profile marc sedwitz, m.d. trauma surgeon elected chief of ...pen-written on his right pant leg,...

8 January 7, 2010 Rancho Santa Fe Review

Profile Marc Sedwitz, M.D.

Quick FactsName: Marc Sedwitz, M.D.

Distinction: A vascular and trauma surgeon, Dr. MarkSedwitz was recently elected to a two-year term as chief ofstaff of Scripps Memorial Hospital La Jolla. He has been onstaff at Scripps since 1985.

Born: New York City, 57 years ago

Education: B.S. degree in biology, Haverford College,Haverford, Pennsylvania, 1974; ; M.D., Boston University,1978; residency in general surgery, New York Hospital/Cornell Medical Center, New York City, 1979-82; vascularsurgery fellowship, University of California SanFrancisco,1983-84.

Family: He and his wife, Irene Miller , a marketing con-sultant, have been married four years. They have a blendedfamily of three sons: Brian, 23, recent GeorgetownUniversity grad now working for Fanny Mae in Washington,D.C.; Tim, 21, a junior at Princeton University; andMekenna, 18, a student at Halstrom H.S.

Interests: Snowboarding and reading

Recent Reading: Connected: The Surprising Power ofOur Social Networks and How They Shape Our Lives, byNicholas Christakis and James Fowler.

Philosophy: As Voltaire pointed out, every man isguilty of the good he doesn’t do.

Trauma surgeon elected chief of staff of Scripps La Jollaas America enters a new era in health care delivery

Marc Sedwitz, M.D.Photo/Jon Clark

By Arthur LightbournIf you see a doctor in

green surgical scrubs walkingaround Scripps MemorialHospital La Jolla with notespen-written on his right pantleg, chances are you’re seeingthe hospital’s newly-electedchief of staff, Dr. MarcSedwitz.

He jots notes on his pantsbecause, as he puts it, “Youcan lose your Blackberry, butyou won’t lose your pants.”

As you might guess, thestocky 57-year-old vascularand trauma surgeon is bothbusy and practical.

We interviewed him inthe Schaetzel Center medicallibrary on the campus ofScripps La Jolla 10 daysbefore he assumed his newresponsibilities on the thresh-old of a new era in health carein America.

He is 5-foot-10, 180pounds, with longish dark hairthat has a tendency to get inhis eyes. For recreation, hesnowboards. He used to do alot of running and basketball.“Now, there’s just enoughtime in the day for runningbetween the hospital and theoffice,” he said.

Asked what would be his

responsibilities as chief of a900-member medical staff asof Jan. 1 for a two-year term,he said they will coincide withthose of the medical executivecommittee which are the cre-dentialing of new physiciansand the conducting the peerreview process.

However: “With healthcare reform being in its nas-cent state,” he said, “the med-ical staff is going to be respon-sible for a lot more of theissues of physician behavior,patient safety, and the abilityfor the hospital to acclimate tonew crises in health care.”

For 25 years, Scripps LaJolla has been North County’sprime acute care emergencyhospital as one of a network ofsix trauma centers serving SanDiego County.

“As these changes occurin medicine,” Sedwitz predict-ed, “this hospital will proba-bly have more and moreresponsibilities and with thatthe chief of staff is going to bededicated toward maintainingthe physician excellence andpatient safety.

“What we’re going to seeis a sudden change in howmedicine is delivered. We aremuch more accountable in

terms of what are called qual-ity parameters, how we distin-guish ourselves from a goodhospital to an excellent hospi-tal; what we’re graded on.

“Physicians have alwaysbeen very, very good at beinggraded. They got 98s in highschool, in college and medicalschool, but medicine now isexpecting 100 percent. Andwhat we live with is trying tominimize that 2 percent ofcomplications, the 2 percentof people with extendedlength of stays, maintainingour excellence in a time whenwe are going to see certainly achange in what economicreimbursement is going to befor this.

“You can’t take 47 mil-lion people and make themhave insurance at a time whenhospitals are full and not havean impact on how your hospi-tal is run and how physicianresponsibilities are met,” hecautions.

The solution, he believes,will rest with educating physi-cians and utilizing new tech-nologies, including informa-tion technologies in howphysicians get informationfrom labs and X-rays and howthey communicate theirthoughts to other physicians.

