Every year, we ask a few of Seattle’s Top Doctors to share what inspires them to practice medicine, the advice they give most often, and what they think the future holds for healthcare. These interviews are part of Seattle magazine’s annual Top Doctors feature, created in partnership with Castle Connolly. None of the doctors paid to be included — all are nominated by their peers.

What inspired you to become a doctor?

My father is a retired primary care physician who would often share his joy when he made a challenging diagnosis or put together a thoughtful treatment plan that made a huge difference to his patients and their families. The science, logic and caring required of a good doctor makes medicine a perfect career choice for me.

What’s one thing about being a doctor that most people misunderstand?

We don’t know all things in the entire medical field. Many doctors become specialized to be an expert on some things at the expense of other subjects (our brains get too full). I specialize in cardiology so my heart knowledge is terrific. But I have had patients try to get me to diagnose a
rash, and I truly have no idea. Dermatology was my worst subject in medical school and has only gotten worse in the 27 years since graduation!

What’s something in medicine you believe will be totally different in 10 years?

I think that artificial intelligence will make diagnosing and treating disease more efficient, accurate, reliable and predictable. But I think that doctors will always be needed to train the artificial intelligence systems and to update the best practice protocols. Most important, doctors will be needed to share the diagnoses and prognoses with patients and families in an understandable and compassionate way that no machine could duplicate.

Have you ever had a patient diagnose themselves correctly?

Of course. In some cases, it can be extremely helpful as some motivated patients have already read about and thought about what I might want to share with them for a particular diagnosis. But it is important not to find some rare disease online and try to fit the symptoms to the disease. When there are a lot more common causes of a symptom, we should consider the most likely diagnoses first before moving on to more rare explanations.

What’s one myth about health or medicine that you wish would go away?

“Can I just do it naturally?” I think that sometimes we think of doing one treatment or another treatment. I spend a lot of time encouraging my patients to follow the American Heart Association’s “Life’s Essential Eight,” which focuses on a healthy lifestyle. At the same time, there are some medications that I recommend for my heart patients that have been shown to offer benefit in addition to the heart-healthy lifestyle.

What’s the most unusual case you’ve ever encountered?

I have diagnosed a pheochromocytoma in a patient once. This disease is thought to occur in an estimated 2.8 out of 1 million people. This adrenaline-producing tumor can intermittently cause someone to feel fight-or-flight symptoms, with classic symptoms being headache, palpitations and excessive sweating. The challenge is that these symptoms can occur for a variety of reasons. I was pretty happy to make the diagnosis, which led to appropriate treatment for the patient.

What’s one piece of advice you wished every patient followed?

A heart-healthy lifestyle makes all the difference in the world. Many patients can help themselves achieve better health than I ever could with my medications. Smoking cessation cuts the risk of heart attack, stroke and death in half. Achieving and maintaining a healthy weight can be as protective as smoking cessation. Regular exercise can reduce the risk of death by 20% when compared to being sedentary. A Mediterranean diet has been shown to be even better than a low-fat diet.

If you could change one thing about the healthcare system, what would it be?

Wouldn’t it be ideal if we could keep all our modern knowledge and therapeutic advances in medical care but go back to the idyllic world of Norman Rockwell where a doctor had time to listen to a patient’s doll with a stethoscope and seemed to have nothing else to rush off to? No preauthorization or surprise medical bills. A doctor, a patient and a lot of caring.