Editors’ Note

Daniel Tishman serves on numerous not-for-profit and corporate boards and is a member of the Board of Directors of the engineering firm AECOM, which merged with Tishman Construction in 2010. A major force in propelling the green-building movement to the forefront of the construction industry, Tishman spent more than a decade as Chairman of the Board of the Natural Resources Defense Council, one of the world’s leading environmental advocacy organizations. He also currently serves on the boards of the Conservation Fund and serves as Vice Chairman of the National September 11 Memorial & Museum. He was previously Chairman of Governor Cuomo’s Airport Advisory Panel and is a long-serving member of the Real Estate Board of New York’s Board of Governors and Executive Committee. Tishman is a longtime supporter of Montefiore Einstein and has been a member of the Board of Trustees for 15 years. He recently served as Vice Chair and member of the Executive Committee. In 2011, Montefiore Einstein recognized him and his wife, Sheryl, by building The Sheryl and Daniel R. Tishman Cognition Neurophysiology Laboratory at Einstein. In 2003, the College of Medicine awarded him the Albert Einstein Humanitarian Award to commend his leadership. Tishman holds a B.S. in ecology and planning from Evergreen State College and an M.S. in environmental studies from Lesley University.

Organization Briefs

Tishman Realty (tishman.com) is a vertically integrated real estate owner, developer, operator and advisor. With roots dating back to 1898, Tishman is comprised of a diversified staff of experienced real estate, financial and hotel management specialists, and is complemented by a technical staff of architects, engineers and construction management professionals. Over the past 30 years, Tishman has owned and developed roughly 10 million square feet for its own account and has sourced and structured nearly $8 billion of debt and equity for its projects. Additionally, Tishman has developed, managed and advised on more than 35 million square feet of real estate projects including hospitality, retail, residential and office.

As the academic health system and University Hospital for Albert Einstein College of Medicine, Montefiore (montefiore.org) is nationally recognized for clinical excellence – breaking new ground in research, training the next generation of healthcare leaders, and delivering science-driven care that puts the patient first. Montefiore is ranked among the top hospitals nationally and regionally by U.S. News & World Report. For more than 100 years, Montefiore has been innovating new treatments, procedures and approaches to patient care, producing stellar outcomes and raising the bar for health systems in the region and around the world.

Will you discuss what makes philanthropy so important to you, and with so much need today, how do you focus your efforts?

Developing one’s philanthropic profile depends, to some extent, on how one learns to be philanthropic to begin with, and I don’t think this is directly connected to wealth. Philanthropy is connected with ideology.

Fortunately, our family has been blessed with a wonderful history in the U.S. for more than 120 years and I’m the fourth generation in the family business.

Going back to our roots, had it not been for acceptance and encouragement for an immigrant family in New York City, we would not be where we are today.

For us, committing time, resources, and money to philanthropic causes has always been important. I learned that philosophy early on, so I started by donating time, which was all I had to donate initially.

Today, we have built a foundation with an executive director and a staff, and our goal is not just to donate money, but to partner with institutions to solve problems.

Do your business skills and expertise naturally translate to your philanthropic work?

I believe they are much more aligned today than they were 10 years ago. Philanthropy is really just a financing vehicle, but ultimately, we want outcomes.

When I was running my business, every day was about how to deliver outcomes to my employees and my clients.

I think the same thing is true of philanthropy. I don’t give away money anymore just because it’s fun to give away. It is fun, but I give it away because I believe there are problems to be solved. For instance, we funded Montefiore research into understanding the human brain. We also give a lot of money to environmental causes, such as climate change or land degradation. We also donate to people fighting for equal and just access to education at all levels through scholarships.

I believe there are institutions in the world that are much better at solving those problems than I would be at building an institution to solve those problems, so I invest in those best-in-class institutions to assist me in solving the problems that I believe need to be solved.

My skills as a businessman did not relate to brain science or advocacy around climate change, but my skills as a businessman can be applied to helping those institutions finance their problem-solving missions. However, we also help them on a regular basis to adapt and adjust their strategy for solving those problems and we want to see outcomes that justify my investment.

