Jason B. Karp, MD, named one of New York magazine’s 2006 “Best Doctors in New York,” offers his insights on what makes a successful pulmonologist.
By Anne McCarthy Strauss
Jason B. Karp, MD, is no stranger to awards for recognition for outstanding achievement among his peers. In 1991, during his residency at Montefiore Hospital Medical Center in the Bronx, NY, he was named Outstanding Resident in Internal Medicine and Ambulatory Care. Most recently, Karp was honored as one of only a handful of pulmonologists named to the prestigious 2006 “Best Doctors in New York” list published by New York magazine.
What makes this honor especially compelling is that the winners are selected by other physicians—thousands of New York’s top doctors who are asked, “To whom would you send a member of your family?” The research company Castle Connolly Medical Ltd conducts the peer-review survey, theorizing that medical professionals are best qualified to judge other medical professionals. Considerations include the nominee’s professional qualifications and reputation, as well as their skills in dealing with patients in such areas as listening, communicating, empathizing, and instilling confidence and trust.
Karp, an unassuming and likeable man, was genuinely surprised when he learned that New York had recognized him. “I didn’t even know I was under consideration,” he says, modestly. “My senior partner, Dr David Brieidbart, told me I’d won when I arrived at work one morning last summer. I felt extremely honored. Later that morning, a patient mentioned it. By lunchtime, it was the buzz around the office.”
Asked what he felt contributed to his winning this prestigious award, he spoke of his penchant for seeing his patient as a whole person, a willingness to incorporate nontraditional therapies into his patients’ treatment programs, taking a team approach to medical care, and constantly educating himself and others regarding new and upcoming treatments and medicines.
“I look at each patient as an individual human being with a unique combination of emotions, habits, and history,” Karp says. “I consider the individual’s complete health picture, not just their pulmonary health. The patient’s condition may also have an emotional component—emotions have a profound effect on respiration.”
Whether the diagnosis is seasonal allergy or lung cancer, Karp makes every effort to educate his patients and their families about their condition and treatment options. “First and foremost,” he says, “I try to explain what’s happening in layman’s terms and to outline solutions to that problem for their condition in a way that is easily understood. I supplement this with easy-to-read handouts that the patient can refer to at home. My goal is to leave no question unanswered.”
Looking at the Whole Person
Karp’s interest in medicine was sparked by his grandmother’s chronic illness while he was growing up, and the death of his grandfather when he was in college. During his grandfather’s illness, Karp acted as a liaison between the doctors and the family. He was stricken to find that the doctors at that time were not very forthcoming with information. It was then that Karp determined that he would pursue medicine, making it his mission to demonstrate openness and caring that would make a difference in the lives of his patients and their families.
Karp chose pulmonology as a specialty because he was intrigued by the physiology of the respiratory system as well as by the opportunity to use his skills as a mathematics major to measure and calibrate with respirators, critical care devices, and pulmonary function testing.
In addition to being open with patients, he is also open to incorporating holistic treatments and modalities into a patient’s treatment plan. “I look at the patient as a whole and form a diagnostic and therapeutic plan that will optimize their quality of life. To me, this should include nutrition, exercise, stretching, traditional therapy, and both natural and chemical pharmaceuticals. Although most physicians are still quite conventional, I feel that doctors need to open up to nontraditional therapies—things like acupressure, acupuncture, and chiropractic. I think patients are, understandably, more receptive to a physician who will look into other things that may benefit his condition.”
Karp advises any medical practitioner to hone their listening skills, saying, “I think it’s extremely important to listen to what the patients are saying. Listening to what their families are saying with regard to their situation, and visualizing what’s going on is also important. As specialists, we may tend to focus on a particular venue and I think this can lead to problems with regard to the patient’s overall treatment.”
The Greatest Threat to Pulmonary Health
Asked what he considers to be the great threat to pulmonary health, Karp cited our changing climate. “The claim is that each year allergies are getting worse,” he says. “I find that more and more people are experiencing seasonal breakdown—as the seasons change, more people are having asthmatic-type bronchitis and the like. The environment, global warming, and increased pollution are all factors.”
