Editors’ Note

Prior to her current role, Margaret Pastuszko served as Executive Vice President, Chief Operating Officer, and Chief Strategy Officer where she led Mount Sinai’s commitment to performance and process improvement and the identification of opportunities for investment and resource optimization. She began her career at Mount Sinai in 2001 as Associate Dean of Operations for the Mount Sinai School of Medicine and then transitioned to the role of Vice President for Business Planning at the Mount Sinai Medical Center. Before joining Mount Sinai, she served as a Divisional Administrator and Practice Manager of Internal Medicine at Temple University Hospital. She also worked as a consultant with APM Management Consultants and, later, with CSC Healthcare. Pastuszko earned a bachelor’s degree in economics with a concentration in multinational management and international finance and an MBA with a major in healthcare management and economics from The Wharton School of the University of Pennsylvania.

Institution Brief

The Mount Sinai Health System (mountsinai.org) is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai hospitals are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, World’s Best Hospitals, and Best Specialty Hospitals” and by U.S. News & World Report’s® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2024-2025.

Mount Sinai Health System is a purpose-driven organization with a long history of supporting its employees, patients, and communities. How do you define Mount Sinai Health System’s purpose and how is purpose at the foundation of Mount Sinai’s culture?

Mount Sinai has a long-standing multi-pronged mission towards advancement in care, research, and the health of the communities we serve, and our employees are the fabric of our system. They are Mount Sinai. Our patients and the communities we serve are why we strive for excellence and, ultimately, who we work for. We are committed to ensuring that every person – regardless of their socioeconomic status, background, or insurance – has access to world-leading compassionate care. From our beginnings more than 200 years ago to today, we continue to advance health equity, medical innovation, and community well-being. We continuously evolve as a system to serve patients better and more efficiently. We are there through the most challenging moments, from end of life or during complex illness, to the most joyous times with the birth of a child. Our employees, our students, our researchers, our nurses, our physicians – everyone is deeply committed to a culture of discovery and innovation across everything we do and embody all that we are. That road can be bumpy and challenging, but we strive for excellence and compassion in all we do.

What have been the keys to Mount Sinai Health System’s strength and leadership in the industry, and how do you define the Mount Sinai difference?

Mount Sinai is in a unique position of having a closely integrated hospital system, outpatient services, and schools of medicine and nursing, and graduate school of biomedical sciences. That allows us to have an alignment of priorities and incentives to deliver on our missions. Our unique integration continues under a single CEO. Mount Sinai has also retained a unique identity as it continues to grow as a health system. We encourage individuality and innovation at every level and role throughout our organization – from our hospital presidents and departmental chairs to unit managers, nurses, and students. Everyone is working towards our mission and striving for system alignment. This can be challenging and difficult to balance, but we continue to evolve, learn, and improve. We are a healthcare delivery system, not defined by a hospital or a practice. This requires a different level of commitment to our communities as well as continuous improvement of the models of care that we develop and advance.

What do you see as the biggest challenges facing leading health systems and hospitals as you look to the future?

One of the biggest challenges for the healthcare industry is its economic outlook and uncertainty. The misalignment between the economics of for-profit payors and not-for-profit providers creates an enormous challenge and difficulty in balancing provider missions. It also puts our patients in the crosshairs. Also, further constraint in research funding will have a long-term impact for development of new therapies and treatments decades into the future.

How important is it for Mount Sinai Health System’s workforce to mirror the diversity of its patients and its communities?

Creating a strong, local workforce is key to sustainability in the long run. Having our workforce represent our communities enables a deeper understanding of the challenges our communities and patients are facing. We are able to better structure programs that meet the patient’s immediate and long-term needs. It’s an intricate part of our success.

How critical is it for medical schools to transform their curriculum to best prepare the future leaders in medicine?

We must continue to transform for the future, not the past. The evolution of our curriculum, our experiences, and our teaching must meet the current and future needs in healthcare. That is foundational to how we will measure our success in the upcoming years. This fundamentally requires constant improvement and being able to recognize that change is good. Change is uncomfortable and sometimes challenging, but it drives us to be a better provider, a better teacher, and a more advanced researcher. We always need to look to the future.

What do you tell young people about the types of careers the medical profession offers?

It is the most rewarding of careers and the most challenging of careers. Healthcare careers are not for the faint of heart, but they are for those who care deeply about people. Our business is people, and our mission is in service of people. No matter which career in healthcare you pursue, you do so to improve the lives of people and patients. If you work in a billing office, it’s about getting the right insurance and copays for patients. If you work in our materials management, it’s getting the right supplies to our units to make sure patients have them readily available. If you are a nurse or a physician assistant, it’s about caring for and healing patients. If you are a researcher, it’s about a discovery that will eliminate pain and suffering for patients and future generations. We are in the business of caring for people.