WO interviews Dr. Steven Safyer, President & CEO Montefiore Health System

William O’Shaughnessy:

It’s 12:33, later than it’s ever been.  And on this morning after Election Day we can take a breather for a while from matters political.  For the next half hour then, while we’re in your care and keeping, a very timely program which I would commend to your favorable judgment even as we begin.  Our special guest – and his presence on such a busy, important – and even historic – day flatters us and honors our local radio station – is Dr. Steven Safyer.  He is the president and CEO of Montefiore Medical Center.   He’s also a former resident of our home heath.  Welcome home, Dr. Safyer.

Dr. Steven Safyer:

Thank you.  It’s a pleasure to be here.  It’s a pleasure to be back home.

William O’Shaughnessy

How long did you live in New Rochelle? 

Dr. Steven Safyer:

25 years.  Raised both our children here.  A terrific place.

William O’Shaughnessy

Where did they go to school?

Dr. Steven Safyer:

They went to the public school system and later did training at the Masters School in Dobbs Ferry.

William O’Shaughnessy:

You’re one of the best known guys in healthcare and the medical field in America.  You run an incredibly successful institution.  Somebody said you’re worth 3 – 4 billion.  How did you do that?

Dr. Steven Safyer:

Montefiore is a great system.  I appreciate your introduction and I appreciate your evaluation of it.  I wouldn’t mind if you were evaluating our financial position either.  I think you’re a little high.  Our budget is $3.2 billion.  And with the addition of these two institutions, it’s close to 3 1/2 billion.  But we have a black bottom line.  And that’s the most important thing.  We’ve been able to generate resources to invest in Montefiore, in the community and we’re going to continue to do that.

William O’Shaughnessy:

Dr. Steven Safyer … were you a doctor doctor before you became an administrator.

Dr. Steven Safyer:

I’m still a doctor .  I’m an internist.  Until a few years ago I was teaching the interns, residents and the medical students.  I spent yesterday with a group of interns at Montefiore.  I love to teach.  And I love medicine.  It’s the greatest joy in my life.  Quite frankly, the kind of work I do  — which I think of as leadership – involves teaching.  So I continue to teach.

William O’Shaughnessy

Now you preside over a 3.2 billion dollar – with a “b” – budget.  Would you rather just walk around and visit patients.  Do you still have a stethoscope? 

Dr. Steven Safyer:

I still have my stethoscope.  But I love what I do.  Everyday I wake up excited and just totally energetic about what we’re doing and going to work at Montefiore.  You can’t do everything in life.  You have to make choices.

William O’Shaughnessy

What would you do if you didn’t run Montefiore? 

Dr. Steven Safyer:

This is the perfect job for me.  It is a destination job.  I intend to be doing this for the rest of my career.

William O’Shaughnessy:

Dr. Safyer … president and CEO of Montefiore … somebody told me, in your field, that nobody crunches the numbers like you do … that you’re a damn good financial guy. 

Dr. Steven Safyer:

It’s a reality that you need to be able to make these institutions work.  The world of healthcare is changing and if you’re going to be successful, you need the resources to make it work.  The only place you’re going to get those resources are from your core business … and our core business is healthcare. 

William O’Shaughnessy:

What kind of hospital is Montefiore?

Dr. Steven Safyer:

Bill, I think you know this and it’s very important for the listeners to know and understand this: we’re the university hospital for the Albert Einstein College of Medicine.  Now I happen to be biased because that’s the school I graduated from.  But as a university hospital, we are really “twinned” with one of the best medical schools in the country.

William O’Shaughnessy:

Where is Einstein?

Dr. Steven Safyer:

It’s in the Bronx. It’s on one of our campuses.  And our faculty are the faculty there.  So we really behave as one institution.

William O’Shaughnessy:

Dr. Safyer … I have to ask you, did you graduate first in the damn class, I wonder?

Dr. Steven Safyer:

No, I didn’t graduate first in the class.  But I did well and it positioned me well in my career and it landed me an internship and residency at Montefiore. 

William O’Shaughnessy:

I said we were flattered when you walked in the radio station a few minutes ago.  You’ve had a very busy day.  Your signs are up.  They went up earlier this week.  It’s now known by a new name … used to be New Rochelle Hospital.  Then Sound Shore Medical Center.  It’s now known as …

Dr. Steven Safyer:

We’ve re-named – as we begin to re-purpose these two institutions, they’re now Montefiore New Rochelle and Montefiore Mount Vernon.   We’ve kept the nursing home name the same and the School of Nursing at this time remains the same.

