I got an MBA. Well, I got an MBA somewhere along—I have a Master of Public Health. I have a doctorate in public health. I have a law degree, another law degree. I don’t have a nursing degree.
Tacey A. Rosolowski, PhD:
That’s next.
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Nope. (laughter) I will not become a nurse. I got enough trouble.
Tacey A. Rosolowski, PhD:
Even if you could be the oldest person to get a nursing degree at a particular institution? (laughs)
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
This PhD I got across the street, that was the nth degree.
Tacey A. Rosolowski, PhD:
That was the nth degree. Gotcha, okay. So you said—
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
I did comedy, too. (laughter)
Tacey A. Rosolowski, PhD:
So you said you offered your service to Dr. Pisters, and—
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Yeah.
Tacey A. Rosolowski, PhD:
Yeah. And so he has—
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Oh, he said, “Oh, thank you.”
Tacey A. Rosolowski, PhD:
He said, “Oh, thank you.”
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
Yeah.
Tacey A. Rosolowski, PhD:
Okay, good, good. (laughs)
Michael S. Ewer, MD, MPH, JD, LLM, MBA:
You know, he’s not knocked on my door. (laughs)
Recommended Citation
Ewer, Michael S. MD and Rosolowski, Tacey A. PhD, "Chapter 12: Views on Changes at MD Anderson" (2018). Interview Chapters. 814.
https://openworks.mdanderson.org/mchv_interviewchapters/814
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