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CEO outlines Roswell Park mission

While he shares his name with one of America's best-known real estate moguls, Dr. Donald Trump brings a much different leadership expertise to his role in Buffalo's medical and research community.

As president and CEO of Roswell Park Cancer Institute, Trump oversees one of the nation's leading research and clinical institutions specializing in cancer care. The Buffalo institution is one of only 41 federally designated comprehensive cancer centers in the country, and the only one in upstate New York.

The 106-bed hospital employs 3,300, including 256 doctors and 107 senior scientists. It handles 4,215 admissions and 161,869 outpatient visits a year, serving cancer patients from around the world. It also receives $87.4 million in grants, with 522 funded research projects, 63 license agreements, 119 U.S. patents and 173 partnerships with drug companies.

It's also one of the primary partners in the Buffalo Niagara Medical Campus in downtown Buffalo.

Q: Are federal health care reforms beneficial or harmful?

A: Health care reform is necessary because the system doesn't work as well as it should. Our health outcomes are not equivalent to the cost and what we pay for health care, so we have to do better. While the reforms that are proposed are not perfect, they're a good step in the right direction toward rationalizing service provision, increasing access and providing incentives for us to do things more efficiently and in a less costly fashion.

Q: What do you see as particularly good and particularly faulty?

A: I think what's good is the focus on achieving access. We should be ashamed that there are millions of people in this country who have to rely on emergency rooms in crisis for their health care. I think it's good that there's a focus on improving quality and beginning to develop the infrastructure to make providers accountable for quality and reward [them] for quality.

I don't have any particular criticisms of anything that was done, except that because it was a political process, it was a partial fix. But it was a step in the right direction, and going back to what we had before would be a terrific disappointment to me.

Q: What still needs to be fixed?

A: What we need to have eventually solved is the perverse incentives that exist in our system for getting paid more for doing more treatment, providing more care rather than quality care. I think that's probably the biggest one.

Q: What does Roswell Park do?

A: Roswell's mission is to understand, prevent and to cure cancer. Understand invokes the necessity to do research and develop the understanding of what causes cancer. Prevention we feel is extremely important. It's not only preventing the new cancer, it's preventing the second cancer in a person who's been cured of the first cancer, and we have a program in the cancer center in research and education and prevention. And then cure. We still treat. Most of what we do clinically is to treat cancer patients and we need to work on curing more of those cancer patients. What people don't realize is that Roswell Park is not a 100-bed upstate hospital. Roswell Park is a nationally recognized, nationally designated research, clinical care and education center for cancer.

Q: What does the "comprehensive cancer center" designation from the National Cancer Institute mean?

A: It's a stamp of approval that gets renewed every four to five years. It's gained by a very rigorous process of peer review.

We are visited by 18 to 25 cancer scientists and clinicians and administrators from other cancer centers, and they have read our 1,000-page application and come in and evaluate whether we are still worthy to carry the NCI stamp of approval as a designated cancer center. And that stamp of approval means a lot. There are only 41, and when you're recruiting individuals to work in an institution like Roswell Park, the ability to say that you're NCI-designated is a substantial escalation in your attractiveness.

Q: How much of an economic development engine is Roswell Park?

A: It was estimated several years ago that Roswell Park contributes more than a billion dollars to the Western New York economy. When we recruit a scientist, for example, that scientist comes with a family and sets up a laboratory. The laboratory will usually employ two to four additional individuals, and on average, each of those jobs created accounts for more than $50,000 ... So because of the nature of the business we're in, we create a large number of jobs, and these are disproportionately high-paying jobs, which is good for the economy locally.

It's also important, and we have to continue to be aware, that we can't just focus on creating jobs for the high-end of the educational spectrum. We need help for our patients from many kinds of very important people, and the neighborhood in which we live is very important to us, so we need to and we are aware of trying to do everything we can to create jobs as we grow in all sectors of our business.

The other important thing economically is that we spin off companies. The discoveries from Roswell Park, with fair frequency, lead to patents, licenses and, on at least eight or nine occasions in the last 10 years, a new company.

Q: What is your relationship to the state and its funding?

A:The single most important event that has allowed Roswell Park to accomplish what it's accomplished in the last 12 years was the establishment of the public benefit corporation.

Roswell was formerly a subdivision of the state Department of Health and that restricted recruitment, restricted clinical program development. For much of its history, Roswell wasn't permitted or able to raise money philanthropically or enter into contracts with insurance companies because of our relationship with the state.

When we became a public benefit corporation, more than 50 percent of the operating budget was derived from a direct state allocation.

This year, that state allocation represents about 14 percent of our operating budget, and the state is very interested in working with us to reduce the need for ongoing state support, and we are anxious to work with the state to do that because the reliance on a source of funding that is as unpredictable as state support makes it difficult to plan.

The problem is that also because of our state affiliation, we have some expenses that are challenging, and we are in the midst now of working with external consultants and very hard work with our board and our senior leadership to explore plans that will allow us to become less dependent on state support.? Q: What are your visions for Roswell Park in five to 10 years?

A: A very important goal is to solidify and continue to renew our NCI designation, and threats to our stability are threats to that designation. So that's a very important goal. Another goal is to provide outstanding evidence-based cancer care to more and more individuals in Western New York, because I think that care is superior care.

And then I'd like to, with my senior team, be responsible for having put in motion a plan that would allow Roswell Park to be unequivocally stable and economically solid for the next 100 years.