Submitted: 27 June 2014
Three interview sessions: 26 September 2012, 28 September 2012, 17 October 2012
Total approximate duration: 6 hours
Interviewer: Tacey A. Rosolowski, Ph.D.
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
Javier Garza, MSIS, email@example.com
About the Interview Subject:
Dr. John Mendelsohn, MD (b. 31 August 1936, Cincinnati, Ohio) came to MD Anderson from Memorial Sloan Kettering Cancer Center in 1996 to become the institution’s third full-time president. Dr. Mendelsohn’s research focused on epidermal growth factors, resulting in the discovery of the monoclonal antibody, cetuximab, that blocked tumor growth. During his fifteen years as president, he was responsible for overseeing unprecedented growth of all dimensions of the institution. After stepping down as president, he continues to serve MD Anderson as a Professor of Experimental Therapeutics and as Director of the Institute for Personalized Care.
Major Topics Covered:
Personal and educational background
Overview of research career
Administration and institution building at UCSD and Memorial Sloan Kettering
The MD Anderson presidents
MD Anderson mission and culture
Overseeing MD Anderson growth: mission areas, translational research, physical plant
Dr. Mendelsohn’s “cancer care cycle” and the MD Anderson Institutes
Global Programs, sister institutions
The Cancer Care Cycle and the MD Anderson research institutes
The Zayed Institute for Personalized Care
Regarding the Transcript and Audio Files
In accordance with oral history best practices, this transcript was intentionally created to preserve the conversational language of the interview sessions. (Language has not been edited to conform to written prose).
The interview subject was given the opportunity to review the transcript. Any requested editorial changes are indicated in brackets [ ], and the audio file has not correspondingly altered.
Redactions to the transcript and audio files may have been made in response to the interview subject’s request or to eliminate personal health information in compliance with HIPAA.
Interview Session One: 26 September 2012
MD Anderson Presidents: Continuity and Sustained Institutional Growth
Chapter 01 / Overview
Chapter 02 / Personal Background
Working with Dr. James Watson
Chapter 03 / Educational Path
Early Experiences with Administration
Chapter 04 / Educational Path
An Overview of a Research Career
Chapter 05 / The Researcher
Institution Building at UCSD and Memorial Sloan Kettering
Chapter 06 / The Administrator
Responding to Immediate Challenges
Chapter 07 / Building the Institution
A New President Takes MD Anderson into Growth Mode
Chapter 08 / The Business of MD Anderson
Interview Session Two: 28 September 2012
Defining the Mission that Shapes MD Anderson Growth
Chapter 09 / Building the Institution
Growth in Research and Clinical Care
Chapter 10 / Building the Institution
Growth in Education and Prevention
Chapter 11 / Building the Institution
Marketing and Fund-Raising
Chapter 12 / The Business of MD Anderson
MD Anderson’s Institutes: Transforming Cancer Care Through Research
Chapter 13 / Building the Institution
The George H.W. Bushes Support MD Anderson Fundraising
Chapter 14 / Building the Institution
The Global Programs and Research Park
Chapter 15 / Building the Institution
Patients: from the Wealthiest to the Indigent
Chapter 16 / Overview: Patient Populations
Interview Session Three:
MD Anderson and the Texas Medical Center
Chapter 17 / Overview
MD Anderson, the Texas Medical Schools, and the Graduate School
Chapter 18 / MD Anderson Past
Prevention and Care Become Academic Fields
Chapter 19 / Building the Institution
Growing Research and Faculty Careers
Chapter 20 / The Administrator
Building Translational Research
Chapter 21/ The Administrator
Chapter 22 / Beyond the Institution
The New Personalized Care
Chapter 23 / Overview
The Institute for Personalized Care
Chapter 24 / An Institutional Unit
Creating Growth and Supporting Values
Chapter 25 / A View on Career and Accomplishments
Life Partnership with Anne Mendelsohn
Chapter 26 / Personal Background
Interview Session One: 26 September 2012 (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Overview)
MD Anderson Presidents: Continuity and Sustained Institutional Growth (listen/read)
In this Chapter, Dr. Mendelsohn first talks about his predecessors, Drs. R. Lee Clark and Charles LeMaistre. He then discusses the challenges that confronted him when he took over presidency of MD Anderson and reflects on what long presidential tenures have enabled each president to accomplish.
