Why did you become a doctor?  And then a surgical oncologist?

This is such a hard question, although you would think it should be easy.  I think being a doctor is a calling.  We all want to help people, love biology and science, and us surgeons are technically oriented, but it’s more than that. I just can’t imagine doing anything else.  The training is long, rigorous, and expensive.  The job is stressful – especially in surgery, let alone surgical oncology.  I tell students: “if you can imagine doing anything else besides being a doctor, do that.”  I tell med students: “if you can imagine doing anything else besides surgery, do that.” For me, I can’t imagine doing anything else, so I know I made the right choice.

Growing up I was always the kid who took everything apart to dissect its components and then put it back together again.  I also had a tremendous love for biology.  I had a microscope as a young kid and used to put everything possible under the lens.  Friends were playing video games; I was looking at bacteria from the local pond.  I pretty much went to college just to become a doctor – I enjoyed college but just couldn’t wait for medical school.  When anatomy class started, my 3 lab partners asked who wanted to make the first cut, yet I had already grabbed the scalpel and started.  I guess it was clear I was the surgeon in the group even on day one.

“General surgeons have to be good doctors and excellent diagnosticians, and then we apply technical skill to treat disease in real time and see immediate results.”

Once in medical school, I met the best people and knew I made the right choice to be in medicine.  I was so excited to be surrounded by so much talent and so many smart people who were as dedicated as I was.  I knew general surgery was the best choice for my career because the profession defined the very essence of why I became a doctor.  General surgeons have to be good doctors and excellent diagnosticians, and then we apply technical skill to treat disease in real time and see immediate results.  We must know anatomy, physiology, pathology, and critical care, and use this knowledge to select the right patients to have the right surgery at the right time and to the best of our ability.  We then get to care for our patients during the critical recovery process.

I love surgical oncology because it’s the most intense part of general surgery.  I perform very complex surgery and sometimes on very ill patients, so there is no room for error.  I also love working with so many other doctors, as surgical oncology is a very multidisciplinary field.  Cancer treatments are moving at a rapid pace, which is very exciting academically.  I regularly speak with primary care doctors, gastroenterologists, medical oncologists, radiation oncologists, radiologists, cardiologists, critical care doctors and other surgeons.  Surgery and surgical oncology are very rewarding fields but also very humbling.

My profession keeps me honest and makes me appreciate life in general.  I also just love having long term relationships with my patients.  People don’t realize that I follow my patients sometimes for a decade as their cancer specialist.  I get to know my patients and see them through some of the most difficult times of their lives.  Surgical oncology allows me to practice both surgery and oncology, and to provide both acute and longitudinal care.

Have you ever been a patient and what did it teach you?

Being a patient taught me that being sick is scary and very inconvenient.  Nobody wants to be the patient and it disrupts every aspect of your life.

Ironically, I developed cervical disk disease from being a surgeon.  Decades of looking down in the operating room left me with severe nerve compression.  My symptoms got so bad I couldn’t sleep because of the constant burning and pain, my shoulders were crooked, and my arms became numb and weak.  I went from being an avid martial artist and exercising daily to being unable to do one pushup.  Of course, I was also worried about my ability to continue being a surgeon, so a lot was at stake with my disease and surgery.

My operation went well but two days afterwards I could barely move my right arm.  I called the neurosurgeon and could hear the concern in his voice.  I’ve been on the doctor’s side of that phone call – your heart sinks when you wonder if you hurt this person when all you wanted to do was help them.  It’s the worst feeling ever.  Now that I was the patient calling the surgeon, it was eye opening.  I didn’t know what was going on and had no idea what was a normal part of recovery and what wasn’t.  Even though I’m a surgeon, neurosurgery isn’t my expertise.  The neurosurgeon had me come to the office immediately – that really meant a lot to get evaluated and reassured.  The uncertainty of what was happening to me and the helplessness I felt was a lesson for me as to how my patients feel.  Although I was back in the operating room safely performing surgery within a few weeks, it took almost a full year to get all my strength back and resume intense exercising and the activities I love.  Being the patient made me realize it takes a lot longer for patients to truly recover than what we usually say.

What is the most important factor in the doctor patient relationship and why?

Trust, no question.  It’s a two-way street.  I know my patients put their faith in my hands and I don’t take that for granted.  Once a patient makes an appointment with a doctor, they are inherently showing trust.  Perhaps they trust their referring doctor, or what they read online about me, or perhaps a patient of mine referred them.  But nobody makes an appointment to see a doctor unless they have some degree of trust.  I try to build on that trust during the first visit.

My opening comment when I see a patient is, “thank you for coming to see me.”  Many patients are surprised with this kind of hello.  This greeting acknowledges that the patient had a choice, they could have seen somebody else, but they chose to see me.  They trusted me, and I thank them for the opportunity to care for them.  I’m a straight shooter and I like to be transparent and honest, and that helps build trust as well.  As a surgeon, patients need to trust my judgement and technical skills both in and out of the operating room.  I like patients to know that we’re a team and there has to be mutual trust to provide good care.  I also explain I’m trusting them to do certain things before and after surgery as well, and that’s necessary for an optimal outcome.

