Submitted: 24 October 2017
Two sessions: 6 July 2017, 12 July 2017
Total approximate duration: 1:50
Interviewer: Tacey A. Rosolowski, Ph.D.
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
Javier Garza, MSIS, firstname.lastname@example.org
About the Interview Subject:
William M. Wooten, PhD (b. 25 February 1947, San Angelo, Texas) came to MD Anderson in 2001 to serve as founding Executive Director of the Office of Business Transformation in the Division of Human Resources. During his 16 years of service to the institution, he provided what he calls “boutique consulting services” to individual leaders as well as departments/divisions to improve work processes and business practices. He acquired detailed and comprehensive knowledge of the inner workings of the institution. He retired in April of 2017, at which time the Office he founded was dismantled.
Major Topics Covered:
Personal background and education
Professional path and evolution of a unique perspective on organizational development
The field of organizational psychology and its relevance to MD Anderson
Critical evaluation of how MD Anderson functions as an organization
Anecdotes to demonstrate process improvement at many levels of organizational function
Commentary on executive leadership
Views on MD Anderson presidents and shifts in administration
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.
Interview Session One: 6 July 2017
Organizational Psychology and MD Anderson
Chapter 01 / Overview
An Evolving Interest in People and Organizations
Chapter 02 / Personal Background
Military Experience and Observing the Military as an Organization
Chapter 03 / Professional Path
Professional Roles Prior to MD Anderson
Chapter 05 / Professional Path
A Critical Perspective on MD Anderson; the Institution’s Style of Decision Making; Management Anecdotes
Chapter 06 / MD Anderson Culture
Interview Session Two: 27 July 2012
The New Office of Business Transformation
Chapter 08 / Building the Institution
A Project with Radiation Oncology and General Comments on Transformation Processes
Chapter 09 / Building the Institution
A Plan for Genetic Counseling and Working with UT Police
Chapter 10 / Building the Institution
Uncovering Surprising Situations in MD Anderson’s Work Cultures, Some Comments on Trust, and Views of Leadership Training
Chapter 11 / Building the Institution
A Project with the Division of Surgery, On Robotics, and an Orphan Project
Chapter 12 / Building the Institution
Looking Back and Looking Ahead to Retirement
Chapter 14 / View on Career and Accomplishments
Interview Session One: 6 July 2017 (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Overview)
Organizational Psychology and MD Anderson (listen/read)
In this chapter, Dr. Wooten provides an overview of his field of expertise, organizational psychology, and notes the types of issues he addressed through this lens at MD Anderson. He discusses the unique features of MD Anderson as an institution and a workforce.
He begins with some general background about the different subfields of psychology and summarizes organizational psychology: the study of how people in large groups operate within organizations. He describes his particular interest/expertise as being focused on the question, How do you make organizations healthier by improving workflow, interrelationships among employees, strategies of dealing with conflict, and coaching support. He notes that organizational culture is key to an institution’s health and shares an axiom: Culture eats strategy for breakfast every day.
Next, he offers some views on MD Anderson culture, noting its extreme diversity as well as the fact that people are “emotionally very tied to the mission.” He explains another of his phrases, Public Pride, Private Pain.
Chapter 02 (Personal Background)
An Evolving Interest in People and Organizations (listen/read)
In this chapter, Dr. Wooten sketches his family and talks about the early deaths of his mother and father, both to cancer, events that inspired his enduring interest in healthcare and cancer. He reflects on his personal interests and talents, noting that he has always been a bibliophile, very curious and interested in observing people and their group behaviors. He notes that he took the lead in organizing events from the time he was very young, as well as his interest in math and science. His empirical, data focus combined with his interest in people led him first to study experimental psychology in college. He explains what led him to shift to organizational psychology.
Chapter 03 (Professional Path)
Military Experience and Observing the Military as an Organization (listen/read)
In this chapter, Dr. Wooten talks about his service in the Air Force (1969 – 1972) providing psychological services to airmen at bases in New Mexico. He talks about the impact of debriefing pilots who had been placed on administrative leave because of their refusal to fly (drop ordonnance) for ethical reasons. He explains that this influenced his own thinking about ethics.
