Editors’ Note

Dr. Philip Ozuah is the President and CEO of Montefiore Medicine, the umbrella organization for Montefiore Health System and Albert Einstein College of Medicine. A nationally recognized physician, leader, executive, researcher, teacher and author, Dr. Ozuah previously served as President of Montefiore Health System. A National Institutes of Health (NIH)-funded researcher and award-winning educator, he also served as Professor and University Chairman of Pediatrics at Albert Einstein College of Medicine and Physician-in-Chief of Children’s Hospital at Montefiore (CHAM). Dr. Ozuah has been recognized locally and nationally for excellence in teaching and patient care, including as an inductee into the Alpha Omega Alpha Honor Medical Society and a two-time recipient of the Academic Pediatric Association’s prestigious Helfer Award for Innovation in Medical Education. Along with his various awards for teaching and clinical excellence, Dr. Ozuah has also been recognized by Modern Healthcare as one of the “Top 25 COOs in Healthcare.” Dr. Ozuah earned his medical degree from the University of Ibadan, Nigeria, a master’s degree in education from the University of Southern California and a PhD in educational leadership and administration from the University of Nebraska-Lincoln. He completed his Pediatric Internship and Residency at Albert Einstein College of Medicine and Montefiore, and his Post-Doctoral Fellowship in Medical Education at the University of Southern California School of Medicine.

Institution Brief

Montefiore Medicine (montefiore.org) is the umbrella organization overseeing both Montefiore Health System and Albert Einstein College of Medicine. Montefiore Health System is comprised of 11 hospitals, including Children’s Hospital at Montefiore and Burke Rehabilitation Hospital, employs nearly 40,000 people, and has nearly 8 million patient interactions a year throughout four New York counties: The Bronx, Westchester, Rockland and Orange. In addition, Montefiore recently ranked among the top 1 percent of hospitals in seven specialties 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.

The world is fighting a public health crisis that is impacting all countries and their citizens. Montefiore Medicine has been on the front lines in this battle. What do you say to your team, the true leaders and heroes risking their lives to protect others?

Every generation, if it is lucky, is called upon to make enormous sacrifices for a greater purpose – the welfare of humanity. When the world shut down, our people stood up, summoned courage, overcame fear of the unknown, and went above and beyond their duty to save thousands of lives at great risk to themselves and their families. Confronted by an unimaginable disaster, they were as ready as any team could have been. The dedication and discipline, the professionalism that saved so many lives, was in place long before the first COVID-19 case arrived at our doors. Their performance in the face of a deadly pandemic was what I expected of them. More importantly, it’s what they expected of themselves. When the history of this pandemic is written, 10, 20, 30 years from now, and the question is asked of this generation, “When the call came, did you answer?”, the entire Montefiore/Einstein community can look back and say, “Yes, we did our part, we made a difference.” I could not be prouder of them.

How critical is it to follow data and science when addressing a public health crisis, especially during a time of partisanship and political division in the country?

I’ve heard it said that democracy is imperfect – it can be messy and contentious, but it is still the best system of self-governance in the world. We are dealing with a pandemic that has disrupted every aspect of life in the United States – political, economic, social. Discord and debate, the aches and pains that are part of being a democracy, are to be expected. We are only human, after all. But when it comes to public health, I believe decisions must be based on science and data. I’m not a politician. I’m a physician and a scientist. I don’t speculate on absolutes without facts. Complex, evolving medical issues require rigorous empiricism in response. Clinical decision-making, the pursuit of solutions to COVID-19, demand adherence to facts and facts alone.

Where do you feel New York City stands in its fight against the virus and what are the keys to winning this war?

