I trusted Memorial Sloan Kettering Cancer Center and believed in it. For more than 30 years, my family and I have literally put our lives in its hands. But it has betrayed my trust and that of many other patients and their families.
Over the course of three decades, my mother, sister, and I have been treated in the hospital’s operating rooms, clinics, and infusion centers. Each of us received top-notch care from the center’s oncologists and surgeons, and I feel without equivocation that I owe my 34 years of cancer survivorship to those doctors. In many ways, Memorial Sloan Kettering has been like family.
I said as much this past June when I had the honor to be the keynote speaker at the 45th annual celebration of volunteers. As one of those volunteers, I’ve always been ready, willing, and able to give my time, and I was speaking from the heart when I declared to the gathering: “You are all members of the MSK family,” the oft-used shorthand for the center.
My sister and brother joined the center’s volunteer corps not long after my treatment for testicular cancer in 1984. Julie distributed books and magazines while Jay helped in pediatrics. More than a decade later, I became one of the patient-to-patient “blue coats” — cancer survivors who meet and speak with patients who have diagnoses similar to their own. That role and those interactions with new patients have been among the greatest blessings of my life. And it’s one of the reasons I’m now a mentor in the hospital’s Visible Ink program, which pairs professional writers with patients who are seeking ways to express themselves.
That history and attachment is why I felt such heartbreak when the New York Times and ProPublica reported that the center’s chief medical officer, Dr. José Baselga, had failed to disclose millions of dollars’ worth of payments from pharmaceutical and other health care companies. It angered me to read that he omitted his “financial ties from dozens of research articles.”
While there is no evidence that Baselga recommended ineffective treatments to his patients, the appearance of influence is troubling. It highlights ineffective oversight, with the potential to cast a shadow on the center’s other excellent doctors. No wonder some physicians say they’re interested in calling for a vote of no confidence in MSK’s top leadership.
When the news first broke, I eagerly read the email sent by the center’s CEO and president, Dr. Craig Thompson, and its chief operating officer, Kathryn Martin, in which they acknowledged that “the matter of disclosure” is serious business. They assured everyone that the hospital has “robust programs in place,” but seemed to hedge when they described the reporting guidelines as both “complex” and “nebulous.”
With all due respect, I think an institution that can so ably tackle the complexities of cancer ought to be able to master disclosure requirements.
Here’s why these conflicts matter: Patients like me, my mother and sister, and thousands more have literally put our lives on the line when we trust that a treatment protocol is the very best available. A seed of doubt now exists: Could those recommendations be colored by a physician’s extra-curricular financial entanglements?
When my mother was diagnosed with lung cancer, I researched her surgeon and his attending physician. The surgeon’s online disclosure revealed he had received a research grant from Bristol-Myers Squibb; his associate acknowledged “relevant financial relationships” with eight drug makers. Those disclosures helped us evaluate whether Mom’s doctors had personal financial incentives in their treatment recommendations. We were comfortable that they did not, but we could not have known to ask our questions without access to their truthful disclosures.
My sense of betrayal only deepened when ProPublica and the New York Times reported on an artificial intelligence startup called Paige.AI, which was granted exclusive access to the center’s archive of 25 million slides of patients’ tissues. The company was founded by three hospital insiders: a member of its executive board, the chairman of its pathology department, and the head of one of its research laboratories. In addition, three other board members invested in Paige.AI, and the center itself is a part owner of the new company.
Are the slides of my cancer among them? My mom’s? My sister’s? I’m uneasy wondering whether they are being commercialized without our consent, or even without our being notified. The hospital claims that the data are anonymous, but anonymous data these days has a habit of somehow becoming identifiable. Data are the currency with the greatest value in research today.
If that weren’t enough, when startup company Y-mAbs Therapeutics, funded in part by Memorial Sloan Kettering, went public a little more than a week ago, Dr. Gregory Raskin, a vice president who oversees the hospital’s ventures with for-profit companies and serves as a Y-mAbs board member, looked set to personally profit from the deal to the tune of nearly $1.4 million.
As a patient whose life was saved by rapid developments in chemotherapy in the late 1970s and 1980s, I applaud innovative approaches to new cancer drugs. But I worry about ethical boundaries being crossed with financial relationships that look like double-dealing.
Memorial Sloan Kettering has long touted in ad campaigns that it provides “the best cancer care anywhere.” My family agrees. But every news article about what is rightfully being described as a crisis at the center deepens our sense of betrayal.
I hope that the center’s rebuke of Raskin translates into greater oversight when it comes to physician disclosure and transparency and stronger rules about MSK staff profiting from their board directorships. But leadership starts at the top. On Tuesday, CEO Thompson did the right thing — for the wrong reason — when he resigned from the board of the drug maker Merck & Company and that of another public company, Charles River Labs. Instead of acknowledging the inherent conflict of interest of serving on those two outside boards, he attempted a kumbaya explanation, saying: “I’ve heard from a number of you that you’d like me to be even more present at MSK.” (In 2017, Thompson received $300,000 in compensation from Merck in addition to being paid $6.7 million for his day job in 2016, according to the New York Times and ProPublica).
