Dr. Samaan Rafeq, a member of the EMBA class of 2020 and a New York City interventional pulmonologist, sat down with us with to recount his story of working on the front-lines in Manhattan during the COVID-19 pandemic. Dr. Rafeq is also Fellowship Director and Associate Chief of the Interventional Pulmonary Section at NYU Langone Health, where he is responsible for day-to-day operations of the section. Below, Dr. Rafeq describes what it was like early on in the pandemic, what he has learned in case of a second surge, and how the EMBA prepared him to respond to this crisis.
How did your work as a pulmonologist change because of COVID-19?
It changed dramatically. We had to essentially stop all normal operations, including ambulatory care and elective surgeries and procedures, and focus all the attention on caring for critically ill patients that were coming into the intensive care unit with COVID-19. During that time, I was part of the airway team that performed airway procedures on ICU patients, including bronchoscopies and percutaneous tracheostomies. It was a constant flow of patients for six to eight weeks, day in and day out. Those procedures are part of what we are trained to do, but you do not expect that that would become the only thing that you do in your daily practice for that extended period of time.
What was it like working on the front line in one of the first pandemic hotspots?
It was surreal. It was a mix of emotions all at once. At first, it was as if you’re watching a sci-fi movie or something that you’ve read about in history, but not something that you would expect to be faced with during your lifetime. There was a feeling of fear, anxiety, and uncertainty. There was also a sense of responsibility, and pride, as a physician helping people as much as possible.
Now that New York City is more under control, what is happening on the ground?
We are back to regular operations. Our ambulatory volume has returned to where it was pre-pandemic, which is great. I think we’re close to that level for procedures and surgeries, both on the inpatient and outpatient side. Obviously there are extra measures that are in place to ensure everyone’s safety, such as testing patients, ensuring adequate distancing within our practices, and following proper safety measures with PPE for both administrative and clinical staff.
How are you and NYC hospitals better prepared for a potential second surge?
We learned a lot from what we experienced in the height of the initial wave of the pandemic. We know much more about the disease itself and its management, including ventilation and non-invasive ventilation, thromboembolic complications, and post-ICU care. There is certainly a much better understanding medically and clinically about what we’re dealing with.
We also are better prepared to handle resource management. We’ve come to understand what is necessary to care for COVID-19 patients, so we can allocate resources better, whether that’s equipment or human resources with administrative staff and clinical staff. If there is another surge, then we know, for example, what it takes to get an ICU up and running including equipment, supplies, and human resources.
How has the EMBA program prepared you to respond to this crisis?
I thought initially that the MBA would improve my understanding of the administrative and operative parts of healthcare management, but it also made me a better clinician. I keep going back to the skills I had learned during my MBA degree – operations management, leadership, strategy. It’s amazing that when you start to put the pieces together, how everything becomes relevant to what you see on a daily basis.
What else do you want other physicians to know?
Medicine, as a clinical practice, and management are intertwined. Learning the aspects of healthcare management makes you a better clinician. At the same time, being a clinician and understanding what goes into healthcare management, makes you a better administrator, manager, and leader in your respective healthcare organization. There’s certainly an important role for physician leaders and physician executives to play in the future, not only with this pandemic but also with the healthcare system in general. I think the more people who acquire this knowledge, the better off we will be as a healthcare system and as a society. Applying what I have learned in this EMBA program in the real world has been very satisfying and rewarding.