Dr. Kester Nedd of Design Neuroscience Center: “Giving women and minorities in healthcare the same kind of attention that others get”

The way we pay for healthcare — we have to shift our payment methods to a model of predictive pricing that utilizes consolidative purchasing (we should buy as a large group rather than as individuals). This will lower the cost per unit and make the drugs and technologies we need more available to a broader base of […]

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The way we pay for healthcare — we have to shift our payment methods to a model of predictive pricing that utilizes consolidative purchasing (we should buy as a large group rather than as individuals). This will lower the cost per unit and make the drugs and technologies we need more available to a broader base of the population.

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Kester Nedd.

Dr. Nedd is a Board-Certified Neurologist, with subspecialty training in Neurological Rehabilitation and Neuro-trauma. He currently serves as the Managing Partner of Design Neuroscience Center, a comprehensive brain injury center involved in the evaluation and treatment of individuals with traumatic brain injury and other neurological disorders. For 25 years, Dr. Nedd served as the Medical Director of Neurological Rehabilitation and Medical Neuro-trauma at Jackson Memorial Hospital’s Ryder Trauma Center. He was also an Associate Professor of Neurology and served as Medical Director of the Sports Concussion Program at the University of Miami Miller School of Medicine until May of 2020.

Dr. Nedd completed his medical training at the Kansas City University of Bioscience and Medicine. He received his postgraduate Neurology and Neurological Rehabilitation training at the University of Miami — Jackson Memorial Health System.

As one of the top specialists in treating concussion and TBI, Dr. Kester Nedd’s approach is transformative. He developed the Brain Hierarchical Evaluation and Treatment (BHET) method, which emphasizes a multidimensional over linear approach. The BHET method considers the hierarchical organization of the brain and how this order is impacted by injury and the recovery process.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

At an early age, my mother gave me this advice: If you want to be successful in something, you must choose an area/business or a profession that most people find difficult or hard to pursue, where there are only a few persons with knowledge of the field (limited talent) and there is an intense need in the world for such profession, service or business. Neuroscience and to be more specific, traumatic brain injury (TBI) and concussion fit well within the parameters of my mother’s advice.

In my initial years of neurology training, I found that for most of the patients that we saw, we were able to diagnose but in many cases we had little idea of how to actually treat and cure their diseases. To make a not so good situation worse, in my current area of special interest, concussion and traumatic brain injury, at that time there were only a few training programs for professionals and very few professionals were involved in treating this condition. Following my training in neurology and upon completing my fellowship training in neurological rehabilitation and neurological trauma at the University of Miami-Jackson Health Systems, I became the director of the program. Given the limited talent available in the industry for this specialty and subspecialty, very early in my career, I became the go-to person for the evaluation and management of patients with TBI/Concussion. Being one of only a few persons with this opportunity, to manage a large program with a well-established and well known trauma center (Ryder Trauma Center), I was able to evaluate and treat patients with this condition from the time that they entered into the system of care, through the ICU, rehabilitation and in the post-acute period. I had the opportunity to participate in patient care at all stages following injury and to understand the natural history of the disease. This afforded me the opportunity to develop novel ways of diagnosing and treating this condition. Over the years, I have had well over 250,000 patient encounters with patient’s suffering from neurotrauma, a number that not many would have an opportunity to evaluate and treat in their lifetime.

Can you share the most interesting story that happened to you since you began leading your company?

My most interesting story is about surviving the changes that accompany growth. I learned an important lesson of growth and change, when my company experienced rapid growth and the team that started with me was not prepared to take the company to the next level. Bringing in a new team to integrate with the original team to meet the demands of such growth was not as easy as it seems and not having a clear understanding of how to transition was costly. When I first started leading this company, the original founders and teammates were extremely devoted. We were able to achieve all the goals we set and even exceed them. We kept on growing and when we got to a certain size, we required more structure. The company had to transition by bringing in new leadership. As an inexperienced CEO that was attempting to appease everyone, I was not able to manage the conflicts that ensued between the original staff and management and the new talent that was brought in. On both sides, there was a sense of fear and apprehension. The new talent basically profiled themselves as the “agents of change” while the original teammates saw themselves as the “pillars of concepts” that made the company successful.

