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The Future of Medicine
Editors’ Note
Dr. Steven J. Corwin has served as CEO since 2011 and President & CEO since 2015. Dr. Corwin joined the management team of NewYork-Presbyterian/Columbia University Irving Medical Center in 1986 and served in various management capacities. From 2005 to 2011, he was Executive Vice President and Chief Operating Officer. A cardiologist and internist, he received his undergraduate and medical degrees from Northwestern University, graduating summa cum laude and with Alpha Omega Alpha honors. He completed training in internal medicine and cardiology at what is now NewYork-Presbyterian/Columbia and in 1986 was named to the faculty at what is now Columbia University Vagelos College of Physicians and Surgeons.
Institution Brief
Located in New York City, NewYork-Presbyterian (nyp.org) is affiliated with two of the nation’s leading medical colleges, Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory, and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research, and community service at ten hospital campuses: NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian/Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian Allen Hospital, NewYork-Presbyterian Westchester Division, NewYork-Presbyterian Lower Manhattan Hospital, NewYork-Presbyterian Lawrence Hospital in Bronxville, NewYork-Presbyterian Brooklyn Methodist Hospital, NewYork-Presbyterian Hudson Valley Hospital and NewYork-Presbyterian Queens.
NewYork-Presbyterian and its people have been on the front lines in the fight against COVID-19 and have shown the meaning of resilience and leadership. What do you say to your team who have been the true heroes in this battle?
I will tell you what I have said directly to them. They were asked to do the impossible and they did just that. They are real heroes and I do not use that term lightly. I am talking about every person in our organization at every level of the organization who put themselves in harm’s way to take care of patients and did an extraordinary job. There is no amount of thanks that I can give them that will match the heroic efforts that our people put forth.
Where do see New York today in regard to the pandemic?
I think New York has certainly come through the worst of it, but any time you look at reopening the economy in any significant way you are going to face challenges. Governor Cuomo has done an effective job at focusing on the key metrics including the positivity rate of tests coming back and contact tracing to avoid widespread community transmission which is unfortunately what we are now seeing in other parts of the country. It is difficult to open the economy in any substantial way until the positivity rate comes down and you can do contact tracing in a meaningful way so that you can keep the outbreaks to a minimum.
In New York we worry about a second wave and we need to remain vigilant about that since no one wants to go back to where we were in March and April.
Do you feel we understand the virus today and have the tools necessary to effectively meet this challenge?
We clearly know how to better handle patients with the virus and we are learning every day about the different manifestations it can have in individuals and about who is vulnerable and why they are vulnerable, so the type of care we can give is much better than it was in the beginning of the crisis. We still do not have effective therapies and we still do not have a vaccine. Until those two things happen, we are not going to have success in defeating the virus.
How critical has it been for NewYork-Presbyterian to be able to pivot and adapt to the changes and challenges caused by the virus?
The culture of our organization was critical to how we handled this crisis. Our culture of teamwork, collaboration and working together was instrumental in effectively dealing with the virus. Our management team did a superb job of synthesizing everything our entire organization needed to do. Our chief operating officer, Dr. Laura Forese, was terrific and made sure that we had constant communication and made decisions rapidly, and we communicated those decisions to our 47,000 people on a daily basis so that they knew what was going on which was critical.
Was there a close coordination among the health systems in New York in order to share data and information to best address the pandemic?
Yes, and this was absolutely essential. I give credit to all of my counterparts leading the other health systems and we worked closely together. No one system could have brought New York through this and it was important that the health systems collaborated and coordinated our efforts. In addition, Governor Cuomo was a very effective communicator in making sure we all had the data and numbers in regard to predictive modeling. He then convened all of us to say that we are one state, and New York City is one city within the state, and we have to make sure we are all working together to get through this.
“We often talk about the things that are wrong with this country, but it is clear that people did an amazing job of taking care of each other. I think that the future of medicine is in great hands with the people at NewYork-Presbyterian and the people at other health systems throughout the country.”
How important is it that the focus on defeating the virus going forward is on data and science, and that politics does not influence the decisions being made?
