How Mark Taubman Transformed URMC
They were some of the biggest challenges that health care, and URMC, had ever seen.
Surging patient volumes. Rising costs of care outpacing reimbursements. Rural hospitals staring down bankruptcy, and urban populations wracked by economic downturns and disparities in care delivery. The seismic shift from fee-for-service to value-based payments. Precious dollars stretched thin between new technology and aging facilities. Fierce competition for research funding.
And all that culminating later in a global pandemic that shook the nation’s health care infrastructure to its roots.
Who would be the right person to lead Rochester through it?
How about someone who didn’t want the job in the first place? An accomplished pianist who might have chosen music over medicine. A research scientist who would have been happy never leaving the lab bench.
Twice, Mark Taubman, MD, was called to lead—as dean of the School of Medicine and Dentistry (SMD) in 2010 and then, in addition, as CEO of the University of Rochester Medical Center in 2015.
As it turned out, Taubman didn’t have to give up what he loved. Instead, in a sense, he brought the lab to the CEO office—with a musician’s ear for harmonizing competing needs and agendas.
What he helped change and establish during those years of health care crises and challenges—and what that means for the future of the School of Medicine as his successor, David Linehan, MD, takes the helm—is a lesson in using one’s strengths and understanding how to bring out the strengths of others.
First, though, they needed a plan.
Do the Job That’s in Front of You
Early in his career, Taubman didn’t seem focused on rising to the top. His longtime friend, Bradford Berk, MD, PhD, had recruited Taubman in 2003 to join URMC from Mt. Sinai to be chief of Cardiology. Taubman established his Cellular and Molecular Cardiology lab at the same time.
“In my first faculty jobs, I was a practicing cardiologist spending 75 percent of my time in the lab,” Taubman said. “I could have done that forever.”
But in 2009, SMD Dean David Guzick, MD, PhD, announced that he was leaving for a position as president of UF Health at the University of Florida; Strong Memorial Hospital CEO Steve Goldstein and Chief Operating Officer Kathy Parrinello, PhD, encouraged Taubman to apply.
“I told Steve and Kathy back then, ‘I don’t want to be dean—that’s not what I aspire to. The only job that could be worse would be CEO.’”
Clearly, his tendency to pour everything into what was in front of him caught people’s eye. “I’ve never looked ahead to the next job,” he explained.
“I’ve never looked ahead to the next job.”
But the next jobs had appeared. That same year, Berk—then CEO—suffered a debilitating spinal injury in a bicycling accident. Taubman stepped into both roles, as interim CEO for nine months as Berk recuperated, and then as dean following that. In 2014, Berk transitioned out of the position, and Taubman was tapped to be CEO.
The years working closely with Berk proved crucial. It was in 2014 that URMC would finalize a major strategic plan, begun under Berk’s leadership with input from Taubman.
In many organizations, a strategic plan arrives with fanfare and quickly fizzles out. But at URMC, it was a living document. It had to be, considering the challenges facing health care.
There was an urgent need to grow the system, expand the patient base, build a network across the region to bolster struggling rural hospitals, and fend off competitors from western New York and Pennsylvania.
“Mark played a big role in the strategic plan,” Berk said. “He did a lot of modeling around what were the key fiscal elements in the strategic plan that would enable us to provide money to the medical school for research while giving the hospital a voice in making those decisions. Bottom line: a holistic budget that looked at the two pieces not as separate but as inextricably linked.”
Creating a plan is one thing. Executing it is another. Over the next eight years, Taubman would need to bring home the very ambitious objectives of the plan with the patience and pragmatic approach he used in his research lab. He did it with the touch of another long-held skill of his: music.
Leader as Conductor
In addition to performing as a pianist, Taubman always dreamed of being an orchestra conductor, and he sees the CEO role in that vein: “In music, the orchestra is doing the performance. The conductor is the interpretation: What voices to bring out, what instrumentation to bring in. What speed, what are you trying to convey.”
For Taubman, executing the vital elements of the strategic plan meant listening to how all the parts could work together to create a harmonious whole.
“I don’t remember him ever saying, ‘Adam, go do this,’ ” said Adam Anolik, senior vice president and chief financial officer for the Medical Center. “When discussing an idea, he seeks the input of everyone in the room. A lot of CEOs come in with a big personality, and you can’t talk until the CEO does. Mark is the opposite of that; he empowers not just people he works with on a regular basis but the entire Medical Center and University.”