Dr. Mendelsohn describes Dr. Clark as ambitious and anxious to create a special medical institution in Houston, given his understanding of where medical oncology was going. Dr. LeMaistre brought his strength in organizing and leading medical operations at a time when the institution needed a broader management team. Dr. Mendelsohn credits Dr. LeMaistre with expanding MD Anderson’s interactions with the community and setting up a pattern of growth that he would build on during his own presidency.
Dr. Mendelsohn says he came to MD Anderson during a “wonderful time to be president of an academic, medical institution”, because of the country’s economic strength and growing public awareness of the sophisticated measures needed to treat cancer. It was therefore ironic, he notes, that the institution was downsizing and fearful that managed care systems would not cover treatment costs at “specialty hospitals.” He says the MD Anderson faculty realized that cancer could only be pioneered at a place like MD Anderson. He also notes that the retrenchment mentality did not take account of the American public’s willingness to pay for the best treatment.
In the last minutes of this Chapter, Dr. Mendelsohn comments on the long presidential tenures at MD Anderson. Duration, he explains, gave him time to build trust within the institution so growth plans were not top-down. Growth could also go on unperturbed, evolving through a process. He notes that each MD Anderson president was fortunate to have time and resources to develop action plans that could evolve over years.
Chapter 02 (Personal Background)
Role Models (listen/read)
Here Dr. Mendelsohn talks about his believe that an individual can actively create his/her personality through contact with role models. He begins the Chapter talking about his gift for taking a vision and putting it into action. After a brief description of his high school and family, he talks about important role models, beginning with his parents, his father modeling a gentlemanly demeanor and a passion for books, his mother demonstrating how to organize activities for the benefit of others. Through friends he discovered families organized differently from his own, and discovered that he enjoyed lingering around the dinner table, “solving the world’s problems” (a lifestyle he created in his own marriage). He also mentions his uncle, who was a frustrated doctor, and built heart valves for the University at Cincinnati.
Chapter 03 (Educational Path)
Working with Dr. James Watson (listen/read)
In this Chapter, Dr. Mendelsohn speaks about a key experience that led him to medicine. Though focused on science in high school and early college, Dr. Mendelsohn had never thought about becoming a doctor (and admits that the thought of blood and the responsibility scared him). He had the luck, he says, to be at Harvard when the structure of DNA has just been unraveled, and found an opportunity to work in the lab of Dr. James Watson. There he discovered the excitement of research, of designing experiments to build new knowledge, and the thrill of working with the latest scientific equipment. (He tells a funny anecdote about a centrifuge.) He characterizes Dr. Watson as a researcher with a very clear vision of what would happen in the areas of genetics and molecular biology, but notes that he was not a detail person. Alfred Tissieres, a second individual in the laboratory, influenced Dr. Mendelsohn’s understanding of experimental design. Dr. Mendelsohn explains that Dr. Watson encouraged him to go to graduate school, but he wanted to work with people. It was at this point in his college career that he began to formulate the then unusual idea that laboratory science could help people –an early inkling of the translational approach he would later develop.
Chapter 04 (Educational Path)
Early Experiences with Administration (listen/read)
Here Dr. Mendelsohn gives an overview of experiences that helped shape his administrative skills and put him on track to a good fit with MD Anderson. He first recalls watching and learning as a high school friend used interpersonal skills to get elected to president of a fraternity. Dr. Mendelsohn then reflects on administrative lessons gleaned from the Harvard Medical School. He first saw how a “complex arrangement of prima donnas put together a program.” During rotations through four teaching hospitals, he was also exposed to very different ways of organizing clinical care and learned to see through different lenses. He felt most affinity to the arrangement at Beth Israel Hospital, which was very focused on caring, an attitude he found at MD Anderson as well and an important quality that made MD Anderson a good fit for him. At the end of this Chapter, Dr. Mendelsohn recalls his Fulbright year in Glasgow, Scotland, in 1959, when he recorded his personal passion in a diary. He wrote that he wanted to devote his life to science in order to improve medical care.
