Governor Spitzer may be at war with New York’s hospitals over his proposal to cut their state subsidies, but before he was elected to public office and dubbed the “Sheriff of Wall Street” he served on the board of one of the largest medical institutions in the city.

Mr. Spitzer joined the board of trustees at Montefiore Medical Center in 1994, serving there and as chairman of the Mosholu Preservation Corporation, a nonprofit the hospital set up to revitalize the dilapidated Bronx neighborhood surrounding the hospital.

Mr. Spitzer spent four years at Montefiore, the third-largest teaching hospital in the country, before he was elected as attorney general in 1998 and became defined as a crusader. Several people with knowledge of how the board works said it is difficult to have any major impact on hospital policy without being there for a long time.

A spokeswoman for Mr. Spitzer, Christine Anderson, said via email that Mr. Spitzer did not recall whether he voiced concerns about Medicaid cuts or health care spending while on the board, as he is now doing. She said he remembers his involvement mostly in connection with the preservation corporation.

The CEO of the institution, Dr. Spencer Foreman, declined through a spokesman to comment on Mr. Spitzer’s role on the board. An industry official with knowledge of the governor’s proposals said Montefiore Medical Center stands to lose $16.8 million if the proposals are enacted. Ms. Anderson said, however, that the cut would cost Montefiore about $5 million, or 0.26% of its $1.9 billion operating budget.

Mr. Foreman has expressed concerns about both the state Medicaid cuts and the cuts being proposed by President Bush.

“We now have a national understanding that we are short of both general physicians and specialty physicians for the future, so … if you don’t want to have first-class doctors in 20 years, shut down teaching hospitals,” Dr. Foreman said on WNYC last month.

A one-time chairman of the Montefiore board of trustees, Lawrence Buttenwieser said nobody was pushing for spending cuts in the 1990s, when Mr. Spitzer was on the board.

Asked whether the governor’s current position was a contrast to the time he served at Montefiore, Mr. Buttenwieser, who described himself as a friend and longtime Spitzer supporter, said no.

“I don’t think anybody, either on the board of a hospital or in the high reaches of state government, had this on their mind,” he said. “The game was very different. I bet if you look at Pataki’s agenda this wasn’t on it.”

Ms. Anderson said Mr. Spitzer did not talk to anyone at Montefiore about his current proposal, but noted that his time on the board informed his thinking. Board members at almost all hospitals review internal financial documents and revenue projections that inform them of how major medical centers survive financially.

Beyond his time on the board, Mr. Spitzer has deep ties to Montefiore. His brother, Daniel Spitzer, a neurosurgeon, once served as chief resident there.

In a letter to more than 1,000 hospital board trustees Mr. Spitzer invoked his clout as a “former trustee at a major New York hospital,” a status that could resonate with the group. The letter, which out to many of his former colleagues at Montefiore, attempted to sell his proposal to chop more than $1 billion from the budgets of hospitals and nursing homes.

The letter came in the midst of an advertising campaign that the Greater New York Hospital Association and the powerful health care union, Local 1199, are bankrolling to cast Mr. Spitzer’s proposals as devastating.