When the Covid-19 pandemic began, Michael Dowling made an unusual move. Dowling, the chief executive of the largest hospital network in New York, decided to let a documentary team inside one of his hospitals instead of barring them from the facilities.
Dowling was making a break from other CEOs in the health care industry. Most hospitals closed their doors to journalists as people with Covid-19 began to die, claiming that patient privacy had to be protected and that outsiders who weren't medical professionals might contract the virus or get in the way of their swamped staffs. Dowling was a top health official in New York during the AIDS epidemic and didn't think it would be a problem.
He was correct.
Matthew Heineman, the director of the just-released documentary, "The First Wave", is an award-winning director who led the journalists inside Long Island Jewish Medical Center. No patient privacy violations, no Heineman team contracting the virus, and the hospital staff embracing the film were all things other hospital executives claimed to fear if they granted access to journalists.
Hospitals do not have valid excuses for keeping journalists out, and letting reporters inside will confront skeptics with graphic evidence that might sway some of them.
Matthew Heineman filmed a documentary inside the Long Island Jewish Medical Center in New York.
The photo is from National Geographic.
In an interview with The Intercept, Dowling said that it was a mistake for hospital leaders to stand in the way of journalists trying to report on the fatal seriousness of Covid-19.
Dowling said they were unsure if they could trust what went on inside their organization. They were wondering why they would do that, they would never know what would come of it, and it could be a bad report. He said that he was not afraid of taking risks like this. The real story was important to me.
The exclusion of journalists from U.S. hospitals early in the Pandemic meant that there were very little photos or videos of patients. At a time when Americans were making up their minds about whether or not to use anti-covid measures, there was a lack of graphic imagery. A number of academics and doctors believe that stronger visual evidence would have lessened the skepticism that took root in the early days.
The documentation of what is happening in an emergency room or intensive care unit can have a real impact on public safety and national politics. Hospitals are a common location of newsgathering in countries that have been rattled by war or natural disasters. If climate change and political turmoil in the U.S. lead to a greater number of mass casualty events, hospitals will become more of a battleground between corporations and journalists.
The head of the American Hospital Association declined an interview request. Nancy Foster, the vice president of quality and patient safety policy at the American Hospital Association, gave a vague statement that noted that the Centers for Disease Control and Prevention and other health authorities recommended that hospitals restrict outsider access to prevent the spread of Covid and that even family members were not allowed inside Her statement said that media policies always prioritize patient safety and privacy, along with whether hospitals have the resources to keep members of the media away from patients.
CEO of Northwell Health Michael Dowling poses with nurses, doctors, and other staff during an event at the Long Island Jewish Medical Center in New Hyde Park, N.Y., on April 23, 2020.
The photo was taken by Lev Radin/Pacific Press/LightRocket.
Hospitals make a lot of money. HCA healthcare had revenues of more than $50 billion in 2020, and its CEO was paid more than $30 million that year. The educational and professional profiles of the industry's CEOs tend to be the same as those in other fields, with most of them working their way to the top as managers and beginning their careers with business degrees. It would be great for executives at Facebook or Exxon Mobil to allow reporters to attend strategy meetings during a public relations crisis, but the idea of letting journalists roam around their facilities during a Pandemic is just as welcome to them.
Northwell is a typical health care company. Like many, it is structured as a nonprofit, though the business practices of these nonprofits are largely indistinguishable from for-profit networks. According to the latest salary information available, Dowling is paid more than $4 million for his services, and 14 other executives at Northwell earned in excess of $1 million that year. The New York Times reported that Northwell sued more than 2,500 people for an average of $1,700 plus interest, as hospitals stopped taking legal action against patients who were late. Hospitals affiliated with the network but not owned by it filed more than half of the suits.
Northwell is an outlier when it comes to media relations. Dowling came into health care management after public service, as he was a senior official in the Gov. Mario Cuomo's administration. Dowling was in front of the media for 12 years in government. I was not upset with that.
In 2001, Dowling was selected as the leader of the North Shore-LIJ Health System, which is now known as Northwell Health and has more than 75,000 employees and annual revenue of about 15 billion. According to the LexisNexis database, Dowling has become the most visible executive in New York's hospital industry, with more news articles mentioning him than the CEOs of other hospital systems. Dowling has an active account on social media.
Dowling had a close association with Andrew Cuomo, the son of his former boss. Dowling was Cuomo's top Covid adviser in the private sector and often appeared at press conferences with him. When the first FDA-approved doses of the Covid vaccine were to be delivered at the end of 2020, a nurse and doctor at Northwell were selected to receive them, as the event was broadcast live by CNN and showed Dowling standing beside them.
The chair of emergency medicine at Lenox Hill Hospital, Yves Duroseau, MD, volunteered to be the second person to receive the Covid-19 vaccine at Northwell Health at Long Island Jewish Medical Center.
Clary/AFP via Getty Images
The documentary team was given the go-ahead by Northwell to film at the hospital. The team worked there until the end of the year and created an eight-episode series for the internet service. After the team was allowed to return to Lenox Hill, an extra episode was added. At the start of the Covid-19 crisis, Dowling had two teams of independent journalists in his hospitals, one at Long Island Jewish and the other at Lenox Hill.
He said that this was not a big leap for them. We have been doing this for a long time.
Hospitals are concerned that a journalist might reveal the name or identity of a patient without their consent, violating the privacy law known as the HIPAA and potentially leading to heavy fines. The hospital was allowed to view a rough cut of their work before broadcast to make sure that every patient who was identified had given their consent.
Dowling said that they had gone through that experience and knew the protocols that would have to be followed. The other hospital CEOs told me that it was crazy that people were allowed to sit in the hospital and watch everything go on full time. My attitude is that I am okay with it.
Most CEOs did not like it. The sudden battle against Covid-19 was turned into a long war with hundreds of thousands of victims whose terrifying plight could not be witnessed. In its first months, the Pandemic was defined by empty streets and grounded planes, by 6 feet of distance between nervous people, and by strained faces of hospital workers who were swamped and frightened.
The enemy was small, and its victims were invisible.