Dr. Wooten also describes how the military functions as an organization and makes general comments about the intersection between his interests in psychology and in social/organizational behavior.
Chapter 04 (Overview)
Reflections on Links between Individual Psychology and Organizational Behavior –With Comments on MD Anderson Leadership (listen/read)
Dr. Wooten begins this chapter by talking about how his interests became focused during his masters (in psychology, Minnesota State University, Mankato, conferred in ’76 or ’77) and PhD programs (Organizational Psychology, University of Minnesota, Minneapolis, conferred 1981). He talks about the research he conducted for his dissertation on the role of self-talk on an individual’s motivation and talks about the implications for organizations.
Dr. Wooten then reflects more broadly on why organizations are successful and then turns to an evaluation of how MD Anderson chose Dr. Ronald DePinho to serve as the institution’s fourth president, noting that he has seen many transitions in business contexts. He discusses the culture of the institution, noting that MD Anderson is very “Shakespearean.” He briefly sets MD Anderson in the context of the institutional cultures of other cancer centers.
Chapter 05 (Professional Path)
Professional Roles Prior to MD Anderson (listen/read)
In this chapter, Dr. Wooten discusses a job he held during his graduate programs as Vice President/Regional Administrator of REM, INC., in Edina, Minnesota (1975 – 1990), a facility for people with disabilities. He talks about developing his conviction that a “society needs to take care of people” by providing safety nets.
He then talks about working with challenges from neighborhoods that didn’t want group home build and comments on how to help people through periods of change.
Next, Dr. Wooten notes that he worked as Executive Vice President/Chief Operating Officer/Board Director at a similar organization, the VOCA Corporation in Dublin, Ohio (1990 – 1992), but was relieved to be recruited away because of concerns about business practices.
He next briefly talks about his executive leadership program at Ohio State University and notes that he was unusual at VOCA, as he brought together business and psychology through a PhD.
Next Dr. Wooten talks about his work as President of Living Centers run by DevCon and Living Centers of America in Houston (1992 – 1996). He talks about his expanded responsibilities and the relationship he had with the CEO, who relied on him to be a sounding board.
He then talks about being recruited to an opportunity to become a part owner in a start-up that purchased part of American Living Centers.
Chapter 06 (MD Anderson Culture)
A Critical Perspective on MD Anderson; the Institution’s Style of Decision Making; Management Anecdotes (listen/read)
In this chapter, Dr. Wooten talks about being recruited to MD Anderson and provides an overview of MD Anderson as an organization and its approach to a few key issues.
He first talks about his track record fixing operating issues to bring organizations to greater health, noting that this brought him to the attention of MD Anderson. He talks about “job imbeddedness theory” and the three reasons) people stay at an institution (fit, linkages, willingness to sacrifice, noting how this applies to MD Anderson.
He tells an anecdote about firing an individual after only a brief period of employment and the resulting evaluation of the hiring process this inspired.
Next, Dr. Wooten talks about the MD Anderson focus on innovation. He notes that regarding new ideas and technologies, “we are kids in candy story,” and he characterizes MD Anderson as an impulsive organization rather than a reflective organization. He explains that impulsivity is fine if an organization can control the cost of failure.
Chapter 07 (Overview)
Distributed HR, A View of MD Anderson, Physicians as Leaders, and Two MD Anderson Presidents (listen/read)
Dr. Wooten begins this chapter by explaining that the institution is well-intentioned but often disorganized, characteristics that have been masked because the institution enjoyed financial security until the last five years. Money could be used to solve problems. He also explains why the institution has tended to listen to outsiders, reflecting “an inability to lead ourselves, and he notes that physician-led institutions are often not successful. He comments on the leadership styles of Charles LeMaistre and John Mendelsohn.
Next, as an example of the hubris he says characterizes physicians, Dr. Wooten tells the story of working with a faculty member with anger issues, explaining how this individual’s change process unfolded over five years.