Chapter 05 (The Researcher)
An Overview of a Research Career (listen/read)
Here Dr. Mendelsohn provides a synopsis of his work on epidermal growth factor (EGF) and the discovery of monoclonal antibodies up to the point of joining MD Anderson. “Things fell into place between 1964 and 1974,” he says, noting as well that at the beginning of that period, there were no medical oncologists. By 1970, there was a greater understanding of cancer. From research focused on the mechanisms of cell division, some scientists were beginning to think about cancer as a loss of control over cell division. In 1980, during the period when Dr. Mendelsohn was at the University of California-San Diego, he became interested in epidermal growth factors and, in partnership with Gordon Soto, began to see if blocking the binding site for EGF would influence cancer. He explains the mechanism of EGF in tumors and describes the role of tyrosine kinases (one kind of protein that stimulates growth and can become stuck in the “on” position) and how understanding of these processes let to the discovery of monoclonal antibodies that would block the sites where growth factors could bind and stimulate tumor growth. He talks about the first grant proposal he submitted –and how it was turned down (and eventually funded by private money), noting that public grantors are often risk averse and wait until an experimental theory shows promising results. This work was eventually lavishly funded. Dr. Mendelsohn ends this Chapter by explaining that he came to MD Anderson with a laboratory and four grants. However he had to devote all his efforts to the institution and so closed his laboratory –a very difficult action to take.
Chapter 06 (The Administrator)
Institution Building at UCSD and Memorial Sloan Kettering (listen/read)
In this Chapter, Dr. Mendelsohn discusses the two major roles in institution building that prepared him to assume leadership of MD Anderson. First, in 1970, he was invited to start a new medical school at the University of California-San Diego. It began, he recalls, with twenty people, two rooms, and a “teeny clinic.” He talks about the challenges of creating a school from scratch, but notes that it was a “dream school” where the students wanted to combine science and medicine. He also discusses why it was important for the Medical School to add a cancer center and explains why he was asked to create the center –an initiative that gave him his first experience running a capital campaign. He lists the administrative lessons UCSD taught him, then briefly describes his experience working under Paul Marks at Memorial Sloan Kettering, where he was hired to expand the Department of Medicine and integrate laboratory science into the clinical departments.
Chapter 07 (Building the Institution)
Responding to Immediate Challenges (listen/read)
In this Chapter, Dr. Mendelsohn talks about the process of applying for the position of president of MD Anderson and then explains the economic situation he discovered when he assumed the position. Dr. Mendelsohn was invited by the search committee to apply and he was pleased at that point in his career to have the opportunity to head an entire cancer center and notes that when his wife, Anne, first saw the Texas Medical Center, she asked, “Is this Oz?” Dr. Mendelsohn was impressed with MD Anderson because he saw an institution-wide passion for clinical care based on research. He did not know about all of the institution’s economic problems before his arrival, nor did he know of plans to downsize beds by fifty percent, for example. It was clear that there was a faculty of physician scientists who were looking for a leader. Dr. Mendelsohn gives some examples of the challenges he saw when he arrived. (The hospital and the cancer center had different chief financial officers, for example. ) He received good advice from a frienDon’t do anything for one hundred days. Dr. Mendelsohn spent the time talking to departments about what they needed. He discovered, for example, that a new phone system had been installed and users had to push nine buttons before hearing a live human voice, a frustration that caused twenty percent of callers to hang up. He heard complaints about how long it took for x-rays to be read and pathology reports to be generated. These conversations led to concrete action: new hires in pathology and radiology, and putting back the old phone system, for example. Dr. Mendelsohn also observes that quickly doubling the size of the institution also sped up the process of reorganization. He gives the example of how moving faculty offices (and their secretaries) out of the clinics, there was more room for clinical services. Teams were set up to study efficiency and cut costs by twenty percent. He states that this process will again be important if insurance companies bundle services (reimbursing a total of $75,000 to treat leukemia, for example, instead of reimbursing for individual treatments and services required).
Chapter 08 (The Business of MD Anderson)
A New President Takes MD Anderson into Growth Mode (listen/read)
Here Dr. Mendelsohn gives more detail on how he set up to use good business management models to turn around MD Anderson’s trend toward reduction in services just at a time when the field was developing exciting therapeutic possibilities for patients. The Board of Visitors, he explains, was key to the process, being comprised of excellent businessmen, and he told them, “I’m going to pretend you are my fiduciary board.” The Board advised him to hire a chief financial officer who knew how to make deals (resulting in the hiring of Leon Leach) and to develop business plans based on very clear balance sheets.
Next, Dr. Mendelsohn explains that the first four or five years of his presidency were devoted to making MD Anderson a more user-friendly place. He notes some of the accomplishments of the perioreducing wait times, scheduling appointments by hours (instead of less precisely as morning or afternoon), and working to reduce the wait time for an intake appointment to 8-10 days. The first year, in particular, he says was a difficult time as he and his advisors got rid of 80% of management people and also embarked on the project of writing a very bold mission statement. He brought in the Richards Group to design a new logos and theme-line, “Making Cancer History,” both of which enabled the institution to stop being inward looking and embrace the goal of becoming the premier cancer center. The institution’s values were also articulated, which also helped solidify the culture and community.
