Doctor's orders: First, be nice

World-renowned pediatric neurologist Dr. Benjamin Carson had some advice for a packed banquet hall of healthcare executives about how to succeed in this business.

First he had the audience raise their right hands and swear with him a niceness pledge: “You're going to be nice to every person you encounter, for one week. That includes spouses,” he said to the chuckling crowd. “One week.”

Carson, who is director of the division of pediatric neurosurgery at Johns Hopkins Medicine in Baltimore, had plenty of unexpected advice in store during his delivery of the annual Arthur C. Bachmeyer Memorial Address at the American College of Healthcare Executive's annual Congress on Healthcare Leadership in Chicago.

For example, he urged the executives in the room to think about many of the healthcare problems in the U.S. as stemming not from bad health or behavior, but education. “When we're talking about health in our society, we need to talk about mental health, as well,” he said.

Carson also revealed the formula that has led him to make some of the unconventional decisions of his career, such as when he has chosen to operate on pairs of conjoined twins when other surgeons passed on the risks. He uses a four-part analysis he calls the Best Worst Outcome analysis, which involves asking four questions: What's the best outcome of a given action? The worst? What's the best outcome of taking no action? The worst?

Such an analysis can help reveal when outside factors, like a surgeon's instinct to protect his own professional reputation, might be interfering with making the right choice for a patient.

“It's important to have your heart in the right place if you're going to be dealing with people's lives,” he said. “It makes all the difference in the world.”

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