A heart-to-heart with cardiothoracic surgeon and TV host Dr. Oz

Slide 1

Dr. Oz shows an audience member the organ in the body that creates the most toxins, the intestines.

Slide 2

Slide 3

Dr. Oz speaks at a free clinic for Dr. Oz’s Break the Silence on Ovarian Cancer Campaign in a Dallas shopping mall.

Slide 4

Ever since he was a young boy, Mehmet C. Oz, MD, FACS, wanted to follow in his father’s footsteps by becoming a surgeon. Today he’s not only a cardiothoracic surgeon at New York Presbyterian Hospital in New York City but he’s also the host of The Dr. Oz Show, a nationally syndicated health information program that won two Emmy Awards and attracts nearly 4 million viewers daily.1

“My father—a thoracic surgeon who trained in Turkey—always asks me how long I plan to ‘fool around with this television stuff,’” admits Dr. Oz with a good-natured chuckle. In addition to filming six shows a week—where he’s apt to discuss anything from diet and exercise to the importance of regular check-ups—Dr. Oz also consults with patients most Thursdays, and he performs approximately 75 to 100 heart operations every year.

That fast-paced schedule almost came to a grinding halt last year, however, when Dr. Oz’s physician discovered a suspicious-looking polyp during an on-camera colonoscopy. The polyp turned out to be pre-cancerous, and although most of these polyps do not eventually become malignant, Dr. Oz was well aware of the fact that colon cancer usually starts with this sort of growth. The experience transformed “Dr. Oz” into “Mr. Oz,” and it gave him a new perspective on both his role as a surgeon and the role of the patient.

During a recent interview, Dr. Oz discussed what he learned from his cancer scare and offered his perspective on a range of topics, including mentoring residents, work/life balance, and the importance of delivering quality care.

Doctor as patient

In an essay for Time magazine published last June titled “What I learned from my cancer scare,” Dr. Oz presents a candid, look at what, for him, was a life-changing experience:

I take pride in being a good doctor and a good family man, but the fact is, I had been a pretty bad patient. Living my life on television, dispensing medical advice every day leaves me with a solemn obligation and moral imperative to be honest and to own up to mistakes—and I made some. They might not have been big, but they were more than enough to threaten my health, my future and the well-being of my family.2

“When I first became a physician, I thought people didn’t do what was right for their health because they didn’t believe what I told them, or because they thought they wouldn’t live forever anyway—so why bother,” Dr. Oz added. “But I realized it wasn’t any of those things. As for my own situation, I didn’t want to deal with what I would learn [from the colonoscopy]. I was so busy in my life and the whole thing kind of intimidated me. But then I finally realized that I wasn’t getting the colonoscopy for me, but for the people I loved. Until I realized that fact, it wasn’t compelling enough for me to get the procedure. And you know what? It changed the way I talk to patients when I recommend a procedure. I tell them, ‘It’s not always just about you.’”

According to Dr. Oz, “The universe had to drill through three distinct layers of [his] arrogance or denial” as it modified his perspectives on cancer treatment:

First, I was cavalier going into my initial screening. I was healthy, and I knew the statistics, and I figured the risks didn’t apply to me. Second, I felt that decades of research and experience that led to the prep-and-testing guidelines as we know them also didn’t apply to me. And last, I felt that the follow-up was somehow a formality and the risk still didn’t apply to me. The transformation from Dr. Oz to a modest, wiser Mr. Oz did not become complete until I was staring directly at a pathology report.2

Dr. Oz said he feels frustrated when his patients ignore his medical instructions, but at that point in time, he was certainly acting like one of those defiant patients. “I was the worst,” he admitted. “Most doctors are bad patients, but that’s no excuse. Again, you have to remember that you follow doctor’s orders, not only for yourself, but for the people you love,” said Dr. Oz, a father of four.

Mentoring and the “eureka moment”

Physicians are constantly learning—not only from their experience as patients (or caring for patients)—but also from the mentor/mentee relationship, which is a very important component of the academic surgeon’s work.

“Mentoring is essential to where I am now and the way I live my life,” said Dr. Oz, vice-chair and professor of surgery at Columbia University, New York, NY, and director of the Cardiovascular Institute and Complementary Medicine Program at New York Presbyterian Hospital. “I try to find residents who are smarter than me, so that they can grow to continue to be smarter than me. Hopefully, that relationship results in the resident doing things that I could never do.”

In fact—as Dr. Oz’s professional responsibilities continued to rise—he made the decision to hand over a portion of his patient referrals to Mathew Williams, MD, also a cardiac surgeon.

