Staying No. 1
For nearly 15 years, Dr. John Mendelsohn has served as president of the University of Texas M.D. Anderson Cancer Center, overseeing an institution that employs more than 17,000 and occupies 11.5 million square feet in the Texas Medical Center. During the last decade, Anderson has more than doubled its size and number of clinics and it's still growing.
Under Mendelsohn's tutelage, the center has been named the leading cancer hospital in the nation six out of the past eight years in U.S. News & World Report's America's Best Hospitals survey.
During a recent interview with CultureMap, Mendelsohn, only the third president to head M.D. Anderson since its founding in 1941, talked about new approaches to treating cancer, continued expansion in the Texas Medical Center and beyond, health care reform and the continuing search for a cure. Some excerpts:
On current research:
"The most exciting area of research going on here is a new way of assigning therapy for cancer care," Mendelsohn said. In place of testing new drugs in standardized trials with a large number of patients given the same drug, today different drugs are given to different groups of patients based on their individual cancer profiles.
"We have a whole new approach today because we know what causes cancer — abnormal genes within a cell."
With up-to-the-minute technology, cancer researchers can determine which genes within a cell are not working properly, study those genes that are abnormal and get the results back quickly. This allows doctors to "assign therapies based on what is wrong in the patient's tumor," Mendelsohn explained. The beauty of this advancement is that researchers and clinicians working together can coordinate all stages of drug discovery and development in order to design more effective and specific drugs with less toxicity.
This new approach of targeted therapy speeds the research process, involves fewer patients for a specific drug and accelerates information to the FDA. "You're going to hopefully get high response rates because you're selecting a sub-population. The good news is that you can get drugs out cheaper and faster."
"It's very exciting," Mendelsohn said. "It's a whole new way to treat cancer."
This high level of research, Mendelsohn added, is what maintains M.D. Anderson's ranking as the top cancer hospital in the country in the U.S. News & World Report annual hospital survey. "We're really good at taking science and taking it to the patient."
On national health care reform:
"The good news is that 30 million people who had no health insurance will now have access to insurance," Mendelsohn said. The looming questions, however, are the added expense and how it will be paid.
"We have to improve the value of care and not just the amount of care . . . You have to improve two things. One is outcome/results. Two is cost."
By targeting those two issues and allowing the public to decide where to get their medical care, Mendelsohn said, "I believe that will drive down costs and drive up results."
His concern is that "centralized planning can run into trouble" but he understands that "some regulation" is necessary. He would prefer to see competition in the marketplace drive the direction of universal health care with an informed public making choices.
On M.D. Anderson's broad reach:
M.D. Anderson currently has six satellite locations extending from The Woodlands to Sugar Land plus affiliations in Albuquerque and Istanbul, Turkey, with a third location set to launch in 2011 in Phoenix.
"We don't build anything. We don't invest our money in building new cancer centers," Mendelsohn explained. M.D. Anderson is asked or invited to open a department within an existing facility. Anderson might be asked to bring radiation therapy to a certain hospital or to bring oncology surgery to another. These invitations, he said, come in every week from different parts of the country and the world.
"M.D. Anderson provides the practices, trains the people ... establishes a quality of care comparable to what you would get if you went to M.D. Anderson."
This type of expansion, Mendelsohn explained, is mission driven. He points to M.D. Anderson's mission statement that calls for the elimination of cancer throughout the world through programs that integrate patient care, research and prevention and through broad-based education of doctors, researchers and the public.
On hospital expansion plans:
In the last decade, the cancer center has more than doubled in square footage and in number of clinics. Today, there are 500 beds with 320 additional beds in the pipeline and counting. "Locally we've grown. It's demand driven. It's hard to get a bed here," Mendelsohn said.
The 12-story Alkek patient tower was originally constructed with extra steel and concrete reinforcements to meet future needs of expansion and in 2007, the University of Texas Board of Regents approved plans for growth. "So we've just added eight floors on top of the hospital . . . a very interesting engineering fete," Mendesohn said. That expansion means an additional 160 beds by the end of the year with future growth in Alkek as demand warrants.
Expansion in both the hospital and clinics, Mendelsohn said, is done without state money. Funding comes from patient charges and philanthropy.
M.D. Anderson sees close to 100,000 patients a year but only a small percentage stay overnight in the hospital. "If you're in our hospital, you're very sick," the cancer center president said. "You not only have cancer but your cancer has gotten complicated and you're quite ill."
On signs of hope:
Mendelsohn pointed to cancer survival statistics as a definite sign of hope. Today, two-thirds of all cancer patients live five years or longer, he said. Within fairly recent memory, that figure was only one-third, he said.
"M.D. Anderson is a place of hope and of caring and not just treating the cancer but caring for the cancer patient," he said. The philosophy of everyone working at M.D. Anderson from the top down, according Mendelsohn, is "I am here to serve the patient."