Karp spoke of smoking and its effects being less of a problem in this country today than they were in the past. “But, sadly, there is not a corresponding decline in lung cancer as more people with no smoking history are developing this cancer,” he adds. “I think more lung cancers may be related to prior infections such as adenovirus as well as to other types of infections that appear to put people at risk for a cancer that was not very common years ago. That cancer—bronchoalveolar cell cancer—is a non-small cell cancer that has become much more prominent today than it was only 10 years ago.”
While other occupational exposures appear to put people at risk for cancer, Karp theorizes that there may be a viral etiology as well as genetic predisposition behind this that makes some people more prone to the disease. “Retrospectively, in some lung cancer patients,” he says, “remnants of past viral infections are being found in their pathologic slides.”
Karp encourages an emphasis on optimizing the environment in such areas as cutting down on pollution and being more environmentally sound in the use of fuels. “Unfortunately,” he says, “this needs to be done on a worldwide basis and many countries—China, for example—are not focused on this and are beginning to use more [fossil] fuels.”
He added that we need to practice better hygiene to cut down on infections, and to cut the overuse of antibiotics and other resources that may not be needed. We must work to control interior climates. For example, when people go from air conditioning to extreme heat, there needs to be a more gradual and uniform change in temperature.
More Hope on the Horizon
An award-winning doctor knows how to treat his patients today with the tools that are available to him. He is also keenly aware of opportunities for treatment that will be available to treat tomorrow’s patients.
Asked what new treatments and modalities are on the horizon, Karp discussed new diagnostic modalities that should make earlier diagnosis of lung cancers easier. “Better CT scanning, higher resolution procedures, and more sensitive and specific diagnostic sputum tests are all on the horizon,” he says. “Beyond diagnosis, there are a lot more chemotherapies available than there were even 5 years ago, and lung cancer statistics, although not dramatically better, are improved.”
In treating asthma, new anti-inflammatory modalities, other than the usual inhaled corticosteroids, are being pursued. “We’re also looking for new steroid combination products, and inhaled corticosteroids with fewer side effects,” he adds. “That will cut down on steroid-related osteoporosis, glaucoma, and cataracts.”
In the area of chronic obstructive pulmonary disease (COPD), Karp says that there are new modalities that enhance pulmonary rehabilitation and improve quality of life. There are also lung reduction surgeries and bronchoscopic lung reduction, a noninvasive venue.
Karp spoke about his other area of specialization, sleep apnea. “Seven million people in United States are affected by sleep disorders,” he says. “This is a condition that affects quality of life, personality, and memory. Awareness of sleep apnea has grown, as has the ability to treat this disorder. Sleep apnea masks are being improved, and devices are being approved for people with mild to moderate sleep apnea. There are some new surgical approaches awaiting approval and an overall better response to current surgical modalities.”
“The only way a physician can successfully take care of patients is to recognize that medical care requires a team approach,” Karp emphasizes. Karp’s team, both in and out of the hospital, includes nurses, nurse practitioners, therapists, respiratory therapists, transporters, and technicians. “If those things are functioning well, I can function well,” he says.
“If any of those things are out of synch,” Karp adds, “it can cause a problem for the patient, affecting their optimal care. I rely on respiratory therapists for their insights on how a patient is reacting to different treatments and medications—inhalers or nebulized therapy. I rely on nurses to administer medications in a timely way. Beyond that, the team extends to such consulting services as speech and swallowing and physical therapy. And, of course, we need the cooperation of the patient.”
Recognition by one’s peers is, perhaps, the most elusive and coveted form of recognition. The honor of being named one of the Best Doctors in New York is especially prestigious because the winners are selected by their contemporaries.
Karp is partner in a nine-physician practice, North Shore Pulmonary Associates in Lake Success, NY, that provides general pulmonary medicine consultation and treats such conditions as COPD, asthmatic bronchitis, pneumonia, lung cancer, and sleep apnea. Karp is licensed and certified in internal medicine, pulmonary disease, and critical care medicine.
Making a difference in the quality of his patients’ lives is the part of his job that gives Jason Karp the greatest satisfaction and counters the workdays that begin before 5 am and extend into the evenings. “A thank-you is the most important, gratifying thing for me,” Karp concludes. “I am fortunate to do work that I love. I really enjoy medicine in general and pulmonary medicine especially. And dealing with patients has always been, and remains, my favorite part.”
Anne McCarthy Strauss is a contributing writer for RT.