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- This is Chris with the
Becker's Healthcare Podcast.

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I'm thrilled today to be joined by Dr.

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Amgad MCCs, chairman of the Department

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of College Radiology at Nassau
University Medical Center,

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and professor at the Donald

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and Barbara Zucker School

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of Medicine at Hofstra
and Northwell Health.

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Dr. MCCs, thank you so
much for joining us today.

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- Thank you for including me.

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- Doctor, could you please introduce,

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introduce yourself rather,

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and tell us a bit about your background?

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- Sure. Thank you, Chris.

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Uh, my name, uh, as you
mentioned, is, uh, Amad Arias.

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And again, I'm delighted to be
on the Becker's, uh, podcast.

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I am, uh, actually a clinical

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and cardiac imaging
cardiologist here in New York.

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I've been practicing in the
field of cardiology for, uh,

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over 15 years now since
completing fellowship.

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Presently, I'm the chair of the Department

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of Cardiology at Nassau
University Medical Center

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and have been in this role for
the, about the past 12 years.

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We are also affiliated with
the Northwell Health System,

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which is actually, uh, new
York's largest, uh, healthcare

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provider with over 12,000
affiliated physicians, um,

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and many, many hospitals

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and facilities of, uh,

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of which Nassau University
Medical Center is an affiliate.

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Uh, I also serve as a professor
of cardiology at the Donald

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and Barbara Zucker School
of Medicine at Hofstra.

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Northwell. Just a little
bit of background on me.

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I did grow up in New York.

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Uh, I completed my medical
school training at the State

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University of New York Downstate
Medical Center in Brooklyn,

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uh, where I had, uh,
great training over there

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and got to see a lot and do a lot.

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Uh, then I went on to internal
medicine residency as well

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as cardiovascular fellowship
at North Shore University

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Hospital, uh, out here on
Long Island, uh, New York.

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Um, but then I went to Columbia
Presbyterian Medical Center

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and I did a, uh, cardiac
imaging fellowship.

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So I do have all those credentials.

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Uh, today I'm very active
in the cardiology field

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with the national cardiology societies,

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and, uh, I have authored, uh,

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over 200 peer reviewed research papers

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and book chapters and cardiology.

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And my research interest just
to end out with my background,

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uh, include the ideal application

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and equitable integration

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of cardiovascular imaging
into the appropriate diagnosis

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and management of patients with

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and at risk for cardiovascular disease.

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- Thank you so much for that, doctor,

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and thank you again for
lending us your time

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and insights today to get started here.

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So from your perspective,

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what are the top three
issues in cardiology today?

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- So that's a, a, a great, uh, question

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and, uh, you know, when, when
I think about cardiology,

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cardiology as you know, is a, is a great

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and expanding field, and
there's always large trials and,

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and large outcome studies going on.

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And the first thing that
comes to mind for me,

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especially since, you
know, the primary hospital

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that I work at is actually
a safety net hospital,

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which takes care of over
260,000 patients a year

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with over 67,000, uh, emergency
department visits, uh,

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Nassau University Medical Center.

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We care for a lot of
patients who might be under

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or uninsured.

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Uh, so to me, one of the top, uh,

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I guess three issues in
cardiology today is actual

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equitable access to the great things, uh,

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and the great treatments

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and therapies that we have in cardiology.

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And one of the biggest, um,
you know, issues for patients,

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um, is, uh, issues relating

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to social determinants of health.

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And this is one of the things
that I stress to, uh, our,

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you know, fellows, students,
uh, um, residents, uh,

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in training is, you know, you
can be the, the best physician

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around and prescribe, you know,
the, the, uh, cutting edge,

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uh, medications, cutting edge
techniques for treatment.

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But unless the patient can
access those treatments, uh,

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they, the, you know, everything
that you do is gonna be,

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you know, for naugh and,

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and it's not gonna really
improve the patient.

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So, you know, one, one of the big issues

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that I always stress is
social determinants of health.

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And that has to do with, you know,

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a patient's access in their
environment to quality food, uh,

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water, air, uh, whether

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or not they're able to, uh,
access their medications, um,

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uh, housing, all of the
things that we, you know,

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think about in our daily,

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or maybe take for granted
sometimes in our daily lives,

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we have to think about in our patients.

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Uh, in fact, there was a
one study that came out

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that said probably 80 to 90%

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of a person's health are related

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to social determinants of health.

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So this is a big part
of, uh, what I stress

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and I think a major area,
probably not only in cardiology,

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but in medicine, uh, in general.

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Um, a second thing that
sort of this leads me

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to is the idea of prevention.