Interview Session Two: 28 September 2012 (listen/read)
Interview Identifier (listen/read)
Chapter 09 (Building the Institution)
Defining the Mission that Shapes MD Anderson Growth (listen/read)
Dr. Mendelsohn explains how the unprecedented growth accomplished during his presidency was not growth for growth’s sake, but guided by the MD Anderson mission. First he explains the three factors enabling growth in the mid and late nineties. First the public was beginning to understand the complexity of cancer care. Demand for sophisticated treatment was building and patients wanted access to an outstanding facility. Second, MD Anderson had one hundred research programs in existence and they were producing knowledge about what cancer care might be. The faculty wanted to expand research dramatically. Third, growth was managed through discussions with the Board of Visitors and Leon Leach (Executive Vice President and Chief Financial Officer), so that growth occurred in accordance with the institution’s mission. The planned parallel expansion in four areas: Research, Patient Care, Education, and Prevention.
Dr. Mendelsohn then focuses on the area of patient care, noting that expansion of clinical services increases profit margins that can support research. He reviews some growth statistics for the institution and points out the importance, during this period of improving efficiency and streamlining clinical research programs. He also explains that he asked his son (enrolled at the Wharton School of Business) to draw up a reading list for him and he discovered Michael Porter’s Competitive Advantage. (He became friends with Michael Porter, who is now involved in the business management of medical care.) Competitive Advantage underscored the importance of a business understanding what it wanted to be: Dr. Mendelsohn uses Southwest Airlines to explain the concept and explains that decisions about institutional identity were made quickly at MD Anderson, given agreement that the institution should be the best. He notes that it was a ‘gutsy move’ at the time to add twenty million to the budget and he gives the Board of Regents credit for having the faith that MD Anderson knew what it was doing. He then turns to the subject of excellence, noting that physicians at MD Anderson want to be the best in their fields and that they are uniquely positioned to achieve this goal: MD Anderson physicians are “sub-subspecialists” in a team of similar individuals, a situation, Dr. Mendelsohn says, that breeds excellence, and that had the potential to actually be what the mission statement articulated. He then explains that this is why he did not combine MD Anderson with the Health Science Center –an idea entertained early in his presidency.
Chapter 10 (Building the Institution)
Growth in Research and Clinical Care (listen/read)
Dr. Mendelsohn clarifies the vision for changing the organization of the basic sciences. In creating the vision for change, his strategy was to appoint individuals on the front lines to define what was needed. The basic sciences, he says, were integrated in comparison to other institutions, but there were problems with their resourcing and management. Dr. Mendelsohn briefly explains these problems and the solutions instituted. Change was also made in the chain of responsible parties that faculty and staff would go to for resolution of problems or requests for resources. He describes the Executive Committee (Leon Leech, Kevin Wardell, David Hone, and Margaret Kripke) and their working style. He gives an example of how research was developeby putting up the new faculty center and the Mays Clinic and expanding resources for imaging. The major limiting factor in research growth is space, and the Executive Committee planned which programs should migrate to Research Park.
Dr. Mendelsohn states that major growth occurred in research and clinical care, and this built on the consensus about developing ambulatory care, grouping physicians by cancer. He notes that the average hospital could not accomplish what MD Anderson has been able to because of competition within the institution between cardiology and cancer, for example. He notes that the reorganization of clinical services began under Dr. LeMaistre and continued to be led by the faculty. Returning to the subject of research, he notes that there were infinite possibilities for growth when he arrived. The Executive Committee targeted areas in which MD Anderson could become a leadership and that showed promise for patient care.
Chapter 11 (Building the Institution)
Growth in Education and Prevention (listen/read)
Dr. Mendelsohn outlines MD Anderson’s faculty-driven efforts to improve its educational programs and attract top students, noting that the institution has one of the top programs in radiation physics. MD Anderson recruits from its own programs to staff diagnostic laboratories. He sketches the histories of how the Health Sciences Center and MD Anderson were given degree-granting status, noting that MD Anderson is now in a position to have some of the world’s leading scientists. (He also comments on why it has taken MD Anderson so long to get to this stage.) Next, Dr. Mendelsohn talks about the institution’s cancer prevention initiatives inaugurated by Dr. Charles LeMaistre and implemented by Dr. Bernard Levin, who was head of the new prevention division. He evaluates why prevention was so slow to get started –and has been slow to evolve: the prime reason is that healthy people do not think to come to a cancer center for education or testing. What’s needed, Dr. Mendelsohn explains, is a prevention clinic such as the Mayo Clinic has, but he also points out features of that model that don’t work with MD Anderson’s culture. Dr. Mendelsohn points out that each area had the responsibility to create funds for its own growth.
