Conversation with The Cancer Letter
Rosen’s New Role is Part of an Evolution
Of Administrative Structure at City of Hope
Robert Stone, president and incoming CEO of City of Hope, described the evolution of the novel leadership structure at his institution.
While most directors of cancer centers have to fulfill a multitude of very different roles, City of Hope has redistributed these roles, creating the role of provost and chief scientific officer to shape and direct the scientific and educational activities at the institution.
The role encompasses all units of City of Hope: the Comprehensive Cancer Center, the Beckman Research Institute of City of Hope, a National Medical Center, a Medical Foundation, a graduate school for biological sciences, and nationwide philanthropy.
Earlier this week, City of Hope announced the recruitment of Steven Rosen, director of Northwestern University Lurie Cancer Center, to serve as the provost and chief scientific officer.
Stone spoke with Paul Goldberg, editor and publisher of The Cancer Letter.
Paul Goldberg: I don’t know of another cancer center that has this structure. How would you describe the box diagram of authority at City of Hope? How will the institution function?
Robert Stone: We have an institution-wide executive leadership team, of which Steve Rosen would be an integral part as the provost and chief scientific officer. All the academic and research aspects of our organization will flow through Steve.
PG: And then you?
RS: And Steve will report to me.
PG: And the cancer center director?
RS: Interestingly, it will work as Steve determines it should work. I told Steve when we recruited him that he would have the discretion to organize it under him as he thinks best.
It would be up to Steve whether the most effective structure is for him to be the cancer center director, whether he should be the cancer center director for a period of time and then recruit a new cancer center director who would report to him, or whether he quickly recruits a new cancer center director.
PG: He would be doing more than oncology, right?
RS: The provost position is a significant role for us. The cancer center is a major part of the role. We also have an important focus in diabetes research and basic science. We have a graduate school for biological sciences. All of these areas ultimately report to Steve.
We are also in the process of negotiating a relationship with the Providence Health System of Southern California that relates to their five hospitals in Southern California.
An important component of that relationship will be expansion of our research, so Steve would be involved there. It’s a significant job that touches every part of our organization.
PG: Cancer center directors—let’s just focus on one part of his position—have to be good at many, many things. They have to be scientists, administrators, executives of massive health systems, fundraisers, strategists, and nuts-and-bolts implementation people. Is there anything I missed?
RS: I think that covers it.
PG: Can one person be expected to be good at all that?
RS: I think it takes a team. No matter how you structure the leadership positions for our science and academics, it takes a team to be able to handle all the demands, much like it takes a team or a leadership community to handle all of the aspects of the organization as a whole.
Steve would tell you that he does not have any illusions of doing this job alone. He will be a leader of leaders. He intends to rely on good people who are here and good people that he will recruit.
PG: This power-sharing probably exists in most centers. But in this case, it’s actually formal that there is a team, and that the team includes the CEO who is a lawyer by education.
RS: City of Hope is a complex organization that exists in an increasingly complex environment. It takes members of a leadership team that have different skills. Let me give you an example. The Southern California marketplace will change perhaps dramatically as a result of health reform. Funding will become tougher. Reimbursement for clinical care will become less. There will be, I fear, the threat of decreased access for patients who would benefit from our care.
And Steve, with all of the experience he has, would do well in navigating that environment, but his focus should be on creating the most impactful research environment at City of Hope. We also have an executive officer of our medical foundation named Harlan Levine, who is a physician by training. Harlan came to us from WellPoint, where he was executive vice president of comprehensive health solutions.
Harlan is incredibly talented, yet he is not a cancer center expert.
The power we have in our executive team is combining the skills and experiences of Harlan Levine with Steve Rosen. I think it allows us to serve our mission and make an impact far greater than either of those two people can do alone.
And those are just two people. You add to that mix people like Marty Sargent, who is our chief operating officer, and Alexandra Levine, who is our chief medical officer, just to name two.
You start to understand that the whole is greater than the sum of the parts.
PG: How did the idea of power-sharing evolve?
