Welcome to the interview landing page.
Scroll down this page to explore this interview in several ways.
An Interview Profile summarizes this individual’s role, specialization, and contributions to MD Anderson.
A Table of Contents shows the range of topics covered in each interview session: each chapter title links to a chapter summary.
Chapter Summaries describe the specific topics treated in each section; each summary links to the corresponding recording so you can listen to the chapter.
Here is a link to the full transcript so you may browse and search. (link)
Three sessions: 10 January 2018, 31 January 2018, 8 March 2018
Total approximate duration: 4 hours 40 minutes
Interviewer: Tacey A. Rosolowski, Ph.D.
To request the interview subject’s CV and other supporting materials, please contact:
Tacey A. Rosolowski, PhD, firstname.lastname@example.org
Javier Garza, MSIS, email@example.com
About the Interview Subject:
Thomas A. Buchholz, MD (b. Louisville, Kentucky) came to MD Anderson in 1997 and joined the faculty as an Assistant Professor (tenure-track) in the Department of Radiation Oncology, Division of Radiation Oncology. Since then Dr. Buccholz has served as Chair of the Dept. of Radiation Oncology and as Division Head (8/2011-1/2014). And from 2014-7/2017 he served as Executive Vice President & Physician in Chief.
Dr. Buchholz tells his story through the lens of leadership, offering perspective on the institution from many levels of leadership service. He left MD Anderson on 2/28/2019 to take up a position as Medical Director of Scripps MD Anderson Cancer Center.
Major Topics Covered:
Personal background and education
Radiation oncology as an evolving field
Multi-disciplinary research at MD Anderson
Leadership at Department, Division, and Executive Committee levels
Leadership: examples of effective decision-making, critique of “stumbles”
MD Anderson in transition under Ronald DePinho and after his resignation
UT System’s relationship to MD Anderson leadership
Epic: transition to, value of, impact on MD Anderson culture
About transcription and the transcript
This interview had been transcribed according to oral history best practices to preserve the conversational quality of spoken language (rather than editing it to written standards).
The interview subject has been given the opportunity to review the transcript and make changes: any substantial departures from the audio file are indicated with brackets [ ].
In addition, the Archives may have redacted portions of the transcript and audio file in compliance with HIPAA and/or interview subject requests.
The views expressed in this interview are solely the perspective of the interview subject. They are not to be interpreted as the official view of any other individual or of The University of Texas MD Anderson Cancer Center.
Interview Session One:
A Strong Family and Early Experiences with Leadership
The Decision to Enter Medicine
Specializing in Radiation Oncology
Coming to MD Anderson
Creating Research Collaborations Focusing on Breast Cancer
Chair of Radiation Oncology and Views on Leadership
Interview Session Two:
The Radiation Oncology Fellowship Program
A Changed Perspective as a Chair of the Department of Radiation Oncology
A Decision-making Process Includes Lessons about Leadership
Looking Back on Years as Department Chair
On Changes Under Ronald DePinho, MD
An Offer to Serve as Provost and Executive Vice President
From Provost to Physician in Chief
Interview Session Three:
A Physician in Chief's View on Strategic Planning: Successes and "Stumbles"
Shifting to Epic: Taking Stock of a Major Change
MD Anderson in Transition after Ronald DePinho's Resignation: Context
MD Anderson in Turmoil Under Ronald DePinho: A Critical View of the UT System Response
MD Anderson in Transition after Ronald DePinho
A New Opportunity in California
Interview Session One: (listen/read)
Interview Identifier (listen/read)
In this chapter, Dr. Buchholz talks about his years growing up in family: because of his father's frequent moves for work, he experienced different socioeconomic communities. Dr. Buchholz also talks about the impact of the years the family spent in Brazil for his sense of courage to try new things and mix with people of many different backgrounds.Dr. Buchholz discusses his involvement in athletics in school, noting that he was first selected for leadership roles in this area. His leadership, he explains, grew organically. He did not specifically plan or seek out leadership roles. They were suggested to him, he believes, because of his ability to connect with people and create trust.He also talks about the values his parents instilled in him, noting that he learned about leadership from conversations he had with his mother after school.
