SUNY Upstate President David Smith takes

aggressive, proactive approach to managing

By Lou Sorendo

“Ain’t No Mountain High Enough” …

That popular 1960s rhythm and blues song could very well be the mantra for David R. Smith, a pediatrician by training and the president of SUNY Upstate Medical University in Syracuse.

Smith, despite being faced with many seemingly insurmountable obstacles, is slowly but surely maintaining SUNY Upstate’s role as a key player on Central New York’s economic and healthcare scene.

And he is using moxie to do it.

Combining courage with inventiveness, the sixth president of Upstate is in his fourth year of steering Upstate through a maze of problematic issues.

SUNY Upstate is the only academic medical university in the Central New York region, with about 7,200 employees, four colleges, its own University Hospital, and close to a $1 billion operating budget. It’s the area’s largest employer.

Beyond today’s complex problems such as recession, a looming physician and nursing shortage, and much needed healthcare reform, Smith has the background and drive to deal with each problem in a successful manner.

He wouldn’t have it any other way.

The trigger—Smith characterizes his healthcare career as a calling.

He said one of the most compelling events in his life that galvanized him in that direction was his maternal grandfather’s struggle with laryngeal cancer.

“It was particularly difficult because we were very close,” said Smith, noting his grandfather worked in a steel mill in eastern Ohio.

He was a pipe smoker, and developed cancer in the 1960s. “It was a very traumatic event for the entire family to see him go through that,” he said.

He eventually lost his voice box and was unable to communicate.

“He used to slap me on the back and call me ‘partner,’” Smith recalls. “I remember the last time I saw in the hospital, I came up to him, slapped him on the back and called him ‘partner.’”

“At that time it really began to cause me to think about what my career was about,” he said.

In addition, Smith volunteered extensively at a hospital during high school, which further solidified his interest in health care.

“I think later on, your career gets ratified by a number of things, which is unique in my case being that we were National Health Service Corps doctors in Brownsville, Texas,” he said.

His mom was a nutritionist. “There was a clear appreciation for the healing arts and health care in general in our home,” he said.

Smith said that while he is a top administrator, he is also a pediatrician. He enjoys the day-to-day interaction with people, and applying insights of individuals that become part of a broader strategy moving forward.

“It’s exciting to be a student of people,” he said.

He also enjoys the relevance of what Upstate accomplishes.

“It can be the ambulance that pulls up, the diabetic patient going to the Joslin Center, or taking an elderly person at the Oasis Center and keeping them engaged in life and activities, and it changes every day. There is nothing boring or dull about this job. It’s different every day and I learn from it,” he said.

“I can sit in at a lecture of a Nobel laureate or hear one of our incredible alum talk about the latest intervention in cardiac disease, or students talking about transformations in their lives. I get so fulfilled in so many ways because we are so diverse,” he said.

“Then I can run up to Fort Drum, where we are doing more work including mental health [care] and traumatic brain injuries, and see the impact our psychiatrists are having at Good Samaritan Hospital,” he said. “It gives you goose bumps.”

“Here we are reaching out to a dedicated group of individuals—almost 20,000 soldiers and 18,000 dependents—and making a difference in the North Country. That’s exciting,” he added.

Dealing with stress—Taking on a job that has the magnitude of his certainly carries with it a dose of stress.
“You try not to over-personalize the challenges, but you do have to intercalate them,” he said.

Smith said he would be worried about himself if he “weren’t concerned about things” or if he “didn’t wake up in the middle of the night to either break something down or pace the hallways.”

“I can’t say it’s healthy, but I would be worried about a CEO that didn’t do that,” he said.

He said in medicine, it’s imperative to place prevention first and put systems and people in a position to prevent challenges.

“You can’t anticipate everything,” he concedes.

Smith said most of his stress comes from the personal side of management.

“It isn’t about a problem in a building or a lab, we get those all the time,” he said. “I think invariably, it’s either the personal need of a patient, student of faculty member. It’s not having quite the right number of faculty to meet the incredible shortage of nurses in the state.”

People ask, “What are you going to do about it, Dr. Smith?’ That does create stress.”

“A big stress is the budget. I’ve been in public higher education and commissioner of health for a state, but it’s different because of the relentless nature of the cuts,” he said.

Smith said Upstate is also going to absorb cuts from Washington, including slashed Medicare reimbursements.

“What has helped me is doing it a while and having a really strong team,” Smith said.

“You can quickly sit down in a room and get the best ideas from some incredibly bright people and diffuse the challenges and opportunities of stress,” he said.

“If you are solely relying on yourself, which is obviously a little bit too egocentric, you’re going to feel all of that and probably won’t make the right decisions,” he noted.

How does Smith de-stress?—Smith said family time is a “great way” to de-stress. His children are in the area and his wife Donna Bacchia takes on several roles at SUNY Upstate, including being a fellow pediatrician.
Much of his family time is spent in the great outdoors.

“The No. 1 stress relief for me is water, fishing and outdoors,” said Smith, who is not afraid to strap on water skis.

The Smiths have a camp near the Thousand Islands. “It’s a good way to allow your mind to wander,” he said.
“Even when you are not there, it’s sometimes good to let your mind wander there,” he said.

One of Smith’s colleagues on the lake has a Web cam. “For some strange reason, it’s pointed to my island,” he said.

“At any time during the day, I can actually see my island at any given moment,” he said. “That’s sort of an interesting diversion.”

“I love to fish and hunt and like the outdoors,” he said.

Prior to his appointment at SUNY Upstate, Smith served as chancellor of Texas Tech University from 2001 to 2006.