I think it is critically important. I was disheartened that wearing masks became a political issue. The virus does not know red states or blue states or zip codes. We have to be guided by the science and we have to be guided by the data and the metrics. There is a long history in the law, starting with Jacobson v. Massachusetts in 1905, that says that states can enact regulations for the public good as long as those things that are enacted are proportional to the crisis and are not arbitrary and apply to all groups. It is not a violation of someone’s civil liberties to enact a face mask policy and we have 115 years of law going all the way to the Supreme Court justifying that. Masks were never an issue of civil liberties – this was an issue of people acting for the public good and our elected officials have the authority to make this happen in order for people to not only protect themselves, but also to protect family members and all other people they come into contact with.
What are the keys to New York City’s recovery and are you optimistic about New York’s future?
I am optimistic about New York’s future. New York City is a world city and we are going to get through this. I have told our 47,000 employees that part of our role is to help bring New York back and improve the lives of New Yorkers. Clearly, the next year or two are going to be tough for our City and our citizens, but we are going to come out stronger and NewYork-Presbyterian is going to be a part of the solution.
NewYork-Presbyterian has an active and engaged board that is dedicated to the institution. How valuable has it been for you in leading NewYork-Presbyterian to have such a strong board?
We have an extremely strong board that is active and believes in the mission of the institution and the role that we play in providing for the public good. It is incredibly valuable to have a board with such diverse backgrounds and business experience. Our board has been deeply engaged with our efforts relating to the pandemic and has been accessible to me and our leadership team whenever needed. The close working relationship with the board has been essential to the success of NewYork-Presbyterian.
Will you discuss the priority that NewYork-Presbyterian placed on providing services and support to address the mental pressure and emotional stress experienced by its workforce during this crisis?
I am glad you asked this question as it is so important. We domiciled in either dormitories or hotels over 3,000 of our employees who were concerned about going home and infecting a relative, arranged a bus service with over 80 buses so that our people did not have to take mass transit to work, and provided four meals a day to all of our employees so that they did not have to worry about food. Quite frankly, many of them were worried about food security for their families because so many family members of our employees lost their jobs. The provisions around mental health services were absolutely critical. Healthcare workers are not always good at saying they need help and we had to tell people that if they were suffering, we were here for them. I am still worried about a second wave in terms of people handling this again as it was horrific for our people on the front lines and I worry about the emotional impact if they have to go through this again.
What needs to be done in the country to safeguard against future public health crises as we live in an interconnected world?
We live in a world where these types of health issues can travel across the world in a heartbeat. We need to rethink our supply chain and our manufacturing as a country. As a health system, we need to rethink our training of staff in terms of flexibility in regard to the ICU setting, retraining of nurses and doctors, and changing the way we design our facilities. We had thought in a pandemic that we would go from our capability of 450 ICU beds to somewhere around 550-600 ICU beds. At the peak of this crisis, we had to transform many areas of the hospital to ICU areas and were treating over 860 ICU patients. We have to rethink the baseline number of ICU beds, the baseline level of training, the ability to get supplies as we cannot rely on only one country like China and need to manufacture in the U.S. and Canada so that we have different streams that we can draw from should there be a need. The next crisis will not be like the last crisis, but we need to learn lessons around emergency preparedness so we are better prepared in the future. We are now going to have pandemic experts as part of our infectious disease team so that we can better track these eventual problems.
What do you tell young people about a career in the medical profession and the type of opportunities it offers and impact they can have?
There is no question that this crisis elevated the medical profession and healthcare workers, as well as all essential workers, to a level that people now realize how important they are. I was tremendously proud of our young physicians, residents and fellows during this time. We often talk about the things that are wrong with this country, but it is clear that people did an amazing job of taking care of each other. I think that the future of medicine is in great hands with the people at NewYork-Presbyterian and the people at other health systems throughout the country. I cannot tell you the number of people who called us and volunteered to fly to New York to help us – it was a truly astonishing thing. We feel a similar obligation as we try to help other states and cities that are currently going through this difficult time. I am so proud to be a part of this industry.