Blue Ocean Global Technology Interviews Lily Johnston, MD, MPH | Vascular Surgeon

Dr. Johnston is a double board-certified vascular and general surgeon with advanced training in public health. She maintains an active surgical practice while also leading CorSight Health, a clinic dedicated to preventive cardiometabolic care. Her work spans the continuum—from high-stakes operations to lifestyle-first strategies that integrate nutrition, movement, sleep, stress, and social connection with evidence-based medical care.

In addition to her clinical work, Dr. Johnston serves as a consultant and expert witness in vascular surgery and medical malpractice, bringing clarity and precision to complex cases. She has authored more than two dozen peer-reviewed publications and speaks nationally on women’s cardiovascular health, vascular outcomes, and the cultural fractures of modern medicine.

Across every role—surgeon, preventive physician, consultant, and advocate—her focus remains the same: keeping the patient at the center, and advancing a model of care that restores both health and humanity.

Blue Ocean: Tell us about your professional journey. What inspired you to pursue this career, and what continues to fuel your passion for the profession today?

Lily Johnston: I grew up in medicine. Both of my parents are surgeons, and that was the normal thing to talk about at family dinner. We didn’t talk about softball practice or who got the lead role in the school play. My parents would have been happy to, but I liked hearing about the hospital and how they helped people and solved problems. I was fascinated by the body from a very early age.

I went through university planning to attend medical school, completed all my studies, and then trained in California. I thought I would be a heart surgeon like my father, but as I learned more about vascular surgery, a field I initially knew a little about, I began to appreciate its diversity. I can operate in the neck, chest, abdomen, or legs, and I can use different types of techniques.

There is a huge amount of possibility and innovation in the field, and that breadth is what continues to inspire me.

Blue Ocean: What does a typical day look like for you?

Lily Johnston: I actually have a different day almost every day. But about 60 percent of my time is spent on my surgical practice. On those days, I make hospital rounds on patients I’m consulting on or have operated on. Then I either spend the day in the clinic, seeing new patients who may need an operation, or I’m in the operating room performing procedures. Sometimes I’m on call, which means if there’s a vascular problem anywhere in the hospital, I’m responsible for managing it.

I’ve also rediscovered a passion for prevention. I run a separate practice that helps people understand their cardiovascular risk and do everything possible to minimize it so that in five, ten, or twenty years, they won’t need me as a surgeon.

The third part of my work is legal consulting. I’ve started serving as a medical expert, reviewing vascular surgery cases for attorneys, assessing medical records, and explaining whether the standard of care was met or not. It’s a different type of problem-solving that still draws on my clinical experience.

Blue Ocean: Which emerging trends in your profession most excite you?

Lily Johnston: The ability to measure and predict cardiovascular disease risks excites me most. That may sound counterintuitive since vascular surgery is full of technical advances and new procedures. But my passion is preventing patients from ever needing an operation.

We’re learning so much about how to reduce risks and personalized medicine–how to understand each patient’s unique biology and lifestyle. This allows us to design targeted strategies to lower their chances of heart attacks, strokes, or vascular disease. We’re also developing new medications and testing methods that help us get to the root of the problem, which ultimately improves patient outcomes.

Blue Ocean: Can you share a memorable experience in your career that challenged you or changed the way you approach your work?

Lily Johnston: One of the challenges in vascular surgery is that many different specialists treat the vascular system. Cardiologists, interventional radiologists, and interventional neurosurgeons all access the blood vessels to reach various parts of the body. Sometimes complications arise, and while a vascular surgeon may not have been involved in the original procedure, I’m often asked to review the case and determine whether we should have been or whether the standard of care was met.

In those situations, I can’t comment on the standard of care for another type of physician—that’s not my role. What I can do is explain how I, as a vascular surgeon, would typically approach the problem, and what steps I would take in a similar situation.

A unique part of my work as an expert in vascular surgery is being asked to analyze cases where a vascular issue exists but a vascular surgeon wasn’t directly involved. My focus then is on understanding causation—when and how the vascular problem occurred based on the records—and clarifying what considerations a vascular surgeon would normally have in that kind of case.

Blue Ocean: You’ve earned a strong reputation. How do you and your team continue to stay ahead in the highly competitive industry?

Lily Johnston: For us, it always comes down to the patient first. When you keep the patient at the center of everything you do, excellence follows naturally. Whether it’s adopting new procedures or expanding into preventive care, we ask what will best serve the patients and clients—whether that’s a patient, an attorney, or another partner seeking my services. By keeping that person front and center, you naturally develop new skills, new offerings, and new products to support them. When service comes first, that is what drives excellence and helps us stay front of mind in the profession. That mindset keeps us current and connected to the people we serve.

Blue Ocean: What core values or principles do you believe every great professional should uphold, regardless of their practice area?

Lily Johnston: Clarity is a very important value we should all bring. Being truthful and transparent about what you can do, what you cannot do, what you expect will happen, and the limitations of your knowledge and skills.

Some people say I’m very blunt or straightforward, but I believe it’s my responsibility to convey exactly the truth, always with compassion. The truth doesn’t have to be harsh; it can be delivered with kindness, compassion, and empathy.

As Brené Brown says, “Clear is kind. Unclear is unkind.” Being truthful and transparent about what you know, what you don’t, what’s possible, and what’s not are key principles and values I stick to in my practice.

Blue Ocean: What are some common misconceptions people have about your field of work?

