MedicalPhysician Q&A

20 Questions: John Hunt, MD, Peds Pulmonology/Allergy/Immunology

John Hunt, MD is a pediatric pulmonologist/allergist/immunologist from Charlottesville, VA. He received his bachelor’s degree from Amherst College before going on to George Washington University School of Medicine, where he earned his MD. He served in the Medical Corps with the US Naval Reserve from 1992-2003. During that time he completed his residency in pediatrics at the San Diego Naval Medical Center, and two fellowships at the University of Virginia, one in Allergy and Immunology and one in Pediatric Pulmonology. Since then he served in a number of roles, from professor at the University of Virginia to entrepreneur to researcher to author.
1. When did you first decide to become a physician? Why?
Throughout my childhood I had bad asthma and my pediatrician was wonderful so I decided by fourth grade to be a pediatrician. By 9th grade, I was cured of that desire because there was no way in hell I was going to put up with all the years of school needed to become a doctor. I didn’t even consider medicine again until my college senior year, during which I decided to be a surgeon. But somehow, in the end of it all I grew up into a pediatric asthma specialist. My wonderful childhood pediatrician quit medicine to open a chocolate factory.
2. What surprised you most about your medical studies?
That the premedical work was pretty much unnecessary, and that I was very glad that I studied in college all sorts of broad liberal arts as opposed to wasting excessive time with undergraduate chemistry and biology. You learn what you need to in medical school and then in residency, and then in fellowship and then every day through a medical career. So, take as few pre-med courses as you can and don’t waste your valuable college education being a pre-med major. There is so much to learn in college that will help you be a better doctor that has nothing to do with chemistry and biology.
3. What is your specialty and why did you decide to specialize?
I chose pediatrics because children are innocent and awesome, and there is huge bang for little buck. It is highly efficient to help children. And you just gotta love ‘em. I subspecialized. I chose Peds Pulmonology/Allergy/Immunology because nobody knows anything about how the lung really works, so it was easy to be a research pioneer there and look like an expert.
4. What advice do you have for medical students who are currently in school?
Run for the hills. No, I’m kidding. Sort of. Being a doctor remains a most noble pursuit. People respect doctors less now, perhaps because we respect ourselves and our profession less, and that perhaps deservedly so. My advice to medical students is to work to reverse that disrespectful trend. Patients are individuals yet medical care is increasingly and forcibly groupthinked. Beware of the tools that eliminate individualization of care: evidence based medicine and quality-program-enforced “guidelines” are wolves in sheep’s clothing. Seek out honesty, integrity, voluntariness. Respect people who encourage practice change through persuasion as opposed to compulsion. Be humble for gosh sakes.
5. What was your experience like as a physician in the Navy?
To me, it was just like civilian practice except we wore uniforms and got to do some extra exciting things, like spend time at the Marine Corps Mountain Warfare Training Center learning Cold Weather and High Altitude Medicine, learning Combat Casualty Care, and other such adventures hard to obtain in the civilian world. I had great colleagues too. And three years in Iceland for extra fun.
6. Do you have any advice for students considering military medicine?
Maximal flexibility assures maximal happiness. In the military you get to see the world, but you may go places you wouldn’t have chosen to go (and yet will still enjoy). It’s a great chapter in life, no matter how long that chapter lasts. Are there downsides? Yes. War is the health of the state and it is used to distract the population from the shenanigans of the politicians. What will you do if you are committed to the military but disagree with the current propaganda? The military, when used to prevent war, is most noble. However, if the military is used as a tool of political shenanigans, Napoleonic or holy or distracting, what will you do if you are a military officer? What can you do? I loved the Navy and I still do. It is populated with the best and most honorable people I ever met. But it is subject to the control of politicians.
7. What made you decide to go into academic medicine?
I had developed so many questions that I wanted to get answers to. There is a huge difference in lifestyle and philosophy between academic medicine and regular practice. Academic medicine provides much more variability in day to day activities, more freedom from moment to moment, more freedom to travel the world while on the job. And a lot less pay, in general.
8. What did you like most about teaching? What did you like least?
For me, there was no better way for me to digest and contemplate the oodles of available information than by trying to make sense of it while teaching. What did I like least? Well, we called them brown-nosers or “gunners” back in my day: irritating little buggers who have their priorities all askew.
9. You have had a wide and varied career. What advice do you have for students who have not decided what type of medical practice to pursue? 
I am unworthy to give advice, so I will give advice: students should do some serious self-assessment. What do you really care about? Do you care about your individual freedom to do as your choose? Are you a leader or a follower naturally? Are you narcissistic or humble? Are you an early adopter of technology or are you more timid? Find your core strengths and build on them… Then, do what you feel you are good at and you will succeed. And is okay to change direction entirely when things get prosaic or you learn something new about yourself. It is your life, so live it. Oh, and don’t get imprisoned in life by addiction to continuous income. Live cheap.
10. What has been the biggest challenge you have faced in your career?
No doubt about this one. I love practicing medicine. I love taking care of patients. But I absolutely despise having others, who have no business doing so, insert themselves between doctors and patients. The Moral Hazard of health insurance is the cause of so many of the challenges in health care. Health insurance is the problem, not the solution. Health insurance is the disease that causes health care to be so unaffordable. As usual the politicians in the US got the diagnosis all wrong and so prescribed more health insurance when there was already far too much of it, and when the treatment for the problem should have been to excise the health insurance from the system. The politicians committed horrible malpractice and prescribed a completely contraindicated therapy.The health system is now all a big crony-collectivist/crony-corporatist boondoggle. Obamacare reform actually increased the cronyism. By the way, there is another word for crony-corporatism, and that is ‘fascism’. It’s a damn ugly word, but you are effectively immersed in it. Although I loved the practice of medicine, and loved research and loved teaching, I could not continue to support the systemic immorality of collective groupthink. It has been challenging to find another way to use my education. I am still looking for ways.
11. You have made a number of entrepreneurial ventures recently in your career. What led you to shift your career from professor to businessman?
Actually, business was concurrent with academics for me from my first year of my first fellowship. Getting ideas from bench to bedside does not get accomplished by an academic nerd getting a paper published. Getting a new medication or a new device out to the patient requires business planning, market research, capital investment, risk taking, huge amounts of work, and, most sadly and counterproductively, an enormous amount of wasted effort and money to get through nearly pointless federal regulatory rigmarole and coaxing approvals from the various third-party payers. All of it has to be done, and the academics don’t do it. They get their papers published, pad their CVs, get their grants, do their research, publish their papers, pad their CVs more, and round it goes back again. It is still and always will be capital investment and capital risk (true capitalism, not modern Washington cronyism!) that nurtures the best ideas and gets them to the patients.
12. What led you to begin writing fiction?
Writing fiction (in my case novels) is but a small leap from writing NIH grant applications! I don’t have the faintest clue as to what prompted me to begin writing, but I love doing it. I have two novels published, Assume the Physician (designed to keep you laughing while seeing where you have been lied to in medicine) and Higher Cause, a big heroic novel. Between them, I hope to make hundreds of money. I have six more books on the way, coauthored with the great Doug Casey.
13. What has surprised you most in your career?
The conflict between individual morality and the system’s immorality. To me, truth is reflected in its beauty and its internal consistency. When there is a blazing internal contradiction, then that is solid evidence that truth is not near. Supporting our bureaucratic health insurance/government paradigm in the face of huge contradictions seems to me to be a form of moral insanity. Yet so many people have been brainwashed into thinking of health insurance as the way to lower costs, even while bitterly complaining about how horrible health insurance prices and clerks and hassles and rules all are. Do they not see the contradiction? I have learned a surprising lesson in my career: logic and rationality lose to the power of propaganda and lies.
14. Walk us through a day in your life. How do you manage your time?
I rarely wear anything other than pajamas. Sometimes I am binge writing (two weeks straight without a break), ignoring all else and then catch up on life later. I collapse in a wonderfully comfortable bed in a heap, turn on something on the tube and immediately snore. A day and a night, the first day, and I saw that it was good. So I try to repeat… But some days are totally wasted doing tax returns, fighting with incomprehensible FDA insanities and other such evils of man which I hope get washed away in the next Flood. I waste an inordinate time on email—all professional. I have no typical day.
15. Do you have a family? If so, do you feel you have enough time to spend with them? How do you create a good work/life balance?
I didn’t do it any better than anyone else, except perhaps that after a while, I started taking summers entirely off from medicine. That was my method of balance. In exchange, my medical sourced income was very low for a triple-boarded doctor, but I will always trade money for more freedom. I had time to play, to write, to grow, to start businesses (which brought in income!). I think it was a great trade off. Now I am off 12 months a year!
16. Do you do any outreach/volunteer work?
I co-founded Trusted Angels Foundation, a non-profit that supports education and health care and entrepreneurialism in Liberia, West Africa. Liberia had come out of a civil war, the people were very poor and the government had no money, so it was like a really free newborn country. One of our people, Mike Davis, has created the first Respiratory Therapy school in Liberia.
17. Knowing what you know now, what would you say to yourself at the beginning of your medical career?
Buy stock in Google (when it someday came into being) and buy gold and silver too.