Conflicts between the two sides caused me, as the CEO, to shift my role in driving the growth of the company towards stabilization of the personnel. We could not move forward without creating an environment of peace where people could work together. The protectionist philosophy created by both factions of the company did not allow for free flow of ideas and resulted in a significant decline in the business and service levels. Internal fights, gossip, and arguments became the order of the day. Furthermore, as the CEO, I had to learn how to make decisions more on the people side of the business, over the operations, business development, and marketing; in order to preserve what we had. Every aspect of the company’s function was under fire. I had to create a decision strategy to allow for the survival of the company over the individual. Learning to operate under these conditions utilizing certain decision strategies was the only way to preserve the company to survive during this period. So I learned that even though I saw people as the most important asset of the company, I had to prioritize the needs of the company over certain individuals. I will never forget what one of my board members told me in this regard “a company is a selfish entity; it must be selfish to survive”. I also learned that critical to the success or failure of any company is a sense of loyalty and trust on the part of the team. This tied with a sense of accomplishment and incentives can help to sustain and advance a company. In the end, what makes this experience my most interesting story, is that the company lived through it, but at a cost to everybody. We ended up having to downsize to a state that was manageable. We were able to maintain the necessary financial stability and build the company back in a better state.

I have learned that great concepts, business plans, processes, and vetted opportunities must be matched by a well balanced, mature, passionate and dedicated team that is able to put the company’s needs first. Without this a company or project can be easily hijacked in their efforts to be sustainable and grow.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

One funny mistake I made was mixing up two presentations and giving the wrong presentation to an audience. On a particular day I was supposed to give two different presentations to two different audiences. The first was on “how to optimize brain function in business”, which my assistant helped me prepare. The second talk was on “what happens when the brain ages”. My assistant accidently loaded up the wrong topic. I was halfway through the presentation, talking about the aging brain, when the conference moderator raised his hand and said “this is quite a depressing topic, considering you should be giving us hope” and that’s when I realized I was giving the wrong presentation to the group that I was to speak about the positive attributes of a proper functioning brain in business! It was very embarrassing, but I definitely learned that you should not entirely depend upon your staff for all activities but you should at times check yourself. I also learned that you should also double check your topic before giving a talk and to be better in touch with your audience!

What do you think makes your company stand out? Can you share a story?

We have a versatile team that is able to respond dynamically to change. We meet a need that many others do not by offering a unique approach to the evaluation and treatment of traumatic brain injury/concussion and other neurological disorders.

We have a team of highly competent professionals that work well together to serve the brain injury community. We have become the go-to team in our community to evaluate and treat persons with traumatic brain injury and concussions. We have been especially known to resolve problems that others are not able to solve and to manage the most complex cases. This was made possible given our unique approach to the evaluation and treatment of persons with TBI/Concussions.

An executive of a billion-dollar company had a simple slip and fall on a wet pool deck and impacted the back of his head. He experienced dizziness and headaches but didn’t immediately seek medical attention. Over a period of several months, he and others around him, realized he was not no longer the same person. Outside of having trouble sleeping, headaches, vertigo, and losing his temper, he thought everything was going okay. This was until the board of directors of his company asked him to take a leave of absence, to get emotional help. Over the course of the next two years, he saw 4 psychiatrics, 3 neurologists, and multiple psychologists, all because he was given a diagnosis of bipolar disorder. He was treated with medical therapies and medications that had extreme negative effects that did not allow him to function in his job and caused significant breakdown in his personal, professional, and family life. One of his colleagues, who knew of my practice and reputation from treating his wife with a similar condition, called me one day and explained the story of the executive. I then evaluated the executive, and I was able to make the link between the troubles that he was experiencing and the fall on the pool deck two years prior, something that none of the prior clinicians were able to make. He was diagnosed as having a bipolar disorder due to his many symptoms, but his condition was due to the effects of a traumatic cerebral concussion. My team and I set up a new treatment protocol that resolved most of his signs and symptoms, which allowed him to recover to the point that he was able to return to his company in his prior position as an executive and restore his family relationships. Our program and clinic systems, provide a unique approach to the evaluation and treatment of TBI/Concussion, and we have a clear understanding that many persons that presents with traditional psychiatric, psychological and medical illnesses may have suffered a concussion or TBI that often goes undiscovered by many in our profession. This situation lead to inappropriate diagnosis and treatment that made a bad situation worse. This is an example of how our clinic is able to offer a service and an approach that is not common in neuroscience.

