The Importance Of Credible Leadership
By
Leonard Zwelling
This story from The Wall Street Journal on June 2 fleshes out the widely-reported actions of Secretary of Defense Pete Hegseth to block the promotion of eight Navy captains to become rear admirals. Two of the eight are Black; two of the eight are women.
Hegseth is a very controversial figure in a position not usually noted for as much tumult in past administrations. He seems to embrace a macho image that also embodies racism and misogyny although he denies all of that. None of that is what I want to discuss.
What I want to focus on is why Hegseth’s recent decisions surrounding promotions have caused so much rancor. It is because he has no qualifications for his job and, thus, no credibility. This is the case with many Trump appointees such as Tulsi Gabbard (gone) and Kristy Noem (gone) and Pam Bondi (gone). Hegseth is not convincing when he says race and sex did not enter into his decisions. Hegseth has his job because Trump nominated him and the Senate did not adequately vet him. The same has been true of many Trump appointments, including his picks for the Supreme Court like Brett Kavanaugh. They simply are not the best of the best in America.
Now, I must admit that I was once installed in a job for which I was not qualified. When I first assumed oversight of the clinical research infrastructure my only credentials were that I was a board-certified medical oncologist; I had been PI on one clinical protocol and that was at the NCI; and I had an MBA. That latter qualification is questionably relevant for the job.
What got me through to competence, and it took about a year, was perseverance, the backing of Dave Hohn who was Vice President for Patient Care and Fred Becker who was Vice President for Research, and the good will of the faculty of the Division of Cancer Medicine who tolerated me until I proved I would listen to them and serve their needs while keeping the institution in compliance with the Code of Federal Regulations as it pertains to human subjects research.
Then there was the incident, 6 months after I started as an Associate Vice President, when the FDA called Dr. Hohn and me to Bethesda to answer for a major faculty screw up involving the deaths of two patients on a phase 1 study. These deaths on protocol were not reported to the IRB. This was not a Cancer Medicine protocol. The FDA allowed us to stay open (they could have shut down all clinical research for a violation such as this one), but mandated the clinical research computerized registration system my office installed that controlled eligibility for clinical trials. I was very lucky to have had the time to get to competence and the help of some truly wonderful staff members, especially Dr. Carleen Brunelli.
It is my belief that neither the current leadership of this country nor that of MD Anderson is qualified for the job. Neither has surrounded itself with great staff. Even if you grant Mr. Trump the fact that he was President before, his latest misadventures in military action and the resultant adverse effects on the economy indicate he is incapable of thinking through the consequences of his actions despite his experience and now we all are paying for his lack of credibility especially with the leaders of the rest of the world’s countries.
Dr. Pisters is supposed to be leading an institution of research-driven cancer care while having no credentials in research at all. He is also the principal investigator of MD Anderson’s NCI core grant that makes MD Anderson a comprehensive cancer center. Is he a credible core grant PI? Nope.
I only hope that the site visitors can get by Dr. Pisters’ lack of credibility as a scientific leader. Like Mr. Trump, Dr. Pisters does not really have the gravitas or chops to be a convincing leader of those functions in his job description.
For leaders to be credible, they must either bring great credentials to their leadership positions or rapidly demonstrate unique competence.
Mr. Trump seems to be getting worse as a President. In essence he ripped up President Obama’s Iran deal that was keeping Iran’s nuclear ambitions in check and now seems unable to even reinstall a deal as good as that one. Does Trump really have the patience that the Obama team had to be bring success to negotiating for over a year? I think not.
As for Pisters, it is evident that his only concerns are money, awards, and growth. Money is critical, of course, but it is not the reason that MD Anderson exists. Awards are meaningless. Does anyone think these awards by lay organizations actually influence patient decision-making? Growth of MD Anderson to give more people access to MD Anderson cancer care is a good thing. The real question is how easy will it be to franchise quality cancer care to places outside of Houston, like Austin and what exactly MD Anderson-Austin will be now that it is not to be a free-standing hospital.
And is a 25-story clinic tower on Holcombe really a good idea? Parking and traffic alone make this a questionable way to get MD Anderson care to more people.
I am sure if I had been a clinical investigator when I took over as an Associate VP, I wouldn’t have had confidence in me. Fortunately, I had had long-standing relationships with many of the leaders in Cancer Medicine and they gave me the benefit of doubt until I gained credibility.
Mr. Trump is no mystery. He is a brash, crude man with limited capabilities and poor judgment. Only a fool would have invaded Iran and expected an outcome other than the one we have. And only a fool would have appointed a housing official to be our top intelligence officer. Talk about no qualifications!
Dr. Pisters was never the right person to lead MD Anderson into the frontier of molecularly-targeted therapies and artificial intelligence. That must have been obvious to those reviewing the Core Grant application.
Leaders must have credibility if their decisions are to be taken seriously. Credibility is obviously in short supply of late, in Washington, in Houston, and just about everywhere.