Then become a doctor, but work in Africa or some other place outside the US or Europe. At the beginning of my career I wished I had told myself: “John, there are many ways to do good in the world. You don’t have to be a doctor to do good. If you become a doctor, find a place, somewhere in the world, that is consistent with your ideals.” I am a libertarian—an ideology that does not accept force and fraud. The medical system in the US is now filled to the brims with force and fraud, not from the doctors, but from the government and the accreditation agencies and health insurance companies… I wish I had known.
18. In your opinion, what is the biggest problem in health care today?
First answer: too much damn disease. If we could just get rid of disease, health care would be so much less trouble.

In my view, the biggest problem in health care today is the government’s subsidization of—and now mandating of—third party payment schemes, and the resulting moral hazard that entirely destroys all the wonderful natural processes that a free unfettered market could have by now used to create unlimited medical wealth, and by that I mean ever advancing and less-expensive health care with increasing availability to all. Imagine if the health care system was kept as protected from the government as the Internet mostly has been: what a boon! So could Medicine have been by now, with innovation everywhere, unstagnated by the monopolists at FDA, without the malinvestment caused by NIH controlling so much of the research dollars, without the misallocation and loss of resources caused by moral hazard. The individuals who create medical wonders must no longer be stopped by the purveyors of fear and control. Let’s stop bureaucratic medicine. Let health care be abundant, available, and cheap.
19. What information or advice do you wish you had received before beginning your medical studies?
I got good advice: Think of patients, not diseases. Think of patients, not grades. Think of patients, not papers or grants.
20. If you had to do it again, is there anything you would change about your career?
My yes… But that is all unchangeable. The future is yet to come. I am more interested in making the best out of the now, while preserving the ability of the nows of the future to be filled with the most possible happiness for all. Sustainable happiness built on a foundation of truth is the best form of wealth.

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