What advice would you give to other healthcare leaders to help their team to thrive?

  • Know how to build a team.
  • Important that leaders know how to keep their ego in check.
  • Leaders must have an understanding as to the importance of the company’s needs over their own needs.
  • Give credit when due and look out for everyone’s interest, not just your own.
  • Have a passion for what you are doing and making certain that such enthusiasm and passion is felt by everybody on your team. Your passion will stimulate others to have the same passion.
  • Leaders must be able to give hope in times when others are not able to see hope.
  • Be open to the wisdom of others, even if they are critical of your methods.
  • Embrace change when it comes and take calculated risks.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

1. The healthcare industry is driven by profits and not enough by compassion. Customer satisfaction in health care is what will allow the system to be sustainable.

2. While I believe in capitalism as a model for economic growth and development in any country’s health care system, the US health care system has a strong element of narcissism that must be curbed in order to advance. Narcissism as a construct, where each person is for themselves, permeates in the US health care system brand of capitalism. The idea of “I care about myself and not so much of others” resonates throughout. The policies in healthcare are structured in a dichotomous way. Such narcissism is manifested by a double very divided system and standards of care-between the “haves’ and the “have not’s”. This system and standard of care is made evident at all levels and is compounded by issues of race, socioeconomic status, gender and education. If properly constructed, the idea of a balanced health care system of shared and consolidated resources that is value based will allow for sustainability and growth.

3. The disproportionate rising cost of new and innovative treatments makes such treatments not available to the masses. The concept of health care patents providing for price protection on newly developed drug, technology and health care products to protect investors involved in paying for such development, has resulted in the very high introductory cost of novel and important treatments for many diseases in health care. Payment for these high introductory costs of these new and innovative health technologies, products and services are not sustainable in the current health care financing models that pay for health care. As a result, the most advanced technology and treatments are only made available to a small (rich) population rather than to the people who need it most. Fundamental changes are needed at all levels to address this complex issue including health care systems, business, finance and government.

4. Outside of the government funding programs of Medicaid and Medicare, the financing of the US healthcare system is primarily focused on group health (employer-based funding, rather than on individual or on population health based funding). Despite recent changes that strengthen payment systems to enhance individual and family participation in the payments (insurance) systems; there is still a strong bias towards the less risky proposition of employer-group funding options. Despite the limited benefits, programs like Obama Care now offer coverage for all including those with preexisting conditions. Models that combine and consolidate group and individual funding methods work best in keeping cost down and allowing for better benefits and health outcomes. These hybrid models constitute what has now become known as population health models. Population health focus is one is value-based health care system that is outcomes based and ultimately impacts the individual health positively.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

1.) The way we pay for healthcare — we have to shift our payment methods to a model of predictive pricing that utilizes consolidative purchasing (we should buy as a large group rather than as individuals). This will lower the cost per unit and make the drugs and technologies we need more available to a broader base of the population.

