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The Future of Healthcare: “There must be more pressure on the sugar industry to stop targeting innocent children” with Dr. Michael Fisher

…there must be more pressure on the sugar industry to stop targeting innocent children to consume obesity-producing foods and beverages. Prevention and wellness should be emphasized from the moment a young married couple has children. Perhaps pediatricians can be primary advocates of the importance of lifestyle in preventing future illnesses. Famous athletes who advertise junk […]

…there must be more pressure on the sugar industry to stop targeting innocent children to consume obesity-producing foods and beverages. Prevention and wellness should be emphasized from the moment a young married couple has children. Perhaps pediatricians can be primary advocates of the importance of lifestyle in preventing future illnesses. Famous athletes who advertise junk food need to be educated regarding the powerful influence they are having on the health of their youngest fans and should be encouraged to be positive role models for good health. Education is critical. I am certain that if athletes understood the strong link between all kinds of junk food and childhood-obesity related diseases, they would run with the ball. John Salley, a graduate of Georgia Tech and former NBA star, is a vegan and major advocate for a company just going public called Beyond Meat, which offers plant-based meat substitutes. The company’s stock soared 163% after its IPO. Who invests in this health- and nutrition-oriented company? Wealthy, educated investors, who represent an increasing yet small segment of our population. Who buys into the health concept delivered by Beyond Meat? People of means who are open to fact-based information that will improve the longevity and quality of life. I am going to make an effort to reach out to this superstar, who happens to be from my hometown, Brooklyn, to see if his company might participate through donations and perhaps other ways, in the nutritional component of our Santa Barbara Wellness Initiative. My own experience has shown me that it is possible to make very dramatic health changes in poor socioeconomic communities in a relatively short period of time. The program I founded 20 years ago was successful in mobilizing students, parents, teachers and school administrators, the mayor, local universities and college athletes, food producers, philanthropists, and members of the community at large to reverse poor health trajectories and replace them with healthier habits. The data we collected showed significant reduction in body mass index (BMI), the ultimate proof that our program was effective.


Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Michael Fisher, author of Surviving Kidney Disease: True Stories of Love, Courage, Hope, and Heroism…and a Roadmap to Prevention. A nephrologist, former Peace Corps physician, and cancer survivor, he received his medical degree from SUNY in 1968 and did his nephrology fellowship at UCLA in 1972. He was co-medical director of acute dialysis at Santa Barbara Cottage Hospital from 1984 to 2018 and is also the co-founder of Santa Barbara and Lompoc Artificial Kidney Centers. Until his cancer diagnosis, he was associate clinical professor at USC Keck School of Medicine and voted by the medical residents at Cottage Hospital as outstanding teacher of the year. Now approaching retirement, he has an urgent message for both patients and practitioners in the U.S. healthcare system.


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

When I was 12 years old, I read The Citadel, a novel by AJ Cronin that took place in the early 20th century in England. I identified with the protagonist, a young physician named Andrew Manson, who, having recently received his medical degree, began his career in a rural mining town in the suburbs of London. He was intelligent, inquisitive, caring and became beloved by his patients. He paid a “political” price for his excellence in that the older physicians were threatened by his rapport with their patients. Eventually he was offered and accepted an opportunity to practice in London, where he became a physician to the upper class and was soon very successful and wealthy. Ultimately, however, he rejected the superficiality of his new life and the lure of money to return to his “roots” in the town where he got his start. The values and idealism of this fictional protagonist were a major motivation for me to choose a medical career. In fact, after finishing the book, I declared that I would become a doctor. I’ve never wavered from that commitment.

Later, as a teenager I was deeply moved by TV ads to join the S.S. Hope, a floating hospital that delivered healthcare to the underserved in third world nations. I knew that I would study medicine and pursue a practice that served the truly needy. That’s why I became a Peace Corps Physician in La Paz, Bolivia, in 1969.

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

After my Peace Corps experience, I studied internal medicine and nephrology at UCLA Medical Center. After finishing my residency and fellowship in nephrology, I turned down an offer to stay on at UCLA to do research and instead moved to Santa Barbara with my wife, Leslie, and our two children. When I became too busy to handle the increasing workload, I was fortunate to find Dr. Tom Allyn, who had trained at Massachusetts General Hospital. We became partners and, in 1992, developed the Santa Barbara Artificial Kidney Center. We were motivated to develop an alternative to the only dialysis unit in Santa Barbara in order to improve the quality of care and to offer a choice to patients and referring physicians.