Dr. Buchholz begins this chapter by talking about the impact of moving to Rye, New York for his senior year of high school. He then talks about his decision to attend Bucknell University for his undergraduate education (Lewisburg, PA; BA in Philosophy conferred in 1984). He notes his attraction to "what's life all about" questions to explain his major in philosophy. He also notes that this interest matches well with issues that arise in oncology. He then talks about the opportunity he had during sophomore year to shadow a doctor, an experience that convinced him to go to medical school.
Dr. Buchholz begins this chapter by talking about the scholarship he received through the Air Force to support his medical studies [Tufts University School of Medicine, Boston, Massachusetts; MD received in 1988]. He discusses the dimensions of radiation oncology that convinced him to specialize in that field and talks about the research project on lung cancer he participated in during medical school. He notes that today it is very competitive to find fellowships in the field and talks about finding his opportunities at the University of Washington. He explains why he preferred a clinical focus to research in a laboratory.He then alludes to his first teaching position as an Adjunct Associate Professor in Radiology (non-tenure) at the University of Texas Health Science Center at San Antonio, San Antonio, TX, [1/1994-6/1997]. He notes that the Radiology Department in San Antonio started the first stereotactic radiology program in the Department of Defense.
Dr. Buchholz begins by observing that he came to MD Anderson [in 1997] as a seasoned clinician, then explains that he was hired at the institution because he approached Dr. Kian Ang at a conference to ask for advice. He mentioned several people who were important in his early years at the institution, including James Cox, MD [oral history interview], who was instrumental in connecting him with the group involved in breast cancer research.
In this chapter, Dr. Buchholz explains how he found his research niche with the breast cancer group because the radiation oncology dimension of breast cancer treatment at MD Anderson and in the field had not yet been established. He began to use his skills to establish research collaborations that resulted in over one hundred publications that influenced treatment and the field of radiation oncology. Dr. Buchholz describes several of his research collaborations and the projects he worked on.
Dr. Buchholz begins this chapter by noting that it took only ten years for him to become Chair of the Department of Radiology. He explains that he earned the role by being a well-liked and respected leader. Next he discusses how he based his strategy for developing the department on the what he had already accomplished for the residency program.Next, Dr. Buchholz talks about his views of leadership. CLIP He shares an anecdote about how he interacted with colleagues from Harvard and Yale to defuse competition and form meaningful relationships.
Interview Identifier (listen/read)
Chapter 07 (Building the Institution)
The Radiation Oncology Fellowship Program (listen/read)
In this chapter, Dr. Buchholz discusses his strategies and philosophy as he assumed directorship of the department's fellowship program (1998 – 2001). He explains that he and the Division head, James Cox, MD [oral history interview] were in agreement about the importance of education for the department and Division of Radiology as a whole. He notes that he wanted to establish a new culture for education.His first task was to involve the department in writing a mission statement, a step that was met with skepticism based the medical community's distrust of "leadership sciences." He describes this process as an "elucidating moment" where he saw how a group could be transformed. He explains that the mission statement raised productive questions about the program.Next, Dr. Buchholz talks about the process of changing culture in the department.
Chapter 08 (Overview)
A Changed Perspective as a Chair of the Department of Radiation Oncology (listen/read)
In this chapter, Dr. Buchholz discusses the ways that his perspective changed when he was promoted to department chair (2007 – 2014). He talks about how he saw the institutional politics at work for the first time and notes how his social relationships changed with his new status and the importance of not creating perceptions of favoritism.Next, Dr. Buchholz tells a story to document how he learned that sometimes "elegant solutions wouldn't work" when solving department problems because "people can reject self-evident truths." He also talks about the consequences of trying to force people to change and how leaders must do a cost/benefit analysis before embarking on that path. He describes why change can be hard and how important it is for leaders not to be rigid. He also concludes that the art of human relationships is particularly important when dealing with senior faculty.
