by Sally Fay
Baruch Alumni Leaders Survey the Current Healthcare Landscape and Ponder Post-Pandemic Paradigms
Modern medicine is changing the course of human existence, increasing average lifespans, eradicating diseases, and offering relief and hope for those who suffer from chronic and debilitating health conditions. Yet the medical advancements from which millions benefit occur within a complex environment encompassing issues of economics, public policy, and equity, often resulting in dilemmas with no simple solutions.
Given its current challenges, what’s the prognosis for the healthcare sector and in what ways will it continue to foster innovation in the years to come? The global Covid-19 pandemic has definitely spotlighted both the capabilities and the shortcomings of our systems, and one thing seems certain: improvements will require the input of a wide spectrum of healthcare practitioners and industry experts. Among them are thousands of Baruch College alumni—a few of whom share their experiences and perspectives here.
Docs Be Nimble
The dynamic nature of modern healthcare has fostered a host of entrepreneurial ventures seeking to address systemic inefficiencies and unmet needs. Alexander Pollak (MBA ’09), a New York City EMT-paramedic with more than 20 years of 911 experience, recognized a service deficiency while working in the finance department of a national ambulance company. “Large event venues were typically covered by ambulance services, which are trained to transport, not to provide definitive care on site,” he explains. In 2011 Mr. Pollak founded ParaDocs Worldwide, which offers a different care model, providing on-site medical resources and staffing at concerts, festivals, and sporting events throughout the United States and beyond. Its current workforce of about 2,800 EMTs, paramedics, and other trained medical professionals “can essentially create a pop-up emergency room, which not only provides immediate high-quality care for attendees but also avoids costly hospital trips and the accompanying stresses on the local hospital and 911 infrastructure,” says the proud CEO.
For entrepreneurs, adversity often reveals new opportunities. As the pandemic unfolded, ParaDocs pivoted its focus to administration of site-specific Covid-19 testing and, later, vaccines. Most notably, the company was the exclusive tester for the 2021 presidential inauguration and was part of the record-breaking vaccination initiative at New York City’s Jacob Javits Center. Pollak predicts on-site medical services will remain a growing sector in
the aftermath: “Covid highlighted the infrastructure, cost, and health benefits of concierge programs such as preventive care and screenings for both public and private enterprises.”
Paying For A Miracle
The exponential increase in understanding of biology and genetics in recent decades has led to the development of impactful new medical and pharmaceutical treatments, notes Brian Meltzer (MBA ’00), vice president and global medicine leader at orphan drug developer Alexion Pharmaceuticals. A clinically trained gastroenterologist, Dr. Meltzer found himself drawn to the problem-solving aspects of biopharmaceutical R&D as he pursued his MBA in healthcare administration. Today he oversees a team working to develop better treatment options for Wilson disease, a rare genetic disorder that causes a buildup of toxic levels of copper in vital organs. “Pharmaceutical companies are made up of people who genuinely want to make sure patients get the therapy they need,” he says.
Although delivering new and improved therapies is the goal, Meltzer acknowledges that economic aspects of the healthcare system weigh heavily on the process. “Along with being able to prove safety and efficacy to obtain regulatory approval, R&D programs today need to satisfy payors—whether that involves privateindustry or government-funded health coverage—by showing a drug provides value: either better outcomes than existing therapies or similar outcomes at reduced cost, which means drug developers need to create a product profile and a research plan that satisfies both the medical and the value parts of the equation.”
The Patient As Consumer
Delivering the best possible patient care within the constraints of a fiscally complex business model is a challenge Graham Gulian (MBA ’94) faces daily as chief operating officer of NYC Health and Hospitals/Kings County, a Brooklyn-based level 1 trauma center within the largest public hospital system in the country. Mr. Gulian is optimistic about the overall trajectory of point-of-service healthcare delivery. “We’ve seen physician primacy challenged by the health insurers and the onset of managed care in the 1980s and 1990s, and now the growing empowerment of patients as consumers as health information became easily accessible via the internet,” he notes. Yet he acknowledges there are challenges ahead for the U.S. healthcare system: “Sadly, we still haven’t figured out how to provide quality healthcare to every person.” He labels health inequity as the biggest current problem in healthcare and notes the disproportionate effect the Covid crisis had on disadvantaged populations who lack adequate coverage options. “Our national health system continues to be highly segregated by economic status and race,” he says.
Nevertheless, Gulian believes the trend toward facilitating and expanding care delivery will continue. “Health systems are adapting quickly to move from a hospital-centric model to a consumer-centric model with diverse care options,” he says. “Those systems that figure out how to deliver care in the way that consumers are demanding will lead the pack.”
The growing recognition among hospital-centered healthcare leadership that new strategies are needed has driven a trend toward multilevel, vertically and horizontally integrated healthcare delivery networks, says healthcare consultant Annette Catino (MBA ’80). “But in the wake of Covid, rapid innovation has become a matter of survival,” she says. A health insurance industry veteran who spent 25 years as CEO of New Jersey–based provider QualCare, which she founded in 1991, Ms. Catino currently assists health system executives and their boards with postpandemic healthcare delivery strategies. “Covid brought to light the financial vulnerabilities of some of the services that acute care facilities offer and reshaped patient expectations,” she adds. “They’ve had to reimagine care delivery within this new landscape.”
Catino points to telehealth as one of many examples of a service model rapidly embraced by consumers whose access to hospitals and doctors’ offices was constrained by Covid. “Telehealth has exploded now that people have gotten a taste of it,” she says. “And outpatient therapy was becoming more accepted before Covid, but now it’s accelerating; patients continue to avoid hospitals because of fear of exposure to transmissible illness, and
they want care in a nonhospital setting.”
Rebalancing service delivery to meet changing demands poses new financial challenges for facilities still reeling from Covid’s disruption of revenue-generating services such as elective surgeries and diagnostic testing. But this reorientation also presents a significant opportunity to build a better-integrated healthcare system, says Catino. “If I see providers for primary care, specialty/acute care, and long-term care, my electronic medical records may reside in three different portals that don’t communicate,” she says. “That’s not helping me as a patient. To get to where caregivers know what’s going on with the total patient, we’ve got to stop functioning within silos.”
A World Of Opportunity
As the healthcare system strives toward a sustainable paradigm, challenges both old and new will come into play. Gulian stresses the long-term financial toll of treatment—as opposed to proactive preventive care and public policy solutions—for chronic conditions related to health inequities among disadvantaged groups. Pollak cites caregiver burnout, exacerbated by the pandemic, and the resultant shortages in medical staffing. And Catino notes the as-yet-unknown healthcare impacts not only of pandemic-caused postponements in routine care but of Covid-19-related conditions, such as “long Covid.”
Nevertheless, one thing the healthcare system has in its favor is the talent and commitment of these change-making Baruch alumni, along with the countless other industry professionals who devote their efforts to transforming healthcare. “Whether it’s actual medical practice, pharma, policy, IT, devices… healthcare is fertile ground for a very long, rewarding career for people who want to make their imprint,” concludes Meltzer. “There’s so much opportunity, and so much need.”