In the third week of March this year, the positivity rate among people tested for the coronavirus was close to 60 percent in New York City. Today, we are performing tens of thousands of tests daily and the positivity rate is less than 1 percent, so the data speak for themselves. However, I have never lost sight of the thousands we lost, the thousands more who suffered and survived, and the dark early days when we were the epicenter. I think of the people of the Bronx, our neighbors, who turned to us for help and put their lives in our hands. That pain and grief will be with us always and so will the lessons we learned, like the importance of such simple but effective measures as social distancing, wearing masks and washing our hands. Going forward, we must remain vigilant, continue to ramp up testing and tracing, and continue the relentless pursuit of therapeutics and vaccines. We must recognize that there will be difficult and complex decisions to be made. The virus doesn’t respond to passionate arguments about school openings or indoor dining for restaurants. We must defeat it if we are to have any hope of returning to the normal life that we all miss so much.

Montefiore Medicine is a purpose-driven organization with a long history of supporting its employees, patients and communities. How has Montefiore adapted the way it works during this unprecedented time in order to continue effectively supporting its employees, patients and communities?

In times of crisis and unprecedented turmoil, communication is key. I made sure that I communicated with our staff early and often, with near daily e-mails, town halls and virtual calls. We let our people know exactly what was going on in detail, and addressed where we stood, what challenges we faced and what we were doing to meet them. We also communicated about new scientific discoveries about the virus – its manifestations, transmissibility and other critical factors. We made sure that everybody in the organization knew the impact that COVID-19 was having, not only in New York, but around the country and across the globe. As a family, we began every call with a moment of silence, acknowledging team members we had lost.

Clinically, we had to transform the way that we operated practically overnight. We repurposed every space possible to double the number of beds and triple the number of critical care beds. We were spread incredibly thin and everyone had to be flexible to meet the demand – anesthesiologists worked as respiratory technicians, directors worked overnight shifts, nurse practitioners worked as ICU nurses. The pace was relentless around the clock. Remember, we are an essential provider - we do not have the option of shutting down or working remotely from home. When a hurricane disrupts business as usual in every other sector, our community and our patients need us more than ever.

Montefiore Medicine was built with an entrepreneurial spirit and an ability to be nimble and adapt. How critical has it been to be able to adapt and change course quickly in order to meet the challenges of the pandemic?

We had to do it, so we did it. We went from two COVID-19 patients on March 11th to nearly 4,000 one month later. We built new facilities almost overnight. We went to nearly 100 percent telemedicine for our outpatient visits, created new platforms and patient resources, and greatly expanded our health information technology capabilities. This adaptability is baked in for us. We are always looking for new ways to serve our patients and our communities, and new ways to do things better. At Montefiore and Einstein, we have a culture of innovation and a history of firsts, including, for example, the first cardiac pacemaker. When I say we are as ready as anyone for a pandemic, that is part of it.

How critical was it for Montefiore Medicine to support its people and provide services to address the emotional stress and mental toll that the pandemic took on its team?

I fulfill my obligations as CEO through our people. The greatest asset any organization has is its people, and I saw my job during the pandemic as, most importantly, keeping our people safe so that they could then save thousands of lives. With that goal in mind, we spared no expense. We spent hundreds of millions of dollars ensuring the safety of our staff. To give you an example, a mask that used to cost us 43 cents cost $12 during the pandemic, and we purchased hundreds of thousands of them. Supporting our staff and making sure that they get what they need when they need it is at the very center of my role as CEO.

There was an inordinate amount of severe illness and death, even in a profession like ours that is used to dealing with death and tragedy. We provided enhanced mental health services, staffed by psychiatrists and psychologists, to support those who were struggling. We also took action to lift the burden of small, everyday needs. We provided free meals for our workers, free parking, hotel room stays, car rentals and more. It’s been harrowing and tremendously hard on our front line workers.

In addition, in the midst of so much suffering, it was crucial to celebrate our successes. One small step that brought so much joy was a “Happy Code.” To the normal drone of code words we play across the public address system, we added a special code every time a patient with COVID-19 came off a ventilator or was discharged from the hospital. The code wasn’t just a word – it was an anthem: Alicia Keys and Jay Z’s “Empire State of Mind.” That simple act turned an overwhelming mood of melancholy to euphoria and a sense of triumph. The morale boost was transformative. Staff would regularly burst into song and dance in celebration of success.