My company treats international patients who self-pay for their healthcare. I once had an overseas patient with Guillain-Barre Syndrome (an autoimmune disorder, where the immune system attacks the nerves and causes inflammation). To treat this condition, we utilized pooled immunoglobulins obtained from the blood collected from multiple individuals, a treatment know as Intravenous immunoglobulin (IVIG). This medical product is quite expensive due to the cost of acquisition and the many processes of purification that the product must go through. We were rather disturbed when we found that the price we would pay for the same product was radically different between two of the nearby hospital systems. Hospital A which had 1400 beds charged 10,000 dollars per vial for each dose of the medication, understanding that the patient needed 7 vials. Hospital B which was part of an over 40,000 bed health care corporation charged 5 times less per vial (2000 dollars) for the same medication. It was clear to us that hospital B was able to deliver the medication at a much lower cost compared to hospital A due to their significant purchasing power based on volume. The US health care system must utilize creative methods to organize around consolidated purchasing and health care delivery to lower health care cost. This will allow for more health care services to be made available to the masses and yet allow investors to benefit from lower prices but higher sales volume. In my opinion, there is an inherent fear associated with this kind of change from lower volume sales with much higher price tags to higher volumes with lower price.

2. ) Shift the US health care system from a hierarchically based system to a more diverse system to where executive skills are emphasized just as much as academic preparation. There’s an inherent bias in our health care system to where we hierarchically base people’s value solely on academic achievements and less so on their executive skills (ability to make sensible decisions and policy). To overall improve the healthcare system, the focus needs to include the value of academics with the value of executive skills. I’ve noticed that the concept of “being bright” is often associated with where you graduated from and not necessarily on one’s ability to effectuate change and to operate in a system that truly works. Our system of advancement should include an increase in its emphasis on talent, experience, and track records while continuing to value academics. There is the need to shift our systems where health care professionals must learn more critical thinking skills to where decisions are made through analytics from experience and data collected, rather than solely upon such common standardized values.

I once had a resident (A) who graduated from an ivy league medical school with top grades. He was well published, highly respected, and had an incredible fund of knowledge in neurosciences. I had a second resident (B) who had a high degree of sensitivity towards the needs of others, and had tremendous insight into human behavior. However, he attended a foreign medical school that did not have the image and cloud that resident A’s school had. I recall a situation where a patient in the ICU had a tracheostomy tube accidentally pulled out, while in the MRI Scan machine. The patient had significant difficulties breathing (since the tube was removed) resulting in a violent panic attack. Resident A was at the scene and despite his vast knowledge, could not understand why this patient was having a panic attack. He failed to realize the imminent danger that the situation posed, as the patient became extremely confused, violent and could not breathe. He tried without success to reinsert the tube, but the agitation and aggression of the patient prevented the tube from being reinserted. Resident A, himself experienced a panic attack because the situation was out of his control. By coincidence, resident B was next door assisting with another patient, and heard the commotion going on in the other room. He promptly made himself available and made the executive decision to completely paralyze the patient with an IV medication in order to first control the patient’s situation of anxiety and aggression to where the tube could be safely reinserted. This measure was successful and the patient’s life was spared. In reviewing this situation I found that irrespective of either doctors’ education, the ability to make critical decisions during times of emergency required certain executive skills and emotional balance, which is just as important as the academic preparation.

3.) Giving women and minorities in healthcare the same kind of attention that others get.

Within the context of our human existence we have established what is ideal based on race, culture, sexual orientation, gender, and socioeconomic status. Based upon this concept of superiority, we have adapted a “survival of the fittest” mentality in the way we make decisions about people. In other words, we promote what we determine to be normal, beautiful, and superior based on our own established classifications. In this theory of social Darwinism, we have created some form of vulnerability and weakness that has left society with challenges in adaptation. In the case of our biological and human existence, we have lost a level of diversity in creating this purest system, that is ultimately causing us to not only be stagnate but to decline. I believe that diversity in our day is the most important human element in preservation.

In our current healthcare system, we have developed a class system of preference based on socioeconomic status, class, race, and gender.

In some cases, I have seen certain biases occur when a dominate white male (the majority of healthcare professional) provides care to a minority black or Hispanic female. There is a tendency to assume that hysteria and emotions (anxiety) are responsible for many ailments without giving consideration for the legitimate cause.