Chapter 12 (The Business of MD Anderson)
Marketing and Fund-Raising (listen/read)
In this Chapter, Dr. Mendelsohn talks about change in business strategy that enabled MD Anderson to grow at an unprecedented rate. First he discusses shifts in how MD Anderson was described to the public –and to faculty-- as a cancer center that will treat individuals at any stage in their disease. He points out that two thirds of patients will not be research subjects, but faculty had to provide services to such patients to ensure the institution’s viability. He describes the changes in services this requires and then shifts in the marketing of the institution to the public. The original marketing budget was ‘miniscule.’ More money was directed to marketing and a firm hired to create the log, theme-line, and also to develop a strategy to put MD Anderson in people’s minds before they are diagnoses, so they already know that MD Anderson offers them hope. Next, Dr. Mendelsohn talks about the importance of private money for supporting institutional growth. He points out that patient care generates a small margin of income that helps support research, but funds for large growth initiatives in the physical plant and research must come from capital campaigns. Dr. Mendelsohn explains that the director of Development, Patrick Mulvey, raised the goals for fundraising every year until they reached 200 million per year. He praises the development team and tells an anecdote about Mr. Red McCombs’ gift to the institution.
Chapter 13 (Building the Institution)
MD Anderson’s Institutes: Transforming Cancer Care Through Research (listen/read)
In this Chapter, Dr. Mendelsohn explains how the research foci and services of MD Anderson’s institutes (The Institute for Basic Science, the Duncan Family Institute for Cancer Prevention and Risk Assessment, The McCombs Institute for the Early Detection and Treatment of Cancer, and the Institute for Personalized Cancer Therapy, and the Institute for Cancer Care Excellence) interlock in “cancer care cycle.” [Note: during this discussion, Dr. Mendelsohn refers to a diagram he developed, “Transforming Cancer Care through Research.” That image is provided below.] Dr. Mendelsohn explains that he worked out this overall vision of the relationship between the institutes and created the diagram to give potential donors a clear idea of how research has an impact on patient care. He anticipates that that Dr. Ronald DePinho’s research focus on specific cancers will generate optimism for raising money. At the end of this Chapter, Dr. Mendelsohn comments on MD Anderson’s development initiatives and notes that it is amazing for a public institution to raise money at the levels of a private institution, a process that could only happy through the combined efforts of the Board of Visitors, Development, and the Faculty.
Diagram designed by Dr. John Mendelsohn, provided with his permission.
Chapter 14 (Building the Institution)
The George H.W. Bushes Support MD Anderson Fundraising (listen/read)
In this Chapter Dr. Mendelsohn explains the important role of former president George H.W. Bush and his wife, Laura Bush in MD Anderson’s fundraising efforts. He begins by explaining that the Bushes were interested in cancer because they had a child who died of leukemia. Dr. Mendelsohn’s wife, Anne, came up with the idea to ask the Bushes to use MD Anderson as a setting to celebrate George Bush’s seventy-fifth birthday for an awareness and fundraising event. He describes the impact of that large event –raising money and awareness of MD Anderson. Dr. Mendelsohn was interviewed by the Wall Street Journal and other periodicals and the institution was ranked #1. He then explains how George Bush was asked to be on the Board of Visitors, and Dr. Mendelsohn offers an anecdote about his skill at running meetings.
The Global Programs and Research Park (listen/read)
Dr. Mendelsohn begins this section by briefly describing his global program designed to foster training and research exchange with other cancer institutes around the world. His explains that his goal was to strengthen MD Anderson’s global presence and there is no question that sister institutions abroad helped increase the institution’s name recognition, though international traffic to MD Anderson dropped after 9/11. Dr. Mendelsohn next talks about the expansion of South Campus, or Research Park, on one hundred acres of land owned by the Health Science Center. He sketches the sequence of buildings constructed, noting that there was no master plan, but a plan evolved and Dr. Margaret Kripke negotiated many of the details. Dr. Mendelsohn then explains that he had envisioned that Research Park might serve as the hub of a new “silicon valley” of biotech companies around MD Anderson. He then sketches the kinds of relationships that could be forged between MD Anderson and biotech companies.