“Mat Williams was a Columbia University undergrad when I was chief resident. He would take call with me, shadowing me as I worked on gunshot wounds and head traumas, and from the beginning I knew that he was someone very special. I’ve been involved in much of his life, and he’s returned the favor. He is one of the key people who I operate with today,” said Dr. Oz.

Dr. Oz has strong feelings on the topic of resident duty-hour restrictions. As a surgical resident he conditioned himself to get by on only two or three hours of sleep each night, and, as a result, he continues to struggle with insomnia some 25 years later.3

“The danger of work-hour restrictions is that they can inhibit learning,” said Dr. Oz. “The intent of these restrictions is to make sure people have the proper amount of time to reboot and reset. We are struggling at Presbyterian Hospital because the residents want to learn a particular procedure, but can’t because they have to leave due to these restrictions. Look, it was tough to be on call [as a resident] because you did not get a full night’s sleep for a week or two at a time, and yes, it probably did inhibit some learning. But I also learned a great deal from those cases that I did not want to miss.

“If we were better at teaching, it would be possible to mold these restrictions to accomplish the true goal, which is recharging the mind,” continued Dr. Oz. “Our mantra at Columbia is, ‘My job is to teach young surgeons to save lives—that’s my job.’ Sometimes residents have to sleep a lot, and sometimes they have to stay with me in order to keep someone alive.”

A question that surfaces repeatedly when health care professionals discuss the mentor/mentee relationship is, “How do you deal with an incompetent intern?” Dr. Oz says it’s not the incompetent interns one has to worry about. “It’s an intern who doesn’t know he is incompetent,” he explained. “People make mistakes, and this is true outside medicine as well, when we don’t know what we don’t know.

“Mentoring is about helping students see the path where you walked, so they don’t fall where you tripped,” continued Dr. Oz. “And giving them the freedom to walk off the path where they need to.”

Dr. Oz says the early years of medical school often feature a series of eureka moments where the student gleans insight into their existence in the most unexpected ways. For him it was the first time he saw the heart.

“I remember the first time I saw this powerful organ pop through the pericardium, and I was petrified,” recalled Dr. Oz. “You don’t want to touch it, because it could stop, but let me tell you, fear is not a good way of starting a relationship with an organ—and that’s true for any surgeon. You have to make peace with it, and understand it in a way that is much more poetic than a cut here and a snip there. My epiphany was moving from fear to realizing you could hold the heart in your hands and cajole it and help keep a patient alive.”

Dr. Oz says that moment helped him realize why the heart is so infused in religion and the arts, and that it continues to allure him—both as a vital organ and as a symbol.

Work/life balance

Dr. Oz films six episodes of the Emmy Award-winning The Dr. Oz Show a week and has authored seven New York Times best sellers, including You: The Owner’s Manual. He’s launched a charitable foundation, HealthCorps, a national peer-mentoring initiative empowering teens to make healthier choices.4 And, as previously mentioned, Dr. Oz operates most Thursdays. How, then, does this active surgeon—who’s been married to his wife, Lisa, for 26 years—manage to strike a healthy work/life balance?

“It’s not about time management as much as it is energy management,” Dr. Oz observed. “When surgeons are in the operating room and they are working on an interesting case, there’s good camaraderie there with the team, and that is energizing. It’s the tedious chores, the laborious paperwork that drags you down and wears someone out.”

Considering the fact that Dr. Oz has such a hectic schedule, he chooses cases that are low-risk and where there is a pretty defined postoperative course. “I don’t mind spending lots of hours in the operating room, but I can’t do cases too often that are overly complex with lots of postoperative care. I usually do straightforward valve cases and bypasses—cases that are nonreoperative. And I always operate with a partner. I want my partner to be in charge of the patient’s postoperative care, and I always arrange this with the family beforehand.”

One of the biggest misconceptions about the Ohio native is that he entered the media spotlight early in his career, when in reality he only made what he calls “a serious move into media” over the last eight years.

“My career path was specifically designed with academic medicine in mind, and that’s always been the case,” explained Dr. Oz, who has received several patents, including one for a device that allows surgeons to use minimally invasive surgical techniques to repair a defective mitral valve, without opening the chest or stopping the heart.5 His research interests include heart replacement surgery, minimally invasive cardiac surgery, and complementary medicine and health care policy.

Being in front of the camera and a live audience involves a lot of prep work, according to Dr. Oz. “I study for my shows—I have to. It’s like having a board exam every single day, because I have to have a working knowledge of all the topics we cover,” said Dr. Oz.