I once saw a Hispanic female patient who complained of numbness and severe weakness in her lower extremities. She was rather hysterically screaming with pain and was seen in two emergency rooms and cared for by one neurologist, an internal medicine doctor, and a psychiatrist. Without fail, all of her health care providers gave her a working diagnosis of psychosomatic illness with anxiety and panic disorder. She recently went through a bad divorce and the professionals felt that all her conditions stemmed from the trauma of the divorce. My initial assessment of the patient revealed that she had signs and symptoms of spinal cord damage, something that all of the practitioners who previously saw her never truly recorded or suggested. Her records were filled with connotations of a “Hysterical Latin Female”, a well-known and previously common term utilized by medical professionals to characterize Latin women when they present with medical conditions. Yet there was no data presented in her records that established the legitimacy of her concerns and pain. After performing an MRI of her spine, I found a tumor pressing on her spinal cord resulting in her numbness and weakness. This concept of hysteria often clouds the thinking of clinicians who have limited cultural understanding of people’s behavior based on race, culture, economic status, and other factors. The bias held by the clinicians caused the patient to go through extra pain, suffering, and costs that she should not have had to go through. Having diversity and an understanding of others in the medical field allows professionals to overcome certain biases that exist and allows for safe, high quality health care delivery with excellent customer satisfaction.

4.) Utilize many positive principles and attributes achieved in the world from globalization concepts seen in other industries such as banking and trade to improved health care. The US healthcare system in some areas operates in silos to where the collective wisdom of organizing different parties, states, financial systems, health systems to achieve economies of scale is not within our reach. On a health care practice level, we are divided by states and there are very limited federal or international standards we can utilize to make quality health care and health care financing universal. There is a limitation in confidence that we have in each other’s opinions and practices that introduces additional cost and limits the expansion of useful treatment modalities. We limit our human potential in solving the challenges posed by diseases that are complex to evaluate and treat and have the potential to wipe out humans by not making healthcare global. The challenges posed by the spread of COVID -19 represents the most significant failure in our health care system in the USA and globally, due to the lack of globalization in health care.

In my practice, I treat many international patients and sometimes serve as a referral point for persons with complex medical situations. I also work with other medical professionals from various states in the USA and from various countries around the world in finding solutions for persons with health care challenges. In this context, I have found that it is a common practice to repeat all the diagnostic testing performed in the international community when patients arrive in the USA for care. While I understand the need for such repeat testing and services, at times due to substandard diagnostics and services, there is an inherent bias that the international referring providers are less qualified and the diagnostics provided cannot be relied upon. This single bias about the qualifications and experiences of other health care providers from other territories has stymied our ability to benefit from the positive elements and contributions that come with globalization. By not globalizing healthcare, healthcare costs are increased because of duplication of efforts and make one’s ability to pay for healthcare services unsustainable

I served as the medical director for a large international medical center and during my tenure, there was one physician that irrespective of the quality of diagnostic testing performed by the referring provider from the international community, would repeat all studies. There was an international patient who was referred to our health care system with a cancer treatment. He had multiple procedures completed and a thorough work up of his disease performed in his own country. He brought all of the studies including the interpretation. One such examination/procedure was the evaluation of his bone marrow via a biopsy procedure performed in his country. Despite having all of the bone marrow slides and a full analysis performed by very competent oncology specialists, the USA based provider decided without even reviewing the original studies to repeat all of the diagnostic studies, including the very painful bone marrow procedure. These studies were performed at a cost of greater than 50,000 dollars. By the time the patient was ready for treatment, he had used up all of the financial resources he had available to access the needed treatment. It was ironic, that when the same clinician finally reviewed the initial studies performed from the oncology professionals for the referring country, he found no difference between the results of the studies performed in the patient’s country and in the studies performed in the USA. The concept of globalizing healthcare will help to reduce biases related to training and competency, and also healthcare costs.

