Dr Michael Nurok is the medical director of the Cardiac-Surgical Intensive Care Unit within the Division of Cardiothoracic Surgery in the Cedars-Sinai Heart Institute. Prior to joining Cedars-Sinai, he was instrumental in creating the first Intensive Care Unit at the Hospital for Special Surgery in New York, and served as the unit’s first medical director. He is a member of the Society of Critical Care Medicine, Society of Critical Care Anesthesiologists, American Society of Anesthesiologists, and American Society of Bioethics and Humanities.
In a Viewpoint published in JAMA Surgery, Dr. Nurok and co-authors Nicholas Sadovnikoff, MD and Bruce Gewertz, MD, argue that the “ship’s captain” model of leadership is no longer valid in the era of multidisciplinary team-based care. Communication and coordination skills underpin healthcare, and they contend that physicians with highly specialised skills must interact in a collegial but nonhierarchical fashion. They recommend that patients are informed that they will be entering into a matrix environment in which multiple professionals will provide care at differing stages of treatment and recovery.
What are your key areas of interest and research?
My primary research interests are in human factors, medical ethics and perioperative communication.
What are the major challenges in your field?
Patients in Cedars-Sinai’s Cardiac-Surgical Intensive Care Unit are critically ill and often require care from several specialists and ancillary providers. Although this team-based approach results in good patient management, some physicians are hesitant to embrace the concept of multidisciplinary teamwork, as they’re more accustomed to a supervising physician overseeing all of the care that a patient receives. Advocating for a nonhierarchical, team-driven model of care is an ongoing challenge.
What is your key management tip?
I think that effective management is rooted in open communication, transparency and consensus-building.
What would you single out as the career highlight?
I would single out Cedars-Sinai giving me the opportunity to build a multidisciplinary team that’s dedicated to caring for critically ill patients.
If you had not chosen this career path what would you have become?
I’m interested in human behaviour and social structures, so I probably would have become a sociologist.
What are your personal interests outside of work?
Spending time with my family is my top priority. I also enjoy going back-country skiing and competing in triathlons.
Do you have a favorite quote?
A Buddhist principle – not a quote – comes to mind. Instead of categorising actions as being right or wrong, Buddhism shifts the focus to being skilful or unskilful. In short, being skilful is more important than being right.