The Process And The Pick
By
Leonard Zwelling
The past few blogs have been about the surprising developments and current speculation surrounding the sudden retirement of Peter Pisters. We know a few things are likely.
This was not a voluntary retirement. The timing of this occurring in the ninth year of his presidency (the renewal time for his next five-year term) suggests this was a non-renewal action by the Regents. There is much conjecture about what could have precipitated this. Was it a wide-ranging unhappiness in the MD Anderson faculty body? Was it some particular event, perhaps the change of plans for a free-standing MD Anderson in Austin that Pisters had advocated for but about which the Regents or Michael Dell disagreed? Perhaps Pisters was not being a good team player. Could it have been a personality clash? Knowing Dr. Pisters somewhat, I can believe this is possible. He is not a warm and fuzzy guy and surely not a good ole Texas guy. He may have just pissed off his bosses in Austin like he pissed off the MD Anderson faculty. Maybe the faculty’s complaints were no longer falling on deaf ears in Austin. It’s impossible to say from the outside of the process.
Of course, Dr. Pisters may have taken ill and this is all a cover to minimize any intrusion into his personal life, but the rumor is that Dr. Pisters’ wife has also announced her retirement. Why now, if this is about illness? There is a great dearth of hard data and much gossip. I don’t know what to make of it all and, it no longer matters. What does matter is what happens next and how it happens. Pisters is gone. Who’s next? What’s the process? When will it start, if it hasn’t already?
In the past, when Drs. LeMaistre and Mendelsohn announced they were stepping away from the presidency, they both stayed on until their successor could be found. That will not be the case this time. Dr. Pisters will retire in a month. That suggests to me that there was some rancor in the transition. In fact, that may have been the whole problem, as it was with Dr. DePinho. The Regents and the Chancellor cannot have a maverick atop MD Anderson. Ron DePinho was certainly that. He got crosswise with Chancellor McRaven. Perhaps Dr. Pisters too was perceived as not being aligned with the Regents or the Chancellor or even the Governor (I find that hard to believe). Whether Pisters was willing to play second fiddle to Michael Dell with regard to the oncology service in Austin is another unknown to us on the outside.
In both the case of DePinho and Pisters the MD Anderson faculty was fearful, intimidated, and most unhappy during the great majority of their time in office. Perhaps the messages of the many surveys made it to the ears of the Regents. Pisters may have been tasked with correcting his relationship with the faculty five years ago and just did not make any progress. We may never know. If faculty unhappiness was part of Pisters’ downfall, faculty inclusion in the process to find his successor would be advisable, but that’s up to the Regents. I wouldn’t hold my breath.
We will know a few things by what happens in the coming weeks and months.
If there is no immediate forming of a search committee and the equally quick retention of a search firm, this suggests to me that the Regents want to keep MD Anderson under their thumbs with their new chosen golden child, Jeff Lee, who would not pass muster as a candidate in a real search. If this occurs, watch what Lee does with the personnel he inherits. If he keeps them in place, he’s on a tight leash. If he starts to replace the Pisters’ executive leadership team with his own, then he has a green light from the Regents and may well get the nod to lead permanently. However, he graduated from medical school in 1979 making him about 68 years old. That would be a bit older than most newly appointed cancer center leaders.
If a search committee is formed and a more typical academic process initiated to find the next president, watch who the contenders are if you are able to discern who is invited to visit the campus. Will the candidates be leaders of American academic oncology or will they be obvious unqualified choices as were DePinho and Pisters? Will any candidates be pure political appointments? Dr. LeMaistre was clearly that. He was neither a lab-based scientist nor an oncologist. He was the former Chancellor of UT and thus politically adept, but needing to surround himself with people who had talents he lacked. My sources reminded me that Dr. LeMaistre was on the original search committee to identify R. Lee Clark’s successor. He liked what he heard about the job and recused himself from further work with the search committee and threw his hat in the ring. He won.
Finally, as always, there will be pretenders for the job from inside the current faculty. I can name quite a few with high ambition. The list of those actually qualified to take this job from inside MD Anderson is actually quite short. This is all for the Regents to sort through. However, at the time of Mendelsohn’s naming (he was 60 years old on day one in 1996), at the time of DePinho’s naming, and at the time of Pisters’ naming there were candidates from within the institution. These candidates never ascended to the presidency. I would be surprised if anyone emerges from within the walls of MD Anderson to become its new leader. Then again, I could be very wrong.
The intricacies of the process will be most revealing to the extent they are publicly known. Who will chair the search committee? Will it be the Chancellor? Will it be the chair of the Board of Regents? Will Michael Dell sit on the committee? Will any current MD Anderson faculty be involved? Each of these decisions by the Regents will be a clue to what may have happened to Dr. Pisters and what the Regents are looking for in his replacement.
We do know from history that previous Boards of Regents have elected to go very different ways in selecting a leader for MD Anderson. Previous presidential retirements have appeared externally amicable (LeMaistre and Mendelsohn) with the past president staying on to serve until a new person was identified. Other transitions have been hostile. I think this new one falls into that last category.
There is absolutely no chance that the Pisters retirement was voluntary. If he is not ill, I suspect this came as a surprise to him. I still believe the same was true when John Mendelsohn announced his retirement from the presidency. He did not act like he was ready to retire.
The MD Anderson presidency is the best job in American oncology. Why quit at 66 with a potential annual salary of at least $5 million after just having completed a round of major fund-raising along with driving an ambitious building program? That makes no sense.
Like all previous changes at the top of MD Anderson, this will bring about an altered institutional strategy and an altered institutional culture at the cancer center. The last two changes have been disastrous for the faculty and particularly for research. DePinho kept everything for himself when it came to research resources. Pisters had no clue when it came to research. The future of cancer care starts in the research lab. If you don’t understand research, you cannot lead MD Anderson and research is, more than ever, a team effort.
I have no idea if this Board of Regents and this Chancellor can get this right this time after two failures. As far as I know, the first three MD Anderson presidents all lasted over 15 years. The last two together barely managed that.
The outlook for truly altering the toll cancer takes on the American people has never been brighter in all my 50 years in this business. There is rarely an edition of The New England Journal of Medicine without at least one article about a new cancer treatment. Combining the power of AI with modern genetics, immunology, and pharmacology could actually turn cancer into a chronic disease akin to hypertension and diabetes. That’s going to happen. Whether any of the breakthroughs happen in Houston may be determined by the choice of the next president of MD Anderson.
No pressure, Board of Regents. Please don’t mess this up again.
