The chief executive of New York’s largest health system is on a personal crusade to reduce gun violence.
Michael J. Dowling is trying to leverage the power and prestige of his position as president and CEO of Northwell Health, the largest private employer in the state, to rally the health care industry in the region and across the country to join him in fighting for stronger gun control measures.
“America is the shining light amongst civilized societies,” Dowling said during an interview earlier this month at Northwell's headquarters in New Hyde Park. “If we want to maintain that standard, we need to curtail the damage done by guns and gun violence.”
The gun control debate intensifies whenever a mass shooting occurs. After the August shootings that killed 31 people in El Paso, Texas, and Dayton, Ohio, Democrats in the U.S. Senate renewed a push for expanded background checks. The House passed a similar measure.
By not passing legislation that polls show most Americans support, federal lawmakers have shown a "total lack of courage," Dowling said, "and courage is an inherent ingredient in leadership."
Dowling described gun violence in the United States as a “health care crisis.”
He said he is "distraught" when he sees news reports of mass shootings on television, especially when "it’s children who are on the receiving end. Your first reaction is this is crazy."
So far, few top health executives nationwide have publicly committed to the cause.
“There is nobody that doesn’t recognize that this is a public health issue,” Dowling said. “There are some, however, that are somewhat hesitant about getting public about it, and I can’t necessarily specify the exact reasons of why some of them don’t want to go public. But I have my suspicions.”
Some are in states where the public generally opposes new gun control measures, and others are muzzled by boards of directors that don’t want to wade deeply into politics, he said.
Dowling said he isn’t deterred.
He is pushing for stricter background checks and a federal ban on assault weapons.
He pointed specifically at a background check loophole that makes it easier for people to buy guns from a private seller at a gun show.
"We don't need to undermine the Second Amendment to protect the public," Dowling said. "Like with every legislation, there are competing goals and there is a need to find the element of compromise."
Dowling said he has talked to federal and local elected officials on both sides of the aisle about gun control. He declined to name the politicians, saying those conversations were private.
Prior to joining Northwell in 1995, Dowling served 12 years in state government, including seven years as state director of Health, Education and Human Services and deputy secretary to Gov. Mario Cuomo. The Limerick, Ireland, native has been president and CEO of Northwell since 2002.
Dowling said he has placed gun violence on the agenda for a November meeting that will include about 30 health care executives from around the country.
Northwell will pursue "a research partnership with other health care organizations to analyze the root causes of mass shootings and ways to prevent them," Dowling said. He added that Northwell is organizing a December gun violence conference in Manhattan "to bring together others interested in participating in this movement."
"I expect then there will be a lot more people who will participate, a lot more people who will show up," he said. "I know all of these people, obviously, they’re caring individuals, they understand the nature of their business.”
Dowling said along with speaking publicly, health care executives should talk with their employees and speak at local schools about how to stay safe during a shooting. "Be a part of the community that has decided this has to be dealt with," he said. "This is a public health issue, and it's our role to talk about health issues."
Northwell has trained more than 8,000 people at over 180 programs in active-shooter drills and “stop the bleed” programs, he said, "and we plan on placing a greater emphasis on the training programs we make available for both employees and local communities."
Nearly 40,000 Americans were killed in gun violence in 2017, according to the Centers for Disease Control and Prevention (CDC). About 14,500 were homicides, while nearly 24,000 were suicides.
The Nassau-Suffolk Hospital Council, which advocates and lobbies on behalf of regional hospitals, hasn’t made any public comments on gun control, said Kevin Dahill, the council’s president and CEO.
“We haven’t put this on an agenda for discussion, probably because of other parochial issues,” Dahill said. “But I suspect that now that Northwell, through Michael, has been this outspoken, we should have that discussion.”
Beatrice Grause, president of the Albany-based Healthcare Association of New York State (HANYS), added “It will take more leaders like him to bring this to the top of the priority list.”
Dowling spoke Friday about gun violence at a HANYS board meeting in Queens.
A few health care groups and executives have joined Dowling in speaking out, including Dr. Kenneth L. Davis, the president and CEO of Manhattan-based Mount Sinai Health System. In a 2018 op-ed published in The Hill, a political news site, Davis wrote “How many assault rifles are in circulation? How many gun incidents are intentional, and how many are accidental? Is a community safer with more guns or fewer? The answer is no one knows with certainty because for the last 22 years, the Centers for Disease Control and Prevention has been effectively banned from researching gun violence in any meaningful way.”
“That is unacceptable,” Davis wrote.
The American College of Physicians (ACP) last November issued a position paper that called for background checks that keep guns out of the hands of felons, persons with mental illnesses that put them at a greater risk of inflicting harm to themselves or others, persons with substance abuse disorders, domestic violence offenders and others who already are prohibited from owning guns.
“Domestic abusers can’t get firearms now, but there are loopholes,” said Dr. Robert McLean, the president of the Philadelphia-based ACP. “The protections aren’t the same for dating partners. It’s a good example of the sort of loophole that needs to be closed.”
Doctors at Mount Sinai and NYU-Langone, another Manhattan-based health system that operates hospitals and other facilities on Long Island, also said gun violence is a health care crisis.
“We likely need a combination of multiple policies that can work together to address this issue,” said Dr. Magdalena Cerda, an associate professor in the department of population health at NYU Langone in Manhattan. “These include comprehensive background checks, as well as extreme risk protection orders, which empower families and police officers to remove guns in cases where they notice the person is at risk of harming themselves or others. We should also consider whether expanding firearm purchase prohibitions to high risk groups such as those with a history of violence or substance abuse might be an effective policy measure.
“When motor vehicle crashes were treated as a public health issue, it helped to make driving cars safer, and that brought motor vehicle deaths down,” she added. “We can do the same thing with gun violence.”
Cerda said New York’s stricter gun rules have likely made the state safer than the national average. According to the CDC, in 2017, the rate of deaths from firearms in New York was 3.7 per 100,000, compared to the national average of 11.8 per 100,000.
There is also a financial cost to gun violence. A 2017 Johns Hopkins study estimated that between 2006 and 2014, firearm-related injuries accounted for about $2.8 billion in emergency department and inpatient care each year. The university examined records of 150,000 of the approximately 700,000 people who arrived alive at a U.S. emergency room for treatment of a firearm-related injury during that time period.
The majority of patients, 49.5%, were injured by assault. Unintentional injury represented 35%, while attempted suicide accounted for 5.3% of patients sent to an emergency department due to a firearm injury.
The Nassau-Suffolk Hospital Council said it didn't have Long Island numbers.
Northwell treated 118 gunshot victims at the 13 of its 23 hospitals it was able to track between Jan 1, 2018, and Aug. 31, 2019, officials said. The health care system doesn't track the circumstances that bring gunshot victims into its emergency departments, the officials said.
Other business leaders have also started to push for stricter gun regulations. Earlier this month, the chief executives of 145 U.S. companies sent a letter pushing the U.S. Senate to expand background checks and implement stronger “red-flag” laws. Scott Rechler, chairman and CEO of Uniondale-based RXR Realty, was among the CEOs who joined the effort.
“Business leaders need to step up and have their voices be heard,” Rechler said. “It’s strength in numbers. By having more of us, other CEOs are more comfortable to sign on.”
The Long Island Association business group placed gun control on its 2019 priorities list, said Kevin Law, the LIA’s president.
“We don’t usually enter social policy debates,” he said. “But gun violence is a workplace safety issue for employees, customers and clients.”
Dowling said the CEOs are doing the right thing.
“More and more people are basically saying enough is enough," he said.