RS: City of Hope, because it’s an independent organization that has different component parts to it, has always had a tendency towards collaborative leadership.
What I described is not wholly unique to what our history has been. We’ve always had a cancer center director who has the authority that’s required by the NCI. That will not change.
But the notion of taking different pieces and skills and putting them together isn’t new to us. We’ve just taken what for us is the next logical step and formalized it.
PG: Was it the board that came up with this idea? Was it you? Was it Michael Friedman [the retiring CEO and cancer center director]?
RS: The board obviously appointed me and made the decision that I should succeed Michael. But the notion of leadership community is something that I utilized when I became president about 18 months ago.
It actually started formulating when I was chief executive of our medical foundation before that, and this is just a logical extension.
PG: It would seem that a structure like this would work only when people know what they don’t know. Where does your knowledge stop?
RS: It’s a fair question. There are things that I must bring to the leadership team. Knowledge of the marketplace and how to best position City of Hope; how to build the type of culture that we’ve been talking about, a culture that continues our 100 yearlong dedication to serving humanity while still evolving to meet the current environment; and the ability to identify and recruit leaders who know what they don’t know and work well with others. I can bring that to this community—the commitment to putting the mission first.
I am not going to be the one who defines the best scientific direction to make the greatest impact. It’s why I am fortunate to recruit and hire people like Dr. Rosen. And, I know, one of the attractions of the position to Steve is my knowing what I don’t know and my ability to say to him: “You have the authority to set the scientific direction. Your charge is to help us deliver on our mission.”
PG: When did you join City of Hope?
RS: 1996. I joined as a junior member of the legal department and became general counsel of the medical center in 2000. I then became the entire organization’s general counsel in 2003.
PG: Did you ever think you would become the CEO?
RS: It was never in my career path. I came to COH back then because I saw it as an opportunity to make a difference. The successive responsibilities over the years have always been in pursuit of making an impact. When I started, the best way for me to do this was through the law.
As both the institution changed and the environment changed, several years ago, the best way for me to make the highest impact was to move into the strategy area, so I became chief strategy officer.
PG: That was Michael’s idea?
RS: It was. I’ve had the benefit of working with Michael since he got here. To the extent I have accomplished anything here, much of it is due to Michael putting me in the position to contribute.
He appointed me as general counsel and then as chief strategy officer. Then when we formed the medical foundation and the skillset needed there was to bring people together to a common goal, he named me chief executive. And then 18 months ago, he created the position of president and appointed me to deliver on the strategic plan.
PG: So what you are really saying is that Michael is the architect of this idea of group leadership, or power-sharing, or whatever you want to call it.
RS: Again, it’s embedded in our history. Architect is probably a word we never thought to use in this context. But it absolutely is something that has evolved under his leadership over the past decade.
PG: I guess I know many cancer centers that are run by lawyers, but that’s de facto. What’s unique here is that it’s formally so.
RS: First. I am a recovering lawyer. I have great admiration for the profession, but I haven’t practiced law in a number of years. So I look at the skills I bring as knowing the marketplace, the commitment to focus on culture and keep alive what’s been so special about us, and to recruit leaders like Steve Rosen.
If you look at the strength of the leadership team that we’ve assembled, the issue of what my educational background was long ago isn’t relevant. What will be relevant is how I will pull together the leadership and what the vision and direction is that we set into the future.
PG: What does the future look like?
RS: The future for City of Hope is incredibly bright, but the environment will add a level of complexity that will take the strength of the leaders to navigate.
I think we are really well positioned because of the ability to build on the strengths we have now, the ability to focus on making an impact, investing in the people that work here now and recruiting new people, and the ability to partner out in the community so patients and their families will continue to have our level of care available to them.
I don’t know of many cancer centers that are looking out over the next five years and saying that to deliver on our commitment to our community, we are prepared to internally invest more than $100 million in our science and care in order to accelerate the pace of meaningful discoveries that extend both quality and length of life. We are fortunate enough to be in that position.