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Um, just recently, actually
this morning, in, in one

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of these emails that we get from a lot

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of the cardiology societies,
there was this, um, uh,

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statistic that I came across
that even as of November

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of 2023, the American Heart
Association did a survey where

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still more than half of Americans, 51%

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of Americans still don't know

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that cardiovascular disease
is the number one killer,

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despite it being so for the
past century or so in the us.

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So that, that to me is, is,
is relatively shocking and,

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and actually concerning

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because as you know, in,
you know, in cardiology,

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we're very good to treat a
patient once they present

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with a heart attack or a stroke
or anything of that sort.

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But I make it my duty,

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and I stress this again, in, in teaching

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and in training, that prevention
is really a major part of

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what we need to be doing

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and prevention from
everything relating to all

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of the contributors to
cardiovascular disease, like,

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for example, hypertension, diabetes,

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and of course the, the classic ones

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that we all know about
sedentary lifestyle, obesity.

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It's shocking to me that the
obesity numbers keep growing

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obesity and overweight.

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Right now, I think, uh,
it's about 38 to 40%

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of the worldwide population is obese,

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and they expect this to go above
50% over the next 10 years.

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So all of this is, is, is very important,

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and these are all the
things that we look at.

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Another sort of contributor to prevention

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or something that we need
to keep in mind with,

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which we've done a little
bit of research on, has

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to do with mental health.

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I think this is one of
these overlooked things.

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Uh, and when I say mental
health, I mean depression,

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anxiety, loneliness, all
of these things contribute

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to your cardiovascular health.

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And unless we pay attention to them sleep,

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your sleep hygiene is also
another big, uh, factor.

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So all of these things I
try to stress, you know,

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when I see patients on a daily
basis, I try to stress all

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of this to them that my job
is not just to take care

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of you when you come to the hospital,

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but my job is to keep
you out of the hospital

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by helping you prevent the development

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of cardiovascular disease.

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And then just to round it
out, the third issue that sort

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of comes to mind, or,

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or I think is very important is, um,

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everybody knows about
artificial intelligence.

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And, uh, obviously there are drawbacks

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and worries about artificial intelligence,

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but I firmly believe that
as a medical practitioner

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and as a cardiologist,

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artificial intelligence can
actually help us in our daily

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activities, and they can do so

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by maybe lessening the time
consuming tasks that we have

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to take care of, but at the
same time, then freeing us up

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to spend more face-to-face
time with our patients

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where we can actually deliver

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a humanistic approach to medical care.

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So those are the three,
you know, top things

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that I think are, uh, you know,
uh, big issues in cardiology

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and, and in medicine and
the medical field overall.

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- Thank you, doctor. I
know you covered a ton

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of ground there and very important ground.

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Certainly. Uh, next thing
I wanted to ask you is just

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how you see heart care evolving.

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In particular, you mentioned
the social determinants

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of health, so if you have
an examples of how, uh,

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your health system is addressing those,

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uh, please let us know,

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- Uh, exactly, so that,
that, uh, social determinants

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of health, uh, as we mentioned,

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are the daily factors in
a patient's li uh, life,

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which can either hinder, which
a lot of the times they do

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or, uh, make it easier
for them to access care,

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to follow treatment guidelines
and things like that.

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So one, one of one of the evolving things

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that I think are very
important is this idea

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of personalized medicine.

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So our health system is very
big about, you know, social,

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social work, making sure a
patient, uh, will be able

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to access their medications.

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As I mentioned to you, we do
take care of a, a fair amount

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of patients who are underinsured.

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Um, and it's the type of thing
where, uh, as simple as what,

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what other people take for
granted, which is being able

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to pick up, you know,

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your medication from your
local neighborhood CVS,

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there might not be, for
example, a CVS accessible

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to a particular patient.

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So we'll actually go ahead

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and make sure to set up a
transitions of care, uh,

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operation, where we'll be able
to either get the medications

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for the patient before they
leave the hospital through our,

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um, you know, our hospital, uh, pharmacy,

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or we'll make sure that
the patient will be able

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to get the medication on the outside,

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making sure they have the, uh,

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appropriate insurance coverage or,

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or being able to pay for it.

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There are a lot of, uh,
reduced, uh, cost, uh,

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prescription programs out there.

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The other thing is, you know,
just paying attention to,

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you know, healthy lifestyles.

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Uh, as you know, a lot
of areas are called, uh,

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what we call food deserts,
which means there's lack

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of available healthy
options for, uh, food.

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And what we'll try to do is
try to point out to patients

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that, you know, listen, it
might not be so good to go

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to the fast food restaurant down the road.

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Maybe you try to drive for
another, you know, mile or so

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and try to go to a more
healthy, um, option.

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And, uh, you know,
everything from, from all

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of those things I think
are very important.

