Peter Pisters tapped to lead MD Anderson

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Peter Pisters, a sarcoma surgeon and an MD Anderson expat who serves as president and CEO of University Health Network of Toronto, is set to become the fifth president of the Houston-based cancer center.

Pisters was chosen by the UT System Board of Regents at a special meeting Aug. 25.

Under Texas law, the sole finalist can be appointed following a 21-day waiting period. The regents announced their selection after interviewing Pisters and other candidates whose names were brought forth by the Presidential Search Advisory Committee.

The selection was made slightly ahead of schedule. According to the “position specification” document put together by the Phillips DiPisa search firm and dated May 2017, the regents were expected to interview the finalists and make their decision in early September. The document was obtained by The Cancer Letter and is posted here.

The vote at the Aug. 25 meeting was unanimous.

Born in Canada, Pisters graduated from medical school at the University of Western Ontario in London, Ontario. He completed his internship and residency at New York University Medical Center and Bellevue Hospital between 1985 and 1992. In 1994, he completed his fellowship in surgical oncology at Memorial Sloan Kettering Cancer Center between 1992 to 1994.

Pisters also holds an M.Sc. in health care management from Harvard University.

“I am thrilled to be coming back to serve an extraordinary organization populated by gifted and talented faculty and staff,” Pisters said to The Cancer Letter. “I look forward to working with MD Anderson faculty to gradually and surely bring the organization to even greater heights.”

Raphael Pollock, former chief of surgery at MD Anderson, was delighted to learn about the regents’ decision.

“Peter was the first faculty member I recruited when I became chair of surgical oncology at MD Anderson in 1993,” Pollock said to The Cancer Letter. “He has superlative people skills, a broad understanding of cancer care delivery—and he is a highly productive academic oncologic surgeon.

“We remain very, very close,” said Pollock, surgeon-in-chief at Ohio State University. “I think it’s really great. I am happy.”

Pisters took his University Health Network job on Jan. 1, 2015.

Raymond DuBois, former MD Anderson provost, said he was pleased with the regents’ choice.

“When I worked with Peter as provost, he did a spectacular job managing the satellite clinic operation in Houston,” DuBois, the dean of the College of Medicine, Medical University of South Carolina, said to The Cancer Letter. “He went on to take a senior leadership role in the Toronto health system and did an outstanding job in that capacity. He is a very good person, and he has my full support.”

The institution Pisters inherits is very different from one handed to his predecessor, Ronald DePinho, in 2011. At that time, the cancer center was seen as an institution governed from the top down, with a strong president, a politically weak faculty, and few checks and balances.

MD Anderson employs about 20,000 people, of whom 1,700 are faculty members. The institution’s operating revenue budget is $4.5 billion. More than 89 percent of its revenue is produced through clinical operations. About 7 percent comes from restricted grants and contracts. The largest expense category is personnel, at approximately 58 percent of total operating expenses.

During DePinho’s five-and-a-half years in office—in part as a reaction to his actions and his aggressive managerial style—MD Anderson has grown more complex, with power distributed both vertically and horizontally.

The new president will have to consider advice of the Shared Governance Committee, a body created in 2015 to give a more formal voice to the faculty. Earlier this year, a new position—that of a chief operating officer—was created to control MD Anderson’s day-to-day operations. And two months ago, three executive vice president positions were eliminated.

Many of these changes occurred because DePinho’s years at the helm touched off faculty disaffection, which was measured in one faculty survey after another and treated with utmost concern by the UT System Chancellor William McRaven, a former admiral who ran the U.S. Special Operations Command.

An argument can be made that the tragedy of DePinho can be boiled down to the fact that he was led to believe that he had more latitude than he actually had.

Opposition to him emerged quickly. It was related in part to an effort on his part to obtain a large grant from the Cancer Prevention and Research Institute of Texas. The effort prompted CPRIT’s scientific director Al Gilman to turn whistleblower and state publicly that the grant proposal for a biotechnology incubator hadn’t received proper review. A series of stories—Slamming the Door; How Al Gilman Taught Texas a Lesson in Science—is posted here.

On March 8, DePinho resigned presidency, acknowledging his shortcomings as an administrator and communicator (The Cancer Letter, March 9).

“I could have done a better job administratively, a better job listening, a better job communicating,” DePinho said in a remarkable video message to the faculty and staff. “Forgive me for my shortcomings. I regret them, but I was, and continue to be committed to saving lives and reducing suffering, to help MD Anderson accelerate the march towards prevention and cure, particularly for the underserved. I’ve done my very best.”

He is now a member of MD Anderson’s faculty.

At MD Anderson, presidents tend to stick around for a long time. In fact, the 70-year-old institution has had only four.