Chapter 09 (Overview)
A Decision-making Process Includes Lessons about Leadership (listen/read)
In this chapter, Dr. Buchholz continues his discussion (in Chapter 08:
Chapter 10 (Building the Institution)
Looking Back on Years as Department Chair (listen/read)
In this chapter, Dr. Buchholz takes a retrospective look at what he accomplished as chair of Radiation Oncology and summarizes some of what he learned as a leader. He notes that he saw a lot of change in the department. He hired 35 new faculty members and comment on how important it is for a chair to recognize that faculty entrust their professional careers to the chair's leadership. He also notes that this role offered him an opportunity to set expectations about professionalism, workplace behavior and fairness. He explains how he would talk to a new hire about expectations to reinforce the culture of civility. Finally, he explains what he means by saying that being a chair was "fun."
Chapter 11 (Institutional Change)
On Changes Under Ronald DePinho, MD (listen/read)
In this chapter, Dr. Buchholz lays out the context in which the new president, Dr. Ronald DePinho [oral history interview] asked him to take on the role of Provost and Executive Vice President ad interim (2012-2013). He explains why the previous Provost, Raymond Dubois, left the institution. He gives first impressions of Dr. DePinho's gifts and leadership style. He also comment on the issues of equity began to surface, changing faculty perceptions of Dr. DePinho and leading to several years of turbulence at MD Anderson.He then explains how he was offered the Provost and EVP position. He describes why it was challenging. He also provides perspective on why the Executive Committee was dysfunctional and the effect that active circulation of rumors had on the institution. He also comments on how MD Anderson culture changed under Ronald DePinho. He explains that Dr. DePinho took MD Anderson "from incrementalism to boldness" with his view of the Moon Shots and his process for making that shift led to the perception that clinicians are less valued than researchers.
Chapter 12 (Overview)
An Offer to Serve as Provost and Executive Vice President (listen/read)
In this chapter, Dr. Buchholz explains how he was offered the Provost and EVP position. He describes why it was challenging. He also provides perspective on why the Executive Committee was dysfunctional and the effect that active circulation of rumors had on the institution. He also comments on how MD Anderson culture changed under Ronald DePinho. He explains that Dr. DePinho took MD Anderson "from incrementalism to boldness" with his view of the Moon Shots and his process for making that shift led to the perception that clinicians are less valued than researchers.
Chapter 13 (Building the Institution)
From Provost to Physician in Chief (listen/read)
Dr. Buchholz begins this chapter by observing that the role of provost gave him an entirely new perspective on the institution. He talks about role of the provost and why he considered staying in the position long-term, though the Division wanted to see him return as leader. He talks about the selection of Ethan Dmitrovsky, MD for the Provost's role, then being offered to position of Physician in Chief, a better fit for his background, in his view. Dr. Buchholz then talks about stepping into the Physician in Chief role, which he had considered not taking (2014 – 2017). He notes that he "jumped back in to the firestorm" of controversy surrounding Dr. DePinho and the Executive Committee. He also notes that he "underappreciated the job," noting that the Physician in Chief has responsibility for 80% of a 4 billion dollar budget. Taking the role, however, Dr. Buchholz said he felt empowered to make changes in the clinical environment and he lists what problems needed to be addressed. He concludes that he is very proud of what was accomplished and notes that MD Anderson offered a "most unique place" to effect management over a system of clinical care.
Interview Identifier (listen/read)
Chapter 14 (Building the Institution)
A Physician in Chief's View on Strategic Planning: Successes and "Stumbles" (listen/read)
In this chapter, Dr. Buchholz offers his views on the institution's strategic planning process he participated in once he assumed the role of Physician in Chief [in 2014] and joined the Executive Committee. One priority, he explains, was to shift MD Anderson into a more patient-centered perspective in recognition that several dimensions of patient experience directly affect treatment outcomes. In response to a question posed from a "cynical perspective," that treating patients like customers is really about making money, Dr. Buchholz talks about how gratified he feels helping patients. He notes that the institution has made headway in addressing the aspects of patient experience the Executive Committee identified as priorities.For contrast, Dr. Buchholz discusses the lessons learned from a transition that did not go as smoothly as planned: centralizing the process of securing healthcare authorization for treatments.
