Forty-five years is a very long time in any career. In healthcare administration and management there are so many unexpected occurrences, both good and bad, that make this particular field so dynamic and challenging. The pandemic, I must admit, is at the top of the list of challenges.
My career in healthcare administration began with my tenure as the night administrator for New York Columbia Presbyterian Hospital. That job prepared me like no other for all the challenges that followed. As a young hospital administrator, you had to handle any and all situations that arose throughout the desolate night when substantially fewer clinical and administrative staff were around. It was the best training anyone in healthcare management could receive. You were it.
You had to have a really good reason to call the CEO in the middle of the night. The position required good judgement, quick action, and the confidence to defend and justify your decisions. At the time, gang violence and shootings were on the rise in the hospital’s neighborhood of Washington Heights.
It was this experience at Columbia that changed my mind about my college major. At the time, I was attending school during the day and working full-time through the night. The healthcare business is not easy, but it is never boring, and I was drawn to that. I switched my undergraduate college major at St. Peter’s College in New Jersey from general business to healthcare management. At the time, undergraduate study in business of healthcare was unusual. I later went on to earn an MBA from Fordham University.
I grew up in Washington Heights and, at some point, each member of my family worked at Presby. I had a deep connection to and understanding of the local community, and I believe that is one of the reasons why upper management tapped me to serve as the director of government and community relations. That led to the unique position of director of activation where for about two years I used my people and planning skills to oversee the transfer of 900 patients from four buildings into one. Working with construction contractors, interior designers, and representatives from clinical departments, my team and I moved 900 patients over one weekend without incident into the newly constructed Milstein Building. The success of this move was our attention to details, and we listened to clinical staff suggestions. It was an incredible experience – not the type of experience a lot of people in this field get to have.
Shortly after the Milstein move, I was asked to open a community hospital for the Columbia Presbyterian System in Manhattan’s upper west side – the Allen Hospital. I formed a team and within six months we opened a fully-operational 300-bed community hospital. That too was an incredible experience for a hospital administrator. The ‘espirit de corps’ was off the charts. It was our hospital.
After about 25 years, I concluded my career at Columbia Presbyterian as senior vice president and general manager. I became the CEO at New York United Hospital in Port Chester, NY. It was the right move at the right time. In this position, I experienced yet another aspect of hospital administration – private practice medicine. I saw the utility in helping the private practice physicians band together for their benefit and for the hospital’s, and I helped form WestMed, today one of the largest physician practices in the region.
The second half of my healthcare management career began after a chance meeting with former Healthcare Association of New York State (HANYS) president, Dan Sisto, who told me about an opening for a CEO at the Nassau-Suffolk Hospital Council (NSHC). HANYS had recently agreed to manage the Long Island-based hospital association, and it was in need of a leader. In 2002, I took the reins of the organization and in a few short years transformed it into a lobbying powerhouse. Never before was I called upon to use my advocacy, communication, and negotiating skills so extensively and frequently. I traveled thousands of miles between New York, Albany and Washington in pursuit of favorable legislation and regulation for hospitals and the patients they serve. My historical knowledge about a range of complex health policy and regulatory issues certainly helped me communicate the nuances inherent in these. I like to think my straight-forward explanations helped push many pieces of legislation over the finish line. Messages about complex healthcare policy can get mangled in the news media, so I always took great effort to communicate clearly with journalists and the lay public.
In 2010, I was asked to serve as president/CEO of NSHC’s sister organization, the Northern Metropolitan Hospital Association (NorMet), which represents hospitals in the Hudson Valley. I considered the logistical concerns of “being in two places at the same time,” but took solace in the fact that I had excellent staff support in both regions. What followed were years of road travel to member hospital institutions, Albany, and Washington, DC. In 2012, I aligned the two associations as the Suburban Hospital Alliance of New York State (SHANYS). Today, SHANYS represents 47 hospitals in the Hudson Valley and Long Island, and I have come to know just about every hospital leader and the lawmakers who represent those hospitals. This business is about relationships, and new ones are always on the horizon.
I credit much of my success as a hospital advocate from my years running hospitals. When you know so much about how and why hospitals operate, what hospitals are facing, when you advocate, you do so with great energy. . . you are more informed and dedicated to the effort.
Along the way, I have had the opportunity to work with some of the brightest in the business, and I am proud to have mentored dozens of healthcare management professionals. I always placed trust in my staff members and offered them the freedom and autonomy to manage projects and initiatives. I listened a lot to my own mentors and my mentees, and I am grateful to all those who gave me so many wonderful opportunities in this tough business.
It has been an incredible run, but when it is time to retire, you just know. I hand the reins over to Wendy Darwell, who has served alongside me for the past 13 years as chief operating officer. The Suburban Hospital Alliance could not be in more capable hands. I know the transition will be seamless, and Wendy will bring her own special brand of effective advocacy to the two regions. The Dahill Dose Blog will change to the Darwell Dose Blog in 2021, and you will gain important insights and commentary about a range of healthcare policy issues from Wendy, as she leads SHANYS in its next chapter.
Farewell and thank you.