Dr. Wooten defines the difference between rational compassion and empathy and talks about the importance of forgiveness in organizations, including self-forgiveness. Finally, he comments on some of his own coaching and teaching styles, his use of poetry and literature to teach about organizations, and help individuals through the process of change.
Interview Session Two: 12 July 2017 (listen/read)
Interview Identifier (listen/read)
Chapter 08 (Building the Institution)
The New Office of Business Transformation (listen/read)
In this chapter, Dr. Wooten talks about the Office of Business Transformation that was created around his particular skill set and perspective when he was recruited to MD Anderson in 2001. He describes the activities of the office using a medical model/metaphor: diagnosing organizational problems to find their root causes and planning interventions to bring an organization to health. He explains that he would “imbed” himself into a department or division to assess its particular microenvironment and determine customized strategies and solutions.
Next, Dr. Wooten explains the timing for the office’s creation, noting that MD Anderson was poised on a cusp of evolving into a next phase of development created by impending physical growth under Dr. John Mendelsohn. He notes that the institution had a lot of inefficiency stemming from poor technology support and other dysfunction. He comments on challenges to business in general during this period.
He then describes the office as an “internal boutique consulting group” and contrasts his consulting approach to the “mass customization” of large consulting firms. He then talks about some aspects of MD Anderson culture that have created organizational problems.
Chapter 09 (Building the Institution)
A Project with Radiation Oncology and General Comments on Transformation Processes (listen/read)
In this chapter, Dr. Wooten discusses the project he initiated with the Department of Radiation Oncology and their IT group shortly after coming to MD Anderson. He talks about the array of problems he diagnosed focused on structural issues, leadership problems, and difficulties with the customer interface. Dr. Wooten explains that to propose solutions he observes, collects data, models workflow using diagrams, and assesses a situational holistically from the perspective of mission and strategy. He also talks about the challenges of selling a solution he devises to the stakeholders.
Next, Dr. Wooten explains that because of his detailed knowledge of many work microenvironments within the institution, he began to identify a systemic leadership problem, stemming from the fact that leaders and managers were selected not for the people skills, but on the basis of their research or other content-focused criteria. He notes that around this time, leadership training in general at MD Anderson was taken more seriously and developed. He contrasts “feel good” training with “true leadership training” that changes behavior and is susceptible to measurement.
Dr. Wooten again stresses his policy of customizing solutions to the needs of the group. He tells anecdote about an assessment performed by an outside consulting group that was never adopted.
He then makes general comments about how processes in healthcare in general have to undergo a “disruption” so they can move along an entirely new path to evolve into a functional form.
Chapter 10 (Building the Institution)
A Plan for Genetic Counseling and Working with UT Police (listen/read)
In this chapter, Dr. Wooten talks about two projects, one conducted with the University of Texas Police and the other a joint project conducted with the Departments of Breast Medical Oncology and Gynecologic Oncology.
He first talks about his relationship with the Chief of the UT Police, William H. Adcox, whom he describes as visionary. He then defines community policing (at UT Police goal) and lists some of the challenges that the UT Police have to address (e.g. protecting the cesium stored at the institution). He talks about his network analysis of the police force and the different between the formal chain of command and the unofficial chains of command/communication that were creating some difficulties.
Next, Dr. Wooten talks about the consulting with the Departments of Breast Medical Oncology and Gynecologic Oncology. He describes how faculty members representing the two departments were interested in reorganizing how genetic counseling was provided to patients. Dr. Wooten describes his solution to imbed counselors in individual clinics. He then explains the resistance created by the faculty member who at the time supervised all the genetic counselors and how leadership at higher levels of MD Anderson had to order that the reorganization be completed as proposed.
Chapter 11 (Building the Institution)
Uncovering Surprising Situations in MD Anderson’s Work Cultures, Some Comments on Trust, and Views of Leadership Training (listen/read)
In this chapter, Dr. Wooten tells several anecdotes that demonstrate different types of dysfunction he discovered when consulting with various departments and divisions within MD Anderson. In the first, he describes being called in to see why Information Technology was having difficulty with a reduction in bandwidth. Thanks to a whistle blower he interviewed, he discovered that three employees had set up offshore gambling using MD Anderson servers. He then talks about some issues at Smithville and the institution’s concerns to keep secure control of research data. He notes that dysfunctions often indicate that an institution dos not have good practices and policies in place with accountability mechanism. He also describes a project he did systematizing time and effort accounting for research grants.