Since most academic medical centers have two people in those roles, those people tend to compete with each other. In a sense, integrating the roles at Rochester mirrored the goal of integrating the system as a whole.
When Taubman started his tenure as CEO, the Medical Center had two affiliate hospitals, Highland and FF Thompson. Affiliates now number seven, and URMC also has working agreements with other organizations in New York State.
“The importance of the regional network can’t be overemphasized,” said Jonathan W. Friedberg, MD, MMSc, director of the James P. Wilmot Cancer Institute and the Samuel Durand Professor of Medicine. “It has been critical to our success. During Mark’s term, URMC doubled the volume of cancer patients we see, and all the other clinical services grew as well.
“For an institution that provides tertiary and quaternary care, we have to serve a large enough population to justify having specialty services in cancer and other services. There aren’t enough patients in Monroe County alone. Now Wilmot is caring for a large portion of New York state; it provides the most quaternary procedures such as CAR-T cell treatments in the state outside of New York City.”
While a strategic plan can’t be as experimental as a science study, it can keep changing as needed—if someone has the eye for it.
“I like challenges,” Taubman said. “Science is a challenge. When you’re doing basic science, most of the time you know your experiment’s not going to work. You start with a hypothesis, you do an experiment, it doesn’t work, and you have to change your hypothesis. My whole upbringing in science is you’re always analyzing it.”
A strategic plan doesn’t have the same margin of error. But Taubman approached problems like a physician-scientist, gathering the most and best information possible in a given timeframe and proceeding with the best option. In that way, the strategic plan became “a plan that changes every year,” Taubman said. “It has to breathe.”
To balance the Medical Center’s many needs, Taubman would bring another skill to the table—one that surprised even the most experienced of leaders.
The Mathematics of Medicine
With such an ambitious plan, Taubman needed to make the numbers work.
“He had a very instinctive understanding of the finances of the Medical Center—that would be the thing you’d think he wouldn’t have,” said Tom Richards, former URMC Board chair and a UR trustee. “But he did and does. He seemed to easily adapt and understand it,” even in chaotic times. “The ground is changing underneath him here—it’s not like you can memorize a formula.”
But Taubman brought an eclectic background to the job—one born out of a lifetime of interests and curiosity as he was growing up an only child in Brooklyn. His mother was famed piano instructor Dorothy Taubman, who devised the Taubman Approach to help pianists recover from musculoskeletal injury.
At age 12, he attended a science and music camp at Ithaca College. “I remember them taking us to the agricultural school and a room where they were doing a dissection of a horse. An entire horse. Sixty percent of the boys ran out in horror, and the rest of us stayed. I was totally fixated. By the time I came back from that camp, I wanted to be a doctor. I also wanted to be a scientist.”
As a biochemistry major at Columbia, he learned to love mathematical modeling.
In medical school at NYU, he met the man he would succeed as dean at Rochester: David Guzick.
“We started medical school on the same day,” Guzick said. “Mark and I were accepted into the MD-PhD program at NYU …. I was thrilled, as I’m sure Mark was as well, because it allowed us to be trained as investigators as well as physicians. The first-principles training we received in our respective disciplines turned out to be pivotal in the trajectory and scope of our careers in academic medicine.”
Guzick recalls that as a medical student, Taubman, true to form, was focused on the job in front of him: learning.
“Mark was always the first one there, last to leave,” Guzick said. “Because of his scientific background, he could bring information on the underlying pathophysiology of the patient’s condition on rounds. Mark would always add a lot to the conversation.”
Mark was always the first one there, last to leave.
His ability to continue connecting the dots helped him all along the way. Eli Eliav, DMD, PhD, director of the Eastman Institute for Oral Health and vice dean for Oral Health at the School of Medicine and Dentistry, noted what “an amazing researcher he was. As a cardiologist dealing with the system of the human body or as leader of the Medical Center, he is comfortable with complexity.”
This proved vital, especially considering the complexity of the Medical Center and of the strategic plan to transform it.
“I would watch him at meetings run through so many issues, from medical student credentialing to what’s going on with Excellus negotiations to a crisis in the Emergency Department,” said Friedberg. “He would go from one thing to the next without missing a beat. It’s very impressive how much he knows.”
Taubman, though, is quick to share the credit. And he returns to the conducting analogy to explain.
“If you’ve got the right people running your departments, hospitals, clinical services, then you’re directing them—helping push in a direction—but you’re not telling them what to do.”
At the same time, he used his fiscal and mathematical understanding to make sure SMD would thrive well into the future.
