Wed. Jun 19th, 2024

In 1994, Dr. Michel Cohen, a 35-year-old Moroccan-French émigré, opened Tribeca Pediatrics in a storefront on Harrison Street in Manhattan’s TriBeCa neighborhood.

Dr. Cohen had tousled brown hair and wore thick-framed eyeglasses and clothes by brands such as Commes des Garcons, Paul Smith and A.P.C. He rode around the neighborhood on a bicycle and made house calls to newborns and their vulnerable parents, as if TriBeCa were a quaint village and he a country doctor.

Rather than a sterile medical building, Tribeca Pediatrics’s street-level office was actually the front half of Dr. Cohen’s loft apartment, where he lived with his artist wife, Jeannie Weissglass, and three young daughters, who would run in and out while he saw patients.

Cheery and bright, with vintage wallpaper from Secondhand Rose and toys in the waiting area, the practice was “low intervention,” the phrase Dr. Cohen used to describe his approach to medicine. He prescribed antibiotics to children only when he deemed it absolutely necessary, and, controversially, recommended sleep training babies — that is, letting them cry through the night without soothing — at 16 weeks (he later shortened the threshold to 8 weeks).

In the bourgeois, bohemian circles of Lower Manhattan, Dr. Cohen became a local celebrity. He appeared in GQ magazine, published a book, “The New Basics: A to Z Baby & Child Care for the Modern Parent,” and treated the offspring of fashion-world and Hollywood notables like Annie Leibovitz and Jennifer Connelly.

“I was known as a revolutionary hippie doctor,” Dr. Cohen said recently. “And also because of the way I dressed, and my kids, a little bit more funky.”

Today, Tribeca Pediatrics remains innovative, though for a different reason. It has taken the model of the quirky, neighborhood pediatrician who knows your child personally and made it into a replicable, exportable aesthetic — one that embodies the sophistication of living in an exclusive, wealthy urban area like Tribeca.

Now, wherever you are in the city, you are sure to encounter a Tribeca Pediatrics office or a storefront sign proclaiming one coming soon.

Last year, the practice opened 12 new offices, including in areas that are typically not considered gentrified, like Morris Park in the Bronx and Rahway, N.J. Five more are planned for 2024, including the first Tribeca Pediatrics branch on Long Island. It currently operates 48 offices in New York and its suburbs, employing around 400 people, including 112 doctors and nurse practitioners, who treat more than 100,000 patients (including my two sons before my family left the city).

Each location features the company’s trademark design elements: open picture windows; whimsical plywood furniture; bright, contrasting colors; and a blue logo of a curved line meant to evoke a child being cradled.

Meanwhile, Dr. Cohen stopped practicing medicine in 2020 and no longer sees patients. Instead, he now oversees the design and construction of the ever-multiplying offices.

“I promote the big picture,” Dr. Cohen said. “The communication with the office and the building. I attach so much importance to the branding and environment.”

In a city where health care often means faceless corporate medicine (see: CityMD), Tribeca Pediatrics has built a recognizable, trendy brand. But as it expands into a vast empire, is it at risk of losing its personal touch?

With its expansion, Tribeca Pediatrics aims to make medical treatment for your child as seamless and convenient as calling an Uber. In 2020, the company built a digital portal that allows parents to schedule a visit, request a school form and ask questions about a child’s symptoms or medications, all without ever picking up the phone or waiting on hold.

From the start, the practice has understood that for busy working parents a sick child can cause not merely a crisis of health but one of scheduling.

“It’s Sunday night and your daughter says, ‘My ear hurts,’” said Charlotte Blank, 40, the U.S. chief marketing officer in North America for Jaguar Land Rover, setting up a familiar and dreaded scenario. “So you go on to the portal and they have an appointment the next day at 8 a.m. It’s such a relief. Rather than, ‘Which of us is going to have to ruin our day tomorrow?’”

Ms. Blank and her husband needed a pediatrician when they relocated back to the New York area from the Midwest with their two young daughters in 2022. The couple chose the Tribeca Pediatrics office in Ardsley, a village in Westchester County, and enrolled online.

For Teddy Wayne, a novelist and the father of two, the appeal of Tribeca Pediatrics was its omnipresence: Wherever he and his wife lived in the city, there was an office nearby.

“By virtue of their multiple locations, there’s going to be one near you,” Mr. Wayne, 45, said. “A smaller practice wouldn’t have that.”