William O’Shaughnessy:

What do you mean “re-purpose?”  Everybody wants to know …

Dr. Steven Safyer:

Everybody knows that the American healthcare system is changing.  You and I talked a little bit about this before.  I believe that’s a good thing.  In the past, hospitals were very much based on volume … lying people down in the bed.  Your success was measured by how many people you laid down in the bed in one year.  Most importantly, you had to lay more people down the next year.  It was kind of like a treadmill. 

William O’Shaughnessy:

They didn’t measure how many got up?

Dr. Steven Safyer:

It was a good thing if most of them got up and left.  But you were rewarded financially for lying people down in the bed.  I think – and the country is beginning to think – that we should be rewarded for value.  We should be rewarded for keeping people well.  We should be rewarded for keeping people upright – in the community and in their homes.  And that requires a more integrated payment system and a more integrated delivery system.  So stand-alone, small hospitals don’t have a big future in that world.  And even big hospitals – big university hospitals, in my opinion – don’t have a place in the future world either. The system is changing.  So when I say re-purpose, what I envision is bringing back all the community physicians – some of them who have moved away and lost confidence in the institution – but adding, where we can, primary care, home care, more intermediary care, care in the home.  Managing people’s wellness instead of waiting until they get sick and come into the emergency rooms.

William O’Shaughnessy:

Speaking of which, Dr. Safyer, there’s a wonderful physician in these parts.  He’s John Spicer’s doctor.  He’s my doctor forever … Doctor Richard Rocco Pisano.  He’s a physician the way the men of our father’s time imagined them to be.  Have you met him?

Dr. Steven Safyer:

I think I did meet him.  I don’t know him well, but I’m going to get to know him.

William O’Shaughnessy:

He’s a great guy.  He’ll keep you going.

Dr. Steven Safyer:

That’s perfect …

William O’Shaughnessy:

How old are you?

Dr. Steven Safyer:

I’m 64.

William O’Shaughnessy:

Well, if you want to make 75, see Pisano!

Dr. Steven Safyer:

Sounds good.  I want to make 75. 

William O’Shaughnessy:

Dr. Safyer … I want to ask you about the merger.  What is it?  A merger or a takeover?

Dr. Steven Safyer:

There’s no such thing as a merger.  It’s an acquisition.

William O’Shaughnessy:

Ok.  I want to ask you a lot about that and we will, sir.  But while we’re on the subject – what about “Obamacare?”  You were talking about healthcare changing.  Make it simple for us.

Dr. Steven Safyer:

Obamacare aimed to do three things.  One, it has begun to do already … which is to insure more people.  And you and I know there have been some bumps in that road, but I believe it will get there. 

William O’Shaughnessy:

You do?

Dr. Steven Safyer:

Yes, I do.  I think that’s very relevant to these communities. 

William O’Shaughnessy:

You mean Mount Vernon and New Rochelle?

Dr. Steven Safyer:

Exactly.  Mount Vernon and New Rochelle have close to 200,000 people living in it.  Presently a good number of them are uninsured or could have insurance but don’t know about it.  If we get them insured and bring them into the healthcare system before they come into the emergency room, we will bring them into a model I think is sustainable going into the future.

William O’Shaughnessy:

Dr. Safyer … are you really going to have the “local touch?”  3.2 billion is far-away from a “local-yokel” hospital.   Are you going to have local boards and directors to advise you?

Dr. Steven Safyer:

The board of this entity is the Montefiore Health System board.  That’s a fiduciary responsibility of Montefiore.  That’s clear and that’s been announced and people know it. But we’re going to have advisory boards or sub-boards that are local that bring in the people of the community so that we have a feedback loop, that we’re connected to the community.  There are a lot of people in the community I know from the past and I know now and we’re going to bring them in. 

William O’Shaughnessy:

So you’re going to have a Mount Vernon board and a New Rochelle board?

Dr. Steven Safyer:

We’re going to create separate identities for Mount Vernon and New Rochelle and we think that’s very important.

William O’Shaughnessy:

What are your plans for Mount Vernon, doctor.  It’s a land-locked, beleaguered city.

