Peter Pisters: I want MD Anderson to be seen as an exemplar in our work on diversity, equity, and inclusion

When Peter Pisters returned to The University of Texas System as president of MD Anderson Cancer Center in December 2017, one of his top priorities included achieving gender parity and diversifying the hospital’s executive suite.

Of the institution’s senior leadership hires since 2017, 53% are women—selected through a process that was focused on creating a diverse pool of candidates. Among medical schools, the diversity of MD Anderson’s faculty is equal to or greater than the national average.

“We strongly believe that increased diversity among our faculty helps us to better serve our patients and to engage underserved populations, and that diversity of faculty lends itself naturally to diversity in our research and the communities we serve,” Pisters said to The Cancer Letter.

“One recent step forward for MD Anderson was our decision to elevate the responsibilities of DEI to an executive level position and for that individual’s sole purpose to be that of advancing this important work.”

As one of the largest cancer centers in the world with an international network of partner, member, and affiliate institutions, MD Anderson has an outsize impact on research and cancer care. In FY2020, the Houston hospital—which consistently ranks as one of the top two hospitals in cancer care since 1990—invested more than $973 million in research.

In the same year, MD Anderson served more than 151,000 patients, attended to 1.4 million outpatient visits, enrolled more than 8,200 patients in 1,412 clinical trials exploring innovative treatments, and provided uninsured or underinsured Texans with more than $254 million in uncompensated care.

Many leaders in oncology have, at one point or another, trained and practiced at MD Anderson—the cancer center has more than 22,000 employees, including 1,788 faculty members.

To address systemic underrepresentation of Black and Hispanic scientists and physicians in oncology and in academic medicine (The Cancer Letter, July 2, June 25, 2021; Oct 9, 2020), Pisters’s new strategic plan calls for the creation of a recruitment and career development program that improves diversity and supports long-term institutional change.

According to 2019 data from the U.S. Census Bureau, more than three quarters of Houston’s population is diverse—24.4% of respondents identified as “not Spanish/Hispanic/Latino” and reported “white” as their only entry in the race question. White-only respondents make up 41.2% of the population of Texas.

“We know training, mentorship, and sponsorship is needed to address disparities,” Pisters said. “To diversify our recruitment pipeline, we’ve implemented a program called Partnership for Careers in Cancer Science and Medicine focused on building a network to attract, develop and nurture underrepresented young adults across the entire academic science and medicine pipeline, from high school students through faculty appointments.”

In FY20, more than 5,100 trainees participated in educational programs at MD Anderson. This included:

• 1,796 clinical residents and fellows,
• 753 nursing trainees,
• 394 School of Health Professions students,
• 329 research trainees,
• 477 student program participants, and
• 412 observers and visitors in special programs.

Improving health equity and representation of racial and ethnic minorities is an executive priority at MD Anderson, Pisters said.

“A national search is now underway for a chief diversity, equity and inclusion officer,” he said. “This leader will have a faculty appointment, will serve as an advisor, advocate and catalyst for change, and will be responsible for infusing DEI into programs and activities, tracking progress toward these goals and communicating progress to an engaged MD Anderson community.”

In August 2020, MD Anderson established a DEI Executive Committee to “develop an institutional approach to issues of DEI and health equity research.” Separately, a Faculty Diversity, Equity and Inclusion Division Council directs faculty and trainee DEI efforts.

We want MD Anderson to be a complete reflection of the magnificence of our community—our city, our state, which also is one of the most diverse states in America.

Peter Pisters 

A number of other health systems and cancer centers contacted by The Cancer Letter have created similar executive councils and committees as well as executive-level positions focused on diversity, equity, and inclusion (The Cancer Letter, July 9, June 25, 2021).

As part of the hospital’s outreach and engagement efforts, MD Anderson’s community education programs on cancer prevention focus on HPV, tobacco control, diet, physical activity and screening, as well as colorectal, breast and skin cancer. 

“Since December 2017, our community education team has collaborated with more than 500 schools, churches and other community organizations to deliver nearly 1,500 cancer prevention education programs reaching more than 100,000 people,” Pisters said. “Nearly 79% of people planned to adopt a new healthy behavior after attending an MD Anderson health education program.  

