Value-based Health Care: The MD Anderson Experience

Raphael E. Pollock, MD, PhD


Annals of Surgery. 2008;248(4):510-516. 

In This Article


The Porter integrated practice unit is remarkably appealing to health care providers as a genuinely revolutionary concept by which the quality of such care can be materially advanced, to benefit patients, regardless of the specific disease for which they seek help. Direct and bold in its concept, this new approach seeks to place the entire cycle of disease-specific care in 1 easy-to-access locus that clusters the comprehensive expertise needed to effectively treat a given entity, focusing on quality of care as the single most important measure. The University of Texas MD Anderson Center underwent a 5-year reorganization of outpatient care services in the early 1990s along these lines, incorporating and validating many of Porter's premises. This process is continuing in new and initially unanticipated directions 15 years later as our concepts of continuous improvement expand to embrace the 21st century personalized oncology therapeutics, in which the boundary between treatment and research is beginning to disappear, to the ultimate benefit of the cancer patient and those of us accepting the challenge of being responsible for—and advancing—their care.


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