Chapter 16 (Overview)
Patients: from the Wealthiest to the Indigent (listen/read)
Dr. Mendelsohn begins this Chapter with a brief description of a gift of 150 million dollars from Abu Dhabi designed to invest in making cancer care even better. He turns to the subject of MD Anderson’s international patients, noting that there have been fewer since 9/11 and represent only 3% of patients. He MD Anderson could do better in this area. International patients need a concierge service, for example. They pay in cash as they go out the door and billing needs to work differently for them. However, he stresses that despite some special accommodations, it is important to MD Anderson’s mission that all patients receive the same level of care. He recalls the rules the Executive Committee adopted to help decide how to make institutional change: Is this something we do for the sake of our mission; can it be done in a way we can be proud of; can we avoid losing money doing it; and do we have the resources and skills to do it. Dr. Mendelsohn explains that he has not looked at the changes made under his leadership as corporatization, but as responsible management. He then speaks about the indigent patients MD Anderson serves (about 8%) and the difficult cases of individuals who are not technically indigent, but who are very economically stressed. (Patient Services works out payment plans for them.) He states that the U.S. has to work out a system in which everyone is covered.
Interview Session Three: 17 October 2012 (listen/read)
Interview Identifier (listen/read)
Chapter 17 (Overview)
MD Anderson and the Texas Medical Center (listen/read)
In this Chapter, Dr. Mendelsohn clarifies the relationship between MD Anderson and the Texas Medical Center, beginning with a brief sketch of the history of the TMC. He points out that the TMC is run by a not-for-profit board that controls the use of land originally donated by George Hermann. Some MD Anderson land is leased from the TMC. Dr. Mendelsohn reviews the regulations for use of the land and lists the institutions within its limits, noting that it is a mixture of groups related to care delivery. Dr. Mendelsohn explains that he met with the leadership of the TMC fifteen years ago to create more collaboration between the institutions within the TMC, raising its profile as the largest medical center in the world. He offers an example of collaboration between neurosurgery at Baylor and MD Anderson (for five years the two institutions have shared a chair of neurosurgery) and explains the advantages of collaboration.
Chapter 18 (MD Anderson Past)
MD Anderson, the Texas Medical Schools, and the Graduate School (listen/read)
In this Chapter Dr. Mendelsohn talks about the linked history of four educational institutions, MD Anderson, the Baylor College of Medicine, the UT Medical School, and the Graduate School of Biomedical Sciences under the administration of the Health Sciences Center. He goes back in history and recalls that in 1941, the Regents of the University of Texas System made the “amazing decision” to create a branch of the medical school that was a cancer center, with the MD Anderson Foundation providing the money. He recounts the linked history of how Houston acquired by the Baylor College of Medicine and the UT Medical School, then talks about creation of the Graduate School and the move to allow MD Anderson degree granting status on Graduate School degrees. Dr. Mendelsohn then moves to an evaluation of the Graduate School, which he believes should be smaller and focused on admitting only the best students. He discusses several ways in which the Graduate School could be academically stronger, particularly in building up its curricula in computer analysis-informatics, areas that will be key for the biotech workforce in the next ten years.
Chapter 19 (Building the Institution)
Prevention and Care Become Academic Fields (listen/read)
Here Dr. Mendelsohn talks about the significance of building dimensions of MD Anderson’s mission (Care, Research, Education, Prevention) into academic fields, in particular patient care and cancer prevention. He notes that Dr. Ronald DePinho’s Moon Shots Program includes prevention. He mentions a new program in prevention and the fact that nursing has become a more academic field with the granting of Ph.Ds.
Chapter 20 (The Administrator)
Growing Research and Faculty Careers (listen/read)
Here Dr. Mendelsohn focuses on his leadership style and its application to academic growth at MD Anderson. His aim, he states, is to “build what I’m working on into the best.” He does this by building units internally and also by building collaboratively, “when there is excellence nearby.” MD Anderson, he notes, is a very top-down institution, and so it was important to set up a structure with clear leadership for different operational areas: the CFO and vice presidents for education, care, and research. He also talks about the importance of involving faculty when undertaking new initiatives and uses the example of the growth of South Campus. He admits that the sheer size of MD Anderson has been a challenge as his experience was with much smaller environments. He maintained personal contact with faculty during his presidency, and talks about individuals coming to him for career advice, giving an example of a discussion about taking a chairmanship at another institution. He states that a leader of MD Anderson needs to state and restate his/her vision “like a mantra” and confirms that Dr. DePinho has stated a very clear vision, one that he classifies as “a big hairy goal.”