Nearly 400 virtual programs were completed throughout the COVID-19 pandemic, reaching Black, Hispanic, and Asian communities that are served by 39% of these community organizations. MD Anderson’s community efforts also extend to more than 40 local Chambers of Commerce, including Black, Hispanic, Asian, and LGBTQ Chambers.

“MD Anderson has already positioned itself as an award-winning workplace for women, for LGBTQ people, for veterans, for people with disabilities, and we want to extend that to the full dimension of what diversity means to us,” Pisters said. “Through a comprehensive DEI program, we want to be seen as an exemplar in the work that we do.”

Pisters spoke with Matthew Ong, associate editor of The Cancer Letter.

We strongly believe that increased diversity among our faculty helps us to better serve our patients and to engage underserved populations, and that diversity of faculty lends itself naturally to diversity in our research and the communities we serve.

Matthew Ong: What best practices in hiring and recruitment—or in pipeline programs—do you use at your institution to elevate diverse leaders? How effective are these strategies?

Peter Pisters: Enabling diverse leadership teams requires deliberate intent and consistent focus. From the start of my tenure as president, we pledged to be relentless in the pursuit of diversity and inclusion at all levels, and that includes enhancing the role of women at MD Anderson. 

Through impactful approaches, including a new leadership selection process that places emphasis on a diverse candidate pool, we have made tremendous progress in our efforts with women representing 53% of our institution’s new senior leadership hires since 2017. 

Those hires include our chief operating officer, chief academic officer, chief medical executive, chief legal and regulatory affairs officer, and chief of staff. 

Diversity, equity and inclusion (DEI) issues were addressed in our biennial employee opinion survey, which had an all-time record 91% participation rate. 

Impressively, in the category of Inclusion and Diversity, MD Anderson’s results were 19.2% higher than the Academic Healthcare benchmark. And when asked the open-ended question of “What 3-5 words would you use to describe MD Anderson’s culture?” the top three responses were “Caring” at 36%, “Diversity” at 20% and “Inclusion” at 19%. 

While we are encouraged by these results, we remain committed to building on this strong foundation by including DEI in our strategy, recruiting a new faculty leader to be a chief diversity, equity, and inclusion officer, and approaching DEI with a comprehensive institutional effort.  

While DEI efforts have advanced in various departments and divisions across the institution and through our Diversity Council and Employee Resource Group Networks, in Aug. 2020, we established our DEI Executive Committee to develop an institutional approach to issues of DEI and health equity research. 

The committee has diverse membership from throughout the institution, including academic, clinical and business units. This committee has set broad institutional DEI goals that align with our new Strategy and has created workgroups to further develop, monitor and track DEI activities.

MD Anderson also has a Faculty Diversity, Equity and Inclusion Division Council that develops and coordinates faculty and trainee DEI efforts. 

To diversify our recruitment pipeline, we’ve implemented a program called Partnership for Careers in Cancer Science and Medicine focused on building a network to attract, develop and nurture underrepresented young adults across the entire academic science and medicine pipeline, from high school students through faculty appointments. 

How has increased diversity among your faculty improved patient outcomes, as well as your ability to reach and engage underserved communities in your catchment area? Could you provide a few examples?

PP: The diversity of MD Anderson’s faculty is equal to or greater than the national average for medical schools. 

We strongly believe that increased diversity among our faculty helps us to better serve our patients and to engage underserved populations, and that diversity of faculty lends itself naturally to diversity in our research and the communities we serve.

MD Anderson remains one of a kind in the intentional efforts to address health equity. Formed in 2005, the department of Health Disparities Research conducts research and develops solutions to address cancer health disparities. 

The department’s faculty is one of the most racially and ethnically diverse at MD Anderson. 

These health disparities faculty promote health equity, partnering with African American, Hispanic American and Asian American communities and organizations such as low-income housing communities, Federally-Qualified health Centers, and faith-based organizations.

What programs have you led that are or have directly contributed to greater equity i.e. a reduction in disparity of outcomes or disparity of access in your catchment area? What was the nature of those disparities and what have you learned?

PP: Since 1995, MD Anderson has partnered with Harris Health System to provide multidisciplinary cancer care and cancer control programs at Lyndon B. Johnson Hospital for low-income and medically underserved individuals in our community. 

