The Life of Michael Dowling
and How His Experiences Are Impacting Healthcare and Policy Today
Timeline of Michael Dowling
4. Hurling and Leadership
If you’re like most Americans, you’re probably wondering what on earth “hurling” is. Hurling is the much-beloved ancestral sport of Ireland that involves teams of 15 using sticks, or “hurleys,” to move a ball, or “sliotar,” down a grass field to (hopefully) score on an H-shaped goal.
In his new memoir, After the Roof Caved In, Michael Dowling describes hurling as “a combination of hockey, football, golf, baseball, battle and sudden death.” Because of its fast-paced and often dangerous nature, to be good at hurling was, as Dowling writes, “the great equalizer,” dispelling class prejudices otherwise prevalent in 1960s Knockaderry. Learning to lead on the pitch while working in a team dynamic would later help Dowling as the president and CEO of Northwell.
“As I grew more mature,” writes Dowling, “I realized that hurling teaches you about life. No matter who we are or where we come from, we all face difficult challenges along the way, and the ongoing nature of those challenges tests whether we have prepared in a disciplined way to take on whatever happens to lie ahead. In hurling, as in life, study, preparation, and hard work pays off.”
This disciplined preparedness was put to the ultimate test: a global pandemic. In his book about COVID, Leading Through a Pandemic, Dowling writes, “As we discussed the inevitability of terrorism and the need to prepare two decades ago, it was clear that many other types of emergencies could be headed our way as well. We made a decision to build a robust emergency preparedness infrastructure within our health system based on a simple assumption: Bad things will happen. We have to be ready.”
No matter who we are or where we come from, we all face difficult challenges along the way.
3. The Value of Education and Perseverance
Center for Learning and Innovation
Within weeks after taking the reins as president and CEO of Northwell Health in January 2002, Michael Dowling established the health care industry’s first corporate university, called the Center for Learning and Innovation (CLI). Nearly 20 years later, CLI has helped Northwell create a world-class learning organization that fosters career growth among employees and instills a culture focused on patient safety. With a myriad of programs and courses attended by tens of thousands of employees over the years, CLI continues to enhance Northwell’s ability to deliver services in a consumer-focused, competitive marketplace, while investing and developing new groups of leaders at different levels of the organization.
The Spark! Challenge
Northwell’s Spark! Challenge is a far-reaching program that introduces high schoolers to careers in healthcare and other STEM-centric areas of study. Over the past five years, Spark! has welcomed more than 3,000 students from across the New York Metro Area to become actively engaged in clinical programs throughout Northwell’s integrated healthcare system. Click here to stay informed about the next Spark! Challenge.
Medical Scholar’s Pipeline Program
Northwell’s Medical Scholar’s Pipeline Program (MSPP) engages high school students in primarily minority communities as part of an effort to introduce them to careers in medicine. Students attend this six-or eight-week summer program every summer for three or four years. The MSPP provides the types of opportunities that Michael Dowling fought for back in Ireland, a chance to succeed, despite an economically disadvantaged background, through education and perseverance. Many participants in the Medical Scholar’s Pipeline Program have gone on to medical school at Ivy League universities, as well as Zucker School of Medicine at Hofstra/Northwell.
The key to Michael Dowling’s success was his perseverance in education. Growing up poor in Ireland, he faced what he calls in his memoir, After the Roof Caved In, “the cacophony of no,” —the resounding pushback of a world that didn’t think a person from Dowling’s social class could ever amount to anything.
“The idea that we were at the bottom of the social barrel and were destined to remain there throughout our lives was a powerful force in Knockaderry,” writes Dowling. This socioeconomic classism led to Dowling’s intense dedication to lifelong learning and belief in the people society often ignores. It’s a dedication that’s still reflected in his life today, through Northwell’s education and career development programs targeting the health system’s own employees as well as young people in Northwell’s service area.
“My mother knew how important education was to me. She shared that aspiration for me.”
— Michael Dowling, After the Roof Caved In
1. The American Dream: One Immigrant’s Story
Michael Dowling, decades before he would become the top health and human services advisor to former New York Governor Mario Cuomo and then president and CEO of Northwell Health, had humble beginnings. Dowling grew up poor in rural Ireland, the son of a disabled manual laborer and a deaf seamstress and homemaker. His experiences taught him the value of hard work and perseverance, but also instilled in him a compassion for blue-color workers that influences Northwell’s community outreach efforts to this day. As someone who came to America with little beyond hopes and dreams, Dowling believes immigrants are an essential part of the American way of life and disdains the anti-immigrant rhetoric that has resurfaced in recent years. For Dowling, the American dream is actually the story of immigrants.