Chapter 15 (Institutional Change)
Shifting to Epic: Taking Stock of a Major Change (listen/read)
In this chapter, Dr. Buchholz gives his view of MD Anderson's shift to the Epic electronic health records system, calling it "the most significant transformative moment in the institution's seventy-five year history." He first outlines how costly Epic was to implement and lists the administrative and financial advantages of the system, noting that "it taught us as an institution to work on multi-disciplinary project management." Next, he talks about resistance to Epic from physicians, explaining that electronic health records have an impact on physician identity. Acknowledging what is lost in shifting away from "poetic," physician-crafted medical notes, Dr. Buchholz explains that templated notes allow the institution to collect of structured clinical data.Next, Dr. Buchholz discusses the impact of Epic on the institution's financial crisis of 2015-2016. He explains some of the systemic issues that compounded problems with the EHR system and offers his perceptions of how money is dispersed.
Chapter 16 (Institutional Change)
MD Anderson in Transition after Ronald DePinho's Resignation: Context (listen/read)
In this chapter, Dr. Buchholz begins to address the transition MD Anderson has been experiencing around Ronald DePinho's resignation only five and a half years after becoming the institution's fourth president. He first addresses the low faculty morale under Dr. DePinho and offers a critical perspective of how the situation was addressed, based on a White Paper prepared by the executive committee of the Faculty Senate at the request of Chancellor McCraven and published in July 2015. Next, Dr. Buchholz characterizes Dr. DePinho as a boss and talks about the lack of cohesion within the executive leadership team.
Chapter 17 (Institutional Change)
MD Anderson in Turmoil Under Ronald DePinho: A Critical View of the UT System Response (listen/read)
In this chapter, Dr. Buchholz offers a critical perspective on the measures that leadership at UT System took to address the turbulence at MD Anderson under Dr. Ronald DePinho. Specifically, he cites the fact that no one from UT System personally came to MD Anderson to speak with those on the executive leadership committee about the situation or to conduct their own assessment of Dr. DePinho. Dr. Buchholz talks about the UT System solution of appointing Dr. Stephen Hahn [02/03/2017] to be deputy president and chief operating officer. He feels this was done in recognition of the strength of Dr. DePinho's "outward facing skills," but lesser strength as an institution administrator. In support of his view that UT System didn't not communicate adequately with MD Anderson's executive leadership, he explains that the committee was not informed of Dr. DePinho's resignation [8 March 2017] and given no opportunity to discuss preparations for that event or the transition period. Dr. Buchholz talks about a phone call in which Stephen Greenberg tested his interest in serving as interim president.
Chapter 18 (Institutional Change)
MD Anderson in Transition after Ronald DePinho (listen/read)
In this chapter, Dr. Buchholz talks about the administrative confusion that took hold after Dr. DePinho's resignation when the institution was dealing with a complete administrative restructuring, not merely a process of replacing the president. He talks about why Dr. Marshall Hicks was selected as interim president and how the eventual selection of Peter Pisters, MD to head the institution made sense. He comments on his own experience of being asked to leave his position as physician in chief and return his department without any administrative responsibilities.
Chapter 19 (Post-Retirement Activities)
A New Opportunity in California (listen/read)
In this final chapter of the interview, Dr. Buchholz explains his decision to retire from MD Anderson (effective 02/28/2018) to assume the role of Medical Director at the Scripps MD Anderson Cancer Center in San Diego (effective 04/16/2018). He talks with great feeling about his time at MD Anderson and describes the sendoff he is getting from colleagues as "awesome."