As if running one of the biggest academic medical centers in the country wasn’t enough, Spencer Foreman, Montefiore Medical Center’s president since 1986, added dealing with the scourges of graffiti and dumping on area streets to his to-do list early in his tenure.

On his way into work, driving on Webster Avenue alongside Woodlawn Cemetery, Foreman saw dead animals and abandoned cars.

“He’d call me up from the car and say, ‘This is disgusting. You’ve got to do something,'” recalls Dart Westphal, president of Mosholu Preservation Corporation, a nonprofit Montefiore established in 1981 to reverse blight and abandonment in the community.

That was the beginning of MPC’s Gateway’s initiative, which focuses on aesthetic improvements to all the roadways approaching the Medical Center.

It also perfectly encapsulates Foreman’s philosophy that community improvements are a “two-fer” – they benefit the Medical Center and its staff and patients, and also the neighborhood as a whole.

‘Responsibility to improve the world’

“Large successful businesses have a responsibility to improve the world in which they prosper,” Foreman, who is known as “Spike” to most of his colleagues, said in an interview last summer for MPC’s 25th anniversary publication. “Corporate philanthropy, corporate involvement, is very much a part of the great American tradition.”

At the same time, Foreman said, “having a neighborhood which looks good and feels good is very much in the institution’s own best interest. If the place is in good repair, and is orderly, clean and safe, people want to come here. If the neighborhood is a wreck, they don’t.”

It’s why he supported MPC’s efforts to move beyond the renovation of derelict buildings to include graffiti removal as well as the eventual creation of the Jerome-Gun Hill Business Improvement District and the Norwood News.

Foreman’s emphasis on the greater community started early. He was president of Mt. Sinai Medical Center in Baltimore at age 37. Benjamin Cardin, now a U.S. senator from Maryland, was taken with his approach.

“Anytime I talked to him about policy for Sinai Hospital, I always felt he was putting the community first,” Cardin said in a tribute documentary made by the Greater New York Hospital Association. “And he felt that if he could serve the community, the community would be better off and the hospital would be better off.”

Preparing to retire

As Foreman, 70, prepares to retire some time in the next year, Montefiore trustees are busy figuring out how they are going to replace someone who inherited a hospital that was near bankruptcy and turned it into one of the most respected institutions of its kind in the country.

But community leaders who have watched and partnered with Foreman, say he is also leaving some big shoes to fill in the area of community development and hospital-community relations.

When Foreman arrived, those relations had not fully recovered from controversies concerning various hospital construction projects, says Karen Argenti, who served both on MPC’s board and Community Board 7 at the time.

“You couldn’t have a conversation with people in the community because there was no trust, but he allowed that trust to foster,” Argenti said.

On Foreman’s watch, MPC became a bridge between the Medical Center and community residents, Argenti said. He also created an environment that allowed MPC to develop into a respected community organization in its own right.

“Dart became one of the people in the community,” Argenti said, referring to Westphal, the MPC president. “People didn’t look at Dart as the community affairs person [from the hospital]. The looked at him as someone who could help them in whatever it was that they were going to fight and do.”

‘Incredible transformation’

Bill Frey, one of the original organizers of the Northwest Bronx Community and Clergy Coalition who is now an executive with the Enterprise Foundation, agrees with Argenti that Foreman’s community focus has left its mark on the neighborhood.

“It’s just been an incredible transformation, in terms of how Montefiore as a hospital saw itself becoming a good corporate citizen and seeing the benefits of becoming both involved in the local neighborhood as well as working closely with the residents and merchants,” said Frey, who has been on MPC’s board since 1988. “Spike’s leadership was critical in that.”

Frey added that Foreman’s vision beyond Montefiore is unusual for the head of a large corporate institution. “[It was] very different in terms of understanding on how to take … negative aspects of the community and turning them around into community facilities and schools and child care centers,” he said. “All of these were not necessarily directly related to health care but related to the better health of a community.”

Perhaps the clearest sign that Foreman sees MPC’s primary mission as working for the community was its creation of the Norwood News, not the kind of project usually associated with a hospital or even a nonprofit.

Foreman is a champion of the paper and frequently cited its success at ribbon cuttings of MPC projects. He also took pride in its independence.

“From time to time, I get approached by a politician who feels that the paper has published a story that they don’t like, and I always say to them, ‘You should read some of the stuff they write about the hospital,'” Foreman said. “We don’t exercise any editorial control over that paper; that paper should be a community paper, and it should be driven by its own internal imperative. But I believe that as long as that paper exists, it’s a better community.”

Foreman also got behind the creation of a Business Improvement District on Jerome Avenue and Gun Hill Road. MPC manages the BID, which allows property owners to assess themselves a fee in order to provide additional sanitation and security services, and also to remove graffiti.

Foreman is passionate about graffiti.

“In the middle 1980s, when I came, the number one problem for me on the street was graffiti,” he said. “Graffiti is a sure sign that the neighborhood got out of control, that nobody cares, and that it’s unsafe and disorderly.”

Working with neighboring institutions

If one was looking for the tallest monument to Foreman’s focus on the community beyond Montefiore, you could look skyward at the radio tower for WFUV on top of Monte II, an apartment building for Medical Center staff and their families just off Gun Hill Road. Foreman offered the site to Fordham University, solving a decade-long battle between the university, which had begun building the tower on its campus, and its neighbor, the New York Botanical Garden.

Once those institutional tensions were eliminated, all three institutions, and the Bronx Zoo, joined forces on an alliance which has been strategizing and meeting with city officials to discuss shared concerns, like traffic congestion, mass transit, and roadway and parkland improvements in the northwest Bronx.

“Resolving the tower issues set the stage for the four institutions to work together,” said Gregory Long, president of the New York Botanical Garden.

Though this was the first opportunity for Long to work closely with Foreman, Long said he has long admired Montefiore’s role in the community, citing the Children’s Hospital and Montefiore’s satellite doctors’ offices throughout the borough. When Foreman came on board at Montefiore, doctors were leaving the Bronx and hospitals were cutting services, not expanding.

Of course, Foreman’s most significant legacy will be these advances in the provision of health care, but even many of those are rooted in community.

Award named in Foreman’s honor

Citing Montefiore’s community service initiatives such as the nation’s largest School Health Program, the Lead Safe House, 21 community-based primary care sites and the Child Advocacy Center, the Association of American Medical Colleges announced in May that its annual award for community service would be renamed the Spencer Foreman Award for Outstanding Community Service. (Foreman pushed for the establishment of the award.)

Foreman also presided over a remarkable change in Montefiore’s relationship with the community represented by organized labor.

Like the leader of any large institution, Foreman had his disagreements with labor unions. But he also formed an unusually close alliance with the city’s largest healthcare workers union, 1199, even joining in at rallies in Albany for more funding.

“I have relationships with more than 200 hospitals and CEOs across the nation, and what happens at Montefiore is unique – the way that management and labor are integrated to get the best outcomes,” said former 1199 president Dennis Rivera in the Greater New York Hospital Association film. “He has done an amazing job and he did it in the Bronx.”