“The story of the United States is an immigrant story,” writes Dowling in his new memoir After the Roof Caved In. “It is about the talent, perseverance, and dedication of immigrants and their descendants. At Northwell Health, I work with more than 72,000 people, most from the United States, but many from around the world.”
Recognizing that communities of color and those with lower incomes were being disproportionately affected by the coronavirus, Northwell began working with faith-based organizations and other community leaders last spring to provide free diagnostic and antibody tests for COVID-19 to nearly 100,000 local residents in high-risk areas. Once COVID-19 vaccines became available in December 2020, Northwell began establishing and staffing distribution sites in hard-hit communities throughout the New York metropolitan area, which has enabled Northwell to establish even stronger relationships in low-income communities where there has been a history of health disparities.
As of March 30, nearly 400 Northwell staff assigned to about 25 different distribution sites throughout New York City, Long Island, and Westchester County had administered more than 280,000 doses of the COVID vaccine, including vaccinating 171,000 community residents and nearly 109,000 healthcare workers. Besides eligible residents living within high-risk communities, among those targeted were homebound residents, hospital patients being discharged into nursing homes, children with physical disabilities who are unable to travel, “back-stretch workers” at Belmont Race Track in Elmont, and others at high risk of infection. It’s all part of Northwell’s continued outreach efforts and commitment to addressing health disparities impacting working immigrant families, inspired by Michael Dowling’s story.
“There was no doubt that Ireland was a kind of father country to America in the sense that many Irishmen and women had traveled to America to make a better life,” writes Dowling. “I had come to believe that as the oldest in the family I had an obligation to make sure that I could make the family a little bit better off.”
To this end, Dowling openly and often criticizes anti-immigrant and anti-labor sentiment. Read his latest op-ed on the subjects here:
“The story of the United States is an immigrant story.”
2. Inspirational Women
Michael’s mother, Margaret (Meg) Dowling, was the single greatest influence on his life. Despite her own hardships, growing up in abject poverty and going deaf at a young age, this powerful woman instilled her oldest son Michael with “learning, optimism, and kindness,” writes Dowling in After the Roof Caved In. She encouraged him to love learning and love his fellow human. She also stuck up for him, both to his father and to a school teacher who told Michael that it was fruitless to pursue higher education. Now that Dowling has become one of the nation’s most respected voices in healthcare, it’s clear Meg was right. Young Michael had a grand future. Meg believed that with encouragement, hard work, and optimism, you can make a difference in this world. It’s the philosophy underpinning Northwell’s entire mission.
Launette Woolforde, EdD, DNP, RN, NPD-BC, NEA-BC, FAAN, an internationally renowned expert in nursing and healthcare, is this month’s Inspirational Woman. After more than 15 years serving Northwell Health in various capacities, she was recently named chief nursing officer at Lenox Hill Hospital, Manhattan Eye, Ear and Throat Hospital (MEETH), and Lenox Health Greenwich Village (LHGV). She will be responsible for providing strategic oversight of patient-centered nursing care, including implementing quality and safety standards, as well as for fostering a highly engaged, supportive nursing environment that ensures professionalism and collaboration.
Read more about her inspirational story here.
Inspirational Women Spotlight. Is There A Woman In Your Life Who Inspired You? Tell Her Story Here. For Mother’s Day, Nominate Your Mother For The Inspirational Women Spotlight.
“The World Is a Good Place. People Are Good.”
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This Is His Latest Linkedin Column:
These Are Links To A Podcast And A BBC Interview He Did Recently
That Focus Heavily On The Immigrant Experience:
Immigration is the backbone of America. We need to treat it that way.
Life’s Tough — but Michael Dowling is tougher, from Irish immigrant to president & CEO of Northwell Health—the largest healthcare provider in New York State—and true visionary leader of our time.
Michael J. Dowling on his memoir - after the roof caved in: an immigrant’s journey from ireland to America
5. The Lessons of Grief
Grief is a powerful force that the nation continues to cope with.
