Northwell Health CEO Michael Dowling prepares to step down: ‘This has been my life’

Some of Northwell Health’s employees weren’t born when Michael Dowling became president and CEO of the New York health system.

After leading Northwell for more than 23 years, Dowling is stepping down. Starting Oct. 1, he will transition to the role of CEO emeritus and will continue to advise the organization. He also plans to do some writing and teaching.

When asked about having a few employees who may have been born after he became CEO, Dowling laughs that there are “a lot of them.” He continues to meet all of Northwell’s employees when they are hired, and met more than 190 on a recent weekday earlier this month.

“Everybody knows who I am, but a lot of them are younger,” he tells Chief Healthcare Executive.

Dowling has been working to ease the transition to Northwell’s new CEO, Dr. John D’Angelo, an executive vice president who has served with the system for 25 years.

• Read more: Northwell Health's new CEO outlines top priorities

Based in Long Island, Northwell has seen remarkable growth under Dowling’s leadership. Earlier this year, Northwell completed the acquisition of Nuvance Health, a system with seven hospitals in New York and Connecticut, expanding Northwell’s footprint beyond New York state for the first time. Northwell now operates 28 hospitals and boasts more than $22 billion in revenue.

Dowling, who will be 76 in November, says he’s comfortable in his decision to step down as CEO. He says he essentially came to the decision two years ago, when he told Northwell’s board at the time that he would serve two more years. He joined the system three decades ago, serving as chief operating officer before becoming president and CEO in 2002. He says the system is in good hands.

Still, Dowling says, “It's not an easy decision. This has been my life.”

(See part of our conversation in this interview. The story continue below.)

Succession planning

With 23 years as CEO, Dowling’s tenure is far longer than the typical chief executive in the healthcare industry. The average healthcare CEO serves for 7.6 years, according to a 2024 report by Crist Kolder Associates, an executive search firm.

Part of Dowling’s decision-making process in his retirement plan was to ensure Northwell was well positioned for future success.

“I have been around long enough to see CEOs that just stay too long, and they don't realize that they may not be completely on the ball, and they haven't made plans for succession,” Dowling says. “And then the organization, when there is no plan of succession, the organization gets very, very concerned about it.”

D’Angelo was selected by the board who interviewed candidates from outside the organization, as well as a few internal candidates. They’ve had plenty of discussions, and Dowling says he’s available to be a sounding board.

But Northwell is having an orderly transition to its new leader, Dowling says.

“This one is unbelievably smooth, no dissension, no disruption, and no second guessing,” he says. “The organization keeps moving forward, and that's the goal. It's all about the health of the organization. It's not about ‘he,’ and it's not about me. It's about the organization.”

• Read more: Why Northwell Health, Cold Spring Harbor Laboratory expanded their partnership

‘Power of relationships’

Even as Northwell has grown substantially over the course of Dowling’s career, he says he has wanted to maintain the feeling of being small and preserving the system’s unique character.

He says the key to doing that is “emphasizing relationships, being seen in person, walking the floors, meeting with employees, having demos, having breakfast, having lunches.”

“There is a big tendency these days to focus on the hard issues, the budgets, the infrastructure, the technology, the AI,” he says. “All of that is important. But what's more important is the building of relationships, building trust, getting people to know one another, sharing information, being transparent, shortening the distance between the CEO suite and the front line.”

As Northwell has grown, Dowling says he has worked to avoid a widening chasm between top leadership and the workforce.

“We have done everything possible over the years to make the gaps smaller. So I walk the floors all the time, and I take employees out to dinner every month. I meet employees for breakfast in the mornings,” he says.

As Northwell has worked to bring Nuvance into the organization, Dowling has taken that same personal approach.“I can walk into a Nuvance hospital now, even though they're not fully integrated with us yet. And I guarantee you, everybody will know who I am. And the same with our senior leadership. It’s not just me, by the way, it's our senior leadership, and they know who we are,” he says.

Dowling says that he is “big into relationships and the soft issues.”

“Texting doesn't do it. Emails don't do it. AI won't do it. They all have their benefits, but the power of relationships is what makes it work,” Dowling says.

And that’s why Dowling says he doesn’t text or email, as he favors face-to-face conversations.

“Most of what I do, if it's anything serious at all, is in person,” he says. “It requires you work longer hours. It means you're out at night. It means you have early morning meetings. But if you want to do it right, in my view, this is what you have to do. And if you have a job like this, you have an obligation to put into the time to do it right. Otherwise, don't do it at all.”

Northwell Health CEO Michael Dowling and some of the health system's staff. Northwell treated 300,000 COVID-19 patients.

‘No retreat’

Over the course of his career, Dowling has seen significant changes in the delivery of care, including more services on an outpatient basis and the expansion of care at home.

He also says the education of medical schools has evolved, and he touts the work of the Zucker School of Medicine, a partnership of Northwell and Hofstra University.

But he points to Northwell’s work during the COVID-19 pandemic, when New York served as ground zero for the virus in 2020. Northwell treated more than 300,000 Covid patients.

Dowling marvels at the “passion” of Northwell’s staff.

“I saw what employees did,” Dowling says. “I saw the danger they put their own lives in, the danger they put their families in as they did everything possible to protect others from a terrible virus. Those things give you hope and confidence. There's a lot of criticism today by people about Covid, but most of those people that criticize you today were never in the arena.”

Even in the harrowing early days of the pandemic, Dowling maintained confidence that Northwell’s staff would endure, and that the nation would overcome an unprecedented threat. He told 60 Minutes in the spring of 2020 that “the virus is not going to win.”

“There's going to be no retreat, and there's going to be no putting up the white flag,” Dowling recalls of that time. “We win and we move forward despite how difficult it was.”

In a crisis, Dowling says it’s important to prevent a negative attitude from making matters worse.

“It's your attitude towards problems that sometimes is the biggest problem,” he says. “Now the problem is not the problem, it's people's attitude to the problem that becomes the problem. They look at a challenge rather than looking at opportunity. They look at what can go wrong rather rather than what can go right.”

Northwell Health CEO Michael Dowling has spoken out about gun violence and the need for hospital leaders to get involved. Northwell holds an annual forum on gun violence.

Speaking out

Dowling has been a passionate advocate on addressing gun violence. Northwell hosts an annual symposium on gun violence, and he has urged healthcare leaders to confront it as a public health problem.

With gun violence being the leading cause of death among children, Dowling says healthcare leaders can’t afford to stay silent on the issue.

“Every healthcare organization across the United States is building up cancer treatment services for kids, but cancer is the third leading cause of death for kids,” Dowling says. “If you're interested in kids' health, then focus also on the leading cause of death for kids.”

The Trump administration has been staunch opponents of efforts to tighten regulations of gun ownership, and Dowling concedes there are some new headwinds to tackling gun violence. But he points to the growth of the National Health Care CEO Council on Gun Violence Prevention and Safety, which he helped establish.

“There's all of the tailwinds of people's compassion and dedication and resilience and willingness to speak up,” Dowling says, adding, “We need more people to be part of the tailwind movement.”

He also says he’s concerned about the federal government creating more skepticism and mistrust of vaccines, which he fears will lead to more illnesses.

“That worries me when you undermine the infrastructure on public health. That worries me when you create distrust of vaccines,” he says.

Even as he moves into a different role, Dowling says he plans to continue to speak his mind about gun violence and the need for federal health policies based on science.

“I hope to be involved in some of these issues going forward,” Dowling says. “Silence is the worst possible thing now, and it's not about politics. It's about health, because health is affected by everything.”