The first, R. Lee Clark, stayed in the executive suite for 32 years—from 1946 to 1978. Charles LeMaistre stayed for 18 years—from 1978 to 1996. John Mendelsohn kept the job for 15 years—from 1996 to 2011.

Faculty discontent was likely the single most important reason for DePinho’s relatively brief tenure.

In July 2015, a year after becoming chancellor and issuing warning to DePinho that he must right the ship, McRaven mandated formation of a Shared Governance Committee. The move disbanded the powerful Executive Committee, diluting the cancer center’s top-down power structure. The committee is designed to incorporate input from the faculty, and serve as the top advisory body to the institution’s president (The Cancer Letter, Sept. 4, 2015).

During the past two fiscal years, MD Anderson posted several months of operating losses, which were attributed in part to a switch to the Epic electronic medical record and billing system.

Early this year, DePinho lost control over day-to-day operations of the institution and Steve Hahn, chair of the Department of Radiation Oncology was named chief operating officer and deputy to the president (The Cancer Letter, March 3). Hahn’s newly created position eroded the president’s authority.

Last June, MD Anderson made another alteration to its power structure, eliminating three executive vice president positions and flattening out the box diagram, with six vice presidents and senior vice presidents reporting directly to the president (The Cancer Letter, June 30).

“These changes create a more diverse leadership team, built of leaders who know the institution and its needs,” the institution said in a statement at the time. “No new hires or additional costs are needed to support the new structure.”

That reorganization ousted Tom Buchholz, the physician-in-chief and Ethan Dmitrovsky, the provost. Dan Fontaine, former senior vice president for business affairs, who previously announced his retirement, will serve as a senior advisor until January 2018. The job of physician-in-chief (reclassified as “chief medical officer”) and the job of provost (now “chief academic officer”) are being filled on an interim basis. Fontaine will not be replaced, but top officials who previously reported to him now appear on a flat organizational chart.

Earlier in the fiscal year, MD Anderson officials estimated that under the worst-case scenario the institution stood to lose as much as $500 million on its operations. However, with layoffs and program cuts, the gap has been closed (The Cancer Letter, July 2). With the latest operating margin reaching $11 million in July, the institution is on track to meet its budgeted operating margin for the year, officials said.

DePinho, who has an MD degree but who is best known for basic research, was hired based on his publications, history of entrepreneurship, and, likely, personal charisma. Before coming to MD Anderson, he had never run a cancer center or a health system.

“MD Anderson’s next president will need to carefully balance the needs and opportunities for both optimization of current resources and assets and the acquisition of, or investment in, new ones,” the document states.

Here are the “qualities and qualifications” the search committee was looking for in the cancer center’s new leader:

Education/Training

  • MD Anderson’s next president will be a licensed physician possessing an M.D. degree or M.D./Ph.D. from an appropriately accredited academic institution

  • At least five years of experience practicing medicine and Board certification in a relevant clinical specialty with demonstrated clinical leadership in the delivery of specialized health care services.

  • Personal research gravitas as demonstrated by history of extramural funding in a domain relevant to MD Anderson’s scholarly mission

  • Academic work must qualify for appointment as a tenured professor in the appropriate academic department

  • Eligibility for licensure in Texas

Experience

  • Experience in a senior leadership role of an academic cancer center/institute, or an equally complex health care organization. A high performer who presents a track record of distinguished personal and institutional successes

  • A respected physician scientist with a strong personal research background

  • Experience developing strategic plans and directing operations through a highly professional staff and with the oversight of a central governing board.

  • Presenting acknowledged credibility with the National Institute of Health, and its international counterparts, in terms of global visibility, research and leadership experience.

  • Experience in directly managing — as the top executive or a key part of the senior leadership team — the operations and finances of a major clinical enterprise that carries a renowned reputation for providing outstanding patient care

  • Experience negotiating reimbursement for complex clinical services with payers (both governmental and private insurers)

  • Knowledge of current clinical reimbursement models as well as the ongoing transition from traditional fee-for-service to value-based care delivery.

  • A track record of attracting, developing and retaining leadership team members, a personal commitment to diversity, and success in managing organizational/cultural change

  • Direct experience in — or demonstrated ability to lead — fundraising and advocacy efforts, including grants, donations, contracts and legislative/policy initiatives at the regional, state and national levels

  • Record of credibility with legislators, business and community leaders

  • Ability to network with national and global leaders in the field of cancer and health care delivery.

  • Experience in an academic health care organization and an understanding of its diverse community and interrelationships with the local economy.