“The emotional toll and stress put on our healthcare and essential workers has been unprecedented and unthinkable. But it’s affected you, too,” wrote Michael Dowling, President and CEO of Northwell Health in a recent op-ed. “We’ve transitioned from being worried about our health and panicking about our own mortality to dealing with significant loss of life. Grief followed. And COVID has now impacted our jobs, finances, schooling, childcare, families. The list is endless. Daily life hasn’t been the same.”
Remembering those we’ve lost is an essential aspect of grieving. Northwell is remembering those lost to COVID-19 in a new light installation. How will you remember?
Losing a loved one profoundly affects us. The death of Michael Dowling’s mother, Meg, in 2001 changed how Dowling, and by extension, Northwell, would view end-of-life care going forward. In his new memoir, After the Roof Caved in, Dowling describes his heart-wrenching final moments with his mother, as she suffered from dementia, medicated in hospice care. Although he wished she could be at home with him and his sister Mary, Meg’s illness had progressed to the point that they were unable to take her home.
Dowling writes, “I visited during this period, when Mam was in a beautiful hospice facility in Limerick that seemed to me a model of how people in the final stages of life should be cared for (I set up a similar hospice facility at Northwell Health when I returned to New York). The last time I’d been home she was in very bad shape. She’d lost much of her vision and she hadn’t recognized me at first. But I sat by her bed holding her hand, and after a moment, squeezing my
hand, she said my name. ‘Is that you?’ she asked me. I said it was, though of course she could not hear me, but I squeezed her hand, and I believe she knew it was me.”
Because of these end-of-life experiences with his mother, Dowling became a huge advocate of hospice and palliative care. He is currently writing a book about the “aging tsunami” and how healthcare providers and society need to do a better job of helping people age with dignity and avoid spending their final days in a hospital or nursing home, with a focus on helping seniors live independently at home.
“Is that you?”
4. The Educator
Michael Dowling learned the value of teaching while in graduate school.
“My greatest lesson as a teacher,” writes Dowling in his new memoir, After the Roof Caved in, “was how difficult the job was and how much preparation was required.”
It’s a lesson that has followed Dowling throughout his career. Being prepared is crucially important in today’s crisis-prone, powder-keg of natural disasters and global pandemics. Preparedness allows for growth and innovation; if you’re always playing catch up, you can’t be looking ahead.
According to Dowling, that’s what being an educator is all about: preparing for the future. Northwell’s commitment to lifelong learning is one way the organization reflects Dowling’s esteem for continuous education. Through Northwell’s Center for Learning and Innovation (CLI), Northwell employees at all levels of the organization can continue to learn new skills, enhance existing ones, and grow their careers. These continuous learning programs promote enhanced business practices, develop future leaders, and improve patient care by allowing physicians, nurses, and other caregivers to hone their clinical skills through medical simulation training at CLI’s Patient Safety Institute, the nation’s largest patient simulation center. CLI also offers physicians, nurses, medical residents, students, and others the opportunity to gain hands-on experience using cadaveric specimens at Bioskills Education Center.
Northwell’s visionary approach to training the doctors and nurses of tomorrow is best demonstrated by the innovative, hands-on curricula offered at the Zucker School of Medicine at Hofstra/Northwell, which opened in 2011 as New York’s first allopathic medical school in about 40 years, and the Hofstra Northwell School of Nursing and Physician Assistant Studies, which offers both graduate and undergraduate nursing degrees. As an integrated, academic health system, Northwell also offers 166 medical residency and fellowship programs that serve as a training ground for more than 1,900 future physicians. These highly trained residents and fellows then matriculate to serve patients in one of Northwell’s 23 hospitals, or at other hospitals around the country. Yet another gem in Northwell’s academic enterprise is the Elmezzi Graduate School of Molecular Medicine, based within Northwell’s research enterprise, The Feinstein Institutes for Medical Research. The Elmezzi School confers PhD degrees to highly trained, young physicians interested in careers in biomedical research, offering them an individually tailored, three-year program with a strong emphasis on translational research.
Committed to Teaching
the Doctors of Tomorrow
3. The Businessman
Despite the altruistic mission of healthcare providers, healthcare in the United States is a business, too, requiring not just a compassionate spirit, but a sharp mind for efficiency and innovation. In the business of healthcare, Michael Dowling has helped Northwell Health grow into the largest integrated health system in New York, making it one of the largest health systems anywhere, and the largest private employer in the state.
