Mark Goulston, M.D.

Dear President Obama,

While you are still going gently into this "good" election and before you "rage against" your opponent, you might do well to remember that Senators Clinton and McCain lost the election as much as you won it.

One of the ways they did that was to exhibit...

Q: If one picture's worth a thousand words, what are the following videos worth?

A: A nation's thanks

Rather than writing about Memorial Day, I thought I'd share some YouTube videos that caused me to take time to remember and give thanks.

Whether you are for or against this or...

Until you know what someone stands for, stands up for and stands up against, you don't know who they are.

Here is the problem for candidates Obama and Romney. If doing this and letting us know who they really are alienates too large a group of voters, that could cost...

"You can define health care into basically three buckets. There's those that receive, there's those that give and there's those that take. And if you look at those three buckets and you just put yourself in those that receive at the end of the day, that's the patient. And those that give are actually the providers, and in fact, the people that pay. And everything in between is those that take, i.e., the perverse incentives of fraud and abuse, the inefficiency of health care ... If you go to the essence of the question, what is it that you are trying to achieve, and we in the health care industry should be trying to achieve to keep the patient away from the hospital, not into the hospital. But there in no incentive to do that ... The whole issue is value-driven care, both for the patient as for the payer. So there's a combination of what we have to achieve. We need to achieve patient responsibility, patient knowledge and patient centric. The question at the end of the day is what value are we providing, why are we providing the value and who is it for? ... With this 2.3 trillion dollars (being spent on health care), we don't need more than what we are spending. It's not what we're spending that's creating the problem, it's how we are spending what we are spending." -- Patrick Soon-Shiong, M.D., speaking at RAND

Patrick Soon-Shiong is a knight on a crusade to heed an ailing and hurting humanity that beckons to him, but that is challenged and thwarted at every step by too many not-so-ailing or hurting humans and special interests furthering their own personal agendas.

He makes a case that there is currently no incentive to keep patients healthy. Even at UCLA, where he focuses many of his efforts, the wonderful mission is "healing humankind one patient at a time." Shouldn't we be promoting wellness one patient and one family at a time?

In his interview, Dr. Soon-Shiong raises the need for more integrated health care with the patient at the center and focus on the cost of not doing so vs. the current focus on what things cost. He is also a realist about the need to incentivize all parties toward promoting health. That includes the receivers, givers and takers. It has been my experience that people don't do what is important to them; they do what they care about (for example, healthy eating is important to me, but I don't care enough about it to do it that well).

If you read between the lines of Dr. Soon-Shiong's interview you get a sense that he is coming to the conclusion that most global change agents come to, which is: You can't solve a transformational imperative from a transactional paradigm. The challenge others face with transactional people (are you listening Washington?) is that most of them are not able to give up control sufficiently to embrace an as-yet-to-be-created paradigm that will be necessary to be the rising tide that lifts all boats. Until that happens, we are all sunk.

I have heard it said that the measure of a civilization is how it treats those who have hurt it. Soon-Shiong furthers the definition to "how it treats those who are hurting in it." Thank you Dr. Soon-Shiong, and Godspeed.

FOR READERS: In your comments, please suggest ways that might cause the receiver/patients, giver/provider-payers, taker/opportunists-inefficient health care providers and institutions to care enough to actually take action on the health and well-being that most of us already agree are important. I would also be interested in your suggestions that would cause siloed specialized interests to care enough to want to work together toward a shared future more than further their own agendas. I would appreciate your focusing on solutions as opposed to finger...

The Avengers may not overtake Avatar as the highest grossing movie, but it seems poised to give it a run for the money.

What's the formula of a blockbuster?

In the case of both The Avengers and Avatar, you may enter the movie theater identifying with the powerless,...

Let's face it. Many men are masters at baiting (okay, so I had some fun with those words), in that they know how to easily bait you and press your buttons in a way that causes you to take the bait, go off balance, become submissive or defensive -- and...

Disappointment is merely an unmet expectation,
it's only when you imbue it with negative meanings that it becomes painful

World English Dictionary

dys-

prefix

1. diseased, abnormal, or faulty: dysentery; dyslexia
2. difficult or painful: dysuria, dysthymia
3. unfavorable or bad: dylogistic

[via Latin from Greek dus- ]

Ben Bolch of the L.A. Times recently wrote in an article entitled "Win or lose, they want the ball at game's end," that the top NBA closers -- including Kobe Bryant, Chris Paul, Dirk Nowitzki and Carmelo Anthony -- have no fear of failure in the final seconds.

Happiness is not be be achieved, it is to be experienced

Twenty years ago, a man from a primitive tribe in South America came to New York City and was asked, "What do you think?"

He replied, "They don't see the sky."

He recently returned and was asked the same...

There are few things that cause a wife to lose admiration and respect for her husband than when she observes him trying to b.s. other people with things that she knows are not true.

And there are few things that cause a wife to lose trust and confidence in her...

Once again, we have the opportunity to speak with Dr. Harry Chertok. Dr. Chertok is a recently retired high school principal with over 30 years experience in the field of education, the last 16 as a high school principal. He has supervised schools ranging in size from 300 to 5,000...

(Fixing American Education - Part 2 - What's Right With Public Education?)

Today we have another opportunity to speak with Dr. Harry Chertok. Dr. Chertok is a recently retired High School Principal with over 30 years experience in the field of education, the last 16 as a High...

Guilt is about wrong-doing; shame is about wrong-being*

You hurt someone, you lie to them, you betray them, you steal from them, or you abuse them or even worse. All pretty awful and even horrendous. Then you get caught, you pay your penance, or go to confession, or even prison,...

Today we have the opportunity to speak with Dr. Harry Chertok. Dr. Chertok is a recently retired high school principal with over 30 years of experience in the field of education, the last 16 as a high school principal. He has supervised schools ranging in size from 300 to 5,000...

Mirror, mirror on the wall, who's the most visionary of them all?

Being cast as a visionary is a drug and when it turns out you are mainly an opportunist or worse, a one trick pony, the paranoia about being exposed can make you murderous to your people (who...

Part 2 in a Calling All Women Executives Series (View Part 1)

Q: What is one thing men and women in business have in common?
A: They both distrust men

Hell hath no fury or contempt as a narcissist you dare to disagree with, tell they're wrong, or embarrass.

There are all sorts of disagreements regarding people like Steve Jobs, Newt Gingrich and Bill O'Reilly, but one thing most people are in agreement about is that you don't want to...

She: "You need to work harder on this relationship?"
He: "What the f--- does that mean?"

When a woman says the above to a man, he scratches his head and thinks, "Do I need a shovel, do you want me to fix something in the house and when it...

Men like having sex much more than they like responsibility. And women don't mind and even like sex, but they can't stand empty promises by men to get it from them.

I don't know how often this occurs, but there is a not-infrequent situation where a man is sure about...

When in the Course of human events it becomes necessary for one people to dissolve their special interests which have distanced them from one another and to assume among the powers of the earth, the possibility to communicate, cooperate and collaborate with one another to which the possibility of being...