  • Background that includes successfully conducting business in regional, national, international arenas by being attentive to business, technology, education, health care, social issues and economic development

  • Experience creating academic/corporate partnerships that synergistically accelerate novel research and innovative clinical care

  • Thorough understanding of the continually evolving clinical and research informatics challenges and opportunities

  • A keen awareness of evolving health care reforms

  • Experience in personally contributing to state and national issues pertaining to health care and cancer policy

Personal Characteristics

  • Possessing the leadership qualities necessary to successfully direct an interdisciplinary, multi-specialty cancer organization with sizeable budgetary requirements and a complex array of institutional and community relationships

  • Outstanding interpersonal and communication skills that gain the confidence, trust and respect of a variety of internal and external constituents. This includes the abilities to thoughtfully listen, write concisely, and persuasively articulate complex topics in understandable terms

  • A deep financial acumen and an inherent level of comfort dealing with complex fiscal issues

  • A strong, visionary leader whose style is participatory and who is comfortable around other strong leaders

  • Intention to create a positive work environment and culture for the entire organization.

  • A consummate professional and a builder of trust and teams.

  • Understanding that a primary role for the administration is to provide resources that allow teams to achieve their goals of improving patient care and making advances in science and research

  • Sets high standards for performance and personal behavior.

  • Effectively delegates and holds others accountable

  • Able to build consensus among internal and external constituencies

  • Possesses the drive to work with all communities and build relationships

  • Well-refined social skills, including a genuine interest in meeting new people, cultivating relationships, and ultimately asking for support

  • Exhibits tact, diplomacy and a strong degree of political savvy in working effectively and collaboratively with peer organizations within The University of Texas System as well as with UT System executives and the Board of Regents

  • Possesses the ability to quickly adapt to an ever-changing, highly ambiguous health care environment while remaining constantly sensitive to the history and mission of MD Anderson

  • Intellectually curious and possessing a strong, confident style

  • Presents the drive, energy and persistence necessary to translate vision into action and follow through to implement new ideas and initiatives

  • Flexible, resilient and accommodating, but ultimately comfortable in making a decision and promoting it across the organization in a consistent and firm fashion

  • Strong people skills that include motivating, mentoring and providing opportunities to talented staff

  • A demeanor that is calm and composed and innately humble.

  • A person of strong principles, exceptional character and impeccable integrity with a keen passion for MD Anderson’s mission

Here is who selected the finalists:

The MD Anderson Presidential Search Advisory Committee was chaired by Raymond Greenberg, executive vice chancellor for health affairs at the UT System.

Advisory committee members were:

  • Borje Andersson, Professor, Department of Stem Cell Transplantation, Division of Cancer Medicine, M.D. Anderson Cancer Center

  • Michelle Barton–Dean, Graduate School of Biomedical Sciences, Colin Powell Chair for Cancer Research, and Professor, Department of Epigenetics and Molecular Carcinogenesis, M. D. Anderson Cancer Center

  • David Beck–Regent, The University of Texas System

  • Raymond Greenberg– Executive Vice Chancellor for Health Affairs, The University of Texas System

  • Peter Hu–Director, Graduate Program in Diagnostic Genetics, and Director, Undergraduate Program in Molecular Genetic Technology, School of Health Professions, and Associate Professor, School of Health Professions, M. D. Anderson Cancer Center

  • Janiece Longoria–Regent, The University of Texas System

  • Osama Mawlawi–Professor, Department of Imaging Physics, and Chair, Faculty Senate, M. D. Anderson Cancer Center

  • George H. Perkins–Chief Medical Officer, Medical Director, Physician Referral Service, and Professor, Department of Radiation Oncology, M. D. Anderson Cancer Center

  • Daniel Podolsky–President, The University of Texas Southwestern Medical Center

  • Tania Secrest–Division Administrator, Vice Provost for Science Office, M. D. Anderson Cancer Center

  • Michael Tidwell–President, The University of Texas at Tyler

  • Erin Williams–Doctoral Candidate, Graduate School of Biomedical Sciences, M. D. Anderson Cancer Center

The community representatives on the advisory committee were:

  • Scott Caven, Jr. – Managing Director, Atlantic Trust; Former Board Chairman, The University of Texas System Board of Regents

  • Harry Longwell–Past Chair and Senior Member, Board of Visitors, M. D. Anderson Cancer Center; Retired Executive Vice President and Director, ExxonMobil

  • Courtney Johnson Rose–Principal Broker, George E. Johnson Properties

  • Richard Ruiz– Founding Chairman and John S. Dunn Distinguished University Chair in Ophthalmology, The University of Texas Health Science Center at Houston

  • Marsha McCombs Shields–Chair-Elect, Board of Visitors, The University of Texas M. D. Anderson Cancer Center; Managing Partner, McCombs Family Partners

  • Robert “Bobby” Stillwell–Attorney; Former Regent, The University of Texas System Board of Regents

Paul Goldberg
Editor & Publisher

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