Editors’ Note

Prior to being appointed to his current post in 2008, Dr. Steven Safyer held a variety of senior leadership roles at Montefiore from 1990 to 2008, including Senior Vice President and Chief Medical Officer. In the 1990’s, he was an early champion of clinical information systems and launched physician order entry (electronic entry of patients’ lifetime medical records) which supported his focus on creating nationally recognized quality and safety programs. In addition, he galvanized a broad effort to stem the epidemics of HIV and TB that were rampant through the 1980’s and early 90’s, and that took their greatest toll on low-income and inmate populations in New York City. Dr. Safyer led the way for Montefiore to set a new standard for accessible, affordable healthcare. He earned his medical degree from Albert Einstein College of Medicine and completed his internship and residency in Social Medicine at Montefiore. He is board certified in internal medicine and is a Professor of Medicine and a Professor of Epidemiology and Population Health at Einstein. He received his Bachelor of Science degree from Cornell University.

Institution Brief

Montefiore Medicine (montefiore.org) is the umbrella organization overseeing both Montefiore Health System and Albert Einstein College of Medicine. Today, Montefiore Health System includes 10 hospitals including White Plains Hospital and Burke Rehabilitation Hospital, employs 45,000 people, and cares for 3.5 million people throughout four New York counties: The Bronx, Westchester, Rockland and Orange. In addition, Montefiore recently ranked among the top 1 percent of hospitals nationally and regionally by U.S. News & World Report. For more than 100 years, Montefiore has been nationally recognized for innovating new treatments, procedures and approaches to patient care, producing stellar outcomes and raising the bar for health systems around the country and around the world.

What have been the keys to the consistent strength and leadership of Montefiore Medicine?

I have been here my entire career. I attended medical school at Albert Einstein College of Medicine, and then I completed my training here and worked in a wide variety of areas. I did that work during a time when Montefiore represented the kind of mission that I’m drawn to; a mission focused on providing the best possible care to people who need it the most in our communities in the Bronx.

But I always wanted to do more. I was always focused on building out a more comprehensive system that could provide the kind of complicated specialty care that other great institutions in New York and across the country offer.

Of course, this happened during challenging economic times. We lived through a recession and have always had to depend on a disproportionate amount of government payments such as Medicare and Medicaid, which do not cover the bulk of work that we do. Those reimbursement rates have remained flat while hospital costs and expenses continue to go up. But I was convinced we could grow our model of care and live up to the mission of taking comprehensive care to our communities.

I focused on building out all the complex care that is familiar at other academic health systems in New York. We invested in specialty programs and Centers of Excellence in cardiac care, cancer care, all transplant services, and pediatric care at our Children’s Hospital at Montefiore. We have seen tremendous growth and success. For example, 15 years ago, we only performed kidney transplants. If you needed a liver transplant or a heart transplant or a lung transplant – especially lung, which was only done at Columbia Presbyterian – you had to go elsewhere to get that care. Now we excel at all of those extremely challenging procedures, right here in the Bronx.

Many members of our community needed liver transplants for a variety of reasons, and in their most difficult moments they had to travel to places that were challenging to get to. We have managed to bring high-end specialty care to a community that really needed it the most.

In fact, the most recent U.S. News and World Report “Best Hospitals” report puts us in the top 1 percent in 9 specialties, including cancer, cardiology and heart surgery, neurology and neurosurgery, urology, nephrology, diabetes and endocrinology, gastroenterology and GI surgery, gynecology and geriatrics. I am so proud of this.

How critical has it been to keep innovation at the heart of Montefiore’s culture?

It is critical. One of my favorite examples is from about 12 years ago when we had a plan to build a free-standing hospital at a site near the medical school. We called it a hospital without beds. It’s now known as Montefiore Hutchinson Metro Center. It began as a 300,000 square-foot building that was built to our specifications. We envisioned it as a place where we would perform same-day surgery and diagnostic procedures. There would be no beds and patients would be able to go home after their procedures. At the time it was kind of revolutionary, and it has truly exceeded all of our expectations. We have recently expanded into an adjacent building and just this year added three additional operating rooms to accommodate the volume. We are performing surgeries there that I never dreamed we would be doing same-day.

I believe the way we evolve and transform contemporary hospital care is critical and that no patient should ever be in a hospital bed, even for just one night, if they can avoid an admission. That was really our goal in opening Montefiore Hutchinson Campus and today Montefiore doctors and surgeons are performing these same-day surgeries which are on the cutting edge of innovation.

Will you highlight Montefiore’s efforts around building a diverse and inclusive workforce to match the diversity of your patient profile?

This is something I think about a lot. If you count Montefiore’s owned and operated and affiliated locations, we have approximately 45,000 employees, with 15,000 of them living in the Bronx. The Bronx has been the entry point for people coming from other countries for more than 150 years. All four of my grandparents came to the Bronx from Poland.

The Bronx is now home to more than 1.5 million people with huge Puerto Rican, Dominican and West African populations. All of these people are coming here to pursue the American dream.

Our ability to employ them and to keep their families healthy is an incredible honor and responsibility. It is important to remember that our 15,000 employees who live in the Bronx have families and children who need healthcare and they also need to make a good living.

I couldn’t be more proud of what we do in the Bronx as well as in other communities served by our system that are challenged, from lower Westchester to parts of Rockland and Orange counties. We take care of all of our people and we don’t discriminate against anyone.

The challenges and landscapes may change,
but wanting to heal, and wanting to show up with my best self
has always been there for me.

What has made the healthcare industry so special for you?

I became a physician because I thought that the profession was without conflicts. I may have been a little naive about that, but no matter who you are and what your politics are, when you become a physician, you want to heal people.

The challenges and landscapes may change, but wanting to heal, and wanting to show up with my best self has always been there for me.

I was in medical school and an intern and resident when HIV was new and it was prevalent in the Bronx and there were no treatments. At the same time there was a tuberculosis epidemic happening. More recently, hepatitis C has been common in our communities. The public health issues may evolve and change, but we have always worked to treat people with the very best care possible. As I have always said, healthcare is a right and not a privilege. Montefiore lives by that motto.

You recently announced your plans to retire. Have you been able to reflect on your career and take moments to appreciate what you have accomplished?

I am so proud. It is not as if everything that one does is perfect, but it’s what you learn from your mistakes and if you stay on the right path and focus on the best outcomes, you will get there.

One major accomplishment I am especially proud of is the recent formalization of our relationship with Albert Einstein College of Medicine, which is one of the most prominent medical schools in the world in terms of research, teaching, and education. We always worked closely with Einstein, but I always thought the relationship with Montefiore should be tighter. I knew this medical school/health system partnership would be key to recruiting the best physicians and researchers, and to providing the type of excellence in research based medicine we wanted at Montefiore. All that has come to fruition.

We now own the medical school and we are recruiting some of the finest talent from around the world. It is part of us and it will always be part of us. This is critical for many reasons. Here’s just one example: one of the most astonishing surgeries ever performed was the separation of conjoined twins with shared skull, blood vessels and brain. We have now performed 10 of these surgeries out of only 12 successful ones that have been done in the history of medicine, and all of them have been done by the same team. That team wouldn’t be here if it wasn’t for Albert Einstein College of Medicine and Montefiore working hand-in-hand.