Dr. David L. Reich, MD, the Horace W. Goldsmith Professor of Anesthesiology, Professor of Artificial Intelligence, and Professor of Pathology, has been president of The Mount Sinai Hospital and Mount Sinai Queens, both part of the Mount Sinai Health System, since 2013. Mount Sinai Hospital, a 1,171-bed tertiary-care teaching hospital in New York City, is one of the largest private independent medical centers in the United States and one of the highest ranked hospitals in the world. The hospital was founded in 1852 by a group of Jewish philanthropists as The Jews’ Hospital in the City of New York. I spoke with Dr. Reich last week Thursday.
We were scheduled to meet yesterday. At the last minute, however, your office rescheduled the interview for this afternoon because you had to deal with a medical emergency.
There was a patient issue. The patient is now doing very well and will go home tomorrow, so it all turned out okay. But it was scary for a few minutes.
One would think that as the president of the hospital, you wouldn’t be dealing with individual cases.
I’m still a clinical anesthesiologist, so I work in the operating room on Fridays. This happened to be a relative of a colleague of mine who had a procedure, and there was a complication afterwards that required that we act very quickly.
On the subject of anesthesiology, when it comes to medical procedures, people usually do research about the doctor who will be performing it, but hardly anyone does that about the anesthesiologist. Do you ever feel slighted by the fact that no one pays attention to those in your field?
There is a small number of people who do want to choose their anesthesiologist, but they’re usually a bit of trouble. If you go into anesthesiology expecting to be the hero, you haven’t chosen wisely. You have to have a different relationship with your ego. It’s really more of a psychological discussion because patients don’t know you very well, so they don’t see you as your primary doctor. They’ll react very differently to a surgeon or to a general practitioner who does their primary care. That’s where people develop relationships.
We can develop very rapid relationships right before major procedures, but they won’t be long-lasting. Lots of people remember me very kindly, but they don’t usually have any part in deciding that I will be working with them that day. You’re usually assigned an anesthesiologist according to the schedule.
Let’s talk about your hospital. Mount Sinai is one of the most prestigious hospitals in the world. What do you think makes it outstanding?
Mount Sinai has several unique characteristics. As you probably know, it was founded in the 1850s by Jewish philanthropists, and it was originally called “The Jews’ Hospital.” Then it started treating non-Jewish patients sometime around the Civil War or so, and then a short time later they changed the name to Mount Sinai. In the 1960s, Mount Sinai decided that it needed to create its own medical school. What makes Mount Sinai so unique, even long before we became a health system, is that even beginning as a hospital that gave birth to a medical school, it created a new level of expertise and quality. As the reputation of the school has grown astronomically over the past 20 years, especially under the leadership of Dean Dennis Charney, we are able to recruit some of the top doctors in the world because they want to be affiliated with a top medical school. The final thing I’ll say on that is that on the Upper East Side campus of Mount Sinai, it’s very difficult to know where the hospital ends and the school begins and vice versa, which is one of our strengths.
At the same time, people may have concerns about being treated by someone who isn’t fully qualified to practice because students are involved. How would you put them at ease?
I’ve been in medicine for a long time. I was a medical student starting in 1978, so I’ve been in medicine for the vast majority of my life. At the time, in the ’70, ’80s and even ’90s, when I was still in training and in the junior years of my career, residents had a more independent role in terms of making medical decisions, depending on the circumstances. There were differences between university hospitals, private hospitals, city hospitals and VA hospitals, etc., but in the teaching hospitals, the residents generally ran the show. They usually did a pretty good job, but they weren’t as good as the people who were fully trained.
However, over the last two or three decades, there has been a shift. An attending physician is always overseeing and is always responsible. I would say that it’s actually a strength to be in a place with a teaching program, because when you go to a place like Mount Sinai, the residents are very smart, and they are overseen by someone who is very smart. When more than one smart person is involved, they often make even better decisions, because they can ask each other questions and come to better conclusions based on that back and forth.
When I work in the OR, I always work with a resident. I see how they’re sponges and pick up knowledge. Not only are they helpful, but they might be looking at a monitor while I’m looking in the other direction, and they may see something before I do. Two heads are better than one.
The Sages of the Talmud declared, “I have learned from my students more than from anyone else.”
And Maimonides says that teaching someone a profession is the highest form of charity. We certainly agree that having great students is a great stimulus, and in medicine we say that you should always focus on lifelong learning, because the profession is always changing and there is always new knowledge. Another great thing about being in a program with residents is that they’re constantly being educated. There are lectures every week, and they’re of high quality, so everyone learns.
Mount Sinai is ranked by experts among the world’s best hospitals and is number one in the tri-state region. Which field of medicine are you personally most proud of?
There are many things to be proud of. I’m president of Mount Sinai’s campus on the Upper East Side as well as the campus in Queens. There are six other campuses in our health system that are led by wonderful people, but I’ll limit my comments to the areas for which I have responsibility. We won’t try to establish any hierarchies, but this is the hospital that does all of the Upper East Side transplantation, the most complex cardiac surgery and neurosurgery, and there is also a huge cancer program, the pediatric program, and several others that are quite unique in their abilities.
People talk about primary care, and they often refer to hospitals as tertiary care—skipping over the secondary—and in the academic medical centers we like to say that we provide quaternary care, which is that extra level where it’s not just kosher, it’s glatt kosher. What makes Mount Sinai special is that we do the most complex things, and we also do the simplest things at a level where people can know that they’re safe.
The highlights of Mount Sinai include that Crohn’s disease was discovered here. Dr. Burill Crohn [who identified it] was a Mount Sinai doctor. Mount Sinai has been at the forefront of many advances in medicine, and it was a huge leader during the terrible times of Covid in the spring of 2020. We developed new treatments and expertise, and we also learned from the crisis how to be even better at being a health system in managing a terrible disease. We were at the forefront of diagnostics and research, and it was a great experience for the team to grow despite the horrendousness of the disease. As the disease has become more mild and the vaccines and actual immunity have accrued in our community, we have learned how to manage and started to shift back into normal times.
I’m very proud of starting a lung transplantation program, building new programs, and bringing in new talented physicians who do things that no one else does quite as well. It’s a real pleasure. I work in the OR on Fridays with the chairman of Cardiac Surgery, Dr. David Adams. Everyone would certainly agree that he’s in the top five heart surgeons in the world doing the type of heart surgery he does—he specializes in the mitral valve. He might even be in the top one or two, although it’s difficult to make such judgments at that level. But the fact that Dr. Adams, and so many others like him, are very much at the top of their profession is probably the thing I am most proud of.
Mount Sinai Queens is a wonderful addition to Mount Sinai Hospital; it provides community care in Queens. We recently opened a catheterization laboratory, and a new pavilion opened about five years ago. We’re making tremendous progress in making sure that we also provide care in that community.
I had the opportunity to speak to Dr. Ben Carson, who went from medicine to politics. You sort of did the same thing, although you remained in the world of medicine. What prompted you to do that, and what was it like to transition from working strictly in the operating room to directing a hospital of that size?
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