On 'doctoring'

There were myriad factors in my decision nineteen years ago to pursue further training in cosmetic surgery after a decade in head and neck surgical oncology and reconstruction. I can't believe the pathway is entirely foreign to readers of this magazine since so many of us have come to cosmetic surgery from other surgical specialties. But in my deliberations, one of the aspects I was most reluctant to part with—and was most apprehensive about missing—was simply "doctoring" my patients.

INEVITABLE ENDINGS Intense interaction with patients and their families really resonated with me in my early years as a doctor. I actually considered psychiatry in my quest to understand people, life and philosophy, but could not resist the lure of a surgical practice. My personal tipping point came when fate tossed a heavy weight onto the scales. I was touched in a life-changing way by cancer—the very disease I had devoted years to battling. My father-in-law, Sam Phillips, whom I greatly admired, developed prostate cancer and died. He was larger than life—a luminary in the aerospace community who had directed NASA's Apollo Man on the Moon Program. And yet his story ended in the same way as all of ours will eventually.

That was perhaps a final step in my recognition of how thoroughly I was burned out on the demands required of a head and neck surgeon. It was not because of anything relative to cancer surgery itself, but rather the commitment of time and energy. I realized my profession wasn't oriented toward a rational lifestyle for me. I had less and less of me for family, friends, recreation and personal development.

If you look carefully at how we set up our practice and the many hours we spend with people—including people that we don't perform surgery on—I think you would be surprised. I am happy to be a professional in service to my fellow man. And while I make a very good living, I want my primary focus to be patients as human beings.

WHO IS JOHN GALT? Many of you probably share my perception that there is a lot to be concerned about relative to healthcare in America. It has deteriorated in this country. No one is taking care of our patients. We see rampant obesity, unaddressed blood pressure, and very few physicians seem to have time to talk with patients. I do a fair amount of counseling in my cosmetic surgery practice regarding blood pressure and obesity, but I find resistance not only on the part of other physicians to spend time with patients, but also on the part of the patients themselves. They prefer not to take personal responsibility and have been known to explain how they cannot stay out of the sun or stop smoking. As a consequence, politically, healthcare is going to be a phenomenal question in the very immediate future. I do think it will be nationalized and there are issues, both positive and negative, about this prospect. A vast majority of physicians I know, including myself, who at one time would have been vehemently opposed to national healthcare in terms of an Ayn Rand reaction, now feel we almost have to go this route to utilize medical resources effectively—including a physician's time with patients.

DOCTORING LIVES As it turns out, ironically, today my practice is in large part concerned with physical and mental health. It is very much predicated on a philosophical perspective founded in a belief in the human spirit—all within a specialty that fulfills my need for "doctoring" my patients. Establishing a connection—being able to interact with each individual within my own sense of time and timing, I find that I can help them become more comfortable with themselves. And in so doing, surprisingly, I make more of a difference in people's lives now than when I was a head and neck cancer surgeon. I have taken care of more than 1,000 tumor patients in my career. I used to live for that.