Lily Johnston: The biggest misconception in vascular surgery is that the operation we do fixes the problem. Atherosclerosis, the formation of plaque in the arteries, is a body-wide, systemic disease. When we perform an operation, whether it’s a bypass in the leg or scraping plaque out of the arteries in the neck, we are addressing one symptom of that disease, not curing it.

Most of our patients will still face complications of that disease, whether that’s a heart attack, stroke, or another issue caused by plaque throughout the body. So surgery is a solution to a very specific problem, and while it’s impactful and important, we also have to treat the larger disease.

Another misconception is that many people think vascular surgeons are just “vein specialists” who treat varicose veins. We do treat varicose veins, but our scope of practice extends far beyond that. We repair aneurysms, restore blood flow, prevent strokes, and more. It’s a much broader and deeper field than most people realize.

Blue Ocean: What distinct value do you bring to your patients, especially when managing complex or high-stakes situations?

Lily Johnston: The most valuable things I bring to my patients are perspective and humanity. Perspective means looking at each patient as a whole person, not just a surgical case. For example, if I see someone struggling with poor circulation in the foot, but they are frail, don’t really walk anymore, and are also undergoing treatment for cancer, we have to weigh the risks and benefits in light of their personal goals.

If a patient tells me, “I need to walk down the aisle at my granddaughter’s wedding in three months,” then that’s our focus. If another patient says, “I don’t need to walk, but I want to stay in the house that I’ve been in for the last 40 years and not move into a care facility,” then we tailor care to that goal. It’s not always about doing the bypass and saving the leg at all costs. Saving the leg doesn’t mean we’ve truly helped if the outcome leaves the patient somewhere they never wanted to be. So I try to stay very clear about what we’re trying to achieve and how my care can further the patient’s own goals.

The humanity part is delivering care with kindness, compassion, and the recognition that every person in front of me is deeply loved by someone. Every human is worthy and deserves compassion, empathy, and the same care I would want for someone I love in my own family.

Blue Ocean: How do you maintain emotional and psychological resilience when handling sensitive or high-pressure cases?

Lily Johnston: Surgery is very often a high-pressure situation, and vascular surgery in particular can be very high stakes. People come to us with life-threatening and limb-threatening problems with some frequency. Emotional resilience is a skill, just like physical resilience, built through practice. By putting yourself in these situations repeatedly, you build the muscle that allows you to remain calm and focused on what matters: providing the best care to the patient in that moment.

Sometimes that means asking for help. If I don’t have the capacity to do everything on my own, I reach out and get support. It’s about circling the team and making sure every member is focused on the task in front of us. I’ve learned that it is not my job to save everyone all the time, but to do my absolute best each moment. What I do is stay rooted in clarity and make it clear to my patient and their family what is possible, what is likely, and the fact that we may not succeed.

When outcomes aren’t what we hoped for, it’s natural to get down on ourselves and wonder if we could have done better. That’s when reflection and support is essential. We talk to colleagues and friends, processing what happened, and remembering that being sad isn’t the same as failing. All of that helps sustain my resilience over time.

Blue Ocean: What advice would you offer to aspiring professionals entering the profession today?

Lily Johnston: Medicine is very different than it was a generation ago. I grew up watching my parents deeply satisfied and in love with the practice of medicine in their environment. When I entered the field, I found a very different reality. At first, I wasn’t in love with my job, and I struggled with that until I realized I needed to reconfigure my career in a way that worked for me. That process is still ongoing as I continue adjusting how much time I spend on surgical practice, my book, my med-legal practice, and my prevention practice.

My advice is to find the version of medicine that keeps you connected to who you are. This work is too demanding and too important to do without love. Reimagine your career if you need to—go part-time, change specialties, adopt a different practice model, or move into a non-clinical role. Whatever it takes, find a way to practice medicine that doesn’t require the sacrifice of your soul or your humanity.

Blue Ocean: Is there a guiding principle, philosophy, or quote that has significantly influenced your career and life?

Lily Johnston: The Mayo Clinic, where I did my fellowship, has been very influential for me. The Mayo brothers, who were among the founders of that institution, had a guiding philosophy: “The best interest of the patient is the only interest to be considered.”

What they meant is that while it’s easy to get caught up in the business side of medicine, in which specialist gets more money, or which department gets the newest technology, at the end of the day, we are here to serve our patients.

When that is your guiding principle, when every decision is made through the lens of what is best for the patient, you really can’t go wrong. That focus becomes your guiding light, and it ensures you make the right choices. As long as we keep returning to that, I truly believe there is hope and promise for the practice of medicine.

Blue Ocean: What hobbies or interests do you enjoy outside of work?

Lily Johnston: I’m really passionate about weightlifting and cycling. I really enjoy feeling powerful in my own body. That reminds me to be grateful, because many of my patients no longer have that ability. Every time I’m able to move and train, I feel gratitude and inspiration to keep using my body, protecting it, and being good to it over time.

I also cultivate orchids. I have a whole cabinet full of them in my apartment, and a couple are in bloom or about to bloom. Caring for plants requires patience, dedication, and wonder. It’s very different from caring for humans, but it’s rewarding to see them grow, bloom, and flourish.

Conclusion

Throughout her journey, Dr. Lily Johnston has shown how passion, clarity, and compassion guide both her practice and her life. From embracing innovation in vascular surgery to prioritizing prevention, she brings perspective and humanity to every patient encounter. Her philosophy—focused on putting patients first—reminds us that medicine is not only about technical expertise, but also about empathy, resilience, and staying true to one’s values.