Sara Hines discovered Tribeca Pediatrics when she was pregnant with her first child and saw a flier for an orientation for new parents at the office in Boerum Hill, close to where she and her husband lived at the time. Many of the doctors, including those Ms. Hines met, were on the younger side or raising children themselves.

“As people who worked in media and tech, the fact that they had a nice office, a digital portal where you could do things and doctors that were reasonably of our generation and understood our lives — this all felt right,” said Ms. Hines, 41.

Another parent, a Brooklyn father of two who asked not to be identified because he was talking critically of his pediatrician, said that he was embarrassed by how well Tribeca Pediatrics nails the urban bobo demographic, down to the organic lollipops in the lobby, especially compared with the basic doctor’s office he went to growing up.

“It feels like a Brooklyn retail shop,” the dad said, adding that he had initially wondered, “Oh, are they just spending tons of money on unnecessary frills?”

The focus on image would bother him more, he said, if the care weren’t “totally fine.”

Fifteen years ago, Dr. Cohen woke up to realize that his practice, which had three locations in the city at that point, in TriBeCa, Williamsburg and Boerum Hill, wasn’t making any money. He was $400,000 in debt.

“I couldn’t care less about billing. And I was caught in the celebrity thing a bit,” Dr. Cohen said, referring to the press. (He was also featured in the best-selling book about French-style parenting “Bringing Up Bébé.”)

He continued: “One day I said, ‘No, if I built all this, I now want something that actually has a reality.’ I turned away from this celebrity and focused on my system.”

In turning things around, Dr. Cohen did something unorthodox. He hired Leslie Pennypacker, a bartender he had met at Yaffa Café, a TriBeCa hangout. She was 24 at the time and had dropped out of graduate school after getting pregnant. She was not studying to become a doctor nor did she have experience in health care.

Two months after she was hired, Ms. Pennypacker recalled, Dr. Cohen decided to go surfing in Spain and put her in charge of running the operation, which then had six providers and a full roster of patients. He would often take off on a whim, Ms. Pennypacker said: “He has a wind app. If the wind was good …”

For Ms. Pennypacker, it was “trial by fire,” and she learned quickly. As Dr. Cohen told Crain’s New York Business in 2018, the practice began to “chase every claim relentlessly” to get money from insurers and invest in the business.

Dr. Cohen said the push to expand was partly to meet a need for more primary care pediatrics in New York. But it was also a business strategy. “We knew that without having heft, we would not be able to survive as a small private practice” in the city, he said.

Now 41, Ms. Pennypacker is the executive director of the multi-million-dollar medical practice. She helped build the behind-the-scenes infrastructure — including the digital portal and a centralized call center in Lower Manhattan — that allowed Tribeca Pediatrics to scale up.

Most locations require one doctor and two furnished rooms, or two doctors and four rooms. The small size creates a neighborhood feel within a large network, and the uniform design means the staff can move between the various offices when needed. The Band-Aids and lab supplies are stored in the same cabinets in every location.

“Each assistant is assigned a tray of vaccines, like being assigned a cash register in a bar,” Ms. Pennypacker said. “This number of vaccines should have been given to this many kids. You count them at the end of the day.”

When he wasn’t seeing patients, Dr. Cohen was scouting new locations on his bicycle. The same real estate instincts that brought him to TriBeCa in the early 1990s led him to Jersey City in 2011 (today the largest and busiest office in the network); Harlem and Bay Ridge in 2014; and East New York in 2022.

Dr. Cohen has also become a developer, buying land and building new offices himself, including a building in Staten Island with a facade made to look like giant Lego bricks.

“I don’t know that it’s a good investment for Michel,” Ms. Pennypacker admitted. “I don’t even know if he cares. He just likes building and creating stuff.”

Contrary to appearances, however, Tribeca Pediatrics is not a universally exportable brand. A foray into Southern California in 2013, with offices in Marina del Rey and Silver Lake, didn’t work logistically given the time difference and the centralized call center based on the East Coast.

The “Tribeca” name and hip design has also hampered the expansion into lower-income neighborhoods locally: Some families may get the impression that Tribeca Pediatrics does not accept Medicaid (it does) or doubt that it aspires to be the pediatrician for everyday New Yorkers.

Dr. Wendy Johnson, 56, is a provider in the East New York location, having previously worked in the Williamsburg office. She recalls Dr. Cohen at a staff gathering some years ago, jumping around with a microphone like a hype man, shouting, “Who has the best pediatricians in New York? Tribeca! Who’s opening an office in East New York!”