In the last decade, MD Anderson’s oncology program at LBJ Hospital has seen the patient population triple, which reinforces the importance of ensuring these services are available to the residents of Harris County. 

To help reduce the impact of cancer in Texas, especially in medically underserved communities, MD Anderson has a broad range of departments and leaders working collaboratively on community outreach and engagement by assessing and monitoring community needs, fostering community-based research, implementing cancer control actions and evaluating our impact. 

Policy efforts range from institutional priorities such as raising the age to legally purchase tobacco to advocating for programs that enhance access to care for the low-income and uninsured communities in Texas.  

Through MD Anderson’s Moon Shots Program®, the Cancer Prevention and Control Platform ensures that our prevention strategies impact population-level health outcomes on a transformative scale. 

One key initiative is the Be Well Communities^TM program. Be Well Communities is a place-based strategy for cancer prevention and control, working with communities to promote wellness and to prevent cancer. 

The program unites individuals, schools, workplaces, government agencies, health care providers and policymakers to plan and carry out sustainable, community-led solutions to make long-lasting changes in people’s lives through healthy lifestyle choices to help reduce their risk for cancer.

MD Anderson’s community education work is integral to advancing cancer prevention efforts throughout the greater Houston area. Programs focus on cancer prevention priorities including HPV, tobacco control, diet, physical activity and screening, as well as colorectal, breast and skin cancer prevention. 

Since December 2017, our community education team has collaborated with more than 500 schools, churches and other community organizations to deliver nearly 1,500 cancer prevention education programs reaching more than 100,000 people. Nearly 79% of people planned to adopt a new healthy behavior after attending an MD Anderson health education program.  

During the pandemic, the work continued with nearly 400 virtual programs completed. Thirty-nine percent of these organizations serve Black, Hispanic and Asian communities. Our work also extends to more than 40 local Chambers of Commerce, including Black, Hispanic, Asian and LGBTQ Chambers, that share information and assist communities. 

For the past 10 years, MD Anderson has made community-based screening services for low-income or uninsured individuals available in various cities across Texas. Nearly 15,000 colorectal, breast and skin cancer screening exams were provided in fiscal year 2019. 

MD Anderson has a variety of efforts underway to meet our community where they are and to constantly learn from them about what they need. It is our desire to serve and to care for those who need MD Anderson that drives us to improve each and every day. 

What are your next steps?

PP: At MD Anderson, diversity and inclusion begin with our 22,000 employees working in an environment where different backgrounds, cultures and talents are valued and respected, regardless of a person’s race, gender, sexual orientation, age, disability or creed. This cultural dimension is vitally important to our future.

Houston is the most diverse city in America; and we want MD Anderson to be a complete reflection of the magnificence of our community—our city, our state, which also is one of the most diverse states in America. 

MD Anderson has already positioned itself as an award-winning workplace for women, for LGBTQ people, for veterans, for people with disabilities, and we want to extend that to the full dimension of what diversity means to us. Through a comprehensive DEI program, we want to be seen as an exemplar in the work that we do, which is why it’s integrated into our strategic plan. 

There is much work ahead and we are exploring other important efforts and initiatives to advance DEI. We know training, mentorship, and sponsorship is needed to address disparities. We also are focused on creating a recruitment and career development program that improves diversity and generates evidence to support long-term institutional change and to produce leaders in academic medicine.

One recent step forward for MD Anderson was our decision to elevate the responsibilities of DEI to an executive level position and for that individual’s sole purpose to be that of advancing this important work. 

A national search is now underway for a chief diversity, equity and inclusion officer. This leader will have a faculty appointment, will serve as an advisor, advocate and catalyst for change, and will be responsible for infusing DEI into programs and activities, tracking progress toward these goals and communicating progress to an engaged MD Anderson community. 

This elevated position will be critical to our success. For anyone interested, the job posting can be found by searching the title at https://jobs.mdanderson.org.

With the continuous advancement of our diversity and inclusion efforts serving as part of our strategy, MD Anderson is primed to develop and implement new, innovative initiatives that provide additional support and resources to help our employees thrive in a truly inclusive workplace and to meaningfully impact the health of those in underserved communities. 

MD Anderson is committed to DEI, and we look forward to tracking our progress in the months and years to come.

This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.