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The Yoshi Effect: The Absence Of Health and Well-Being


Robert A. Beltran, M.D., M.B.A.

President/CEO of Wounded H.E.A.R.T.S. Foundation

Minister of Health and Well-being


Who knew? Who would have suspected? Why did he do what he did? These are the many questions asked by colleagues, friends and family that remain unanswered. 


In December of 2014 Dr. Yoshi Makino spoke to his family, friends and to all of medicine. It was only then that we all would understand the seriousness of his message.  


He spoke with finality, clarity and amazement. His message was simple and clear: No one is immune from the perils that fall on those who lack health and well-being as physicians- healers of those with hurting bodies and minds.


Dr. Yoshi Makino , Assistant Clinical Professor of Medicine, GI Specialist chose to commit suicide on the Keck School of Medicine of USC campus.     


Dr. Makino’s suicide is a stark reminder of the vulnerability and fragility of our minds and souls.


So what is the Yoshi Effect? In layman’s terms it is what Dr. Dike Drummond calls-  “When Working Harder Isn’t Working !!!” ( 1)


 It’s hitting that proverbial “brick wall.”


 A more formal definition of physician burnout is  ” … an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”  (2)

Many if not most physicians are struggling to understand and appreciate the rapid pace of change which is taking place in medicine today. One of the most unfortunate consequences of this change is the erosion is the loss of Physician Autonomy, Physician Leadership and most importantly a loss of  Influence and Governance over our Medical Profession.  The end game for many of these physicians and society is a huge loss.


Here are just a few of the realized losses (3):

  • Lower quality of care

  • Lower patient satisfaction rates

  • Higher medical error rates

  • Higher malpractice risk

  • More frequent disruptive physician behavior

  • Higher turnover in physician and staff members

  • Higher rates of physician divorce

  • Physician alcohol and drug use and addiction

  • Suicide

    Burnout is bad:


  • For the doctor

  • For their family

  • For their parents

  • For their staff, colleagues and co-workers

  • For their organization


    Burnout is everywhere, all the time . ( 3)


    Now is the “once in a life” opportunity, a zeitgeist opportunity, to create a culture of transformational change that will put out the fire of physician burnout.


    No doubt, it will be challenging and complex, but a Coalition of the Willing must come together- medical schools, hospital systems, organized medical groups, medical societies, state and national medical associations – in a collaborative , integrated and coordinated manner to “Stop Physician Burnout” as Dr. Drummond espouses so clearly in his book.


    Yoshi is definitely a True SC ( Strong and Courageous) Trojan. We all bestow upon him the honorary degree of Emeritus Professor of Health and Well-Being from the Keck School of Medicine of USC (University of Strength and Courage) from this day forward.


    Fight On !!!! Keck Trojan Warriors !!!


    1. Drummond, Dike. “Stop Physician Burnout” Heritage Press Publications, 2014


    2. Physician Burnout: Why its not a Fair Fight http://www.thehappymd.com/blog/bid/295048/Physician-Burnout-Why-its...   Dec. 29th, 2014 


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