Montefiore is a leader in New York City. What are the keys to New York City’s recovery and how critical is it for there to be a strong public/private partnership to ensure a safe and effective reopening of New York City?

We received tremendous support from our board of trustees, private institutions and other donors assisting us in securing crucial resources to provide lifesaving care for our community. As the city recovers, these partnerships will continue to be important in helping New Yorkers of all backgrounds get back on their feet in the coming months and years.

New York City, including our home borough, the Bronx, has been devastated not only by COVID-19, but by massive unemployment as well. I’m proud to serve on the recently formed New York Jobs CEO Council, a coalition of CEOs from 27 major companies, including the CEOs of companies like JP Morgan and IBM, that is committed to providing training and opportunities to place 100,000 minority and low-income New Yorkers in jobs. These types of initiatives will be crucial in helping communities like the Bronx, which have been disproportionately affected by both the health and economic impacts of the novel coronavirus, recover from this pandemic.

What are the key lessons that health systems and hospitals have learned in dealing with the pandemic that will help them be better prepared for future crises?

As medicine has learned more about COVID-19, we have refined our treatment protocols and the clinical picture for patients has improved even as the virus has continued to spread. That is good news, but the virus has unmasked another problem, an underlying public health crisis, a chronic virus, if you will, that has been afflicting and killing minorities and the poor for decades. Poverty, unemployment, hunger, crowded and substandard public housing, violence, threats to public safety, limited access to healthy foods – such social determinants of health can combine to leave entire communities at increased risk for the chronic diseases and disorders that have left them particularly vulnerable to COVID-19. According to the Centers for Disease Control and Prevention, COVID-19 hospitalization rates for Blacks and Latinos are five and four times greater, respectively, than that of non-Hispanic whites. For patients with underlying conditions, hospitalizations are six times higher and deaths 12 times higher than for patients without those complications. In the Montefiore Health System, fully half of the 2,450 patients killed by the coronavirus had diabetes. As if that wasn’t enough, we now find ourselves in the midst of the biggest reckoning on race and racism in the United States since the civil rights movement of the 1960s.

This combination of tragedies, this extraordinary level of pain, requires an extraordinary response. I’m a physician, and I can handle COVID-19 and other diseases when they appear. But I need partners – elected officials, community leaders, law enforcement, religious leaders, business leaders and more – to address the deep-seated issues that drive so much of the suffering in this country. Our future depends on it.

How critical is it for health systems to work together and collaborate in order to most effectively address public health challenges?

I believe it is essential. Here in New York, the CEOs of the five major health systems came together to fight this pandemic as a team. We put competition and territoriality aside and shared information. We spoke nearly daily. We shared discoveries, solutions to challenges, we shared equipment and other critical resources. When necessary, we moved patients around to assure them the best possible care. We shut down all profit-making lines of business to singularly focus on saving the lives of New Yorkers. We endured hundreds of millions of dollars in losses to ensure that we saved the greatest possible number of lives. I believe that is a model for emulation.

You are known to be an optimistic person. During this difficult and uncertain time, what are you telling your people and what would you say to young people across the country who are deeply concerned and uncertain about the future?

It’s hard to be positive, never mind optimistic, in these troubling times. But I believe that in our response to COVID-19 we can find the answers to some of the other daunting challenges we face as a nation. The sacrifice, discipline, dedication, passion and commitment to helping others that we have brought to bear on the coronavirus is exactly what we need to confront the racial and social injustices that continue to plague us. Americans have changed their behavior in such profound and fundamental ways to mitigate this virus, from self-quarantining and working from home to wearing masks and literally risking our lives to care for the sick. I dare to believe that we as a people have the capacity – the nobility – to summon the same selfless courage and determination to establish equal justice for all and finally prove the true strength of our shared humanity.