In a heavy blow to Oregon Health & Science University, internationally renowned cancer biologist Dr. Brian Druker has stepped down as CEO of Knight Cancer Institute while taking his concerns public that the university has “lost sight of what is crucial and forgotten our mission.”
Druker, in a Dec. 3 email to university leadership and staff at the institute, wrote that he made the decision to step down with “deep sadness.” He’d always believed that at OHSU, “we could do things that no one else could,” he wrote, but his goals no longer feel so achievable. He's decided to shed his administrative responsibilities and focus on research in his lab.
Druker helped make OHSU a prominent player on both the national and international stage. A physician, he specialized in chronic myeloid leukemia at Harvard Medical School and Dana-Farber Cancer Institute in Massachusetts until Oregon Health & Science University recruited him.
Not long after moving west in 1993, Druker spearheaded work that led to the pioneering leukemia drug Gleevec, turning a fatal condition into a treatable one. The advance garnered national and international recognition, made him the subject of multiple books, and helped drive the formation of the Knight institute thanks to charitable gifts Druker attracted.
Druker’s email was first reported by Willamette Week, and its full text follows below. The Portland Business Journal has added further coverage.
In the wake of his announcement, the university issued a statement thanking him for his contributions. “Today, Dr. Druker announced his resignation as CEO of the OHSU Knight Cancer Institute. Dr. Druker has led the OHSU Knight Cancer Institute since 2007 and leaves an indelible legacy, such as the successful completion of the historic Knight Cancer Challenge. OHSU is grateful for his many years of leadership and looks forward to continued collaboration with him at OHSU through his research and patient care endeavors.”
Druker’s decision comes at a rough time for the university. It’s battling financial pressures that have led to deep layoffs and a decision to deemphasize less profitable types of care. At the same time, it’s experienced chaos and dysfunction in its top management, while battling prominent concerns over its increasingly controversial bid to take over Legacy Health.
The drug researcher's willingness to push institutions to do better is not new. While championing OHSU’s role in research, Druker has also pushed the pharmaceutical industry to make drugs more accessible and for the federal government to negotiate with drugmakers to bring prices down. He once joined other doctors in a public letter calling on the profession to champion the cause of lower drug prices in Washington, D.C.
The following interview has been edited for clarity and brevity.
The Lund Report: Can you talk about the process that led up to your decision?
Brian Druker: Over the course of my career, I've gotten further and further away from research and patient care and more and more into administration. And as I think about what I want to do in my last chapter, if you will. I really want to do something that's going to impact patient care, patient experience, the health of Oregonians. And by spending my time and doing the administrative work, I find that as OHSU has grown, it's gotten more bureaucratic, it's gotten more difficult to get things done. And I kind of want to get back to my roots, which were doing research, patient care and having an impact.
TLR: Your email talks about having concluded that those goals of advancing cancer research and improving patient care are ‘no longer achievable at OHSU,’ can you talk a little bit more about what you meant? When you say ‘we've lost sight of what is crucial and forgotten our mission,’ can you talk about what you meant specifically?
Druker: As you have reported and The Lund Report, and anybody who covers healthcare knows, the finances of health care have gotten really difficult. Our costs have gone up, our revenue hasn't. It's a tough time to be in the healthcare field, but at OHSU, one of our missions has to be developing life saving medicines like Gleevec, and that's what that's what we do. It's what our mission has to be, which is, of course, we want to deliver great patient care, but we want to make sure that we're developing knowledge that will lead to the next breakthrough that will benefit people that live and work in Oregon and beyond. And if we're solely focused on the financial aspects of medicine, and forgetting that we have to make some tough choices when resources are constrained — and they are — we have to make some really tough choices about where do we best invest to excel. And that requires strategy and leadership, and that's really hard. What I'm saying is that we have to be able to make those tough choices, and if we don't make those tough choices, then we lose sight of what's important, and that's developing life-saving medicines for the next generation of people.
TLR: There was, of course, the university’s strategic alignment that seemed to focus on doing potentially more profitable surgeries, but it doesn't sound like you're necessarily alluding to that. It sounds like you're alluding to a lack of focus on the research and the life-saving aspects of that.
Druker: I get that if there's no margin, there's no money to invest in research. I get that. But ultimately it also means making some really tough choices about, are there areas where we can cut, are there areas where we should grow? Those are the really tough decisions that we have to face because we can't do everything. And so again, it comes down to, what is it that we want to focus on? And it can't be that we have to focus on making money. And if that's the message that comes across, that leads to the low morale that we have at OHSU. People need believe that we're doing something that's bigger than ourselves.
