At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.



I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.



I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.


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aligning values among team members helps to guide decision-making even when a team member lacks the immediate input of a supervisor or physician. Weaving these values into our fabric as professionals can guide decisions when no answer is immediately at hand.

There are many patient problems we each face as physicians where the solution is not within a pill, injection, or surgery. National public health conditions such as obesity or addiction cannot be fully treated without addressing larger societal problems, such as our population's diet and activity levels or how physicians address pain. Moreover, our input into the larger political sphere can significantly inform our profession on methods to improve clinical care to our nation.

General Hertling recognizes that healthcare, represented as a group of professionals, faces monumental challenges. When we feel overwhelmed with our decisions as physicians, he leaves us with this quote from actor Will Smith: “I do not have to build a perfect wall today. I just have to lay one perfect brick.”


Hertling M. Growing Physician Leaders:

Empowering Doctors to Improve Our Healthcare. New York, NY, Rosetta Books, 2016

What advice could a retired US General give a doctor, to improve healthcare? I recently read Growing Physician Leaders, by Lieutenant General Mark Hertling, US Army (Ret.). General Hertling, a recent retiree from the US Army, was at one time the commander for US Army Europe and the Seventh Army where he had over 40,000 soldiers under his command. As an Army general charged with the safekeeping of thousands of lives his post-Army experiences provide much to inform physicians about their command roles within the U.S. health system.

Upon his retirement, General Hertling was hired by the Florida Hospital System (FHS) in Orlando to observe the roles physicians occupied in this healthcare system and to provide feedback on how physicians could foster enhanced leadership among FHS physicians. The general learned that FHS physicians felt disenfranchised, voiceless, and unhappy. General Hertling provides a novel perspective on medical leadership based upon his years of empowering soldiers to lead.

Of the 6500 hospitals in the nation, General Hertling notes that less than 4% of them are led by physicians acting as a hospital/system CEO. In spite of the years physicians spend becoming experts in their fields, their medical education does not train them how to lead or to translate their medical expertise into the logistics skills and leadership needed in healthcare. As a result of the disconnection between administering healthcare and the practice of medicine, our nation spends nearly 1 of every 5 dollars of national GDP on healthcare.


General Hertling suggests that physicians step back from their clinical roles and become introspective about their influence as professionals and role models in our society. He parallels the respect and authority that physicians have with that of generals. Society looks up to physicians, but as a group we commonly fail to provide sufficient direction to healthcare using a macro-perspective.

A good leader should demonstrate a command in “understanding motivations, influencing people/teams, and communicating purpose and direction…” To refine these skills, General Hertling advocates that physicians use introspection to better understand how they interact with individuals and teams in healthcare. When leaders fail it is often a result of failure to communicate values specific to the organization. As such, in order for leaders to align with their teams, he recommends establishing a core group of values and obtain buy-in from the team members. The Florida Hospital System formalized their values within an easy-to-remember acronym: IC-BEST.

According to General Hertling, values always precede action. In medicine, it is probably impossible to design a decision tree that fully fleshes out the appropriate action for every decision. In the ever-growing team-based model of medical care,

Danesh Mazloomdoost MD, a born and raised Kentuckian, pursued his medical degree and anesthesiology training from Johns Hopkins and subsequently a fellowship in pain manage- ment at MD Anderson Cancer Institute. He is the Medical Director of Pain Management Medicine, a multi-disciplinary practice begun by his family of physicians in the 1990s. Dr. Danesh advocates for a paradigm shift in healthcare to reduce its reliance on opiates. He guides patients through rehabilitative and regenerative techniques in healing the underly- ing causes of pain using translational science and the latest innovations in the field.