Also, advances intechnology will improve howhospitals will view and ana-lyze data revealing whether ornot they are doing a good jobin terms of ‘bundled’ servicesbetween hospitals and theirphysicians to ensure the fair,equitable and collaborativedistribution of reimburse-ments.

“Doctors will always dowhat they do best which is tocare for people,” he said. “Theonly question is how do wemanage costs and who isgoing to determine what therules are for doing it.

“Some of the medicineswe give for cancer, forinstance, cost thousands andthousands of dollars for a six-month increase in lifeexpectancy. We still measuresuccessful health by how longwe live rather than quality oflife. We have the conflict ofour spiritual, emotional anddefinition of quality of life,with measuring it in numberof years. That’s why at the endof life it’s so expensive inhealth care.

“Do we deprive someone

at the age of 80 or 90 animportant operation for theirheart or their brain or theirback to improve the quality oftheir life knowing that theirlife expectancy is limited?”

Those are the types ofethical and social questionsthat we are going to have toaddress as a society, he said.

Born in New York City,Sedwitz was the elder of twoboys in his family. He grewup in Bethesda, Maryland,where his father was an econ-omist with the Organization ofAmerican States (OAS).

With thoughts of becom-ing a researcher, Sedwitzmajored in biology atHaverford College, a Quakercollege in Haverford,Pennsylvania.

Although he is not aQuaker, what he learned at thesmall 690-student college, hesaid, was a sense of communi-ty and the value of consensus,qualities that he hopes mayprove valuable in his role aschief of staff in an era ofchange.

“Based on a consensus ofa community, having different

opinions are always invited,but it is how you move for-ward to take different opin-ions and come up with a planto do something that everyonecan be responsible for,” hesaid.

While on a sabbaticalfrom Haverford College withone of his teachers at theUniversity of Basel inSwitzerland, “I decided beinga physician wouldn’t preventme from being a researcher.Being a clinician and a scien-tist was a very effective com-bination.”

He earned his M.D.degree from BostonUniversity in 1978 followedby a residency in general sur-gery, New York Hospital/Cornell Medical Center, NewYork City, 1979-82; and a vas-cular surgery fellowship at theUniversity of California SanFrancisco,1983-84.

In San Diego, he beganhis career on staff at UCSDMedical Center before joiningScripps La Jolla and ScrippsMemorial Hospital Encinitasin 1985 as a vascular and trau-ma surgeon.

At Scripps La Jolla, he isone of a team of five traumasurgeons averaging four tofive trauma cases each day.

He defines trauma as“any significant injury pro-duced by a fall, an accident, orby guns, knives or hanging.”

One of his mentors usedto say, there will eventually bea cure for heart disease andcancer, but there will never bea cure for trauma.

A good trauma surgeon,he believes, is fundamentallya skilled clinician and “themost general of generalists.”

“What is called ‘thegolden hour’ in trauma is thefirst 60 minutes where muchof a patient’s outcome will bedetermined by how quicklyyou can assess someone whocomes in, sometimes uncon-scious and suffering frommultiple injuries, and decidewithout even a laboratoryvalue or clinical test, what youneed to take care of thatpatient in the most expedientand successful way.”

Often, lives will besaved; sometimes, not.

“Recently,” he recalled,“there was a trauma that wasactually a hanging of a 17-year-old boy. He sustained ananoxic (inadequate oxygen)brain injury and came in in avegetative state. Brain dead.

“It wasn’t really an exer-cise in the management of thehealth problem; it was …. thecompassion that the nursesand the staff had for the fami-ly dealing with the death ofone of their children.

“He was revived on aventilator until a decision tolet him go was finally decidedby the family.

“We later had a letterfrom the family that was actu-ally one of the most movingexperiences for me in that itwasn’t about what we did; itwasn’t about operations ortechnology. It was the factthat we managed the end oflife in a 17-year-old that wasin his prime of life in a waythat was acceptable and com-passionate for the family.

“What they stated wastheir view of the hospital hadchanged; that we weren’tabout bricks and mortar andmonitors, we were about peo-ple taking care of people.”

And dying, he said, ispart of taking care of people.