Reflecting in his new memoir, After the Roof Caved In, Dowling writes about how the health system’s integration efforts over the past quarter-century helped prepare it for the enormous challenges of the coronavirus pandemic, writing, “At the start of the COVID-19 crisis, Northwell Health had grown exponentially, expanding across Long Island into Brooklyn, Staten Island, Westchester, and Manhattan to include twenty-three hospitals across the New York region along with 800 ambulatory sites, making us the largest health care system in the state as well as the largest private employer in the state. Our 72,000 employees care for patients with cancer, heart disease, diabetes, schizophrenia, and every other imaginable mental and physical malady.”
Northwell needed all 72,000 employees to handle the COVID surge of 2020. While Dowling’s business acumen certainly contributed to Northwell’s rise, the true power of Northwell is in its employees. Here’s Dowling reflecting on the future of healthcare, post-pandemic, in his book, Leading Through a Pandemic: “The coronavirus is a painful reminder of life’s fragility. Virtually overnight, it changed how we think about life and how we will live in the future. The severity and speed of the virus presented a test for which no one in the world of health care was fully prepared. Yet, overall, the medical community in the epicenter that was New York responded to the crisis with grit, determination, and much success. The pandemic revealed the professionalism and commitment of health-care workers throughout the country, particularly in New York, where we were inundated and nearly overwhelmed.”
Click here to get Dowling’s take on how hospitals and health systems need to adapt as they move beyond the worst of the pandemic.
Healthcare is the business
1. The Policymaker
Michael Dowling served for 12 years in New York State government as the top health and human services advisor to former Governor Mario M. Cuomo, helping the administration craft policies that often reflected Dowling’s bioethical philosophies aimed at preserving families and expanding health access to all who need it.
“Growing up in Knockaderry certainly gave me a visceral understanding of people in need,” Dowling writes in his new memoir, After the Roof Caved In, about moving to Albany to serve in the first Cuomo administration. “I made it a point to get out of the office and see firsthand the challenges that people we served faced in their lives. I went out to homeless shelters in the middle of the night to see the conditions and the people with my own eyes.”
In light of recent events, Northwell is now pushing for healthcare leaders to recognize gun violence as a public health crisis and drive prevention efforts within the communities they serve. Click here to read about Northwell’s response to the March 22nd mass shooting in Boulder, CO, that killed 10 people, including a police officer.
This experience profoundly shaped not only Michael Dowling’s understanding of poverty in America, but also what might be needed, from a policy standpoint, to help them, later reflected his welfare and healthcare reform initiatives.
“Our welfare,” he writes, “should be built upon a few key principles, including that jobs and employment must be the central goal of the welfare system — not just the distribution of cash assistance; all work is good and all efforts to work must be supported and rewarded; if you’re on welfare you should be doing something in return for your check.”
“Growing up in Knockaderry certainly gave me a visceral understanding of people in need.”
2. The Innovator
As CEO and president of Northwell, Michael Dowling pushes his leadership team to pursue innovation throughout every area of the organization, whether it be the latest medical technologies or AI initiatives that improve efficiency and effectiveness. Northwell’s fully integrated healthcare model was an idea Dowling had when he joined the organization in 1995. Here, Dowling writes in his new memoir, After the Roof Caved In, he envisioned “an integrated system (that) would be capable of providing all of a patient’s medical needs from birth to death — primary and specialty care of all kinds, including world-class care for stroke, heart disease, cancer, mental health, and more.”
This innovation not only proved prescient — as healthcare providers around the country took notice — an integrated network was also instrumental in Northwell’s battle with COVID-19.
Writes Dowling in his book Leading Through a Pandemic, “When the tsunami struck, we were able to cope thanks to the scale and integration of our health system.”
Dr. Ira Nash, executive director of Northwell Health Physician Partners, put it this way: “Scale is necessary, but it is hardly sufficient. What I believe distinguished the Northwell effort is the utilization of scale, which was possible only because of our true integration . . . coupled with a sense of obligation to support all parts of the organization. I have heard stories of other health “systems” (which also have scale) but which failed to execute the way we did because they either lacked true integration (unified leadership) and/or, when push came to shove, some parts of the organization were valued more than others.”