“I thought, ‘East New York? Is he serious? Half of these people don’t even know where East New York is,’” recalled Dr. Johnson, who lives in the neighborhood.

But true to his word, Dr. Cohen bought a rowhouse on Sutter Avenue and transformed it into a striking, modern, cube-shaped doctor’s office.

“I think some people were not sure what we were,” said Dr. Johnson of the early reaction. “Sometimes people can be hesitant if something appears a little high-end.”

But even within the gentrified, family-friendly neighborhoods of Manhattan and brownstone Brooklyn, there is a counternarrative around Tribeca Pediatrics.

On parenting blogs and at the playground, the scuttlebutt is that Tribeca Pediatrics is cultish; that Dr. Cohen is an anti-vaxxer; that his style is too laissez-faire. (For the record, Dr. Cohen said Tribeca Pediatrics believes in vaccines, although the practice does see patients who are not vaccinated, following the recommendation of the American Academy of Pediatrics.)

The greatest pushback surrounds the topic for which Dr. Cohen is most famous: sleep training. Letting a newborn cry itself to sleep at 8 weeks old is barbaric, some parents say, and they bristle at being told to follow a doctrine.

“My instinct was telling me this is not right. I was, like, ‘No, no, no,’” said Amanda Spain-Perales, 41, of sleep training her child so young. After a few visits at Tribeca Pediatrics, she soon found another pediatrician.

While Tribeca Pediatrics does have a clear philosophy, which can be found in Dr. Cohen’s parenting book and the monthly email newsletters that arrive in parents’ inboxes, many parents say it is not zealously preached.

Sleep matters aside, the rapid growth of Tribeca Pediatrics may be coming at a cost.

One former doctor said that she was given 10 minutes to see patients for sick visits and 20 minutes for well visits at Tribeca Pediatrics, less time than at her current practice. It was good training as a young physician, she said, but the high volume led to burnout.

“I felt like my head was spinning at the end of the day — I was barely forming sentences,” said the doctor, who has since left the city and did not want to be identified speaking critically of her former employer.

There is also a fair degree of staff turnover at the practice. Some young doctors see working there as a steppingstone; others transfer between the many offices.

Dr. Cohen no longer lives in TriBeCa. In 2010, following his nose for real estate, he bought a house in Gowanus, Brooklyn. Two years later, he purchased the house next door, as well as an adjoining parking lot, clearing the land and building what Ms. Pennypacker laughingly called a “Barbie Dreamhouse for a Frenchman.”

The seven-story building has a facade of cement and wood that was inspired by Japanese architecture, Dr. Cohen said, giving a tour on a recent afternoon. The lower levels are large cement-floored workshops devoted to building out the offices.

Dr. Cohen, now 64, lives alone on the top three floors. His personal life is complicated. He and Ms. Weissglass divorced in 2013; he has since fathered three more daughters, including one who lives in the Dominican Republic. He had also remarried, though he is currently separated from his wife, he said.

Dressed in a flannel shirt by the Japanese brand Blue in Green, pants in a loud camouflage pattern and black Blundstone boots, Dr. Cohen had the moneyed-hipster appearance of a successful older artist. His gray hair was artfully mussed, and his glasses were so chunky as to look Brutalist.

Upstairs in his penthouse apartment, which is decorated with funky, inexpensive furniture and features a glassed-in swimming pool on the top level with a view of the Manhattan skyline, Dr. Cohen explained his latest ambition.

He aspires to create a separate nonprofit entity based on the Tribeca Pediatrics model at a national level. The profitable offices would help subsidize care in low-income areas, he said. The rampant growth of his practice locally may be only the beginning.

Indeed, Tribeca Pediatrics has grown so large that, these days, many newer patients are only vaguely aware of its origin story; others don’t know that Dr. Cohen exists.

Lately, the man who used to make house calls on his bicycle has been taking flying lessons. Meanwhile, Tribeca Pediatrics keeps expanding across the city and its suburbs.

Its growth has caused one urban planner to write on Medium that Tribeca Pediatrics now plays a role once symbolized by Starbucks — “the leading predictor” of gentrification, according to Alexander McQuilkin, a senior analyst at the New York City Department of Housing Preservation and Development.

“That a medical practice — unremarkable, unsexy, ubiquitous — should take the mantle seems so unlikely,” Mr. McQuilkin wrote.

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By NAIS

THE NAIS IS OFFICIAL EDITOR ON NAIS NEWS

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