Who Will Replace the Baby-Boomer Generation of Cancer Center Directors?

Richard A. Skinner, Ph.D., Senior Consultant 

By now, those of us born between 1946 and 1964 have gotten used to the attention paid us, most likely because we tend to be legends in our own minds and have spent much of our adult life fixated on who we are and how we changed the world.

It should come as no surprise, then, that we periodically wring our hands over how the world can possibly go on when we retire. 

The search business is no different from the broader portrait of Baby Boomers: Those who lead corporations, businesses, universities, and research organizations are typically members of The Generation. And claims to the contrary notwithstanding, those persons (still overwhelmingly males) will grow old, stop working, and, believe it or not, succumb and slip off this mortal coil.

The harsh truth is the world will somehow go on when Baby Boomers no longer preside, but it is intriguing to speculate on who or what will replace us, especially since it allows us to once again stare at our navels, though with the several rolls of skin around our expanded middles, those navels may not be so easy to see anymore.

Let’s begin with some pesky matters, facts. In 2015, Millennials – those between ages 18-34 – surpassed Baby Boomers as the largest living generation. Even Generation Xers – those ages 35-50 - will outnumber Baby Boomers by 2028. And while Boomers occupy most leadership positions at present, time does march on and the inevitable passing of the torch will take place as Millennials age up, pushed by their juniors, the Xers. 

While life expectancies for Boomers are longer than their predecessors, their successors seem poised to be the first generation in American history not to live longer than their immediate forefathers and foremothers. These factors may enable Boomers to work longer, but even the most optimistic among us Boomers has to accept that our time in the C-Suite is not indefinite.

As a search firm working in the fields of academic leadership, academic medicine and research, and related sectors, we were curious to see if one particular group, the persons who direct the nation’s cancer centers, reflected the more general demographic trends of the country. Here’s what we found.

To begin with, we were expansive in our definition of “cancer centers” and included not only those recognized and typically funded by the National Cancer Institute of the National Institutes of Health but also those aspiring to NCI-designation or of an age to suggest they were more or less fixtures in the field of cancer research, approximately 100 institutes or centers.

The major characteristics of the people who direct these cancer centers are as follows:

• women make up a very small number of these centers, fewer than 10;

• immigrants have a presence among the directors, often persons from Europe and Asia;

• the average age of the directors is between 61-63, with the youngest 46 and the oldest well into his 70s;

• most directors have been in that job for more than five years, although it was possible to see some turnover in recent years; and 

• specialization in oncology is common.

Here’s what we drew from this general depiction:

o   there will likely not be a lemming-like flight from the ranks of cancer center directors in which an especially large number of leaders depart within a short period of time as the year-to-year turnover appears to have been 5-8 positions vacated but promptly filled annually;

o   it is hard to see how the number of female cancer center directors can remain so small in light of their significant presence in the life sciences in undergraduate and graduate education as well as the relevant professoriates and national laboratories;

o   more persons born outside the U.S. are likely to move into cancer center directorships, if for no other reason than their larger numbers in both Millennial and Generation X cohorts than was the case for Baby Boomers and the success of Asian-born persons in earning American M.D.’s and Ph.D.’s in fields of relevance and significance to cancer research, including genomics and data analytics.

Not revealed in this analysis are the forecasts of support for cancer research. On the one hand, the Cancer Moonshot served to accelerate the sharing of information among research organizations and thereby raised the possibility of cost savings accruing from organizations not duplicating efforts in certain fields of cancer research. 

Depending on one’s method of accounting, the Moonshot also injected $5 billion of federal funds into cancer research.

By contrast, President Trump’s “skinny budget” proposal called for a 19 percent cut in NIH funding, so the picture for future funding of cancer research is unclear.

These events and trends will have a great deal of influence on the amount of cancer research that can be undertaken and will therefore also affect how readily cancer researchers aspire to direct cancer centers.

One joke has it that a cancer center director from the Boomer Generation wakes up to find herself standing before the Gates of Heaven, on one side, and the Ovens of Hell, on the other, confronted by an angel and a devil. The center director asks, “What am I doing here? Who are you?”

The devil replied, “Your life in the mortal world ended and you will now be judged whether to spend eternity in total bliss or in eternal anguish.”

The cancer center director responded, “To hell with that sort of stuff: I’m not supposed to die!”

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