“The support for the academic medical mission has never been higher,” CFO Anolik said. “Under his leadership, he implemented an integrated financial model across the Medical Center that enabled us to invest some of Strong Memorial’s cash alongside the University endowment in an Academic Reserve Fund. Today, that fund generates over $16 million in annual earnings that directly benefit the Medical School.”
Yet nothing would challenge the fiscal and operational balance of the system more than what hit five years into his CEO tenure: COVID-19.
Walking the Walk in a Pandemic
“The leadership of the response to COVID is a good example of how Mark conducts business,” Richards said. He noted that Taubman had Strong Memorial’s COO Parrinello and Chief Medical Officer Michael Apostolakos, MD, chair the meetings, not himself, because they were responsible for leading hospital operations.
This is where his listening ear, and his belief in empowering individuals to lead, proved vital. It took the combined knowledge and leadership of thousands of people in the organization, both from hospital operations and the scientific side of the house, to guide the Medical Center through the pandemic.
Taubman’s experience as a researcher gave him the confidence to trust others’ expertise and recommendations. Parrinello said, “Good researchers realize how complex problems can be, and they respect others’ expertise. The best researchers get a team together to meet the challenges of the times. Mark as a leader appreciated unique skill sets and supported people who had those skill sets to lead. He was inclusive of everyone’s perspective. He gathered voices and got the best solution.”
Taubman’s management-by-fact mindset was the right leadership approach for physicians and researchers. “Mark would say to me, ‘These people are scientists, and you need to lead them through the scientific process,’ ” said Richards. “ ‛They are not going to move unless you demonstrate with the processes they use every day that this approach is going to work.’ That matches with the institution we are—not just a hospital, but a large research organization.”
Kathy Rideout, EdD, former dean of the School of Nursing, remembers seeing patients in the hospital during COVID and finding Taubman—a walker who tallies his daily steps—making laps around the building. She’d fall into step to discuss the issues of the day.
He never lost his cool, never showed tension or anxiety. He just kept saying, ‘We will make it through.’
“He never lost his cool, never showed tension or anxiety,” Rideout said. “He just kept saying, ‘We will make it through.’ That calm demeanor from the top helped all of us. That kind of leadership is contagious.”
Even amid the crisis of COVID, he continued to think big. While other institutions were retrenching, URMC was not only sustaining itself but growing.
“In August 2020, we borrowed $225 million for the ED and patient-tower expansion and the orthopaedics campus,” Anolik said. “Mark had the foresight to recognize the short-term challenges but also say, ‘We have to build for the future.’”
Today the Medical Center is three times the size it was in 2010. “The growth has been tremendous—in buildings, faculty, staff. He’s never been afraid to invest in the future.”
It’s not just a matter of sheer size. “We’ve grown substantially, internally and externally,” Richards said. “We are a much more accomplished, established, and successful place than when he first came here, but always focused on medicine of the highest order.”
Research and Problem-Solving
“I’m grateful for having a CEO who is a researcher, who has had a lab and knows what it’s like to do research on a tight budget,” said University Vice President for Research and Chief Research Officer Stephen Dewhurst, PhD. “He values research very much—it’s part of the way he works to get to some form of ‘yes’ when it comes to research investments.”
He values research very much—it’s part of the way he works to get to some form of ‘yes’ when it comes to research investments.
Clinical revenues that support the research mission tripled under his leadership, from $40 million to $120 million, endowed research chairs from $45 million to $126 million. He has placed emphasis on early-career faculty; the number of assistant professors in research rose from 84 in 2014 to 133 now.
The investment and foresight, said Dewhurst, will sustain the research mission over time: “URMC has a cadre of outstanding early-career faculty, as well as a highly collaborative and interactive research environment. Those assets will serve us very well long into the future and will enable us to achieve research goals and develop new research partnerships that would be extremely difficult to do in other places. The culture here that he has helped sustain at the highest level makes a profound difference. Over the next several years, Rochester will be increasingly attractive for many academics.”
Taubman places great emphasis on recruitment—for himself and for the people he recruits into leadership. All but four of the current chairs are his recruits, as was new Dean and CEO David Linehan, MD.
“The whole key of everything is picking great people and empowering them,” Taubman said. “Everything we’ve achieved has been achieved because we get great chairs, great associate vice deans, and senior associate deans who get it done, with support from the entire staff at URMC.”
For him, a good recruit is also a good recruiter. When Ophthalmology Chair and Flaum Eye Institute Director David DiLoreto, MD, PhD, interviewed for the position, Taubman asked about his strength in recruiting. DiLoreto took it as motivation to become a great recruiter himself.