My experience in Bolivia had made me fluent in Spanish and, as a result, many of our patients were Latino and had family in Mexico. We were told that many children and adults were dying from kidney disease because of a paucity of dialysis centers. We decided to build one in the city of Leon, Mexico, where incidentally, most of the shoes worn in Mexico are made. This decision took us on an unforgettable adventure.

While in the Peace Corps in Bolivia, I’d worked with Bolivian medical students to develop a clinic to serve the health needs of a large indigenous population. As my term in the Peace Corps came to a close, I convinced the Bolivian Department of Health to assume support of the clinic. Now I drew on this experience, along with my fluency in Spanish and Dr. Allyn’s business savvy, to establish the first free-standing dialysis unit in Mexico! We modeled it after our state-of-the-art unit in Santa Barbara, working closely with Mexican physicians — without whom we would not have succeeded. Tom and I made several visits to Mexico where we met with officials from the Mexican Department of Health. On one occasion we were invited to dinner and all sat around a large table. The Minister of Health, smiling happily, told us that we were quite fortunate because it was the time of the year when we would be able to sample a special delicacy. My jaw dropped when they declared that it was the season for eating large worms! Gusanos in Spanish. However, my Peace Corps training at the Foreign Service Institute had taught me of the importance of “cultural sensitivity,” so Tom and I looked at each other, smiled to our hosts, and offered no resistance when the gusanoswere served. In point of fact, they were deep fried and tasted like onion rings.

It took several years to finish the dialysis unit in Leon, which was named “Centros de Dialisis Santa Barbara en Leon.” Like its namesake in Santa Barbara, it, too, was state of the art. President Vicente Fox honored us by attending the opening of the unit. Today it is delivering lifesaving support to children and adults, and a vigorous kidney transplant program is also ongoing, saving many lives. The unit is completely in the hands of Mexican doctors with whom we remain in close contact. I describe this adventure in my book, Surviving Kidney Disease, True Stories of Love, Courage, Hope, and Heroism, Plus a Roadmap For Prevention.

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?

Medical school was demanding, with long hours that frequently left us sleep-deprived. One morning during our second-year physical diagnosis course, I was in a patient’s room with a classmate. The patient was said to have an interesting heart murmur. I had slept perhaps three hours the night before because I was preparing for an important pathology exam. In a fog-like state, I placed the earpieces of my stethoscope just under my ear canal but was unaware of my mistake. At that precise moment, the professor walked in with a group of second-year students. They all gathered around the bed, waiting their chance to listen to the heart murmur. Smiles broke out on all of their faces when they realized that, as a result of my state of oblivion, I could hear nothing through my stethoscope. It was a lesson in both the necessity of sleep and of not taking myself too seriously.

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

I believe that what makes our practice stand out is our patient-centered care. Unfortunately, the dictates of the profit-oriented healthcare system often put empathetic patient care on the back burner. Because my partner and I own our practice — as well as the two dialysis units we have founded (Santa Barbara Artificial Kidney Center and the Lompoc Artificial Kidney Center) — we can put patients’ needs — including their psychological and emotional needs — first. We’re not limited in the amount of time we can spend with our patients. We’re not constrained in the types of support that we can offer or recommend.

We also understand the importance of health education and can make it a priority in our work with patients and aspiring physicians. Both my partner and I have earned the title of Associate Professor of Medicine from the USC Keck School of Medicine, and we both have been honored on multiple occasions as among the 10 best professors at the Santa Barbara Cottage Hospital Residency Program, an affiliate of USC. We’ve also been named outstanding teacher of the year; Tom was voted outstanding teacher of the year on three occasions!

Dr. Allyn was also very supportive of me when I founded the Diabetes Resource Center of Santa Barbara County, a nonprofit community health organization whose mission was to develop effective comprehensive programs to reduce childhood obesity in underserved communities — specifically the 99% Latino community served by Franklin Elementary School — where 60% of kindergarteners were already overweight or obese. Our program included nutritional education, an on-site garden, sports and physical activity, stress management, and involved both students and members of the community.

We were so successful in substantially reducing the weight and increasing the physical conditioning of participants in the program that the Governor of California’s Council on Fitness awarded us the Gold Medal. Blue Cross simultaneously awarded the school a complete $100,000 gym for the children and their parents. Although I had to discontinue the program when I was diagnosed with lung cancer, it has now been resurrected as the Santa Barbara Wellness Initiative, and is being led by the community itself. I’m very proud that they thought enough of the program to take ownership of it as a means of battling the life-threatening issue of childhood obesity.