5.) Providers (doctors, nurses, PAs, NPs, etc.) should become more involved in the administration of health care. There are some fundamental biases that exist regarding clinicians becoming administrators. However, I’ve found that this is because many clinicians are put into certain roles, without the appropriate education or training. Because of this bias, many administrative systems do not include significant input from clinicians in making decisions, which leads to a system that is often insensitive to the needs of patients and medical providers.

I once ran a large brain injury program in Miami, Florida that was in existence for over 25 years. Despite the significant contribution of that program to the care and treatment of patients with Traumatic Brain Injury (TBI) and to the entire hospital system of care; the program was shut down by administrators who did not have a clear understanding of the program’s impact on the healthcare delivery system, other clinicians, and the patients. This abrupt shut down also affected clinical services for patients, the discharge process, and the ability to retain an established model system of care for people with brain injury. After realizing the impact of this shut down, it became impossible to recreate the working system as many of the original professionals involved in the development and operations of such a system were gone. Having clinician input into the decision of shutting down this system could have resulted in a different outcome. Not only did the system lose talent, revenue, reputation and opportunity, it allowed for competition that still today impacts on the institution’s ability to be the DeNovo leader in the field.

Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

  1. Individuals: As a function of our education system, at all levels there should be a strong emphasis on personal responsibility for our health. We should all know how our lifestyles and practices impact on our own health, the health of others and the community in which we exist. At the individual level, we must understand how our individual actions influence healthcare in the population and drive the cost of healthcare. We need models of primary health care that promote primary prevention preventing certain diseases such as high blood pressure and diabetes from occurring, and a secondary prevention measure where when we already have a disease, we institute measures to prevent the advancement of such conditions. Learning about proper healthcare practices and preventative measures to preserve health is essential.
  2. Corporations: For now, corporate health and wellness is driven by finances and not by sensible valued-based healthcare principals. I believe that people should be incentivized through their employers to participate in exercises and measures to improve and maintain health. We have to value the human at the same level we value corporate profits. Humans are the most important asset at a company, so investment in the wellbeing of the employee will ultimately promote the success of the company.
  3. Communities: Communities must have an understanding of the strength and weaknesses of their healthcare delivery system. They must utilize their collective strength to drive the necessary changes to make their systems become more effective. This can be done by providing feedback directly to their healthcare delivery systems and providers, or through the political process promoting leaders with policies that can make high quality health care available, affordable and sustainable. Communities can further influence the system through their employers, unions and health insurance companies, to where they can drive the healthcare delivery system towards better quality.
  4. Leaders: I believe it is critical to start at the highest level with the leaders, in regard to political and administrative policies and systems. Leaders must have the political will to put health care in the forefront by making health care standout as a part of our human existence and survival. We have learned from COVID-19, health care as a construct can have a significant impact on our economy and our overall wellbeing. The concepts of state versus federal authority in health care decision making is a major point of contention for our political leaders as it will eventually impact on where we go as a nation in the evolution of our health care delivery system. Personal needs, concerns of the economy and business, our tax system and the way we research and develop health care technology and products in health care will be influenced by how our leaders model the health care system in these modern and changing times.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

As it relates to the interplay between general health care and mental health care– There is a remarkable and well established relationship between mind and body, the so-called mind-body relationship, where if the mind is impaired then the body is impaired, and vice versa. Our culture and practice in health care does not reflect the facts that support these relationships. The segregation of general health care and mental health is driven by the following:

  • Reimbursement systems in health care are driven by health care procedures that generate higher revenues to the health care providers. As such, the entire system of health care on the provider side is set up and geared to push surgical and medical procedures that generate higher reimbursements. Mental health procedures generate less income and tend to be just as time consuming as procedures in general health. Funding sources, also provide for lower reimbursement for mental health procedures.
  • Stigma associated with mental health — There is a stigma that exists in society about persons with mental health and there is a kind of fear associated with the vulnerability that is attached to mental health and its consequences. On a policy and an individual level, we have to change such biases and stigma about the evaluation and treatment of mental health conditions. The newer treatments available for mental health can result in highly functional humans, while in the past this was not the case.
  • Limitations in funding mental health training and research — While we have seen some improvement in this area in recent years, there is a need for the training of additional professionals in mental health and in research programs to answer fundamental questions that plague the industry. Research methods are more qualitative and more difficult to design and produce reliable measurements that are objective.

