Since the dramatic downturn in oil prices, Houston has avoided slipping into a recession by virtue of its diversifying economy, led by the largest medical center in the world. But now comes news that the MD Anderson Cancer Center has run up $102.4 million in losses during September and October, the first two months of fiscal 2017.

"MD Anderson executives are urging faculty members to add clinical days and make efforts to convince out-of-town patients to remain at the Houston-based cancer center for the duration of their treatments," The Cancer Letter reports on a Nov. 15 forum MD Anderson President Ronald DePinho held with faculty. "Also discussed are frugality measures, including eliminating overtime, instituting a hiring hiring freeze, curbing catering, and turning holiday parties into potluck events."

At the forum, DePinho said all programs could be trimmed, even his vaunted cancer Moon Shots initiative, according to The Cancer Letter, which notes that two peer cancer institutions, Memorial Sloan Kettering Cancer Center in New York and the Fred Hutchinson Cancer Research Center in Seattle, are both well in the black.

The Cancer Letter quote DePinho as accepting "full responsibility" for MD Anderson's financial challenges.

This won't be the first time in his tenure that the nation's top cancer hospital has faced a sizeable deficit. As the Chronicle's Markian Hawryluk reported in his definitive March 2016 DePinho profile:

Many felt DePinho's bravado in launching Moon Shots program, although much criticized, energized the institution. But launching Moon Shots and boosting research capabilities came with a hefty price tag, and in 2013 expenses outpaced revenues.DePinho attributed the shortfall to investments aimed at improving efficiency, including improved information technology and increased hiring. He announced a series of cost-cutting moves. He told department heads to increase productivity and raised the amount of grant funding required from researchers - even as National Institutes of Health grant funding was drying up. "The business plan of academic medicine in the country, not just M.D. Anderson, is to charge more for clinical services and plow the margin into research and education," said Dr. Leonard Zwelling, a former M.D. Anderson professor. Doctors had already been asked to see more patients in 2008 in response to a financial crisis. Now DePinho was pushing an already taxed staff even harder.

DePinho succeeded then in bringing the storied institution back to fiscal health. Now, in any even more unforgiving and uncertain funding and insurance environment, he's going to have to do it again.