Dr. Steven Safyer:

First thing is … our plan it to keep people working.  And that’s probably as important as providing superb health care.  Because when people are working, they remain healthy. Just take a look at the situation.  There were 2,000 people working a week ago in these two institutions.  And there are going to be – I predict – more than 2000 people working in these two institutions over the next year.

William O’Shaughnessy:

So, you and your associates from the Bronx, you’re not coming up here to fire the hell out of anybody?

Dr. Steven Safyer:

It’s the last thing we would ever do.  It doesn’t serve us or serve the community well.  There are excellent people here.  You should have seen the looks on people’s faces this morning as we walked around.  As we had “town hall meetings,” as we introduced ourselves … they are excited.  They are motivated.  We’re ready to go with them.

William O’Shaughnessy:

When you did your due diligence, and I’m sure before you did the acquisition – as you call it – you did that due diligence.  Did you see anything you actually liked at Sound Shore or Mount Vernon?

Dr. Steven Safyer:

Well, Bill, as you know, I used to use New Rochelle Hospital so I loved the convenience, its availability, its small-town feel, its warmth.  When I began to do my due diligence a year ago, some of that was lost, quite frankly.  There was a lot of fright, demoralization, fear about the future and we need to turn it around and change it.

William O’Shaughnessy:

You say you used it – New Rochelle Hospital.  I bet my kids had more time in the emergency room than yours!

Dr. Steven Safyer:

We’d have to get a referee to call that one because my kids were active in sports in the community. We’d go there a lot!

William O’Shaughnessy:

Dr. Safyer … what about the “competition” now.  You’re here, as of today and earlier this week.  You own the damn thing now, don’t you?

Dr. Steven Safyer:

Yes. 

William O’Shaughnessy:

The papers are all signed?

Dr. Steven Safyer:

All signed!

William O’Shaughnessy:

And you’ve got your sign up:  Montefiore New Rochelle Hospital … Montefiore Mount Vernon Hospital.

Dr. Steven Safyer:

You got it.

William O’Shaughnessy:

What about the competition.  When people think of great hospitals, very respectfully, they think of Montefiore.  And they think of Columbia Presbyterian. And to a little lesser extent, Westchester.  Who is your competition? 

Dr. Steven Safyer:

Our intention is to keep all the healthcare that is in this community … in this community.  Our intention is to strengthen both hospitals.  To improve their capacities.  To make them more robust institutions.  I can refer you to two other hospitals we’ve done this to:  Our Lady of Mercy in the north Bronx and Westchester Square in the east Bronx.  Both of these institutions, one is more recent – that’s Westchester Square. But Our Lady of Mercy, when we came in there, there were just a few more employees than at these two local institutions, there are 500 more people working there now.  We’ve rebuilt the facility.  We have new programs there. We’ve added 75 more beds.  And we’ve provided more comprehensive care in the community. 

William O’Shaughnessy:

Doctor, it’s 3:00 in the morning – or at any desperate hour.  What should someone expect from their local hospital if they’re scrambling and not feeling so great?   They’re feeling “few” and they’re damn scared.  It’s 3:00 in the morning … what should they expect from you?

Dr. Steven Safyer:

They should expect professional, high-performing care that is state of the art.  There are things that are not done at New Rochelle Hospital now and won’t be done in the future.  Like heart surgery … that’s not likely.  It should be done in a big institution.

William O’Shaughnessy:

Do you do that?

Dr. Steven Safyer:

Oh sure … patients that need to be moved out for advanced care will be moved out and supported by our outstanding programs in cancer, child care, heart care, transplant, orthopedics.  These are world class programs and we’ll be able to bring those patients down to Montefiore when they need that care.  But we’re not looking to admit people with pneumonia or asthma or things that can easily be cared for here in a comprehensive and safe way and with great outcomes.

William O’Shaughnessy:

Can I get my pacemaker tuned up down at your place.

Dr. Steven Safyer:

You can get it tuned up here or down in the Bronx.

William O’Shaughnessy:

So you’re not going to use these two local hospitals to feed your big one in the Bronx. 

Dr. Steven Safyer:

Our goal is to bring members into our system.  Patients who get all or most of their care in our system – hopefully over time – more and more of them are pre-paid like the Kaiser model.  And then we are working to design programs to keep people well.  We already have close to 900 people that work in a company actually located in Westchester, that takes care of people while in their home, while ambulatory, trying to prevent admissions  and trying to keep people well.