To resolve many of the issues of separation of mental health and general health we must change the incentives such as funding bias and allow for more cross training of professions to where they will not only see the links between mental and general health but also establish protocols that force clinicians to pay attention. Policy makers must be prepared to make laws that promote better funding for mental health and physical health integration.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider will have the following characteristics:

  • Constantly reevaluating their understanding of how they practice and be able to modify their decisions as new information becomes available. The provider must be open to change when needed.
  • Must have a sense of empathy to where they can put themselves in the position of the patient and appropriately respond with a level of sensitivity that makes all the difference.
  • Be able to work with others in a collegial manner by promoting a team.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“In order to advance, you must let go.”

  • Throughout my life, I find that to succeed you must embrace change. This concept of change can create both anxiety and opportunity as well as be liberating despite the risks involved. I find in myself and others a kind of fear that is created by change. Such fear stunts our growth as we constantly seek the comforts of what we know and expect over change. It does not go without saying that change is risky at times, but calculated changes can be empowering. For true advancement and in order to grow and develop, change must be welcomed with adequate preparation and determination. Life possibilities can be unlimited during change. The monkey bar rule… “ In order to advance you must let go”. This is the essence of change.

Are you working on any exciting new projects now? How do you think that will help people?

  • Yes, I am! I am working on creating and implementing an affordable, accessible healthcare delivery and financing system for developing nations.
  • I believe this will have population health impact in ensuring that people at all levels of socioeconomic status have access to quality healthcare that is also affordable.
  • I am currently promoting my book Concussion: Traumatic Brain Injury from Head to Tail”, which introduces the BHET Method. The BHET method introduces a new way of evaluation and treating patients based upon the hierarchical organization of the brain and how such organization is disrupted by injury and how the brain reorganizes during the recovery period.
  • In my direct area of specialty, I am writing my second book on utilizing the BHET Method as the basis for treating people with concussion and traumatic brain injury. This will help people by providing a transformative approach to properly classifying brain injury and applying the appropriate treatment modalities at the proper times and stages following injury.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?


  • Brene Brown’s books on vulnerabilities have been fascinating to me, especially Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. Outside of my significant training in medicine, understanding my own humanity and vulnerabilities has allowed me to make mature decisions that are not always driven by my emotional needs and my desire to promote my own self. I have also developed a great understanding that in helping others even more than yourself is the best way to build your self-worth and self-confidence. Forgiveness and acceptance of yourself and others can be quite liberating.
  • Healthcare Value Proposition: Creating a Culture of Excellence in Patient Experience by Vincent K. Omachonu — This book has helped me look at health policy and systems in the context of measuring value based upon outcomes and cost.
  • David Brooks — The second Mountain — Gives a good understanding of how to look at where you are in your journey in life. It helped me look at the concepts of success in relation to change.


  • Fareed Zakaria’s podcasts and his perspective of the global impact of decisions on the world.
  • Riche Davidson, MD — Concepts on mind body relationships — He states that wellbeing is a sense of mindfulness that creates balance in one’s ability to pay attention by managing distractions, connecting with kindness and empathy, having insight of who we are and the world, and having a purpose that is our true north.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Value-based Movement — My movement would be to transform the educational and health care system to focus on value. Value as measured not just in dollars and cents but in utilizing measures of outcomes that speak to quality of life, and the health and education of a population starting with individual responsibility over a segment of the population that is privileged and preferred.

How can our readers follow you online?

My website is and I am also on social media platforms including Facebook(, Instagram( and YouTube (

If anyone is interested in my book, it’s available here

Thank you so much for these insights! This was so inspiring!

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