That means we need data and metrics and those are things institutions haven’t been particularly good at historically. However, successful business people have often made their money by paying attention to data and metrics. They know how to collect and analyze data and evaluate if they’re succeeding or if they need to pivot. If there is one thing that business does well that many philanthropic institutions do not do well on their own, it is knowing how to pivot.

You recently became board chair for Montefiore. Will you discuss how your relationship with Montefiore developed and what makes Montefiore such a special place for you?

I got to know Montefiore through a business transaction. For the past 15 years, I have been on the board of Albert Einstein College of Medicine. The College of Medicine was an institution that our family had an on again/off again philanthropic relationship with.

I was invited to sit on the board because I had a commercial relationship with the institution – my construction company was building their new research institute. That was how I got to know Montefiore.

A number of us on the board realized that Albert Einstein College of Medicine had to be more closely aligned with the hospital in order to deliver on its promise. It was aligned with a university, but it had reached the point where it had to be aligned with a hospital in a more formal way.

A group of us structured a plan for Montefiore to acquire Albert Einstein College of Medicine from Yeshiva University, and the deal was completed four years ago.

As an active participant in that transaction, I got to know Montefiore very well. I was particularly interested in early childhood learning disabilities, because we had a family member who grappled with learning disabilities. We also saw a nexus between health and environment, which are two areas we’re involved in because we know that many of the ailments affecting young people are stimulated through environmental exposures.

There was some groundbreaking brain research being done at Einstein on this issue and, as one of our first contributions to Montefiore, we funded one of their labs and have continued to fund this lab for years.

When I was running my business,
every day was about how to deliver outcomes
to my employees and my clients. I think the same thing
is true of philanthropy.

Once the transaction between Montefiore and Yeshiva was complete, the institution asked if I would be willing to chair what essentially is the holding company board of the combined institutions. What excited me about this was that Montefiore Health System would now be backed by the academic and research engine of a powerhouse medical school, making it one of the biggest systems in the New York City region.

Montefiore’s population base is extraordinarily large and underserved. I am a firm believer that quality healthcare is deserved by all, and that healthcare is to be provided by private enterprise and not the federal government. I saw a huge opportunity to partner with other institutions that we have now acquired, and we successfully provide quality accessible healthcare to an underserved population in a way that has become a national model.

The communities we serve in the Bronx and in Westchester are much more diverse than the population in Manhattan and they are reflective of the vast healthcare needs in the U.S.

We hear about the struggles to find accessible, affordable healthcare every day. We read about people foregoing basic medical care because they simply can’t afford it or they can’t get to an appointment. But Montefiore is on the ground working to change these stories. Our accountable care organization and population healthcare models, which reward doctors for keeping people healthy, are pioneering, and I believe they are going to turn healthcare around.

The prospect of being involved in an institution dedicated to this kind of work incentivized me to boost our philanthropic investment and, as I mentioned, part of my definition of philanthropy is not just giving money but also giving time.

Is the ability to pivot you discussed earlier necessary to allow Montefiore to stay ahead?

Montefiore is special because 10 years ago it was a single hospital with a children’s hospital and a few outlying facilities – it had no medical school and virtually no presence elsewhere. Today, it’s a system that is a teaching and research powerhouse that touches the lives of about 4 million people throughout the Bronx, Westchester and the Hudson Valley.

It is still early on in the integration of so many new entities and we are in the process of truly becoming a Health System. If we define it as a business, it’s a business that has been in the merger/acquisition mode for a few years and is now in the process of reinvention. This is exciting and is where a business background can be helpful.

We now know a standalone hospital like Montefiore was 10 years ago will not be able to survive on its own. Hospitals will always be required in order to provide people with care, but now there are so many more options for appropriate, “right-sized” care and services that all add up to a smarter and more sustainable business model. For example, not every surgery requires someone to spend the night in the hospital, which costs thousands of dollars. Montefiore’s Hutchinson campus handles hundreds of ambulatory surgeries every week, where people come in the morning and go home at night. That’s what you call a pivot that makes sense. Montefiore is also working hard to get people to rely on primary care instead of just showing up in the emergency department.