“He supported recruitment of 29 Ophthalmology faculty in the last four years,” DiLoreto said. “We’ve had huge growth—basically doubled our department in size and grew from six to 11 satellite offices.”
“People want to come to a place where they think they can accomplish something, which means they are going to get the resources,” Taubman said. “We have done very well, compared to our peers, through COVID. People don’t see an institution retrenching or downsizing here. They see an institution that’s vital.”
Leadership as a Partnership
Taubman said his approach to leading is straightforward. “Everyone knows it’s an open door. Anybody who wants to talk to me, they can. I also want to make it clear that they can say anything. Maybe I’ve yelled twice. Nobody is going to hear me yell or disparage them. Most everyone who comes in here with an idea, it’s a good idea. Let’s work on how we get this done.”
People discussing Taubman’s leadership style use many of the same words: Open door. Empowerment. Listener. Kind.
Taubman describes it this way: “I’m here to make you succeed; you’re not here to make me succeed. I will succeed if you succeed, but ultimately, you’re not here for me—I’m here for you.”
Again, it’s the calm patience of a researcher who knows he’s working on the problem. DiLoreto shared a saying Taubman would use: “The Medical Center could be losing money, losing patients, we have COVID, but everything would be better if the Yankees would just start hitting.” A stalwart Yankees fan since he was a child (ever since the Dodgers left Brooklyn), Taubman’s irrepressible sense of humor has helped the people around him.
“He has a very different vibe than a lot of leaders I’ve worked with,” DiLoreto added. “He gives people confidence, accessibility, hope, motivation. We always feel good about leaving a meeting with Mark,” regardless of the outcome. “He said no, but why do I feel better?”
And he has done it amid the complexity of all he oversees.
“Mark has exceptional leadership skills,” said Medical Center Board Chair Diana Kurty. “He was able to handle the complex issues that faced the Medical Center. This ability was crucial in collaborating with our varied constituencies at the Medical Center and University. That’s a very important aspect of his leadership style.”
He has done it by being a collaborator and partner instead of being hierarchical, said Michael Rotondo, MD, vice dean for Clinical Affairs and CEO of the UR Medical Faculty Group.
“He’s someone who really enjoys solving complex problems, and he’s particularly skilled at bringing people around the table to do that. There are always many different viewpoints; he doesn’t get locked into a decision until he has worked collaboratively with people. What kind of person does that? Someone who’s analytical, with enough emotional intelligence to look at complex problems with equipoise, and then he acts. That is uncommon.”
And he did it amid the ongoing challenges facing the Medical Center. “Every era presents financial and operational challenges, but no Medical Center CEO saw more challenges than Mark,” said Steven I. Goldstein, MHA, senior vice president of the Medical Center, who also serves as president and CEO of Strong Memorial and Highland hospitals.
Goldstein cites the enormous amount of time Taubman spent traveling the region to build the network of hospitals, reflecting his commitment to establishing trust between the institutions—a trust that proved invaluable when the pandemic hit.
What’s Next: More Exploration
“We have a large health care system, but it needs much greater integration to reflect the fact that we’re a system,” Taubman said. “There’s a lot I’d love to do in care management. Ultimately, we will get into all value-based contracts, take more financial risks.
There’s an enormous amount we can do to take out waste in health care delivery.”
As CEO, he launched the Diversity, Equity, and Inclusion program to address disparities in the region, but he knows that’s just a start. “We put things in place but there is much more that needs to be done. We clearly have a way to go in diversity in terms of the faculty.”
But he leaves behind an academic medical center that has changed immeasurably since the beginning of his tenure.
“He has charted a vision and a future that includes all our missions,” Apostolakos said. “Other health care organizations, in the face of challenges of the past few years, have cut back on the services they provide. We’ve never done that, and we’ve always kept research and education at the forefront. I think that’s really his legacy.”
He has charted a vision and a future that includes all our missions.
Taubman can look back and know he helped lay the groundwork for whatever future problems need to be solved.
“It’s a real honor to have been CEO and dean for a great medical center, and I’m thrilled to help it move forward. With the regional network, we now have the size to be able to navigate under almost any reimbursement circumstance, and we can focus increasingly on delivering value. Integrating the budget has ‘de-risked’ the future of education and research. I’m very proud of the increase in endowed professorships. Eleven percent of everyone applying to a medical school apply here.
“What more can you ask for?”
Now if the Yankees would just start hitting. RM
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