By Sabina Mollot
On the heels of Mount Sinai Beth Israel’s president, Suzanne Somerville, stepping down, a Peter Cooper Village resident who began his career as a resident in the hospital network 25 years ago has been named the president of Mount Sinai Downtown. This includes the current and future Beth Israel as well as the Eye and Ear Infirmary.
Additionally, Jeremy Boal, MD, who currently serves as executive vice president and chief medical officer of the Mount Sinai Health System, is being promoted to executive vice president and chief clinical officer. Though the transition has already begun, the appointment having been announced internally last Wednesday, he won’t be fully assuming the new role until January, 2017. Prior to his current role, he served as chief medical officer at North Shore LIJ (now Northwell Health).
Earlier this week, Boal spoke with Town & Village about community concerns such as potential loss of services from the neighborhood, the status of the medical giant’s real estate and the enhanced offerings that have been promised to patients at the future, much smaller hospital building adjacent to Eye and Ear.
Since 2003, Boal has been a resident of Peter Cooper where he lives with his family, which includes two daughters, one 13, the other 16.
The interview, edited for length, is below.
Town & Village: Did this appointment come as a surprise to you or is it something you inquired about?
Boal: Ken Davis (president and CEO of Mount Sinai) asked me if I would consider the responsibility (following Somerville stepping down) and I didn’t even hesitate. I didn’t inquire about it but I was offered the opportunity relatively early in the process.
Now that you’ve been appointed, what’s priority one?
In the short-term, it’s to take care of our existing patients and to take care of our employees, making sure that there’s a viable path for them (to stay at Beth Israel or transfer to another Mount Sinai hospital). Whenever a president steps down, there’s uncertainty. Taking care of our patients and our employees is where it starts.
The top concern I’ve heard from employees is that they will get transferred and lose their benefits and their pensions. Can you say anything about this?
Unlike the closures (of hospitals) that have happened in the last decade where people are locked out of the building whether they’re union or not, we have worked really hard and collaboratively with our unions to do this a better way. The majority of employees will maintain their benefits and seniority but not everybody will. Not all the unions in our health system are the same as at Mount Sinai Beth Israel. (Some will) be going to a different union. In very complicated discussions, we’ve gotten to a very good place. Everyone will have a very good, well paying union job with all the security that entails. We are collaborating on extensive training so many employees can assume new jobs. Many are needed in the future health care system. Our staff is fully capable with the right training. (We’re doing this) without firing or laying off, but it’s not perfect.
What’s going to happen to pediatrics, the NICU (neonatal intensive care unit), the maternity ward? Will Beth Israel still deliver babies?
In pediatrics, right now in the hospital on any given day there are only a handful of admitted children. Most of pediatrics has been moved to ambulatory and typically the length of stays is pretty short, two to three days. Our view is we want to make sure there’s access to the community at the new hospital. We’ll still have a pediatric emergency department and attending physicians. For kids with more serious illnesses or who are staying in the hospital for a longer time, Mount Sinai Kravis Children’s Hospital (uptown) is a better option. In terms of healthcare for specialized care, places that do a lot of it tend to be elsewhere. An important message for the community is we will not take away emergency access or take away inpatient care. The NICU will remain in place for as long as we deliver babies.
Babies getting delivered is being phased out?
We don’t have a hard deadline. We’ll keep some OB, (but) you have to get to a certain threshold of volume.
But it seems like there are a lot of young families around here.
It’s true, but a lot of those folks don’t deliver downtown. We delivered at Lenox Hill even though we live downtown. People follow their OBs wherever they deliver. They’re not choosing hospitals based on their hospitals being local to them. It will be phased out; that’ll happen before we open the new facility.
About half our patients who deliver here live in Brooklyn so we’re looking at building a relationship with a hospital in Brooklyn that will have a Mount Sinai branded facility. A big portion of deliveries will be staying in Brooklyn but a big portion will stay at Mount Sinai West and Mount Sinai Hospital so it will break down to three hospitals.
Will Beth Israel still have a hospice?
We’ve started looking for the right program for hospice. This is one of the things I’ll be deeply involved in, whether it’s ambulatory versus inpatient. We know New York City and Manhattan need a certain about of hospice coverage. We’re committed to making sure it continues to exist. Our hospice at Beth Israel is run by Metropolitan Jewish, so we’ll be working with those types of community partners. I don’t know yet if there’ll be hospice beds in the new Beth Israel, but there will be enough within the hospital system.
Have you given any thought to longterm care or opening a nursing home, since that is something the community doesn’t have?
We actually don’t have any nursing homes in the health system, but we do have relationships with quite a few. (We believe) our relationships with nursing homes will only get stronger. At this point it’s not in our strategic plan (to open one) but we believe they’re really needs to be adequate nursing home coverage. We’re certainly advocates for that. With nursing homes, geography is very important (so family and friends can visit patients), and there have been too many closures unfortunately.
What are the biggest challenges Beth Israel and Mount Sinai are facing?
With regards to Mount Sinai Beth Israel, for us it was a combination of the infrastructure being incredibly old and outmoded and work to rebuild it would have meant starting fresh or a gut renovation and the day it opened, it would be obsolete. It doesn’t need as many beds as we have. Then there are changes in reimbursements and in what we get paid for teaching and charity care.
All these things have an impact on the finances of Beth Israel. The way out of that is if we switch to ambulatory care model. (For example, currently) if you have diabetes, you go to one location (for one doctor) and on another day another location (for a different service). We’re designing a center so we collocate specialties in a much more patient-centric model. That’s where we see healthcare going. Instead of a tower, we’re rebuilding a hospital we think is an appropriate size. But we’re also investing in a large platform of ambulatory and specialized services.
Again, we’re hoping to convince people that Beth Israel isn’t closing. There are a lot of rumors out there, and given everything that’s happening in healthcare, I understand why people are skeptical.
What can people expect at the new hospital?
This is going to be a full thickness hospital, with a regular ED (emergency department) that can treat all conditions, from broken bones to strokes to heart attacks. This isn’t like an ER lite. This one will take everything that comes in. We’re going to do surgery, lots of eye and ear surgery obviously. The things that won’t be there are very complicated procedures (which will be sent) to high volume centers of excellence. Heart surgery would be sent to Mount Sinai on the Upper East Side or St. Luke’s. What I’m talking about are elective cases. If it’s a complex brain tumor that requires special equipment, that we would do at one of our other facilities, but we would still be able to do pre-op care in the community. We’ll keep physicians downtown who will interact with patients.
As far as the hospital’s real estate is concerned, what’s been sold and what’s on the market?
Gilman Hall, our residence for residents, which is at the north of the superblock (on First Avenue between 16th and 17th Streets) and the adjacent brownstones are currently on the market, but have not been sold. I believe that’s the only thing right now on the market. Residents have been relocated around the neighborhood including to Stuyvesant Town. We will retain Bernstein Pavilion (home to behavioral services). We cannot meet the community’s needs without the behavioral health beds. It’s a community asset and we will revitalize and enhance it as well.
Are the bulk of your patients still from the surrounding communities of Stuyvesant Town, the Lower East Side and Chinatown and observant Jews who rely on the kosher meals?
It’s changed considerably. We serve a high population from Brooklyn and lot from the West Side and midtown and from Chinatown and the Lower East Side and of course Stuyvesant Town and Peter Cooper Village. We don’t keep statistics on patients who are Jewish but it’s considerably smaller than in the past, because there are so many other communities we serve as well. Our patients represent a cross section of New York.