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Keith Loria is a contributing writer to Medical Economics.
Growing up in in Limerick, Ireland, Michael J. Dowling admits his family situation was a little complicated-his mother was deaf and his father suffered from heart disease and arthritis. Read more about his early life and what led to his rise in healthcare.
Growing up in in Limerick, Ireland, Michael J. Dowling admits his family situation was a little complicated-his mother was deaf and his father suffered from heart disease and arthritis.
“Because of that, I already had an interest in the health and human services field and I think that’s what led me to the arena,” Dowling says. “When I went to college I got involved volunteer-wise in a lot of health issues and homeless issues, and it just was natural to me. I always was drawn to it.”
That early passion for healthcare has never ebbed.
Today, Dowling serves as president and CEO of Northwell Health, the largest integrated healthcare system in New York State with more than 67,000 employees.
Under his leadership, the healthcare system has grown from an organization with 30,000 employees, 18 hospitals, and a few dozen outpatient locations to more than 67,000 employees, 23 hospitals, and over 665 ambulatory facilities. Quality has also improved. The health system’s education, awareness and clinical efforts have helped reduce sepsis mortality by more than 60% over the past decade.
“We were the first health system to be created in New York and we are currently the largest and we continue to expand,” he says.
In addition to those impressive hospitals and ambulatory location numbers, Northwell also boasts 6,675 hospital and long-term care beds, a full complement of long-term care services, a research institute, and medical and graduate nursing schools. Overall, Northwell is one of the largest health systems in the U.S., with $11 billion in annual revenue.
“We have all components of the healthcare business, we have everything from primary care all the way to end of life,” Dowling says. “We are very committed to serving everybody irrespective of circumstance. Many organizations like to focus in on those things that only do well financially. We take care of everybody, including people with substance abuse, alcoholism abuse, etc., so you want to be an organization that is focused that way.”
From politics to healthcare
Dowling earned his undergraduate degree from Ireland’s University College Cork and his master’s degree from Fordham University, picking up honorary doctorates over the years from Queen’s University Belfast, University College Dublin, Hofstra University, Dowling College, and Fordham University.
After graduation, Dowling became a professor of social policy and assistant dean at the Fordham University Graduate School of Social Services and director of the Fordham campus in Westchester County.
When Mario Cuomo was elected governor in 1983, Dowling was offered a position on his administration as deputy commissioner in the Department of Social Services, which was responsible for all welfare programs in the state. Dowling didn’t know Cuomo and had never really been involved in politics before, and he declined the position-at first.
Then he decided it was a chance to make a difference on some of the issues he cared about, and decided to give it a go.
“I’m a risk taker, and thought it would be a good new experience,” Dowling says.
Although he expected to stay about one year, Dowling ended up spending 12 in the administration. During that time, he was continually promoted, including serving as state director of Health, Education, and Human Services, and as deputy secretary to the governor and social services commissioner.
“I had all of the welfare programs, health programs, education programs, and mental health, substance abuse-all behavioral health as part of my portfolio,” Dowling says. “I worked with some very great people, we did some very interesting things, and I’m very fortunate that I was [asked to serve] because having the opportunity to work with Mario Cuomo was one of the best things that ever happened to me.”
One program Dowling is most proud of from that time is Child Health Plus.
“It was a program that provided coverage to kids who didn’t have it and it was a very innovative program at the time and still exists,” he says. “That was the one that I think I spent probably the most of my time on during those couple of years and was one I always look back on as something of a success.”
The road to Northwell
After Dowling left the government, he became a senior executive at Blue Cross Blue Shield in Manhattan, but he stayed less than two years.
“I’m not a person who likes to just sit in my office looking at paperwork; I like to be out in the field where the real action occurs,” he says. “I got a call from North Shore University Hospital asking if I would be interested in talking to them and I was excited about the possibility.”
Dowling accepted a position as chief operating officer of North Shore University Hospital, a large tertiary campus where Northwell Health’s creation began, in the early 1990s.
“I was ready to leave the insurance side to get back into the world of where I thought the real work occurred, which is to be on the provider side where you actually were dealing with patients every day and making a difference in people’s lives each and every day,” he says.
He moved up to president and CEO of Northwell Health in 2002, and not a day goes by when he doesn’t deal with people-his favorite part of the job. For instance, each Monday morning he meets with all new employees to the organization, averaging about 150 a week.
Besides meeting and mentoring staff, he deals with the press, works with politicians, offers opinions to the board, works with community organizations, and oversees the administrative, technical, and budgetary initiatives.
“Every day is a little bit different and things pop up all the time because when you’re on the provider side, when something goes wrong, if it really goes badly wrong, it’s dangerous because it’s mostly life and death situations,” Dowling says. “In healthcare, a bad decision can result in a very, very bad outcome for somebody so that’s why you’ve got to have the right people and the right physicians, officers, and administrative leaderships in the right positions, to make sure that those things happen rarely and are not a common occurrence.”
The power of innovation
A unique program at Northwell Health replicates the show “Shark Tank,” where it holds an annual competition among employees called the Innovation Challenge in which it invests more than $1 million a year to support promising commercialization ideas that originate with the health system’s physicians, researchers, and other staff.
“We try a lot of new things. Our medical school is very innovative, our nursing school is innovative,” Dowling says. “We do a lot of innovation programs. We’ve built up new businesses based upon ideas coming from staff.”
For instance, as part of this year’s President’s Award for Innovation, it awarded $500,000 to researchers at its Feinstein Institute for Medical Research to further develop a non-invasive approach to diagnosing endometriosis, a painful condition that affects one in 10 women and can cause infertility.
“You have to be innovative and creative in this world today. You don’t want to be a prisoner of the past,” Dowling says. “You want to be an organization that is constantly pushing the edges of the envelope and known as the place where people can get the best care, best coordinated in a holistic way, and you want to be a place where people enjoy coming to work.”
Dowling is a big believer in the team and his philosophy is to guide the ship but let the people that he puts into place do the work. He wants his employees to understand they have an obligation and responsibility, not necessarily a job.
“I try to light a fire in people rather than lighting a fire under them,” he says. “I try to inspire people, try to convince people that what we’re doing is good. I’m an optimist, I believe that we do great work in healthcare, and I think it’s important to get people to understand that they’ve got to be proud of what they do, acknowledge the great things that they do, and feel optimistic about the potential, while acknowledging the fact that they need to get better and better all the time.”
When Dowling reflects on his career and his work at Northwell Health, he is happy that he gets to come to work every day and be with a group of great people who share his views on helping people.
“When you’re in healthcare and you walk around the hospital and you walk through the children’s hospital, you walk through the oncology ward, it gives you perspective on life. You realize how fortunate you are to be working in such a place, and also how fortunate you are that you are today temporarily healthy,” he says. “By the end of the day, you can say, ‘Today we helped people, we made people better today.’ We did the right thing for those people who depend upon us for the care.”
Keith Loria is an award-winning journalist who has been writing for major newspapers and magazines for close to 20 years.