Quality care for all

A key issue of concern to Dr. Oz and his team is the provision of high-quality care. “Quality care is a cultural thing. If you make it easier to do the right thing, then the right thing happens,” he said. “Quality control systems, and things such as checklists in the OR, are hugely valuable because they get people thinking differently about the process—and not just trying harder, but trying smarter. The most expensive thing in health care is bad health care. If we can avoid complications, we can save lives and save money.”

Being fiscally responsible is a top priority for Dr. Oz, who has a business background in addition to his medical credentials. After graduating from Harvard University in 1982, he obtained a joint MD and MBA in 1986 from the University of Pennsylvania School of Medicine and Wharton Business School, both located in Philadelphia.

Dr. Oz—who was an invited participant in the 2012 Economic World Forum in Davos, Switzerland, earlier this year—noted that economic growth on a global scale must include affordable and quality health care if it is to succeed.

Closer to home, Dr. Oz said health care legislation will not succeed unless we become a healthier country. “We’re not going to figure out how to address health care expenses in Washington, DC. We’re going to win the health care battle in our homes, and in our kitchens and living rooms, because that’s actually where we decide how healthy we’re going to be. If we’re sick as we are right now, we’re not going to be able to keep up, no matter what kind of legislation is passed,” he said.

One key health care finance issue that leaders in Washington will, in fact, have to deal with, according to Dr. Oz, is the topic of care for the uninsured. “It is essential that we have affordable health care coverage for all, and I think that most people at the College would agree with that,” observed Dr. Oz, who has first-hand experience in dealing with patients whose health care coverage is less than adequate.

“As a practitioner, I have been sued by insurance companies for saving the lives of patients. This is public record. In one case I was asked to take care of a man who was in need of a heart transplant. He had undergone an unsuccessful emergency bypass surgery elsewhere, and he was in need of a mechanical pump that would keep him alive while he waited for a donor heart. His policy covered the heart transplantation—not the mechanical pump. I was sued by the insurance company because without the pump, they would never have been saddled with the bill for the transplant!”

Conclusion

“One of the reasons I did this interview is because I care about what the [members of the] College think. I care a lot—and that’s one of the reasons why I have so many doctors on my show,” revealed Dr. Oz.

He described his TV persona as that of the “gooey parts of Marcus Welby,” a role he uses to help walk viewers through various health-related topics, mixing in personal anecdotes with science and research. “I want to make it easier for people to have a conversation with their own doctors, the Fellows of the College. We try to give people the confidence to ask their doctor about whatever is bothering them, and to know what questions to ask. We don’t always get it right, but when we do, we try to make the doctors’ jobs easier.”

Despite all of his professional accomplishments, Dr. Oz is most proud of his relationship with his family.

“I’m proud of the fact that I’ve kept my wife of 26 years still loving me—which is a huge challenge, and I’m proud of raising four kids, who, at least to me, seem happy. I’m also really proud of the fact that I’ve matured as a listener. I think that’s a big call to action for so many surgeons, and everyone, really. We’re not taught to listen to patients, to staff, or to each other. But the art of listening, and spending time with patients so that we can address the real problem rather than quick-fixes, is ultimately cost-effective and just better medicine in the long run.”


References

  1. Singer S. How love and teamwork have made Dr. Oz successful. The Palm Beach Post. January 10, 2012. Available at: http://www.palmbeachpost.com/health/how-love-and-teamwork-have-made-dr-oz-2093870.html. Accessed February 2, 2012.
  2. Oz M. What I learned from my cancer scare. Time. June 2, 2011. Available at: http://www.time.com/time/specials/packages/article/0,28804,2075133_2075127_2075098,00.html. Accessed February 2, 2012.
  3.   Oz M. How to sleep better in 2012. Parade. January 20, 2012. Available at: http://www.parade.com/health/2012/01/dr-oz-sleep-better-in-2012.html. Accessed February 2, 2012.
  4. HealthCorps. Available at: http://www.healthcorps.net/about-us. Accessed February 2, 2012.
  5. Columbia University Medical Center. Department of Surgery. Cardiac procedures and innovations. Available at: http://www.columbiaheart.org/bowtie.html. Accessed February 2, 2012.

Tagged as: ,

Contact

Bulletin of the American College of Surgeons
633 N. Saint Clair St.
Chicago, IL 60611

Archives

Download the Bulletin App

Apple Store
Get it on Google Play
Amazon store