A lifelong connection to medicine: Incoming president wants to build a better future

Ever since he can remember, Peter W. Carmel, MD, DMSc, knew he wanted to be a physician.

During his childhood, he was surrounded by the doctors in his parents' social circle. His father was an internist with an interest in rheumatology.

"I don't recall a single day in my life that I didn't think I was going to be a doctor. I never had any doubt about it," he said.

After more than 40 years as a pediatric neurosurgeon, Dr. Carmel remains enthusiastic about his profession. He draws on that passion to help inspire new physicians and to motivate more experienced physicians to play a role in improving health care.

Dr. Carmel has earned a reputation as a man of principle and foresight who believes in giving back to the profession, the age-old contract of a firm handshake and being upfront and honest with colleagues and patients.

"He has the ability to look at something from 20,000 feet and come up with a creative solution, and then motivate and convince everyone to make it happen," said Charles Prestigiacomo, MD, a neurosurgeon and associate professor at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in Newark. "When so much is happening in health care, he is a strong voice who speaks for the doctors and the patients."

Starting on June 21, Dr. Carmel will use his skills as an eloquent speaker, educator and motivator to represent the American Medical Association as its next president. As president-elect, he has spent the past year traveling around the country and as far as Sydney, Australia, speaking to physicians, patient groups and hospital organizations about the future of health care and the Patient Protection and Affordable Care Act.

Dr. Carmel, a member of the AMA Board of Trustees since June 2002, said he always has seen a clear link between the AMA's actions and improvements in the day-to-day practice of medicine. He strongly believes in helping to better the profession for the benefit of physicians and patients alike.

"This is a time of vast changes in our health care system and doctors are worried sick," Dr. Carmel said. "They're worried that their practices will be threatened and that their socioeconomic status will be threatened. It is important for the AMA to be a clear and trusted voice for those doctors."

Building a legacy

Each weekday morning, Dr. Carmel drives 16 miles from his home in Manhattan across the Hudson River to UMDNJ in Newark, where he is professor and chair of the department of neurological surgery and co-medical director of the Neurological Institute of New Jersey. His eighth-floor office is filled with stacks of books, its walls adorned with the many honors he has accumulated in his career.

During his years at UMDNJ, Dr. Carmel has built a lasting legacy. He was recruited in 1994 from Columbia University College of Physicians and Surgeons to oversee what was then a floundering neurosurgery division.

Edwin A. Deitch, MD, chair of UMDNJ's department of surgery, said Dr. Carmel was the first person he recruited when he came to head the department. "We needed someone who could really stabilize and build the program," he said. "It was clear that he was incredibly experienced and talented."

Dr. Carmel hired top-notch faculty and quickly built the residency program. Within three years, the program had gained full approval from the Accreditation Council for Graduate Medical Education's Residency Review Committee for Neurosurgery.

The result is a neurosurgery program ranked among the best in the country, Dr. Deitch said.

Dr. Carmel, an avid researcher and educator, enjoys being part of an academic medical center where he can contribute to the advancement of medicine. He said a major accomplishment has been faculty development. Each department's six faculty members has been invited to speak by the Congress of Neurological Surgeons and the American Assn. of Neurological Surgeons.

"It's one of the most distinguished faculties in the country," he said. "They're so excited about what they're doing, and they're doing such incredible things. It is so much fun and so exciting to be a part of."

Dr. Prestigiacomo said Dr. Carmel was one of his mentors as a medical student at Columbia. He is a talented teacher who constantly pushes students and residents to learn more and be better physicians.

As department chair, he motivates the faculty by offering support and encouraging creative thinking. "A handshake with him goes a long way," Dr. Prestigiacomo said. "He will always be there at your back and protect you when you need to be protected. He is a genuinely good person who will go out of his way to help you."

A voice for the AMA

Within his specialty, Dr. Carmel is known as a highly skilled surgeon and a mentor to many who have gone on to be leaders in the field, said Saleem I. Abdulrauf, MD, professor and neurosurgeon-in-chief at Saint Louis University Hospital and director of the university's Center for Cerebrovascular and Skull Base Surgery.

"He is an icon in our field," Dr. Abdulrauf said. "He's a great surgeon, a great teacher, a great mentor, and he really understands the future of health care. He has contributed to the evolution of neurosurgery and neurosurgical techniques."

Dr. Carmel graduated from New York University School of Medicine, was a research associate at the National Institutes of Health and completed his residency in neurosurgery at Columbia University's Neurological Institute of New York. He also has a doctorate in neuroanatomy from Columbia, where he spent 27 years on the faculty and helped found the division of pediatric neurosurgery.

As AMA president, Dr. Carmel said he will continue to advocate for the AMA and its initiatives, including finding a permanent solution to Medicare's sustainable growth rate formula and correcting misconceptions about the health reform law. He said he's frustrated by the rampant misinformation about the law, such as fictitious reports of "death panels."

"It bothers me that the popular press has presented such distortions of the [law]," he said. "It is the AMA's great responsibility to inform physicians and patients."

Dr. Carmel speaks regularly about the role physicians will play in the creation of accountable care organizations. Though the regulations that will govern the formation of ACOs have yet to be finalized, it's vital for physicians to be involved from the outset. "The AMA believes strongly that accountable care organizations should be run by physicians," he said.

He also is a strong advocate for talking with patients in advance about end-of-life care. "It is a conversation that is hugely important and terribly difficult," he said. "But it is a needed conversation, and it is the best thing we can do for patients."

Dr. Carmel is passionate about reducing waste and redundancy in health care. Millions of dollars could be saved with practical solutions such as implementing standards to reduce hospital-acquired infections and sharing medical records among institutions to prevent tests from being repeated when patients are transferred, he said.

The medical profession also needs to improve how it polices itself and be a better steward of limited resources. "There is no question that we can improve health care, and that improvement can be substantial," Dr. Carmel said. "If the hospitals, the physicians and the patients were all in alignment, we could save a lot of money."

Rooted in family

At his spacious, sun-filled home overlooking the lush treetops of Central Park, Dr. Carmel credits his father with instilling in him the importance of giving back to his profession. He said his family serves as his ultimate foundation.

His wife, Jacqueline A. Bello, MD, is director of the division of neuroradiology and professor of clinical radiology at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center in New York. The couple married 17 years ago in an intimate ceremony on the porch of the stone farmhouse they own in Orange County, N.Y. The house was finished in 1822, and its basement was used as a shelter for settlers hiding from attacks by Native Americans in the 1750s.

At their home in the city, nearly every inch of shelf space is filled with framed photos of Dr. Carmel's three sons, daughters-in-law and seven grandchildren. Among them are two doctors: Dr. Carmel's son Jason is a pediatric neurologist, and his daughter-in-law, Amanda, is an internist.

Dr. Carmel and Dr. Bello share a love of history. Their living room is furnished with antiques collected during their travels abroad, including a 400-year-old coffee table and two large ancestor portraits from China. They love to entertain and relish time spent with family, who all live no more than 15 minutes away.

Fourteen years ago, on Dr. Carmel's 60th birthday, Dr. Bello planned an elaborate hoax to surprise him with a four-day trip to Puerto Rico with his children and grandchildren. "His birthday present was time with family. That's what you give someone who has everything -- time," she said.

Dr. Bello said her husband's passion and sense of caring will make him a strong leader of the AMA. He cares about patients, physicians and the future of health care. "Caring is really the one word that covers it all," she said.

Dr. Carmel said he is privileged to represent the AMA as president and looks forward to the year ahead.

"It's a huge honor," he said. "I feel terrific being able to go out and beat the stump for doctors."