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Most care will move outside the hospital, Northwell Health CEO Michael Dowling says


Hospitals will always have a place for those who need intensive care. But in the near future, he says most care will be done on an outpatient basis or at home.

More patient care is being done outside the hospital, and Michael Dowling sees that trend as a window into the not-too-distant future.

Dowling, the president and CEO of Northwell Health, told Chief Healthcare Executive® in a recent interview that in the coming years, “Most care will not be in the hospital.”

Today, 46% of Northwell Health’s patient care business is done in the hospital, he says. The rest of it is provided in outpatient settings, ambulatory surgical centers or in the home.

‘Hospitals will be very, very important, but they'll be very important for the sickest of the sick,” he says. “Everything else will be outpatient.

“It’s not a hospital business,” he adds. “Hospitals are one link in the continuum of care. You've got primary care, you’ve got home care, you’ve got ambulatory care, you’ve got hospital care, and you've got post acute care. Hospitals are one link in the chain. You’ve got to look upon it as all the pieces of the chain.”

(See part of our conversation with Northwell Health CEO Michael Dowling in this video. The story continues below.)

Eventually, he sees hospitals as focusing largely on intensive care or taking care of chronically ill patients. More orthopedic surgery is heading to the outpatient area, he says.

Many cardiac interventions are also going to be done on an outpatient basis more frequently, Dowling says, adding that, “the quality is there and the science is there.”

“So hospitals will change, but so will everything else,” he says. “But hospitals will not disappear. They will become very important for those that have to be there.

“Hospitals are great places to be if you have to be there but not great places to be if you shouldn't be there,” he says. “For those that shouldn't be there, you provide alternatives.”

When asked if that presents a challenge for today’s healthcare leaders in planning for the future, Dowling says, “It's not a challenge, it's an opportunity.

“Every challenge is an opportunity,” he says. “It's the opportunity to think differently, to think creatively, to think about where you should be 10 years from now.”

Dowling says leaders must create a hopeful vision for their organization, and he says looking at something difficult as a challenge becomes “more depression.”

“Every time you come up against something that is difficult, the question becomes: How do I use it as an opportunity to improve? A challenge is an opportunity to improve,” he says.

“And if you look at it that way, it's more positive and optimistic. It's exciting, it's not boring. I mean, boring would be having everything stay the same. And that would be boring.”

Dowling says he finds excitement in doing something different.

“You do your best work under pressure,” Dowling says. “And stress is not necessarily all bad for people. Good stress creates innovation.”

Read more: Northwell Health CEO Michael Dowling says complacency is the biggest danger

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