As a general rule, underserved populations tend to use emergency departments for primary care and that dynamic doesn’t work for many reasons. It doesn’t deliver the full level of care they need for their issue; it’s vastly more expensive; and it’s unlikely the patients or the hospital will get reimbursed for those treatments.

In communities throughout the Bronx, Montefiore is working to reeducate patients about what preventive healthcare really means, so they don’t have to show up in the emergency department; this will redefine the healthcare system of the future.

Montefiore is a great example of this complexity.
It is a multifaceted institution that must rely on the
deep technical capabilities of the board.

Will you discuss the platform that Montefiore offers to researchers?

Research at Montefiore provides many things that are extraordinarily important for a large system such as ours.

First of all, the fact that we have a medical school, that we can do research, and that we have a diverse patient base makes our institution remarkably attractive to researchers. We have had some of the best researchers in the country come to us just because of that dynamic.

Researchers want to work at places that will allow them the greatest opportunity to solve problems that they have spent their lives trying to solve. Researchers today are also drawn to translational medicine, which involves not just solving a problem scientifically, but once they solve it, discovering how to best bring it to the bedside and how to bring the greatest benefit to the patient through the research. It’s not just research about investing, patenting, and selling a drug for a lot of money.

For instance, there are many researchers who want to understand diabetes, which will lead them to a study of obesity. At a place like Montefiore, this, in turn, will lead to having conversations with people at risk for diabetes directly in their kitchens, so they can get hands-on guidance about healthier food choices that might help prevent this disease.

Montefiore’s patient population base gives researchers a fertile environment in which to work on this translational medicine.

Are you optimistic that the healthcare industry is going to be able to meet the challenges of an increasingly difficult healthcare environment?

I’m very hopeful, because I’m an optimistic person by nature, but it’s not going to be easy.

One of the major philanthropies we are involved with right now at Montefiore is focused on brain science. We are directly focused on brain science studying addiction, as our population faces an overwhelming struggle with addiction.

We are studying what actually triggers behaviors that define addiction, and it’s not just addiction to things like opiods, it could be addiction to food or behaviors. We’re searching for common threads in those addictions in order to understand if there are particular triggers that activate them. If we can determine what those triggers are then, like a light switch, we can learn to either dim or turn them off. This is an area of real excitement and something our foundation is thrilled to invest in.

This helps us start dealing with some of the issues that lead to chronic health problems that make healthcare unaffordable for some people today. If we can turn off the addiction to unhealthy foods, we could potentially reduce the incidence of diabetes, which is very costly to deal with.

It is an intricate web that we are well-positioned to be weaving. For me, this is an area we can invest in, we can measure, and we can make pivots on a real time basis.

We meet with the scientists periodically and learn where they need to pivot because some of the assumptions they made a year ago may have proven to not be accurate. They know that they can come to us and ask about changing things and explain their rationale.

Research at Montefiore provides many things
that are extraordinarily important for a large system
such as ours.

How has the role of boards evolved?

I’m not sure there is a uniform answer, because the role of boards in various sectors has changed dramatically.

Twenty years ago, the only role a philanthropic board was supposed to play was to write a check. The institutions didn’t want boards meddling unless they had a crisis.

Today, the complexity of running these institutions is significantly deeper than it was 20 years ago. Boards are now being called on not only for their philanthropy, but also for their technical expertise in helping deal with extraordinarily complicated issues.

Montefiore is a great example of this complexity. It is a multifaceted institution that must rely on the deep technical capabilities of the board.

With all of the impact and success that you have had in business and philanthropy, are you able to take moments to celebrate the wins?

I find myself basking in success and glory much more in the philanthropic world than I did in the business world. When I can sit around a table at Montefiore and witness a presentation by world-renowned doctors who successfully separated twins conjoined at the head in a 27-hour surgery, saving the children’s lives and enriching the lives of the family, this is a wonderful thing.

Whether or not it was my money or my expertise that contributed to supporting an institution that enabled that procedure to happen, it’s a feel-good moment.