As one of the overarching innovations of Northwell inspired by Dowling, an integrated system allows for new forward-thinking solutions to emerge. One of Northwell’s latest innovative changes to the way healthcare providers operate is the Northwell Direct Program. Northwell Direct mirrors the care and respect Northwell has for its employees by offering customizable healthcare systems so that employers can keep their teams healthy and productive. Using the vast resources of the largest health system in New York State—including world-class physicians, specialists, and wellness experts—Northwell’s single integrated network can fulfill all of your employees’ health care needs, from immediate and COVID-related needs to what is needed in the long-term to stay healthy for years to come.
The integrated nature of our organization enabled us to load balance,” Dowling writes, “that is, to distribute patients to anywhere within our system where beds were available.
A Truly Integrated System
Preparedness and Lessons Learned
2. Future Recommendations
During his long and successful career in healthcare, Michael Dowling has continually looked forward, making prescriptive recommendations to improve the healthcare industry. In some respects, the world of 2021 looks very different from the world of 1950s Knockaderry. Yet, in other ways, it’s still the same world Dowling’s mother told him about: “The world is a good place. People are good.”
Building from this core belief, here are the thoughts of Dowling and other prominent healthcare CEOs about what we can expect in the months ahead, and how the medical community needs to prepare for and respond to new developments.
Where do we go from here?
3. “A Good Ending”
Mr. Dowling’s leadership has been invaluable to Northwell’s consistent expansion and prominence. In 2020, he successfully navigated the health system through the first COVID-19 epicenter in the U.S., detailing his experiences in Leading Through a Pandemic: The Inside Story of Humanity, Innovation, and Lessons Learned During the COVID-19 Crisis. Overall, Northwell has treated more than 150,000 COVID patients, and the health system utilized a strong innovative culture to expand hospital bed capacity (adding 2,000 beds in two weeks), 3D-print nasal swabs for COVID testing, convert bi-level positive airway pressure (BiPAP) machines into mechanical ventilators, and take advantage of its large, integrated health system to “load balance” and transport 810 patients from overrun hospitals to those that had bed capacity. Northwell also kept employees safe, investing in critical personal protective equipment to help those working the front lines, one of whom — Sandra Lindsay — was the first person in the U.S. to receive the historic COVID vaccine in December 2020.
Before becoming president and CEO in 2002, Dowling was the health system’s executive vice president and chief operating officer. Before joining Northwell Health in 1995, he was a senior vice president at Empire Blue Cross/Blue Shield.
Dowling served in New York State government for 12 years, including seven years as state director of Health, Education, and Human Services and deputy secretary to the governor. He was also commissioner of the New York State Department of Social Services. Before his public service career, Mr. Dowling was a professor of social policy and assistant dean at the Fordham University Graduate School of Social Services, and director of the Fordham campus in Westchester County.
Dowling has been honored with many awards over the years, including his selection as the Grand Marshal of the 2017 St. Patrick’s Day Parade in New York City, induction into the Irish America Hall of Fame, the 2012 B’nai B’rith National Healthcare Award, the Ellis Island Medal of Honor, the 2011 Gail L. Warden Leadership Excellence Award from the National Center for Healthcare Leadership, and the 2011 CEO Information Technology Award from Modern Healthcare magazine and the Healthcare Information and Management Systems Society.
In 2020, Dowling received the Deming Cup from the Columbia School of Business and was ranked No. 2 on Modern Healthcare’s list of the 100 Most Influential People in Healthcare, his highest ranking in 13 years appearing on the list. Additional awards include the National Human Relations Award from the American Jewish Committee, the Distinguished Public Service Award from the State University of New York’s Nelson A. Rockefeller College of Public Affairs and Policy, an Outstanding Public Service Award from the Mental Health Association of New York State, an Outstanding Public Service Award from the Mental Health Association of Nassau County, the Alfred E. Smith Award from the American Society for Public Administration, and the Gold Medal from the American Irish Historical Society. He was also ranked No. 44 among large company CEOs in the U.S. and was the nation’s top-ranking health care/hospital CEO on Glassdoor’s Top CEOs in 2019 list.