He then talks about how many problems arise because of a lack of trust at the institution. He explains why this can happen in an institution where information represents power. He notes that employee surveys often show that trust is a consistent problem at MD Anderson. He explains that “this is a relationship business” and he advises hires to build their social capital as soon as possible.
Next Dr. Wooten comments on the current institutional reorganization and the plan to move Faculty and Academic Development into Human Resources. He explains why he believes this is a positive move for the institution. There is discussion of how training faculty and staff leaders together can enhance respect within the institution. The theme of respect is continued in the next segment.
Chapter 12 (Building the Institution)
A Project with the Division of Surgery, On Robotics, and an Orphan Project (listen/read)
Dr. Wooten begins this chapter with a discussion of a project he conducted beginning in 2011 at the joint request of the Division of Surgery and the Departments of Anesthesiology and Perioperative Care and their concerns about workflow in surgical theaters. He describes safety issues that were arising, discusses problems arising from hierarchical differences within the institution, and describes the revised governance system he proposed.
Next, Dr. Wooten talks about his process of analyzing and redesigning systems. He describes himself as a visual thinker and a model builder, and he describes how he draws on these skills to formulate systems in his mind as he envisions solutions to workflow problems. He also talks about the computer simulation software that he and his team have used to model and test solutions. He uses waiting room traffic flow as an example of how computer simulations can assist in problem solving.
Next, Dr. Wooten addresses the plans to take more advantage of robotics at the institution. He uses the example of a proposal to use robotic processes in the onboarding process for new hires. He notes that robotics don’t really replace people, but are used to perform repetitive and routine transactions.
Dr. Wooten then notes that internal clients have, at time, chosen not to implement solutions that he and his team have proposed. He gives an example of a project he conducted for the Department of Clinical Research Administration where problems centered on a difficult faculty member who was ultimately removed from a position of leadership. He notes that in partnership with Raymond Dubois, the then Provost, he formed the Research Operations Committee to formulate a monitoring process, however it was never adopted.
Chapter 13 (Overview)
On Resistance to Change, Future Visions, and the Fate of the Office of Business Transformation (listen/read)
Dr. Wooten begins this chapter with a discussion of the difficulties people have with change and the response of some to serve as saboteurs within an institution. He tells an anecdote about a hotel executive’s strict rules about his employee’s behaviors in order to ensure high quality customer service. This leads him to discuss the move to customer service at MD Anderson. He notes that the hierarchies within medical practice have made medicine slow to adapt to the customer service model. As an example of hierarchies, he explains that the length of white coats that healthcare workers wear indicates their status within the culture.
Next, Dr. Wooten explains that with his retirement, the team of the Office of Business Transformation has been split between different departments. He observes that his office was unique in the Texas Medical Center when it was founded. He says that, “What I do is much like music,” especially jazz. Dr. Wooten then reflects on where MD Anderson might be in ten years, noting that the institution now has serious competitors within Houston and Texas. He expects that the institution will have to form partnerships and notes that the biggest factor will be decisions made about healthcare funding at the federal level.
Chapter 14 (View on Career and Accomplishments)
Looking Back and Looking Ahead to Retirement (listen/read)
Dr. Wooten begins this chapter by observing that others have told him he has an impact on the institution. He says he hopes he has left a legacy of teaching people to be mindful of how to approach problems. His own philosophy of his contribution is that “we are all part of a relay race” and pass the baton on to others. He has felt very fortunate to have been affiliated with MD Anderson and to work in an institution working toward constant discovery.
Next he talks about some of his retirement activities, such as helping to lead a think tank on the future of healthcare and working with the United Way.
He closes the interview by speaking about the complexity of MD Anderson. He says “it’s theater. You see the play, but don’t really know what goes on behind the scenes.”
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