In fact, basketball coaching great Bobby Knight—known for his fiery demeanor—had a highly publicized argument with Smith in 2004 at a Lubbock grocery store. Knight coached the Texas Tech men’s basketball team at that time.

Smith said he enjoyed coming back to Central New York with its natural beauty, water and distinct seasons.
“I’m a Northern guy,” he said.

“I knew this job and the geography of this area were going to be a better alignment,” he said. “I selected this position as much because of the area and people. Generally, these positions select you and you have to move.”

“This was the first time where I saw alignment between some of the things I value very much—family time, outdoors, water, lakes, boats, water skiing,” he said.

Smith said he also works out, but not as much during the summer as he seeks opportunities to get to the water.

While he is swimming or water skiing in the warmer months, he takes to the snowshoes and downhill skis in the winter.

‘Foodie’ at heart—Smith also characterizes himself as a “foodie.”

He, along with his wife, join Syracuse University Chancellor Nancy Cantor and her husband Steve and visit different restaurants every two or three months.

“We try to get out and pick a new restaurant and do a little foodie thing,” he said.

“I tell people on the health side that when you’ve been in senior management for a while, your DNA doesn’t repair quite as quickly as it used to. You had better figure out what you’re going to do to flex some of that,” he said.

After his summer camp closes for the season, Smith heads back to Fitness Forum.

He is a hockey player as well, and participates in a three-day annual hockey tournament in Canada along with several of his cousins and friends from Quebec.

Smith lived in Toronto—a hockey hot bed—for 10 years, and former Boston Bruins hockey great Bobby Orr is a close friend of the family.

He works out at the Fitness Forum to aerobicize and develop muscle tone for his skiing and hockey endeavors.

He’ll hit the stationary bike for about 30 minutes, and then work the Stairmaster for another 10. He then lifts weights, working on various muscle groups on alternating days.

“It’s got to a point where I’m doing more reps than heavy weight because of my age,” he said.

Smith was diagnosed about a year ago as being allergic to wheat and gluten.

“I’m pretty good about avoiding wheat products. It’s challenging,” he said.

He noted that more restaurants are cognizant of the fact that about 6 million people face the same circumstance.

His daughter, Jocelyn, is a chef who graduated from The Culinary Institute of America and is presently enrolled at the Cornell School of Hotel Administration.

“She’s also gluten intolerant, and we love it when she visits and cooks,” he said.

Smith has discovered ways to deal with his allergy.

He has discovered as a lover of pasta, there are many types that are made with different kinds of flour other than wheat.

“You can even do neat things like marinara sauce on spaghetti squash, which is an incredibly healthy meal,” he said.

He also opts for soy milk and watches his lactose intake, a measure which has resulted in Smith dropping 12 pounds over the past year.

The family also enjoys game meat, but often opts for lean products such as chicken and fish.

The Smiths have also formed a co-op with an Amish farmer and enjoy the wide variety of vegetables that are offered on a seasonal basis.

Smith said his energy level and mental status both benefit from adhering to a diet and workout regimen.
“I believe in a holistic approach to healthcare,” Smith said.

Smith was involved in a project that resulted in Bill Moyers’ book, “Healing and the Mind.”

“There’s very much an incredible mind-body connection and obviously nutrition and exercise are a part of that,” he said.

Smith conceded that he is a “little more negligent than his wife, who is phenomenally committed in this area. She is a pediatrician and nutritionist, which is a good combination to have.”

His wife is also director of the Central New York Master of Public Health program.

“It’s good to have her as an influence, because she walks the talk every day,” he said.

Healthy marriage—The Smiths met at Cornell University while they were undergraduates there. They have been married for 32 years.

“We actually knew each other before either of us were physicians,” he said. “I was heading that way, while she was doing a master’s in nutrition and applied to medical school after that.”

“It’s a great balance in life. We have a diversity of interests as well,” he said.

“She’s really incredibly astute and brings a different set of talents to the table than I do,” he noted.

“She brings all those assets and a lot of energy and commitment, and I think that’s been great,” he said.
“We’re both pediatricians, but our kids didn’t have a chance,” he said with a chuckle.

If there was any downside to being married to a fellow physician, it was that the Smith’s first child, Chris, got to watch his parents experience residency.

“He occasionally had to sleep at someone else’s house,” he said.

Chris, however, has become “incredibly connected” to the area, his dad remarked, and wanted to come back to be closer to family.

“That’s a great ratification of it,” he said.

Despite sharing a profession for many years, the couple avoids talking shop.

“The big benefit for me relative to this job is we don’t talk business very much,” he said.

Bacchia has also artfully guided Smith through his dietary restrictions experienced in the last year.

“I’d be better off at home very night cooking dinner together,” said Smith, who notes that his activities often force him to eat out.

“She’s a good therapeutic counselor for me in that regard,” he said.

What’s down the line?—Retirement is certainly many moons away for Smith, and he is unsure as to how he will spend his golden years.

“I’ll be doing this for a while. I really don’t have any other plans. People often ask if there is another rodeo somewhere because I was in Texas a lot,” he said. “I don’t see that.”

“Because of the alignment of the area, this is as close to home as I’ve ever been. That feels good,” he said.
“More likely, I’ll be engaged in academic higher education, probably here,” he said. “I’ll probably be moving to some of the advocacy and broader health policy issues that we continue to face.”

Smith said he can foresee making a transition from direct management to some of the other policy arena issues that Albany and Washington tackle, particularly in the areas of child and public health.

“My other passion, having been a commissioner of health, is probably getting back and even doing some teaching and things in that regard. That is another significant part of what gets me jazzed at the end of the day,” he said.