And go back to the energy, during the Knight challenge that we were focused on — we want to end cancer as we know it. We want Oregon to be the place where that happens. There was energy and excitement around that, and that's what I'm really trying to get at, is we need to get that energy and excitement back, for all of us are doing something that's bigger than ourselves. You know, I look at the front line, our nurses, our physicians, they're always doing the important work, and I get messages every day from patients who are thankful for those people on the front lines. But ultimately, we have to do something bigger, and we have to coalesce around something that's bigger.
TLR: Is there some specific decision or lack of decision at OHSU that helped you reach this conclusion?
I don't know if there was anything specific. It's just something that, as I reflect back on the last couple of years, as you know I moved from the director of the OHSU Knight Cancer Institute to the CEO, because I wanted to get away from a lot of the day-to-day operations. And what I found is even in that transition, I wasn't getting away from the day-to-day operations, it was just that it changed from more of the research to the clinical operations. And as I've reflected on that transition, I want to get back to doing things that will have a big impact for our patients and for the way we manage our patients.
TLR: In terms of next steps, it sounds like you are open to opportunities.
Druker: First of all, I love Oregon. I love living and working here. I love OHSU and that there's things that I can do here, that is always going to be my preference. But if an opportunity comes along that I think is world-changing, and it's not here, I'd be open to that.
TLR: Was there any discussion with OHSU about this announcement? I mean, I assume they were probably begging you to do other things. It sounds like if that happened it wasn't successful.
Druker: Uh (laughs), yeah. It wasn’t.
TLR: You touch upon a lot of issues that I think are in the background ... like the cost of care, it’s just sort of crunching everybody.
Druker: When I got to OHSU thirty odd years ago it was a pretty small, sleepy place, and it's got 22,000 employees now. This place has grown exponentially in the last 10 to 20 years, and that brings some growing pains and some ebbs and flows, and then you've got all the challenges with health care financing. You know, it's just lots of things happening.
And ultimately, I need to decide where I can make my biggest contribution. And if working in a big bureaucracy isn't something where I can make things happen or where I feel most comfortable, that's okay. Are there other places, other things I can do? (Then) I should be doing them.
Full text of Brian Druker’s email
Dear Colleagues,
It is with deep sadness that I am announcing my resignation, effective immediately, as the CEO of the OHSU Knight Cancer Institute. I will be returning to where I started, running my lab and seeing patients, while exploring options for where I can continue to make an impact.
When I arrived at OHSU over 30 years ago, there was a culture of curiosity and unlimited possibilities. My focus was on improving outcomes for patients with cancer. From this, came Gleevec, the first of its kind targeted therapy, that took a leukemia with a three to five-year life expectancy to a disease where I can confidently tell a newly diagnosed patient that they can expect to live a normal life span. Every week in clinic, I get to hear their stories and see pictures of their children and grandchildren, many they never expected to see.
I am proud of the work we have accomplished together at the Knight Cancer Institute. I have had the privilege of building a center of excellence with our focus on improving outcomes for patients with cancer. Through our recruitment of a dream team of scientists, we have continued our leadership role in precision oncology. Our SMMART clinical trial not only matches patients with the right treatments, but we monitor the tumor as it evolves on treatment, so we can stay ahead of the cancer. We also established the first of its kind cancer early detection program and have helped launched a blood test that can detect up to 50 cancers at early stages. We are already seeing the benefits of this with stories of lives being saved due to early detection of cancers that would never have been identified at such early, curable stages. We launched the first OHSU program for under-represented high school students over 25 years ago and many of these students are now in the health care field. And we’ve always kept our focus on our patients by providing navigators throughout our center. None of these great things would have happened were it not for the incredible support of Penny and Phil Knight, the Boyle family and so many others who believed in us.
I would not have been able to accomplish any of this without the remarkable faculty and staff who do not always get the recognition or support they deserve. I’ll always remember Laurie, the long-time cashier in MacKenzie Hall who would remind me to eat when I worked long hours. Susan Hedlund, who pioneered patient support and care, who was always there to console me when I lost a patient to cancer. Chris Eide, the technician who has been with me for over 15 years and has been responsible for much of the best work coming out of my lab. There are so many others of you who have worked tirelessly to advance our mission and I am grateful for your work.
Throughout my career, I have had opportunities to lead some of the largest medical institutions in the world. But more than titles or prominence, I have always come back to what would have the most impact on advancing cancer research and improving patients’ lives. I always believed at this institution, in this beautiful, under the radar spot of the world, we could do things that no one else could.
I still have more I want to do to advance cancer research and improve patient care. With much reflection, I have concluded that at this time those goals are no longer achievable at OHSU. We have lost sight of what is crucial and forgotten our mission. I will continue to see patients every week who always remind me why the work we do is so important.
Brian Druker