MSK’s catching up is not finished. According to the Times and ProPublica, Thompson’s resignation doesn’t affect his eight colleagues who sit on the boards of outside companies. And while Thompson has convened a task force to assess the situation and make recommendations, he hasn’t given this group a deadline. Get on the express train, or get off.
MSK’s board chairman Douglas A. Warner III was right about one thing when he acknowledged the widespread anger being directed at the hospital. “The question you’re asking quite properly is: Where the hell was management and the board in all this …?”
I am pained because of my family’s long attachment and devotion to MSK and the great gifts — cures and life-extending treatments — that were given to us by the amazing staff. With patients making life-and-death treatment decisions in real time, a commitment to full transparency and appropriate safeguards about profiteering would be one less thing for us to worry about. After all, we too want Memorial Sloan Kettering to remain “the best cancer care anywhere.”
Steven Petrow is a columnist for USA Today, a contributing writer to the Washington Post, a past president of the National Lesbian & Gay Journalists Association, and author of several books.
Things have changed since the days of Dr. Manuel Ochoa, apparently.
Only hospital I don’t trust! They pretend to be the best while they disregard patients. They are horrible and I’d never recommend
Based on what? You can randomly throw out terms like “trust” and “horrible” but you’d best have first hand experiences that you share if you expect anyone to believe this gibberish.
MSK also betrayed my trust and has profoundly affected me and my entire family in a negative way. In 2016 I was told I had an agressive cancer that was growing rapidly and needed surgery. Unfortunately I went ahead with the surgery which turned out to be unnecessary! While I am grateful I did not have an agressive cancer, i am left with the horrific aftermath as they also botched up the unnecessary surgery. Afterwards I went to Mayo Clinic with my slides to get their opinion and they were shocked by what took place. I now have medically induced PTSD. I believe it was all for $$ at MSK. Devastated.
From the moment I starte private practice over 30 years ago, I wished that I had my income from another source than my practice. I always felt a pang of guilt because I knew that no matter what, at some small level, finances played a role, though minor, in my decisions. The last 6 years of practice were Locum Tenens and I felt free of that financial tug. I earned less but the feel of freedom was well worth it.
So, can MSK still be TRUSTED to give THE BEST care to cancer patients? OR, does it depend more on monetary profits? First do no harm?
You are,absolutely right.
Next time a visit to a clinic in Mexico will not be tarnished by a conflict of interest
One problem is none of the evildoers are going to jail in the US after committing white collar crimes. It is like they are above the law. Let’s do as has been done with VW’s Oliver Schmidt who got sentenced to 7 years in prison for his part in the diesel scandal. That might restore faith in one institution. We have big problems with insurance fraud, particularly Medicare.
Dear Dr. Dunn,
I agree with your post. In my opinion, President Obama’s intentions could not be realized because of the profound prejudice still present in this country. He has shown himself to have greater integrity and emotional stability than any congressman or president since Eisenhower. Those two men are the greatest two presidents since the second world war. “Trust” that our leaders have the best interest of the nation in mind is key to the success of democracy. Trump and company with its connections to the Saudi Prince and Putin cannot be trusted to put the country first, which means building a medical system that works. We need to take an example set by the German judicial system, which put
I agree wholeheartedly. I did not enter medicine and psychiatry for monetary gain. I feel sure I could have made more money doing any number of things, but I had no idea when I entered the profession that I would be taking orders about what I could do clinically from people with a GED or high school diploma, who have no idea why I might want to do things they don’t understand and might actually do more harm than good.
I agree with a majority of what was said on this piece.. physicians and hospitals not disclosing financial assistance they receive from the various companies because in my opinion that creates a conflict of interest. I think any healthcare professional should be required to be completely transparent in what funding they receive, what they are researching, etc. Where my “disagreement” and take the word disagreement with a grain of salt.. is when it comes to research and personal health information (PHI). PHI is HEAVILY gaurded. The author questioning the research aspect and whether their data was released, I pose a few questions, and let me state this up-front, clearly this individual wants to better people’s lives, specifically those who are suffering with similar Cancer’s (made evident by the volunteer history mentioned in the article). Why would you not want your slides to be included in research? That could contribute to future treatments and cures for not only your cancer but others. Secondly, what exactly of your PHI are you worried about “leaking?” PHI is very heavily gaurded in the research world (I know this because I work in it) and if PHI is disclosed you can lose your liscense, you can lose funding, your job etc.
Time and time , circumstance upon circumstance , the profession of Health professionals fall willingly , not as victim to the business of medicine but to the sensual alure of profit. ( more). Their reasoning may appear in someway logical,l; personal gain, but the price paid in confidence is sumarized in one statement ; “can I trust “? As the country ages and more care is needed, can the public trust that we have integrity with honesty, truth? Its simple, just be open , and truthful. The public isn’t asking for perfection.
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