New chief medical officer oversees all care provided at Crouse Hospital — still sees patients at the ICU and finds time to volunteer as firefighter
By Chris Motola
Q: How long have you been chief medical officer of Crouse Hospital now?
A: Chief medical officer? About six weeks.
Q: How do you like it?
A: It’s fantastic. Seth [Kronenberg, CEO] and I are having a really good time.
Q: What are your duties?
A: The chief medical officer is widely seen to be responsible for all things related to the physicians, the PAs, nurse practitioners, the care delivered to patients at the provider level, the quality of that care, what that care looks like. The overall medical care at the institution is my ultimate responsibility.
Q: What got you interested in assuming that position?
A: In truth, it wasn’t something I had been interested in doing. I was the chief of the department of medicine at Crouse for the last 12 years or so and a practicing ICU physician. I still am. I had been very active in those roles and very happy with the level of administrative involvement I had with the hospital throughout the quality line and clinical line. As Seth moved forward into the CEO position from CMO in March there was a vacancy. We’d formed a pretty solid friendship over the last decade or so, and I saw this as an opportunity to be even further engaged, to work with Seth and to, in many respects, pay forward some loyalty to an institution that had been good to me and my family. And I saw an opportunity where perhaps I had something to offer to give back.
Q: Crouse seems to have had a pattern of physicians in the CEO role. Is that unusual?
A: As you look around, it’s not. Certainly, we have physicians in leadership roles both at Upstate and St. Joe’s, so locally it’s not the unusual at all. And if you look around the country, you’ll see a lot of very successful physicians in those administrative roles. What we do as doctors doesn’t always directly translate to the administrative side, but I think a lot of principles we use in trying to care for patients does translate into administrative problem-solving even though these aren’t exactly the same kinds of problems we dealt with in our clinical career. I do think the relationships that physicians develop with each other are incredibly important in getting both the clinical and administrative lines of a hospital aligned. If you want to see a successful hospital you will find that the goals of the physicians and hospital are aligned. And I think it can be easier for a physician, who has lived the life of a physician, to understand a physician’s needs and be able to bridge that gap and align those goals and create longstanding, durable relationships.
Q: What kinds of challenges does Crouse face right now in delivering quality health care?
A: Crouse has the same challenges that all the other hospitals across the country and particularly New York state have. Operating margins are tight. The system is designed to keep them tight. We do a really good job being efficient with our resources to make sure we have a functional organization that can meet its financial responsibilities. Because, ultimately, we’re just stewards of this institution and in this moment there is a group of us in leadership who is ultimately responsible to make sure this hospital continues to serve the people of Central New York. We don’t own it, but we do make sure that it’s here and works. The people of Central New York own it. So we work with those financial challenges. It’s tough, but we’re doing a great job. Under Dr. Kronenberg’s leadership we are moving forward quite well. The other challenge is staffing. Staffing at every level, clinical and non clinical, is a challenge for all institutions. We have many open positions, as do many hospitals, and we’re doing our best to fill those positions. There is some paucity in the workforce.
Q: Is that since COVID-19, or was it a problem even before?
A: That was even before, but in some respects it’s more pronounced now. There are some market pressures that may have not been as pronounced before as they are now. But certainly COVID is part of it.
Q: What are some of those market forces?
A: It’s always been challenging in Central New York. If you live here, you live here, but it’s always been challenging to bring in people from outside. It’s always been hard for us to distinguish ourselves. I’m not native to the area, I’m from downstate, but I’ve been up here 20 years so it’s my home now. But I’ve seen that it’s one of the difficulties. There are some issues with lifestyle and job choices and the way people are choosing to work. There’s a greater desire for remote work. That translates fine for some jobs we have, but doesn’t translate for up-front patient care. There’s no place to be but at the bedside for that. And there are different work paradigms that exist today more prominently, like traveling. That means you’ll work somewhere distant from your home and likely be paid significantly more money to do so and have all your costs covered. It can be challenging for a geographically, physically constrained job to try to meet the needs of a workforce that has a significant percentage of people who don’t want to work that way.
Q: How can you sweeten the deal for in-person work?
A: For those jobs that could potentially be done outside the hospital but we’d prefer you be present, or for clinical jobs?
A: For clinical jobs there’s no way around having to be here, but if we can give people the kind of scheduling they prefer, whatever that looks like, we try to be more flexible and work with them to meet their lifestyle needs. With respect to the other group, we’re trying to bridge that gap by bringing as many people back into the hospital as we can. And we’re trying to be flexible with work schedules enough to say, “OK, maybe it’s a hybrid position.” I personally think there’s value in sharing physical space with other people and having tactile interactions that aren’t just visual and electronic. I think having support staff be with us who are providing clinical care can help them understand our jobs better and in turn do a better job in administratively supporting us.
Q: Are you still clinically practicing?
A: Yes, part time. Since I’m a hospital-based physician, it’s easier to maintain my practice than it would have been if I were outpatient. As an ICU physician, I’m in the hospital and have developed relationships throughout the institution. I’m finding that continuing to practice clinically I’m able to get some of the work done that really is chief medical officer-related, since it’s so based on relationship management. It makes me be the best I can be to try to set the best example I can set whenever I’m interacting with a patient.
Q: You’re also a firefighter. Where do you find the time?
A: I’ve been doing it for 30-plus years. I’m on fire calls, EMS calls all the time. It doesn’t pay the bills, but it’s my love.
Name: David Landsberg, M.D.
Position: Chief medical officer at Crouse Hospital
Education: Medical degree: Saba University School of Medicine (Saba, Dutch Caribbean); residency and internship in internal medicine: Mount Sinai Hospital, New York City; fellowship in critical are medicine: Memorial Sloan-Kettering Cancer Institute, New York City
Affiliations: Crouse Hospital; University Hospital, St. Joseph’s, Auburn Community Hospital, Rochester Regional
Organizations: American College of Chest Physicians; American College of Physicians, National Association of EMS Physicians; Society of Critical Care Medicine
Family: Wife (Stacia); son (Solomon); daughter (Graeson)