Michael Dowling is president and CEO of Northwell Health. He previously served in New York State government for 12 years, including seven years as State Director of Health, Education, and Human Services and Deputy Secretary to the Governor.

In his latest LEADERS Magazine interview, Dowling talks about how his upbringing informs the way he approaches challenges as the leader of a health system.

I learned the importance of discipline and hard work from my father. With him, you avoided making excuses. He was a tough taskmaster and parent — with many characteristics that would not be tolerated today. He had a tough life and never had the opportunity to pursue more than a basic education or display his many talents. My mother was a wonderful, loving and caring individual who inspired me my entire life. She had a love affair with books, history, and education. Reading was her pastime and her periodic respite from the daily grind of a difficult life. My love of books and passion for learning came directly from her. She was an optimist — always seeing the good in every person and feeling positive about the future. She held the family together and each of us give her much of the credit for any success we have had. She did not like it when I left home, but understood its necessity. She gave oxygen to hope, decency, and kindness. I remember her continuing advice — “don’t ever let your circumstance, however difficult, limit your future potential. Everything is possible.” After my father passed, I brought her to the U.S. every year. She would stay for up to a month each time. She would go to church — she was very religious — read, take walks, and relax. She loved her visits but always looked forward to going home.

My personal and work lives are guided by a number of key values and principles: decency, honesty, respect, integrity, kindness, and trust. As a leader, I consider these the foundations of success. Relationships matter — personal contact, getting to know and understand people, being able to appreciate various points of view, giving people the opportunity to be engaged and contribute, and being part of the solution. I believe strongly that most individuals don’t just want to work for an organization; they want to belong to a cause, to something important, something greater than themselves. Leadership is about having a positive influence on people, inspiring them and allowing them to dream about what’s possible, so they aim high and stretch themselves. Organizations are like a mosaic — multiple components, each with its own personality and culture, but it’s the beauty and uniqueness of the whole that is extra special. That is why I see a similarity between a leader and an orchestra conductor. The latter does not need to know how to play each instrument, but he/she has to make sure there is harmony when they all play together, producing a consistent, quality product that benefits the consumer. This, of course, requires talent, and the responsibility of the leader is to create the environment and the structures to optimize each person’s individual capabilities and personal growth. This is a core strategy at Northwell and has been a key to our success. This is also a component of why I meet all new employees — about 300 each week — and have been doing so for the more than 22 years that I’ve been CEO, building relationships and explaining the possibilities.

I don’t view things through the lens of challenge — each challenge, in my view, is an opportunity to excel, to be proactive, to avoid playing victim, and to succeed. As the late self-help author and motivational speaker Wayne Dyer stated, “If you change the way you look at things, the things you look at change.” All CEOs continuously face a multitude of issues: financial, supply chain, personnel, competition, etc. The responses and the answers continue to evolve as circumstances change. There is never one right answer. That understanding is key as it requires a perpetual attitude of flexibility and adaptability. This will be especially relevant as AI accelerates and we try to come to grips with its benefits and risks.

One other point worth noting is the danger of complacency, which is the greatest peril for CEOs, especially those who believe their organizations are successful. Leaders should never take their foot off the accelerator or believe their own press releases. Maintaining your organization’s competitive edge necessitates continuous grit, hard work, resilience, entrepreneurship, and that competitive spirit on which many businesses were founded. And, of course, we all need some amount of luck.

I am an advocate of defining it very broadly. A person’s health is affected by almost everything — much more than just the provision of medical care. The ability to have a job, the opportunity to pursue education, the neighborhood you live in, your family’s circumstances and dynamics, the food you eat, etc., all impact a person’s well-being. That is why I believe that healthcare leaders have a special responsibility to do as much as they can to influence those circumstances while also ensuring the provision of top-quality medical care. This is why we at Northwell have focused on tackling issues such as gun violence (the leading cause of death for children and adolescents), climate change (including the healthcare industry’s impact on the environment), the care of veterans, and how we prepare young people for future career opportunities. On the latter, we are working in partnership with the City of New York and the Bloomberg Foundation to open the Northwell High School of Health Sciences in the fall of 2025. The curriculum for this first-of-its-kind school will focus on nursing, radiation medicine, mental health, and physical therapy. By more closely connecting students to the world of work and dramatically increasing their opportunities for rewarding, well-paying jobs, we are improving their health and the health of their families.

We all need to broaden our perspective — not just health care leaders, but leaders in all industries.

I appreciate the compliment, but I believe that, despite our successes to this point, we still have a long way to go. As an organization, we continuously aim high and look at every challenge as an opportunity. We are innovative and competitive, optimistic and resilient, and we have a strong team-oriented, collaborative culture. We are not a collection of isolated, individual entities — we are highly integrated as a corporation, yet we maintain close ties with all of the communities we serve. We are also more than just hospitals, which now comprise only 47 percent of our overall business. Throughout the region, we have more than 900 locally based outpatient locations and the most comprehensive, post-acute set of clinical services. We are growth-oriented and continue to expand, geographically and programmatically. We serve everyone who walks through our doors, irrespective of their ability to pay, because we understand that our core commitment is improving the health of the communities we serve, providing excellent care and being addicted to customer service. As noted earlier, we also recognize our responsibility to tackle gun violence, climate change, and other social issues that impact community health.

Being positive and optimistic is essential. As mentioned earlier, all challenges are opportunities. As we ponder the future, it’s also important to reflect on the dramatic successes and advances over the past 50 years or so in increasing life expectancy and improving the quality of life for all Americans. Think about the medical care we provide today that was almost unimaginable decades ago — in pediatrics, heart disease, cancer, orthopedics, etc. Our entire nation is benefiting from ongoing medical and scientific innovations and discoveries. In 2018, I published a book entitled Healthcare Reboot: Megatrends Energizing American Medicine, which looks at the powerful trends leading the nation’s healthcare system toward greater quality, safety, access, and affordability. As an organization with a renowned research entity, the Feinstein Institutes for Medical Research, I marvel at the innovations I see and the subsequent benefits that future generations will enjoy.

Of course, there are still many complex issues that we must respond to, such as: 

• Expanding access and the provision of more equitable care to the most vulnerable individuals and communities that have experienced health disparities;
• Optimizing the benefits of artificial intelligence without losing the human interaction that is such an essential element in the provision of care;
• Reversing the growing disrespect for science that was so evident during the Covid-19 pandemic and has been accelerated by the growing anti-vaccine movement;
• Continuing to broaden the definition of health by focusing on the many non-medical, social determinants that impact personal health and well-being;
• Educating policymakers that quality and access cannot be fully achieved as long as the government — the nation’s single-largest health insurer through Medicare and Medicaid — fails to reimburse providers at levels that cover their cost of delivering care; and
• Adequately addressing the growing problem of mental health and the many problems associated with social media.