Chapter 21 (The Administrator)
Building Translational Research (listen/read)
In this Chapter Dr. Mendelsohn reviews the ambitious goals of the four (full time) MD Anderson presidents. He explains that he himself built on the achievements of Dr. R. Lee Clark and Dr. Charles LeMaistre with the aim of linking research to bedside care. He notes the research advantages of the legislation passed in the 90s that allowed patients to self-refer to MD Anderson. A broader range of patients enabled faculty to see patients at all phases of the disease cycle and to give complete care from diagnosis throughout the course of the disease, a goal that has required implementation of multidisciplinary care teams.
Chapter 22 (Beyond the Institution)
Sister Institutions (listen/read)
In this Chapter, Dr. Mendelsohn talks the lessons learned by creating two sister institutions, MD Anderson Espana in Madrid (originally a for-profit institution) and Banner Arizona. He explains that it is important to select institutions that have the resources and will to operate in the “MD Anderson way,” and that it is important to visit the locations and spend the time necessary to offer on-site instruction and support. (He notes that the head nurse in leukemia spend three months in Madrid for this purpose.) Dr. Mendelsohn lists the benefits of these inter-institution relationships and explains that an aim is to raise standards at centers that may not originally offer the best quality of care.
Chapter 23 (Overview)
The New Personalized Care (listen/read)
In this Chapter Dr. Mendelsohn defines personalized care and offers an historical sketch of its development. Originally, Dr. Mendelsohn explains, doctors had few tools to treat cancer, so they offered care. Now it is possible to profile a disease in individual patients at the molecular and cellular level so physicians can hand-tailor care to what is wrong with an individual.
Chapter 24 (An Institutional Unit)
The Institute for Personalized Care (listen/read)
Here Dr. Mendelsohn discusses the mission and activities of the new Institute for Personalized Care, which he directs. Through the Institute faculty are studying the molecular, chemical, and genetic profiles of tumors in order to tailor care. He explains that the procedures under study are not reimbursed by insurance so Institute activities currently require philanthropic support so the mechanisms can be scientifically proven and admitted to the roster of “standard of care” procedures. He goes on to explain that this kind of personalized care requires a sophisticated infrastructure of support fields such as pathology and radiology. He also notes that it is a challenge to shift the thinking of clinicians and researchers so they understand that profiling tumors along the course of treatment can influence the treatment prescribed. Dr. Mendelsohn describes two protocols currently underway. The Clearing House Study of individuals with advanced cancer profiles tumors to insure these individuals are receiving the correct therapy. The Unusual Responders protocol focuses on patients who receive an experimental drug and seem to respond, but then no longer react positively to the drug. These tumors are sequenced a second time to investigate why responsiveness ceased. Dr. Mendelsohn notes that Institute protocols are currently examining forty-six genes, but will expand to two hundred. He notes that he will soon be meeting with the group that handles lung cancer to integrate tumor sequencing into their course of treatment so the results can tailor therapy.
He explains that this pioneering work will insure that MD Anderson continues to be the number one cancer center. The Institute is developing instructional tools so that physicians can quickly take advantage of discoveries. He stresses how important it is to build a medical informatics system to process the complex data from these studies. The Institute is currently talking to IBM about means of tracking and packaging data.
Next, Dr. Mendelsohn outlines future plans for the Institute for Personalized Care. The Institute will continue to build up training, particularly in data-interpretation. (One challenge is creating programs to account for the genetic degradation of samples, for example.) He notes that a project on the genomes of survivors will be linked to Dr. Ronald DePinho’s “moonshots.” There are also many areas for further research. The tools are all available, he explains, to discover how the genes of a tumors influence RNA and protein expression. It will also be important to examine the role of patients’ immune systems and eventually the immune profile will form part of what the Institute for Personalize Care provides. Dr. Mendelsohn explains that it is important to investigate less invasive ways of getting to a patient’s tumor and explains a blood test that will eventually yield information about the tumor profile. He then explains tumor heterogeneity –tumors change genetically at a very rapid pace.
Chapter 25 (A View on Career and Accomplishments)
Creating Growth and Supporting Values (listen/read)
In this Chapter Dr. Mendelsohn discusses his most meaningful accomplishments as MD Anderson’s third president. He is very pleased that the number of patients served doubled during his tenure and that he build up the institutions research, education, and prevention initiatives in parallel with patient care. MD Anderson, he says, is saving a lot more people and doing a lot more research. He is pleased that the institution is rated number one by rating agencies and by the cancer community. He is also pleased at the levels of grant supported research and the increase in the research budget. MD Anderson is number one in receiving funds from the National Cancer Institute and especially strong in grants supporting translational and clinical work. This means that the institution can attract patients and also attract excellent faculty. He is also pleased that MD Anderson is “a happy place to work” and that he had a part in formally articulating the institution’s values. Finally he says that he is pleased with the spirit of collaboration that he had a part in developing, particularly as collaboration is so important in bad economic times.
