Devotion to Founding Principles the Key to Long-term Success


As the CEO of a hospital named after Albert Einstein, I’m often asked which of our namesake’s quotes is my favorite. My answer is unexpected but always the same: “Life is like riding a bicycle. To keep your balance, you must keep moving.”

Our ability to keep moving has enabled Einstein Healthcare Network to survive 150 years and grow from a 22-bed hospital in an old farmhouse to a comprehensive health care provider and education leader with hospitals and health centers across the Philadelphia region.

We’ve adapted, adjusted and advanced — to the changing financial environment, to new trends in health care, to the dizzying onslaught of new technologies.

Other urban hospitals have not survived this torrent of change. The startling truth is that nearly half of the urban hospitals in 52 major cities closed between 1970 and 2010, according to a recent study. In the two years between 1998 and 2000 alone, 113 urban hospitals closed, according to the Federal Inspector General.

Some hospitals simply followed their more affluent patients to the suburbs to capture larger reimbursements from private insurers. Others were doomed by competition, which led to over-expansion, duplication of services and ultimately, mergers, acquisition and closures.

Even now, hospital beds remain empty, as health care rapidly pivots toward outpatient and ambulatory care. New technologies and medications enable patients to be treated without hospitalization. Ongoing consequences from economic upheaval continue to force some people to avoid, or delay, treatment.

Einstein has been buffeted by these same circumstances, of course.

Einstein began in 1866 as the Jewish Hospital with a motto that appeared over the building’s entrance: “Dedicated to the relief of the sick and wounded without regard to creed, color or nationality.” This powerful phrase — groundbreaking at the time — assured Jewish Civil War veterans, freed slaves, women and children, immigrants, and the impoverished that they could rely on us for outstanding medical care delivered with compassion and without discrimination. We’ve long since changed our name, but the Jewish ethic of tikkun olam — literally, “repair the world” — is still our guiding principle.

Our commitment to serving a vulnerable population informed our decision not to abandon the urban neighborhood we serve today, even when we acquired a suburban hospital 12 years ago and subsequently opened a new hospital just four years ago. The expansion was a strategy to diversify our payer mix and support our efforts in Philadelphia, as our neighborhood began to show the wear of fleeing middle-class residents.

While we grow in other locations to enlarge our patient base and safeguard our financial security, we’re staying put: atop Philadelphia’s longest street, once the main north-south artery before the advent of expressways, next door to a public transit hub, surrounded by row houses and modest storefronts.

Our Philadelphia campus remains the largest independent academic medical center in the region, training more than 3,500 health professional students a year. We know that urban hospitals play a pivotal role in maintaining the vibrancy and health of a city. We not only care for some of the city’s most vulnerable populations, but we anchor challenged neighborhoods, maintaining stability by providing thousands of jobs and acting as an oasis for folks with a tenuous foothold in society.

Indeed, Einstein’s patients are so diverse that interpreters translate 45 to 65 languages every year, including some African dialects that are virtually unknown. One out of four residents in our urban zip code makes less than $10,000; one in 10 is older than 65 and living in poverty; nearly 90 percent are minorities; the median income is half the average median income of the United States. Many of our patients remain uninsured despite the expansion of Medicaid and are beset with chronic conditions associated with poverty, such as heart failure and diabetes, which require consistent treatment.

Our neighborhood would suffer immeasurably, as others across the country have, if we closed our facility. Instead of abandoning these patients, we’ve worked to find creative solutions to provide access of care with enhanced services at our outpatient care centers and physician practices throughout the city. We’ve also added satellite centers for MossRehab, Einstein’s rehabilitation facility, which is ranked among the top 10 in the nation.

Surviving 150 years in an urban setting that has undergone tumultuous change required a strategy and vision that propelled our growth while reinforcing our mission. We set out to change the world and adapted to a world that changed us — while we remained devoted to our founding principles.

Barry R. Freedman is the president and CEO of Einstein Healthcare Network.


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