Michael Dowling is one of health care’s most influential voices, taking a stand on societal issues, such as gun violence and immigration, that many health system CEOs shy away from. As president and CEO of Northwell Health, he leads a clinical, academic, and research enterprise with a workforce of more than 75,000 and annual revenue of $14 billion. Northwell is the largest health care provider and private employer in New York State, caring for more than two million people annually through a vast network of more than 830 outpatient facilities, including 220 primary care practices, 52 urgent care centers, home care, rehabilitation, and end-of-life programs, and 23 hospitals.
Northwell also pursues pioneering research at the Feinstein Institutes for Medical Research and a visionary approach to medical education highlighted by the Zucker School of Medicine, the Hofstra Northwell School of Nursing and Physician Assistant Studies, and one of the nation’s largest medical residency and fellowship programs.
Meet the Author
Michael Dowling looks at every event in life as an opportunity to gain new understanding of the world around him, and how he can use that knowledge to better care for the population Northwell serves. In his book, Leading Through a Pandemic, Dowling discusses in detail the importance of being prepared to combat future pandemics. He outlines the “Thirteen Steps to Prepare for Current and Future Viral Threats”:
1. Plan ahead.
2. Build an emergency management culture.
3. Commit to regulatory flexibility.
4. Immediately address inequities in access to care.
5. Protect the physical and emotional health of staff.
6. Recognize the benefits of integrated health systems in a crisis.
7. Partner with government, other health systems, and community groups.
8. Reverse America’s cultural disrespect for science.
9. Develop leadership at every level of the organization.
10. Accelerate the movement to virtual care.
11. Educate the public.
12. Increase focus on safety measures in congregate settings.
13. Commit to creating a new normal.
“We believe that these thirteen prescriptive steps, if taken seriously, will save lives,” writes Dowling. “On their own, these actions are powerful; taken together they have the potential to transform our collective ability to fight future pandemics.”
So, what did we learn from the COVID-19 pandemic? Dowling identifies several lessons:
1. “Bad things will happen—of this there is no doubt—and in order to care for patients, our absolute number one priority must be protecting the physical and emotional health of our staff, as well as ensuring their safety,” Dowling writes. He continues, “We also reaffirmed our belief that an emergency management capability should be a core competence of every health system. Preparation rests upon creating a culture where emergency teams are valued and respected throughout the organization, and where emergency management departments are as essential to the organization as departments of cardiology or oncology.”
2. “We learned that an emergency preparedness culture gives leaders the confidence to change and improve in the midst of chaos” and that “the importance of relationships with vendors is magnified in a crisis.”
3. We learned “that vendor relationships nurtured over time prove far more durable than purely transactional relationships. We learned how to expand our inpatient capacity far beyond what we had ever believed possible.”
4. “We learned the remarkable morale-boosting power of leaders going to the front lines to be present with the troops, to support them and to try in some way to help calm their fears.”
5. “We learned that low-income and minority neighborhoods were particularly vulnerable to the virus, further highlighting persistent inequities in access to care and health outcomes.”
6. “We learned the power of an integrated health system. In the pandemic crisis, the scale, adaptability, and integrated nature of our organization saved lives. Large, integrated medical systems have been much maligned in recent years, but after this experience that attitude may soften.”
7. “We learned that by integrating research into the emergency response we could perform clinical trials even during a crisis, producing data to benefit the entire world.”
8. “We learned that acceptance of telehealth by patients and providers is growing because of its convenience and effectiveness.”
9. “We learned—or, rather, our belief was reaffirmed—that the major insurance companies are more interested in profits than people’s health.”
10. “We learned that stripped-down regulations gave us invaluable flexibility to perform quickly and effectively, that we can handle a major crisis and not buckle under its assault, and that we can collaborate well with competing health systems.”
11. “Our belief that politics has no place in the world of science was reaffirmed. We learned what it was like to be in the epicenter of a global pandemic.” From the beginning of the pandemic in March 2020 through April 1, 2021, Northwell treated more than 190,000 COVID-19 patients, including 31,324 who were hospitalized. “Tragically,” Dowling said, “we lost twenty of our beloved fellow Northwell employees to the virus.”
12. And, possibly most soberingly, we learned that, when there was a resurgence of the virus in parts of the country last summer, another surge after the Christmas holidays, and, more recently, yet another surge after spring break, “we were reminded of the harsh reality that the coronavirus will be with us for at least the foreseeable future.”