Abstract: This paper contributes to the evolving body of literature diagnosing the “business-like” transformation of American medicine by historicizing and recuperating the concepts of medical leadership and the corporation. In an analysis of the evolving uses of “leadership” in medical literature, we argue that the term’s appeal derives from its ability to productively articulate the inevitable conflicts that arise between competing values in corporations, and so should be understood as a response to the neoliberal corporation’s false resolutions of conflict according to the single value of profit (or consumer welfare for the business-like nonprofit). Drawing on midcentury theories of the corporation to reframe dominant social histories of medical corporatization, we go on to argue that large medical institutions are productive sites for the public deliberation over the medical profession’s social contract. Our primary case study for this longer historical and broader theoretical argument is the M. D. Anderson Cancer Center, the world’s foremost cancer patient treatment hospital. We hold that the historical trajectory that led to MD Anderson’s exceptional but exemplary place in the evolution of American corporate medicine is reflective of historical trends in the practice.
In early 2017, I was teaching and writing while also recovering from a craniotomy. I had just won a grant from Rice’s Doerr Institute to support my teaching for Rice’s new interdisciplinary minor in medical humanities. The grant-funded course I taught was on “Medical Leadership,” in which we explored the evolution of the discourse of leadership in the practice of American medicine, most notably in the wake of the transformation that Paul Starr called “The Coming of the Corporation” (see Social Transformation of American Medicine, chapter 5).
I was also teaching a practicum course, in which students intern at local institutions and produce research projects about their work in parallel. My medical humanities student, Bilal Rehman, was working for the M. D. Anderson Cancer Center Library, helping with their oral history project. The archive is a treasure trove for anyone interested in how the institution was formed and came to be what it is today. It is the perfect companion piece to institutional histories of medicine, such as James Olson’s Making Cancer History.
Bilal started finding interview after interview that aligned brilliantly with the theories of leadership and corporatism that my other class was exploring, and so after he finished his final paper for the course, we integrated the theory and archival research as an extended case study in the corporatization of American medicine, in order to recuperate concepts like “the corporation” and “leadership,” which many have underappreciated by characterizing these as mere catchwords for neoliberal ideology. Bilal presented the paper at the Texas A&M Future of Healthcare conference in 2018, and our article is available online with the journal Medical Humanities.