Chapter 26 (Personal Background)
Life Partnership with Anne Mendelsohn (listen/read)
In this Chapter, Dr. Mendelsohn speaks about his wife, Anne, who has been an important “intellectual and action partner in everything” he has done. (He notes that they just celebrated their fiftieth anniversary.) As examples he explains that Anne Mendelsohn created the equivalent of the Board of Visitors at the University of California –San Diego. At MD Anderson she started the yearly Christmas party for faculty and was also instrumental in building relationships with Board of Visitor members and other potential donors. He notes that they have been honored as a couple seven times, which is very rare. Dr. Mendelsohn explains that he and his wife are a part of the Houston community. They have friends from all parts of life. When he retires, they will stay in Houston, which is now home. He is now chairman of the board of the Houston Grand Opera.
This interview of Dr. John Mendelsohn (b. 31 August 1936, Cincinnati, Ohio), was conducted during September/October of 2012 as follow up to an interview conducted in 2005 by Dr. James Olsen. From 1996 to 2011, Dr. Mendelsohn served as MD Anderson’s third full-time president. He continues to serve the institution as a professor of experimental therapeutics and as Director of the recently created Institute for Personalized Care. The interview sessions take place in a conference room at the Institute for Personal Care in the John Mendelsohn Faculty Center on the main campus of MD Anderson. Tacey A. Rosolowski is the interviewer. The interview, in three sessions, has a total duration of about six hours.
Dr. Mendelsohn earned his B.S. in biochemical sciences from Harvard College in 1958. In 1963, after spending a year in Glasgow, Scotland, on a Fulbright Scholarship, he was awarded his M.D. from Harvard Medical School. He completed his residency training in internal medicine at Brigham and Women’s Hospital in Boston. He served as a Research Associate at the National Institutes of Health (’65 –’67) and completed a Fellowship in Hematology at Washington University in St. Louis, Missouri (’68 – 70). In 1970, Dr. Mendelsohn joined the faculty of the University of California, San Diego where he established a National Cancer Institute-designated cancer center, which he directed from 1976 to 1985. While there, his team initiated research on epidermal growth factor reception inhibition and produced a monoclonal antibody, cetuximab, that blocked tumor growth. In 1985 Dr. Mendelsohn moved to Memorial Sloan-Kettering Cancer Center to chair, reorganize and expand the Department of Medicine. He held the Winthrop Rockefeller Chair in Medical Oncology and co-headed the Program in Molecular Pharmacology and Therapeutics for five years. He has authored over 250 scientific papers and book chapters. Dr. Mendelsohn assumed the presidency of MD Anderson in 1996. During his fifteen-year tenure the institution grew at an unprecedented pace: the research budget quadrupled, the physical facilities tripled, the number of patients doubled, and the level of philanthropy grew tenfold. The institution was named the nation’s number one cancer hospital during eight of the last ten years of his presidency and the institution began to award graduate degrees in biomedical sciences and bachelor’s degrees allied health professions. Among Dr. Mendelsohn’s numerous awards are the 2006 Dan David Prize, the 2005 Fulbright Lifetime Achievement Medal, the 2008 Dorothy P. Landon-AACR Prize for Translational Cancer Research, the 2009 Lifetime achievement Award from the 10th International Workshop on Molecular Targeted Therapy of Cancer, the 2011 American Cancer Society Medical Honor for Clinical Research, and the 2012 Sixth Annual AACR Margaret Foti Award for Leadership and Extraordinary Achievements in Cancer Research. He has also been selected for the Research America 2013 Builders of Science Award.
In these interview sessions, Dr. Mendelsohn traces the evolution of his collaborative leadership style and discusses in detail his strategies for planning the growth of MD Anderson in the areas of research, education, patient care, prevention and philanthropy. He gives significant insight into how MD Anderson’s administration was transformed to take advantage of business principles and has thereby successfully navigated through difficult financial times. He also discusses his research and his lifelong commitment to bench-to-bedside translation of science, an interest that he continues to pursue in current role as Director of MD Anderson’s Institution for Personalized Care.