William O’Shaughnessy:

Can you get some of the rich folk from Rye or Scarsdale to our two new hospitals?

Dr. Steven Safyer:

Well, we already do because we’re in clinical programs in 20 different sites in Westchester.  And people travel to the Bronx and about 5% of people admitted to Montefiore are from Westchester already.  So it’s already a very active program.  But those individuals in the surrounding communities through the years have depended on New Rochelle.  If you live in Larchmont, you go to New Rochelle Hospital.  If you live in Rye, you go to New Rochelle Hospital.

William O’Shaughnessy:

Pelham …?

Dr. Steven Safyer:

You go to New Rochelle Hospital or Mount Vernon.  And right now people are avoiding those institutions and we need to bring them back.

William O’Shaughnessy:

Do you think you’ll do it?

Dr. Steven Safyer:

Absolutely!

William O’Shaughnessy:

I must ask you … where once you sit right now at this microphone there was often a fellow we have special regard for … he’s a very nice man.  John Spicer.  You inherited his work and industry and his reputation when you bought Sound Shore.  What are your plans for Spicer?  I haven’t talked to him in a long time.  I hope he doesn’t mind me asking you that.  I hope you don’t mind.

Dr. Steven Safyer:

I certainly don’t mind.  First of all, I should say I’ve known John a long time.  I have high regard and respect for him. We’ve been good colleagues over the years.  John came to me and engaged me in a discussion about his needs, his organization needs.  And, Bill, you know that discussion began over a year ago.  I felt we had something to offer him.  He has been a prince.  He has worked to make this transition happen.  I’m indebted to him. I said exactly that just this morning both at Mount Vernon Hospital and at New Rochelle Hospital.  There is no blame here.  The thing that needs to happen is we need to collectively change these two institutions and John is going to help me going into the future.

William O’Shaughnessy:

He has a wife who is also highly regarded in our home heath, Kathy Spicer.  Was she part of the deal?

Dr. Steven Safyer:

Well, she’s part of the deal because she’s married to him.  I don’t know her … but I can’t wait to meet her.

William O’Shaughnessy:

Well, she’s a great woman.  When they had a strike, she was in there swinging pots and pans.  She’s great!  Dr. Safyer … what about your neighbors?  Are we getting fat and obese?  You’re a trim guy.  You work out? 

Dr. Steven Safyer:

I do, every day.

William O’Shaughnessy:

You look like you’re in good shape.  Are Americans going to hell?

Dr. Steven Safyer:

I’m worried about the country. I’m especially worried about the obesity epidemic which is a growing epidemic.  We haven’t stemmed that tide.  It’s especially growing in the youth.  So in a place like the Bronx, two thirds of the Bronx is overweight or obese. 

William O’Shaughnessy:

Say that again …

Dr. Steven Safyer:

Two thirds of the Bronx – a million and a half people – are overweight and/or obese, clinically obese!  And the numbers in New Rochelle approach that.

William O’Shaughnessy:

Did you ever go into a Target or a Walmart?  You must freak out!

Dr. Steven Safyer:

I have, super-sized!   I’ll tell you one thing … this morning, walking around, one of the employees came up to me with a big smile when they came in this morning and they couldn’t find soda with sugar in one of the vending machines.

William O’Shaughnessy:

And what did you say?

Dr. Steven Safyer:

We can start losing weight together … and the employees here are feeling better and preaching that to our patients.  I think we’ve got to walk the walk.

William O’Shaughnessy:

Doctor, what about the whole Medicare/Medicaid thing?  But let me ask you something, where did the name Montefiore come from?

Dr. Steven Safyer:

Montefiore was founded in 1884.  It was named after a European Jewish philanthropist.

William O’Shaughnessy:

Mr. Montefiore?

Dr. Steven Safyer:

Yes, Montefiore literally means “mountain of flowers” in Italian.  He lived in London.  He was a financier.  He was a friend and colleague of the Rothschilds.  He made a lot of money.  And Jews all over the world in 1884 – which was his 100th birthday – named institutions after him in hope that he would send money.  He never sent any money.

William O’Shaughnessy:

I’m going to go down to Mario’s on Arthur Avenue and tell that marvelous story.  Do you ever go down to Mario’s? 

Dr. Steven Safyer:

I do … I do.  I love it!