Finally, I am proud that our kidney centers have received perfect state inspection ratings. Even though we understand the necessity of keeping kidney disease patients alive via dialysis, we champion kidney transplantation for as many patients possible. We also experience very little turnover of staff because we understand the stressful nature of their work and support them with bonuses, educational programs, and emotional support.

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

I would remind my colleagues that we are charged with the safety and health of our patients and can never forget our mission, even if we work in a non-supportive environment. I would encourage them to do whatever is necessary to advocate for their patients, whether that means spending more, receiving less, or battling insurance companies who refuse to cover drugs and exams that are indicated to adequately treat our complex patients. This is important for our staff, too, because they can become discouraged when they see patient needs being neglected or subjugated to cost considerations.

Also, in an age of high technology, we must never forget the importance of “high touch,” or supporting the emotional needs of our patients and their families. Our employees, too, are under a great deal of stress, struggling to raise families on much less income (in real dollars) than in previous generations. Find the time to talk with them, ask what they need, and deliver relief. Never forget the value of recognizing great work. Verbalize your approval of the work being done when it is warranted and motivate employees by emphasizing the noble nature of their work — saving lives.

Last but not least, it is essential that each physician develops self-knowledge and finds a healthy balance between work, family, exercise, and relaxation. The most talented and dedicated doctors are likely to “burn out” if they ignore their own mental and physical health.

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?

There are many reasons that, despite leading the way in developing medical technology, we in the U.S. are not the best in delivering it. Wealth disparity is an important reason because along with poverty comes lack of medical insurance, which translates into lack of medical care. David Blumenthal, the head of the Common Wealth Fund which ranks health care systems of developed countries, states “the literature on insurance demonstrates that having insurance lowers mortality. It is the equivalent to a public-health intervention.” More than 27 million people are without medical insurance today.

Knowledge disparity about prevention and wellness, including the use of better nutrition, exercise, and stress reduction techniques, is another major reason. Healthcare professionals are, in general, not paid to educate their patients about proper nutrition, while, at the same time, the food, alcohol, and pharmaceutical industries expose people relentlessly to advertising that encourages unhealthy behaviors or the taking of yet another drug for whatever ails them. As a result, lower-income and minority populations are leading candidates for developing obesity-related chronic illnesses. They are literally “digging their graves with a knife and fork.” Obesity is ravishing communities that are already at greater risk for developing adult-onset diabetes; in fact, it is doing the same throughout the nation. Diabetes is the leading cause of kidney failure worldwide. The cost of treating obesity-related illnesses is about 1.3 trillion dollars — or 33% of our 3.3 trillion healthcare budget! Investing in health education and prevention — particularly in lower socioeconomic populations — far from being an expense, actually represents a huge cost savings over time. Instead, our system spends enormous sums to treat severe chronic illnesses in populations deemed “less important,” e.g., less wealthy. The notion that preventive care is a “luxury,” and if you can’t pay for it, you don’t deserve it, is a major reason our healthcare system is spiraling downhill and almost at the breaking point. If a family prone to develop diabetes by family history, ethnicity, or socioeconomic status had medical insurance and could get medical help immediately, diabetes and its costly sequelae could be prevented.

The stalemate and animosity between the parties in Washington is adding to this daunting problem. Unless legislators understand the precarious state of healthcare and make a serious, bipartisan effort to make intelligent changes in a system that is failing many Americans, costs will continue to soar, quality of care will suffer, higher morbidity and mortality will follow, and a further drop in the relative ratings of our healthcare system is inevitable. There are only a couple of reasonable choices. One is to improve upon so-called Obamacare, which, after all, has been used successfully in Massachusetts for years. The other is a single-payer system such as Medicare for All. Citizens who can afford their private insurance should be allowed to keep it; however, if the new system is crafted well, most will ultimately change to Medicare. But assuring that they can keep or choose their physician and maintain their previous coverage and benefits, should neutralize any opposition.

As insurance companies are subtracted from the equation, funds will be available to satisfy physicians’ needs for fair compensation. The ultimate success of the system depends on those who deliver it — the doctors and other healthcare professionals! Profits currently taken by the insurance companies can be used to provide more comprehensive prevention and wellness programs, which will effectively reduce the cost of medicine by halting the spread of epidemics we have been talking about — obesity, hypertension, diabetes, kidney disease, etc. Funding could be used to educate, not only at-risk communities, but the public at large about the power and importance of lifestyle and prevention strategies in reducing morbidity and mortality.

