Great Teaching Makes Great Doctors
Worth Media Chairman Jim McCann recently sat down with Dr. Robert Grossman, the man behind NYU Langone Health’s national success in medical education. In this excerpt, they discuss Dr. Grossman’s achievements, his next steps as an educator, and the future of medicine. They touch upon the evolution that has taken place in treatment due to COVID and how Dr. Grossman pioneered making medical education more accessible for all.
This excerpt has been edited for clarity and length. The full interview is available on all podcast networks as part of Worth’s Power and Impact with Jim McCann series.
McCann: You’ve taken a sound health system and made it a great health system. And that’s hard to do. How do you reshape your next set of goals?
Dr. Robert Grossman: So getting there is just the beginning, honestly. The goal is building sustainability and continuing the dynamism, growing the vision and enterprise, having a reasonable strategic plan, and then continuing to execute that plan. You need to be totally focused on the goals you continue to set. And by that, I mean a lot of businesses, when they achieve success, they get defocused.
Vizient, an agency that collects data on health systems around the country, recently rated NYU Langone Health System as the number one teaching health system in the country. What impact has that elevation of the NYU Langone Health System brand had on the NYU brand?
We are part of NYU, but we’re also separate because health is very different from the rest of the university. The biggest part of our business is actually taking care of patients. And I use the term business as opposed to educational business. I think we’ve been a tremendous asset to the university and have a wonderful partnership with them. But culturally, we are different because we’re this big business with a large research component and a relatively small educational component. The university is basically an academic business with a small business component. I focus on trying to do the best I can for the institution.
I would like to know if, in your new set of goals, there might be the idea to increase class size from 105 students in the future?
We think about that. What we’ve done is have a second medical school on Long Island focused on internal medicine, family practice, and primary care. We felt that if we were going to focus on primary care, it would be more advantageous to do it on Long Island. We created a curriculum that was for individuals who desired from the start to do primary care. So we did increase the size of the school.
But the problem with increasing the size of the medical school in Manhattan is that a lot of education would go on the ambulatory side. In doctors’ offices, you want to make sure the opportunities for the students are excellent. You don’t want 20 students; you want five or three students or one-on-one.
I wonder if you’re seeing any benefits of remote psychiatric services. Are people being treated more effectively and frequently through digital contact?
What I know for sure is that accessibility has had a positive effect on students particularly. When I went to medical school, I didn’t know anybody who sought psychiatric help. [Now] 40 percent of the class has engaged at one level or another in mental health counseling.
I’m going to guess that’s because of two things. One, the stigma is gone. And two is that people are having more considerable challenges because of the complications of natural life here in the city and COVID.
And how to deal with stress.
It was a moral imperative to become tuition free… It was important for future doctors to graduate with a minimal amount of debt.”
Under your leadership, the NYU Langone Health System was the recipient of a substantial NIH grant to coordinate all the national research efforts related to long COVID and what we’ll be dealing with for the next ten years. How should we think and expect to deal with long COVID for the next decade?
Well, the first thing I would say to every listener is “Make sure you’re fully vaccinated.” That is critical to prevent getting long COVID. The probability of getting long COVID increases with the severity of the disease and hospitalization.
Hospitalization doesn’t cause it; it’s just emblematic that you have a more severe case of the disease.
You can get long COVID and not be hospitalized. But if you’re hospitalized, there’s a higher probability of getting long COVID. And it’s a terrible problem.
At the Grossman School of Medicine at NYU, just a few years ago, you and Ken [Langone] announced at the white coat ceremony at graduation that in the future, there would be no tuition. The place erupted, families were crying, and people were screaming. And then you went further to say and for those of you who are already here, and on a second or third year [get the same], and of course you engineered, and revolutionarily changed the curriculum to make it a three-year curriculum rather than four. It’s changing how people look at medical education. I know it took Ken a few years to endow the school so you could do just that, and then just a week later, I think it was John Hopkins, Michael Bloomberg wrote a check so that they could do it. How do you think that will reverberate around medical health care nationwide, maybe worldwide?
What was happening to our students was that they were graduating with this enormous debt burden. And they weren’t any different than any other students around the country going to medical school, the average debt for students in medical school was $200,000 a year. For a married medical student, it’s $400,000, $500,000 a year. So I thought it was a moral imperative to become tuition free. As a scholarship kid, I knew how to live from hand to mouth. They were living on the margin; their parents were working like crazy to help support these kids.
We wanted a lot of copycats because it wasn’t only about us. It’s about the country. Unfortunately, it’s a difficult thing to do. When you have somebody like Ken Langone, who’s your chairman, and it [still] took us 12 years to do it, it’s very difficult. It means focusing on this particular issue, as opposed to using philanthropy for other things. It was important for future doctors to graduate with a minimal amount of debt.
The two researchers who develop the Pfizer mRNA vaccine expressed some confidence that they would have a cancer vaccine within the decade, your thoughts?
You know, this isn’t a new idea about a cancer vaccine. Basically, the idea is the same in terms of immunization against cancer, which has different antigens than your normal body. So it’s very possible, it would be great.