William O’Shaughnessy:

I gave the eulogy for the papa, the patriarch, Mario.  There were a thousand people in the church, all the greengrocers, the fishmongers.  Is it your kind of place?

Dr. Steven Safyer:

Oh, it’s a great place.  I love Arthur Avenue. I also love the Mediterranean Diet … I think it’s quite good for you.

William O’Shaughnessy:

Are you a pretty healthy eater?

Dr. Steven Safyer:

I do my best …

William O’Shaughnessy:

What did you have for breakfast?

Dr. Steven Safyer:

I had whole grain cereal. 

William O’Shaughnessy:

What are you going to have for lunch?

Dr. Steven Safyer:

I haven’t figured that out yet!

William O’Shaughnessy:

You’re careful?

Dr. Steven Safyer:

I like to eat healthy because it makes you feel better.  I’m not fanatical.  But I love eating good food.

William O’Shaughnessy:

Speaking of which, Dr. Safyer, hospital food has a terrible rep …

Dr. Steven Safyer:

It’s earned!  But we’ve made the food at Montefiore quite good.  Come and have lunch with me someday.

William O’Shaughnessy:

You mean the Jell-O is good?  How about the applesauce and crackers?

Dr. Steven Safyer:

We still have that!

William O’Shaughnessy:

Why do you give patients ginger ale? 

Dr. Steven Safyer:

I think it’s probably something the soda industry foisted on hospitals!  I don’t know … I think it settles their stomach.

William O’Shaughnessy:

Dr. Safyer, there used to be a legendary guy before John Spicer, George Vecchione was there for a while, he was well-known in your tribe. But there was also a marvelous man named Alec Norton.  Norton was the pied piper of Irish nurses with a mega-watt personality.  He’d round them up and take them out for a night on the town.  Aren’t nurses – after the doctors – about the most important thing you’ve got? 

Dr. Steven Safyer:

I could say, as a physician, that nothing compares to nurses on the healthcare team.  They are the structure and function of a hospital in any health care system.  They really are the professionals – they are there at the bedside, always with the patients.  Very caring and instrumental in keeping people well and getting them better too.

William O’Shaughnessy:

When you go out to dinner, does the guy next to you say listen … I have a little … uh … something in my throat … or a little pain in my ankle.  What do I do about it?

Dr. Steven Safyer:

Yes … I get that.

William O’Shaughnessy:

Do you help them?

Dr. Steven Safyer:

I do … I try to.

William O’Shaughnessy:

But can you ever get away from it?

Dr. Steven Safyer:

A lot of my friends are doctors!

William O’Shaughnessy:

You’re in the Bronx, do you do any business with the Yankees?

Dr. Steven Safyer:

Yes.  The Yankees have been great for us.  We do events there.  They help us with fundraising.  I get to go on the field once a year.  It’s quite amazing.

William O’Shaughnessy:

Welcome home, sir.  So many people respect and admire you and I just have a feeling, a hunch, that this deal you’ve put together – Montefiore and New Rochelle and Mount Vernon – is going to be good for the community.  

And we’re going to do everything we can to help you with it.  You’re acquiring – I don’t like that word – you’re inheriting some really nice people who work there and others like us who rely on that hospital which is now in your care and keeping. 

Will you come by often and the next time take calls from our listeners?

Dr. Steven Safyer:

We’ll be here often.  We’ll be responsive.  I appreciate your kind words and I promise you we’ll make you proud of what we do there.

 

# # #

 

William O’Shaughnessy, a former president of the New York State Broadcasters Association, was chairman of Public Affairs for the National Association of Broadcasters in Washington.  He has been a point man and advocate for the broadcasters of America on First Amendment and Free Speech issues, and is presently chairman of the Guardian Fund of the Broadcasters Foundation of America.  He operates two of the last independent stations in the New York area: WVOX and WVIP.

 

He is the author of “AirWAVES” (1999) … “It All Comes Back to Me Now” (2001) … “More Riffs, Rants and Raves” (2004) … “VOX POPULI: The O’Shaughnessy Files” was released in January, 2011.  He is currently working on his fifth book for Fordham University Press, an anthology which will include this interview with Dr. Steven Safyer.

Contact:

William O’Shaughnessy
914-980-7003
wfo@wvox.com

Cindy Gallagher
Whitney Media
914-235-3279
cindy@wvox.com

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