Politicians, who are ignorant of the tsunami of chronic illness once on the horizon but now present and accelerating, must step up in a bipartisan effort to apply the brakes to these life-threatening illnesses. Presently, they have abrogated their responsibility to become educated about the real healthcare issues and how to apply prevention and wellness programs. Where is the leadership of our Surgeon General? Do we even have one? Many years ago, our Surgeon General led a campaign to reduce smoking-related deaths. With a concerted effort from our government, the AMA, and local political leaders, as well as small businesses, smoking has been greatly reduced in the United States, with a corresponding significant reduction in lung cancer and cardiovascular illnesses. Presently, there are simultaneous epidemics raging that are wreaking havoc across the nation, just as cigarette smoking did decades ago. These are stress, obesity, diabetes, cardiovascular disease, hypertension, cancer, and end stage renal disease. Early attention to our habits of food consumption, sedentary lifestyle, 24-hour stress and strategies for minimizing (or managing) it — in short, learning how to live healthfully — can prevent or attenuate all of the great 21st century epidemics.

A striking example of this application of epigenetics — or the ability to prevent certain disease- causing genes from activating — is the following: an obese child who has developed pre-diabetes can reverse his condition and actually prevent the onset of type 2 diabetes with an intervention that includes reduced calories (especially of foods that are high in sugar or other carbohydrates), combined with regular exercise. This would be a much more humanitarian and cost-effective way of delivering healthcare than a lifetime of diabetes treatment and its consequences: blindness, cardiac disease, amputations, end stage renal failure, dialysis, or transplantation!

Another reason the U.S. is ranked so poorly in healthcare delivery is that Americans pay the highest cost for medicines in the world, forcing patients to choose between life-saving drugs and the food on their table. It is critical that pharmaceutical companies compromise on profits that pay CEOs mega-millions of dollars. Politicians often talk about this remedy on the campaign trail, but once the election is over and they have had their meetings with lobbyists, the issue is buried until the next election.

Last but not least, we must address the important issues confronting our physicians, who are the best trained in the world, but facing challenging headwinds that threaten their ability to provide the excellent care they are amply equipped to deliver. The study of medicine in the 21st century is very challenging and even for the brightest is a source of severe stress. Superimposed on the natural stress of massive learning in a short period of time is that of leaving medical school in debt. Many students change their choice of specialty not because they are “following their bliss,” but rather to find more lucrative specialties to help relieve their financial burden. As a result, critical specialties remain unfilled. The lack of primary care physicians in rural communities is a case in point. When physicians emerge from medical school $400,000 in debt, their only option that makes economic sense may be to practice in a multispecialty clinic whose corporate owners are focused on generating income rather than maximizing outcomes. Physicians now practice with a computer on their laps, typing, face down, rather than looking at their patients, solely for the purpose of correct billing! So much of the doctor-patient relationship is lost precisely when anxious and frightened patients are so in need of it. Recently, NYU Medical School received a huge endowment to pay medical students’ complete tuition, eliminating a source of severe stress and allowing students to learn the massive quantities of material presented, and freeing them to “follow their bliss,” by entering a field they love, rather than the most lucrative.

Medicine is a human right and we are the only country in the world that does not provide it for all of our people. The system must be reinvented. Insurance companies make doctors and patients victims of their corporate greed. The irony of favoring the rich and forgetting the poor is that, by withholding preventive medical services from them, the poor usually end up in our overly burdened emergency rooms where the cost of treating them is huge. The ER becomes a primary care center, taking valuable time and money from those with true emergencies. The most ominous outcome for the future is that the underserved who are participating in the great epidemics of the 21st century, will soon be presenting with the obesity-related diseases already mentioned. Our dialysis units, already burgeoning, will run out of seats and space. It seems to me that the 21st century is about immediate gratification and selfishness. Let’s invest now in the health of all of our people, save lives, as well as restore our once great healthcare system.

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.

First, we need intelligent and visionary leadership in Washington willing to make hard decisions about the delivery of healthcare. Instead, it seems that a lobbyist group comes out of the woodwork to oppose every sensible solution that comes along, such as a single-payer system, or covering every citizen with the already-available Medicaid for new enrollees of the Affordable Care Act. Instead, governors of some states refuse the money for their poor patients, forcing them to remain without insurance. Why? Their decision is purely political. Medicaid is federally funded and costs the states very little. Moreover, it intentionally charges the poorer states less and the richer states more.

