Can a doctor be president? Ben Carson's trying to be our first.
Polls have him tied with Donald Trump atop the Republican field. Carson's single best pitch for the job? That as a surgeon, he's uniquely qualified to make hard decisions.
"This is a big theme of Carson's presidential pitch: that neither the rigors of the campaign nor those of the White House can faze a man who held children's lives in his hands," Jim Rutenberg wrote in the New York Times, back in March. "His life in brain surgery has prepared him for the presidency, [Carson] maintains, better than lives in politics have for his rivals."
Of course, those rivals don't agree. "Ben's a doctor, and he's not a dealmaker," Trump said on Face the Nation this week.
Experts in surgery, leadership, and presidential history disagree with Carson, too.
"Nothing in the life of a surgeon prepares you for the complicated negotiating structure of the presidency," Elaine Kamarck of the Brookings Institution told me.
How to think about surgeons
There's no question that of all the major candidates, Carson has the most proficiency in a technical skill. He spent four years in medical school, and another six years in residency.
And to become a Johns Hopkins neurosurgeon isn't just a matter of tenure and persistence; you need true talents. "Gifted hands," say.
Regardless of what happens with Carson's presidential run, his life has already defied the odds. And his career has been important and meaningful: He's helped advance medicine, and saved thousands of lives.
But while surgeons play God in the operating room, they're just as human as the rest of us. Many have problems managing their money or their tempers.
The writer Malcolm Gladwell even says we overestimate the difficulty of surgery, and claims that with enough practice — and fine motor skills — nearly anyone who can drive a car can also be a heart surgeon.
"I have a very low opinion of the difficulty of cardiac surgery," Gladwell confessed in an interview last year.
Why surgeons tend to be lackluster leaders
I think Gladwell goes too far. The best surgeons are incredibly driven and exceptionally smart, and it's no surprise that some have found success outside of the hospital. Heart surgeon Bill Frist became Senate majority leader. General surgeon Atul Gawande is arguably America's best health-care journalist.
But Gladwell is right that sheer admiration for surgeons may blind us to the reality of the job. And Justin Dimick, a University of Michigan surgeon who runs a leadership development program, agrees that it's a mistake to ascribe certain skills to all surgeons. That's especially true for a rare quality like leadership.
"Does being a surgeon make you a better leader?" Dimick mused in an interview. "I haven't seen any evidence to suggest that."
Dimick co-authored a recent study that found rising surgeon-leaders admitted to having gaps in key administrative skills, like setting a vision and getting others to follow them. This isn't surprising: Doctors go to school to be doctors. They don't go to school to learn management skills.
"Most physicians have major deficits in those leadership competencies by the time they're elevated to leadership positions," Dimick says. "And that's why we developed our leadership program — to help them develop those competencies in an intentional way."
And while Carson has held that surgery is the best preparation for national leadership, I couldn't find an expert who agrees with him. Instead, a half-dozen researchers kept returning to the same theme: It's very different to be a leader in the operating room, where a surgeon has total autonomy, than it is to be a leader in politics, business, or beyond.
"Some surgeons lead well within the OR, but once they leave that sphere of influence … they can often be horrible at leading others (and leading themselves, too)," University of Alabama Birmingham scholar Christy Lemak said via email.
"For every surgeon who ends up succeeding in the boardroom," Dimick adds, "there are probably an equal number of surgeons who haven't dealt with the stress well and ended up in anger management."
Why a doctor might not be ready for the presidency
Rather than focus on whether a doctor can be president, there's a different way to approach Carson's candidacy: by identifying the qualities of our nation's best presidents.
Kamarck would know: She's a veteran of the Clinton White House, a Brookings Institution scholar, and the author of the forthcoming book Why Presidents Fail.
"Great presidents are great politicians," Kamarck told me. "The presidency was designed by the Founding Fathers to not be an autocratic place." She ticked off a few examples of presidents who were able to navigate difficult politics and build consensus: Franklin Roosevelt, Ronald Reagan, and Bill Clinton.
Based on that rubric, I asked Kamarck who was best prepared among the Republican field. She named John Kasich — the Ohio governor who also served in Congress and ran the House Budget Committee.
"He's conducted the most complicated negotiations in the government, with Congress, and over the budget," Kamarck said. "Kasich stands out from the crowd, in terms of the experiences [that] allow you to be a good president."
Meanwhile, Carson's most prominent leadership experience outside of the hospital is serving on the boards of Kellogg and Costco. And that's why Kamarck's opinion on Carson was less optimistic.
"People who are not used to working in a world that requires negotiation will be frustrated" by the presidency, Kamarck added. "And brilliant doctors — wonderful as they are [for] opening up a heart — don't have to have a negotiation for what they do."
Kamarck said we should think about choosing our president the way we think about choosing a doctor.
"If you needed brain surgery, wouldn't you want to go to somebody who knows how to do brain surgery?" she added. "You look at someone who knows how to do the actual job."
Correction: A previous version of this article reported that Kasich was the former head of the Office of Management and Budget. The piece has been updated.