Michael Dowling, the president and CEO of New York’s Northwell Health (formerly North Shore-LIJ Health System), acknowledges that the future of healthcare will be challenging, yet he looks to the future with great determination and optimism:
“There are a lot of people these days, especially in healthcare, that look to the future with a sense of trepidation and fear and pessimism. They become somewhat catatonic, critical about the world that we are moving into. And yes, there are some dangers along the way, but I look at everything with hope and opportunity and optimism. Because you have to be optimistic. If you’re a leader in the organization and you want to inspire, and you want to create followers, you have to be optimistic… you have to look at every obstacle as an opportunity.”
When asked what he sees as one major change that is beginning to occur in healthcare, Dowling pointed toward the definition of quality, which traditionally has centered around metrics like length of stay, readmission, sepsis, mortality, etc. While some of these metrics will continue, Dowling explained that he expects a shift toward preventative care and population health management as the new focus. “We’ll have to define quality very differently in the future… quality in the future will be how we handle diabetes in the community, how we treat asthma in the community, how we deal with weight management and obesity. Those have to be the quality metrics.”
When the topic of the Affordable Care Act (ACA) inevitably arose during the 2013 interview, Dowling expressed his doubts that the legislation will really work in the long run, fearing it is over-complicated and over-bureaucratized. He voiced concern that the government intends to micromanage the healthcare industry, and that in the long run it will not work. However, he went on to acknowledge that something needed to be done, and that’s why the ACA was developed:
“I think that as healthcare organizations, we’ve actually dropped the ball over the years. We should never have had to be told by legislation or by regulation that we need to be transparent, that we need to improve quality, that we need to display service, that we need to be accountable, that we need to coordinate care. I mean, if you don’t want to do those kinds of things you should not be in healthcare. But you shouldn’t require legislation for it.”
Dowling went on to explain that this is why a lot of legislation comes about, because of the failure or inability of the people or organizations to do what they know they should be doing anyway. “Then when you don’t do it, and legislation comes in to force you to do it, you criticize the legislation.”
Dowling noted that while many things in the healthcare industry must change, not all problems lie within the U.S. health system. “I’ve said this for years, health is driven by lifestyle and behavior and social conditions.” New legislation and stricter policies cannot change the critical fact that there must first be personal responsibility; people must be proactive and make wise lifestyle choices and take care of themselves. As Dowling firmly stated, “There has to be personal responsibility… you are—in many circumstances—responsible for your own condition.”
No matter what the future has in store for healthcare, Dowling remains optimistic and excited:
“A lot of crazy things are going to be happening in the next several years as a result of the ACA and everything. But I think in there is a lure of opportunity for the people who want to be transformed and be creative. So I am actually looking forward to the next five years.”