One potential solution, previously mentioned, is to improve the Affordable Care Act (ACA) or Obamacare, which was modeled on a program created by Republicans under Governor Romney of Massachusetts, where it was, and still is, a great success. Now that it has become associated with President Obama, however, the Republican party has made it their goal to try and repeal the entire plan — even though they have proposed no alternative way of insuring the millions of Americans who rely upon it. As we speak, Democrats in the House are debating the pros and cons of Medicare for all. Although I completely support their effort, it is very difficult not to become cynical.

Two, the AMA, the Surgeon General, and political leadership both at the federal and state level, must lead a massive educational program, similar to the successful one that resulted in a reduction in smoking, to educate our citizens about the health risks of over-eating, especially too much sugar and processed food, and leading a sedentary lifestyle.

Three, there must be more pressure on the sugar industry to stop targeting innocent children to consume obesity-producing foods and beverages. Prevention and wellness should be emphasized from the moment a young married couple has children. Perhaps pediatricians can be primary advocates of the importance of lifestyle in preventing future illnesses. Famous athletes who advertise junk food need to be educated regarding the powerful influence they are having on the health of their youngest fans and should be encouraged to be positive role models for good health. Education is critical. I am certain that if athletes understood the strong link between all kinds of junk food and childhood-obesity related diseases, they would run with the ball. John Salley, a graduate of Georgia Tech and former NBA star, is a vegan and major advocate for a company just going public called Beyond Meat, which offers plant-based meat substitutes. The company’s stock soared 163% after its IPO. Who invests in this health- and nutrition-oriented company? Wealthy, educated investors, who represent an increasing yet small segment of our population. Who buys into the health concept delivered by Beyond Meat? People of means who are open to fact-based information that will improve the longevity and quality of life. I am going to make an effort to reach out to this superstar, who happens to be from my hometown, Brooklyn, to see if his company might participate through donations and perhaps other ways, in the nutritional component of our Santa Barbara Wellness Initiative.

My own experience has shown me that it is possible to make very dramatic health changes in poor socioeconomic communities in a relatively short period of time. The program I founded 20 years ago was successful in mobilizing students, parents, teachers and school administrators, the mayor, local universities and college athletes, food producers, philanthropists, and members of the community at large to reverse poor health trajectories and replace them with healthier habits. The data we collected showed significant reduction in body mass index (BMI), the ultimate proof that our program was effective. I describe the details of the program we implemented in my book, Surviving Kidney Disease: True Stories of Love, Courage, Hope, and Heroism…And a Roadmap for Prevention.

Ok, it’s 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?

John Salley is an individual who is using his celebrity status to advocate for healthy lifestyle changes. There are many others. Beyond Meat is a newly formed company advocating a healthy lifestyle. Again, there are many others. The Santa Barbara Wellness Initiative, which I initiated, is an example of a community taking charge of its health. This community is already deeply committed to a change in eating habits and an increase in exercise for all. They are further strengthening their efforts by introducing an ACE program to intervene in Adverse Childhood Encounters, the early childhood emotional traumas that can trigger a lifetime of health consequences. Finally, they are working to help individuals and families better manage their stress — which is the undiagnosed epidemic underlying many of our major illnesses.

As a mental health professional myself, I’m particularly 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?

Sadly, there is very little interplay between the general healthcare and the mental healthcare systems. Even in the 21st century, too many physicians do not recognize the intimate relationship between mental health and physical disease. In my book, I demonstrate the connection between severe stress, a breakdown of our immune system, and the onset of autoimmune disease, diabetes, heart disease, depression, cancer, and more. This concept has been embraced by pediatrician Dr. Nadine Burke Harris, the first Surgeon General of the State of California. She developed an evidence-based theory that adverse childhood encounters (ACE) are responsible for initiating severe illnesses in children that manifest in the future. The greater the number of emotional traumas that children experience in early life, the greater the risk of developing diseases such as rheumatoid arthritis, cancer, diabetes and many others.

The insurance companies still pay the least to compensate psychiatrists and psychologists compared to any other medical specialty and frequently will not cover even the neediest patients. It seems to me that there are two ways that patients with severe stress in their lives, or are depressed and anxious, are viewed by medical professionals. Most doctors are empathic and try to support their patients but are limited because of time constraints. When they attempt to find a mental health professional, either none are available or they do not accept Medicare or Medicaid patients because the compensation is so low. There is a second set of medical professionals (my own experience) who think that many emotionally challenged patients should “pick themselves up by their bootstraps.” It is as if human beings are “wired” to be either empathic or cruel.

