It is a professional partnership that began as a friendship, broke all the rules and continues to improve the state of the art in regional cancer care beyond their most ambitious early dreams: Dr. Kurt Tauer, an Indiana Hoosier who never wanted to be anything but a doctor, and Dr. Lee Schwartzberg, a New Yorker with a fascination for research.
The two met in 1983 at Memorial Sloan Kettering Cancer Center, New York, where they served together as fellows and lived as neighbors in the fellows' hall. Even their families became the best of friends.
It was part of a series of fortuitous firsts for Tauer. After graduating cum laude from Saint Louis University School of Medicine, he had begun his residency in internal medicine at Baptist Memorial Hospital in Memphis, where the first attending physician he worked with on his first day -- while treating his first patient -- was Dr. William West, then in private practice. The two immediately hit it off, leading to their later association and the development of the West Clinic. The date was July 1, 1980.
Arriving for his subsequent fellowship training in hematology and oncology at Sloan Kettering, Tauer said, "the first guy I met was Lee Schwartzberg -- and the rest is history."
Schwartzberg, who had attended medical school at New York Medical College and done his internal medicine residency at Cornell University/North Shore, stayed on to continue in research at Sloan Kettering following his fellowship, while Tauer returned to Memphis to join his mentor in West's practice in 1985.
When Tauer later invited him and his family to visit Memphis over Thanksgiving, Schwartzberg recalls that "after dinner, Bill (West) took me into his study, locked the door and interviewed me for a job I had not applied for. That's how it started. I came down in '87 and we became the West Clinic -- adopting the name in 1989."
For a New Yorker who'd never owned a car, a certain level of culture shock was involved, but he hasn't regretted a moment of the 30 years of dramatic evolution they've seen in the field of cancer treatment as well as within the West Clinic/Cancer Center itself.
What began as a medical oncology clinic has become multidisciplinary, adding associates specializing in GYN oncology, surgical oncology, radiation oncology and more. "Every method to treat cancer is under this roof, and that's how we've expanded it," Tauer said. "So we really are truly a cancer center now, and not just a cancer clinic."
Because of that expertise, Schwartzberg added, "We're very proud that now the vast majority of people don't have to leave town to get the most advanced treatment and comprehensive services."
The Center has always had a very active clinical research program, he explained. "Currently we have 50 0pen clinical trials, from early phase to phase III."
Together, Tauer and Schwartzberg have also evolved their own unique style of managing the West Clinic cum Cancer Center; it follows no plan or rule book, but like ivy on a trellis, it has shaped itself to their personal tastes and principles and grown abundantly.
Schwartzberg, who had favored a research career, claims to have discovered he was a much better clinician than basic researcher. Like Tauer, he loves taking care of patients. Likewise, both love teaching but don't have enough time to do more of it. Both handle administrative roles in addition to their clinical roles and teaching, and divide responsibilities easily.
"We're very like-minded," Tauer said. "We both have the same core values and the same vision of how we want to go forward. We often will approach a situation from different perspectives, but as we work through it, we come to a consensus. It's a unique management style, but it's worked for us."
"I think it's actually one of our strengths and one of the reasons that we've been successful over the years," agreed Schwartzberg. "By having mutual respect and shared vision, and coming at it from different perspectives, we're often able to reach a consensus that is stronger than either of our original positions."
Put the patient at the center of the care and business follows it, Tauer said. "We didn't have any grand scheme or business plan -- we just took care of patients and the rest kind of evolved."
The "If you build it, they will come" philosophy has worked for them: 30,000 patients a year are now treated at West Cancer Center.
Schwartzberg's stature as a widely respected cancer researcher and scientist at the national level has played an important role in the development of the clinic, while Tauer's efforts as community-focused clinician have also fostered growth.
Their recent collaborative partnership with Methodist Healthcare and the University of Tennessee Health Science Center represents a giant step forward. It enables them to combine clinical research in a patient-focused setting with translational methodology in the UTHSC laboratories -- driving development and delivery of the most innovative and effective patient care possible.
"It has led to the creation of a cancer council made up of all three partners," said Schwartzberg, who serves as UTHSC's chief of the Division of Hematology/Oncology. "The council is able to fund scientists, projects, research, service -- and especially education. West took on the UTHSC medical oncology fellowship program, and we're proud to be training the next generation of oncologists."
"I'm greedy for bright young minds like those we're already bringing in," Tauer added. "They bring everybody up by giving to everybody else."
The partnership will also allow them to focus on addressing the disparity of care at multiple levels from different angles and with greater leverage.
"Only a few percent of patients in the whole country go on clinical trials," Schwartzberg pointed out. "In our center, for the years that we've been doing clinical research, we've always had the same proportion of African-Americans in our clinical trials as in the community at large. This reflects the trust our patients have in us."
The new Methodist tower under construction on the university campus will house a cancer center for both inpatient and outpatient care that will become another major West facility, in addition to its new Wolf River Center in Germantown.
Their ultimate partner-shared goal is to pursue National Cancer Institute (NCI) designation as a comprehensive cancer center -- an expected journey of five to 10 years.
"Healthcare is changing, and being nimble to change with it is a challenge," Schwartzberg said. He cites experimenting with new forms of reimbursement as they move toward a value-based healthcare system, keeping up with EMR technology, complying with changing regulations and pursuit of approvals that are difficult and sometimes demoralizing for patients and staff.
Tauer agrees that medical economics is probably the biggest issue they face.
"The insured American patient has really developed cancer medicine for the entire world, and that pool is becoming increasingly smaller as resources are less readily available," he said. "Where will the engine come from that powers future research?"
But despite the challenges these friends and partners face, their still youthful sense of wonder and passion for seeking answers burns brighter than ever.
"In an era when doctors sometimes say they wouldn't tell their children to go into medicine today, I love it more now than I did 30 years ago," Schwartzberg said. "I'm still excited to come to work every single day."