What are your favorite activities outside of work?

I have been an avid photographer since I was about 12 years old.  Mostly I enjoy landscape photography, and once I had two daughters, I became interested in portrait photography and action photography for all their sporting activities.  Recently I’ve become interested in drone photography and videography and got my drone pilot’s license.  I currently fly the DJI Air 2S and think the camera quality and the drone itself is phenomenal.  Viewing the world from an aerial perspective makes even the most mundane landscape fascinating.  Adding movement to the video provides a totally new dimension, such as filming waves at the beach in slow motion while flying upwards in a spin or doing time lapse photography as clouds go by.  I’m still experimenting with drone photography, but it’s reinvigorated my interest in a lifelong hobby.  Flying the drone also gets me outdoors more and I enjoy many different activities during the four seasons.  I go mountain biking, hiking, skiing, or am at the beach whenever weather permits.

You recently joined the Doctorpedia team as a Founding Medical Partner. What about Doctorpedia resonates with your personal and professional mission?

As a doctor, my goal is to diagnose, treat, and heal patients. Many people don’t know that the word doctor also means teacher. To be a partner in my patient’s healthcare journey, it’s my responsibility to teach them about their diagnosis and treatment. The challenge is that patients have access to a tremendous amount of information online, but most internet searches lead to misinformation, or disorganized information that creates confusion and worry. Many patients arrive at my office in a panic with wrong self-diagnoses or asking for treatments that don’t apply to their disease. For example, if you look up “abdominal pain” on one medical website you may think you have appendicitis, a perforated stomach ulcer or even pancreatic cancer, when in fact you may just be constipated. My challenge personally and professionally is to navigate patients comfortably through this misinformation, yet until Doctorpedia, there hasn’t been a good medium to achieve this goal. Doctorpedia brings together a community of dedicated and accomplished physicians and organizes medical information in a cohesive manner that has never been done before. This provides the most up to date and accurate information in an easy-to-use platform and high quality videos where patients feel like they are talking to the doctor or in a mini classroom learning about their disease. It’s a brilliant design and I’m thrilled to be part of the team.

“As a surgeon, patients need to trust my judgement and technical skills both in and out of the operating room.  I like patients to know that we’re a team and there has to be mutual trust to provide good care.”

What problems do patients and physicians face that Doctorpedia can solve?

Doctorpedia is a medium that is going to enhance the doctor patient relationship by properly educating patients with accurate information.  Information itself is just data, and when data gains some perspective, we call that knowledge.  Once knowledge has real world experience then it becomes wisdom.  Wisdom is not something that can be looked up online.  That’s why doctors aren’t ready to practice after medical school – we have lots of information and some knowledge but without any real-world experience.  Only after years of residency training and years in practice do we become experts in patient care delivery.  The challenge is: how can physicians educate patients and provide this knowledge and wisdom online?  Doctorpedia solves this problem.

Organized disease-based channels, patient journeys, and educational videos are all created by experienced physicians who add the necessary perspective and experience to teach patients what they need to know.  Patients have never had a way to get a doctor’s wisdom online, but with Doctorpedia, now they do!  I look forward to the day when I can send my patients home with a new diagnosis, recommend a series of videos they can watch on Doctorpedia and share with their family, and then we meet again to discuss the next steps.  I only have so much time to meet with patients in person.  Doctorpedia is going to be an extension of the doctor’s office visit and completely enhance the patient experience beyond anything currently available.  Doctorpedia is going to make everybody’s lives better, because every patient is happier when they’re educated and don’t feel helpless.

What are your other roles in healthcare and what do you learn from them?

After finishing almost two decades of college, medical school, residency, and fellowships, I thought I was done with education except for keeping up with new medical literature and techniques.  I was so wrong.  One of my favorite sayings is, “Medicine is a science, healing is an art, but healthcare is a business.”  This is so true, but nobody teaches you any business skills in medical school or even residency.  Similarly, most administrators who run hospitals don’t know how to care for patients, so you can see that there is a problem with this entire process right from the start.

After establishing myself as a physician and surgeon and identifying weaknesses in the system, I realized that to fix some of these healthcare problems I needed to be involved in committees and become a physician leader.  Spending over a decade in private practice taught me a lot about the business aspect of medicine, and simultaneously I accepted other leadership positions, ultimately becoming President of the hospital medical staff and serving on the hospital board of directors.  These experiences were invaluable and allowed me to recognize deficits in my own education that would limit my ability to grow as a healthcare leader.  Taking care of patients and understanding financial statements are very different, but I asked myself: why not do both?  These are the kinds of dual skill sets needed to improve our healthcare system.  I enrolled in physician leadership courses and ultimately in an MBA program to achieve these goals.  There are so many ways to help patients, sometimes it’s helping people one at a time, but there are also opportunities to make system changes that affect entire populations.  This is another reason why I’m so excited about Doctorpedia: I think the platform has the ability to help thousands, hopefully millions of people.