Psycho-neuro-immunology is a relatively new science that demonstrates the intricate relationship of the mind and body and begins to explain the relationship of stress and disease. The brain was recently found to be bathed in lymph, a colorless fluid containing special immune cells derived from the thymus gland called T cells. They produce potent proteins that modulate our immune system and helps us ward off disease. This fluid bathes the brain, fosters communication between the brain and every organ system in our body before it drains back into the bloodstream. Severe prolonged stress for an example, can modify the immune cells in close proximity to the brain and lead to myriad illnesses.

However, a person experiencing stress can help to prevent or reduce its noxious effects. One technique, for example, is yogic breathing or pranayama. I learned to use this technique for relaxation and stress reduction during 15 years of yoga practice. It helped me tremendously during the two months that I was taking a new drug to treat my recurrence of lung cancer, in anticipation of a scan that would determine life or death. I did my breathing technique daily for about 25 minutes. It relaxed me, increased my clarity, and enabled me to keep my anxiety to a minimum until I had a CT scan that revealed that my tumor had been reduced 50%! There is also scientific data that show a significant reduction in inflammatory markers in the blood of those who practiced this type of meditation, relative to those who did not.

How would you define an “excellent healthcare provider”?

My bar is set quite high and assumes that each provider has great medical knowledge, along with a high degree of empathy and an ability to express sincere caring for their patients. They also need to have developed some semblance of balance in their lives so that they can act as role models to their patients. This is a great challenge for physicians, who find it difficult to practice medicine, be a good spouse and parent, stay fit, and not become anxious, depressed, or an alcoholic. This task of finding balance is the perhaps most challenging and daunting task for the caring physician.

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

My favorite quote is from Friedrich Nietzsche, the great German philosopher, who said: “He who has a why to live can bear almost any how.” My essential practice has been to always keep hope alive for my patients. Many of them have lived through an epic journey, from the first diagnosis of kidney disease, followed by kidney failure, and the lifesaving but harsh treatment of dialysis. My job was to support the patient and family to receive the Holy Grail of ESRD treatment, a kidney transplant. Many times patient and family members were deeply depressed and fearful for the life of their loved one. Nietzsche’s voice helped me understand the power of hope and love to be the catalyst of a successful journey. My book attests to this through the true stories of love, courage, hope and heroism in patients I have known, documenting how the human spirit gets fired up when one knows that, no matter how difficult the journey, the reward is additional quality time to share with loved ones at its end.

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

I am almost retired but I find meaning in acting as a consultant to the Santa Barbara Wellness Initiative I have alluded to. It is allowing me to go full circle to my Peace Corps experience, but this time it taking place in a Spanish-speaking community in Santa Barbara, rather than Bolivia.

I have also been writing blogs and doing interviews on radio and TV to educate the public about many of the issues we’ve discussed here. I am considering a second edition to my book, explaining more of the science, or perhaps I will write second book. If people heed my words and do some additional reading about how they can prevent the diseases that are rampant in our country, I will be happy.

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

I regularly review the medical literature in the areas of psycho-neuro-immunology and epigenetics. I am also quite interested in immunology and the value of nutrients in preventing disease. The study of Eastern medicine and healing techniques is another area that I am studying and actually applying some of the principles such as yoga and pranayama to my own daily life. I continue to read the New England Journal of Medicine and others, such as the American Journal of Nephrology. However, I have also just finished Macbeth and will read two of Shakespeare’s comedies in preparation for the Shakespeare festival in Ashland, Oregon, which my wife and I will attend this year. I also strongly recommend Sapiens, a fascinating summary of the development of humanity from the Big Bang to the 21st century.

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.

I would love to see a one-year service program for high school graduates, the Health Corps, who would have a real life experience in a different part of the country from their high school, serving in a Peace Corps-like fashion. Students would get to know something about different cultures, the health challenges they face, and get a feeling for just how complex and daunting these challenges are.

Afterwards, these new graduates would go off to college with a great experiential education and would be less likely to waste their first year on too much beer and partying.

On a more basic level, I would like to see our society recognize that profit is not the highest good; nor is it the standard by which we should measure whether a thing is worth doing. I would like to see physicians able to practice from the empathy that was probably their motivation for entering medicine in the first place. And I would like to see our leaders recognize that caring for everyone is not “too expensive;” rather, it is how we build an inclusive society that pays huge dividends over time.

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