Becker's Hospital Review

42 42 THOUGHT LEADERSHIP Montefiore CEO Dr. Philip Ozuah on why he refused to ration a 1-day supply of N95 masks By Alia Paavola P hilip Ozuah, MD, PhD, began as president and CEO of Montefiore Medicine in November 2019, just months before the COVID-19 pandemic slammed New York City. He was tasked with leading the New York City-based health system of 13 hospitals, a medical school and 300 clinical locations, through the once-in-a-century global pan- demic. e pandemic forced Dr. Ozuah and his executive team to quickly adapt and make difficult decisions. Despite the unprecedented challenges, Dr. Ozuah said he believes Montefiore's COVID-19 response was as good as it possibly could have been — a testament to his leadership. Before becoming president and CEO of Montefiore Medicine, Dr. Ozuah was president of the Montefiore Health System, physi- cian-in-chief of the Children's Hospital at Montefiore and professor and university chairman of pediatrics at the Albert Einstein College of Medicine, all based in New York City. Here, Dr. Ozuah discusses how his experience as a physician shaped his leadership style and shares the most challenging decision he's had to make as CEO and accomplishment he's most proud of in his first year at the helm. Editor's note: Responses have been lightly edited for length and clarity. Question: How has your experience as a physician affect- ed your leadership style? Dr. Philip Ozuah: Physicians are problem solvers. We diagnose the condition, figure out the cause or causes, and come up with a treat- ment plan. Oen we must solve problems without having all of the information, and we don't have the luxury of waiting for the final piece of confirmatory data — the patient may be dead by the time that becomes available. So, my approach to management is similar to my approach to medi- cine. Whenever I'm confronted with a problem, I first take a thorough history. When did it begin? How did it progress? When was it at its worst? And in the medical history we have what we call the review of systems. Even though a problem is presenting in the eye, you also inquire if other organ systems are affected. Is breathing affected, is the heart affected? Next comes the physical examination, when you get as much hands-on insight as possible. en, based on the first two steps, you order certain tests, which pro- vide more data. From all of that you establish the top three most likely reasons for the symptoms you are seeing. And you rank and re-rank them based on new information. You treat for the most likely, but you keep in mind the second and third possibilities. You monitor closely whether the patient is improving or getting worse. You remain flexi- ble, ready to alter your treatment plan if necessary. is is the same approach I bring to solving complex management problems. e real key to this approach, as a physician or as a CEO, is to build trust in your judgment and authority through open and honest communica- tion with the people who are depending on you. Q: Can you describe the most challenging decision you've had to make as CEO. Why was it so challenging? PO: I think the most challenging might have been in April of 2020, at the peak of the coronavirus pandemic, when we only had a one-day supply of N95 masks le in our hospitals. Many on my senior manage- ment team recommended that we start to ration them, to save some, because if we ran out, we couldn't render care anymore. at was a reasoned recommendation. Yet if we did that, we would put some of our people in harm's way. If our staff started getting sick at an alarming rate and became unable to take care of patients, then our people could lose confidence in my ability to protect them. And you could lose your army from demoralization as well as physical illness. Remember, we were in the midst of fighting a furious war against this virus. On the other hand, if you hand out all the masks, and in two days there are no masks, then you can't render care either. You may have to shut down a major part of your operation. And everyone suffers. So, I made the decision to hand out all the masks, without any guaran- tee that we were going to get more. We were working hard to get more, of course, but they hadn't come in. at was a very lonely moment, because I had to make that call alone and assume the responsibility for the consequences of that decision. But I said to the team, and myself, that we must protect our people today, right now, and protect them maximally. And that we'll figure the rest out tomorrow. It was a particularly tough decision, made in real time, when every- body was having difficulty getting these masks. We'd been scouring the globe trying to find them. As it happened, we managed to get a handful of masks a day later, and then another handful. And we got through that crisis. Q: In terms of Montefiore Medicine's COVID-19 pandem- ic response, is there anything you would do differently based on your experience? PO: Frankly, I think our response was as good as it possibly could have been. We went from two COVID-19 patients on March 11 to nearly 2,000 less than a month later. We built new facilities almost overnight. We went to nearly 100 percent telemedicine for our outpa- tient visits, created new platforms and patient resources, and greatly expanded our health information technology capabilities. Clinically, we had to immediately transform the way that we operated. We re- purposed every space possible to double the number of beds and tri- ple the number of critical care beds. We were spread incredibly thin. Everyone had to be flexible to meet the demand: Anesthesiologists worked as respiratory technicians; directors worked overnight shis; nurse practitioners worked as intensive care unit nurses. e pace was relentless around the clock. When the world shut down, our people stood up, summoned courage, overcame fear of the unknown, and went above and beyond their duty to save thousands of lives at great risk to themselves and their families. Confronted by an unimaginable disaster, they were as ready as any team could have been. e dedication and discipline, the professionalism that saved so many lives, was in place long before the first COVID-19 case arrived at our doors. eir performance in the face of a deadly pandemic was what I expected of them. More importantly, it's what they expected of themselves. I could not be prouder of them. n

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