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Uh, and I think this is an evolving area,

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and the more the medical, uh,
field pays attention to this,

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the better outcomes we are
gonna obtain in the treatment

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and care of our patients.

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- Thank you for outlining that, doctor,

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and looking a little bit
more into the future.

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So this two part question,

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what are you excited about right

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now and what makes you nervous?

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- So my excitement has
to do with, uh, again, AI

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that I mentioned already

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and the whole idea

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of all these great
technological advancements.

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So I call this gadgets.

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Um, and this can be anything
from telemedicine, uh,

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allowing us to reach the
patient, uh, in their place, uh,

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without them having to come
to the hospital, to the idea

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of remote monitoring

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and evaluation of the plethora
of, uh, patient wearables

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that, uh, a lot of patients
now have access to.

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I, uh, I will mention
to you that I, that, uh,

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very few patients these days
don't have either some kind

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of smartwatch or some
kind of fitness tracker,

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00:10:45,305 --> 00:10:47,615
which allows them to
track their heart rate.

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Some of them will actually
give you pulse oximetry,

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which is the oxygenation.

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So I think these are great
advancements that we need

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to be able to harness, uh, the details

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and the idea of all of these.

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And the other thing that excites me is,

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and this is really the reason
why I went into cardiology.

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Cardiology is one of these
areas where there are always

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large multicenter
randomized trials looking at

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00:11:11,755 --> 00:11:14,935
how we can improve our
treatments, our uh, devices,

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how we deliver care to patients.

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And, uh, this is really
why I went into cardiology

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because I am, uh, I always like to see

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that we're progressing the field.

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00:11:25,195 --> 00:11:28,375
And, and again, that's, I
think a, a duty of the medical,

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uh, you know, medical
professionals is to always try

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to figure out better ways
of treating our patients.

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In fact, we're gonna be
at the American College

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of Cardiology meeting in
Atlanta coming up, um, in April.

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And we, we have some of our

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own research that we're presenting.

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Uh, so we're very excited.

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And of course there's gonna be a lot

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of other cutting edge trials
coming out over there.

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So a lot of excitement going on.

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But with the same time, I
think you mentioned, uh, some

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of the nervousness or the
concerns that I might have,

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00:11:55,865 --> 00:11:57,685
and they, they sort of relate to

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00:11:57,685 --> 00:11:59,485
what I mentioned in
terms of the excitement.

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00:11:59,505 --> 00:12:01,245
Uh, I know we talk about ai,

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00:12:01,265 --> 00:12:03,045
we talk about all these patient wearables.

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I think data security and
privacy issues are very important

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00:12:07,005 --> 00:12:10,565
because as we all know,
um, you know, uh, issues

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00:12:10,625 --> 00:12:12,485
of data compromise and,

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00:12:12,505 --> 00:12:14,725
and things like that are really out there.

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00:12:15,265 --> 00:12:18,645
And more and more of the
cardiology societies,

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because there's all these wearables,

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00:12:20,325 --> 00:12:22,645
but in fact, there's
also implantable devices

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that transmit data.

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So making sure that these are secure

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00:12:27,225 --> 00:12:29,765
and our data is going to where
it needs to go as opposed

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00:12:29,965 --> 00:12:31,765
to leaking somewhere
else is very important.

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00:12:31,765 --> 00:12:35,485
That gives me a little bit of
concern, as well as the fact

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00:12:35,515 --> 00:12:38,765
that, again, the lack of
knowledge of importance

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00:12:38,765 --> 00:12:41,205
of prevention, of cardiovascular
disease out there,

294
00:12:41,485 --> 00:12:43,845
I think is striking, even
though it's everywhere.

295
00:12:44,265 --> 00:12:48,045
And, and also the equitable
access to this care also, um,

296
00:12:48,265 --> 00:12:49,645
uh, concerns me a little bit

297
00:12:49,645 --> 00:12:52,565
because, uh, it's, it's
really prevalent out there.

298
00:12:52,565 --> 00:12:53,965
Cardiology is very prevalent.

299
00:12:54,105 --> 00:12:57,805
We have an aging society,
and unless the knowledge

300
00:12:57,945 --> 00:12:59,645
and the foresight to know

301
00:12:59,645 --> 00:13:01,805
that this is a major issue is out there,

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00:13:02,075 --> 00:13:04,605
then these patients won't
reach the care that they need.

303
00:13:05,275 --> 00:13:08,725
Combine that with what I
think is also another concern

304
00:13:08,725 --> 00:13:11,245
that I have is the workforce
crisis in cardiology.

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00:13:11,785 --> 00:13:14,205
Um, there, there was a
statistic that I came across,

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00:13:14,225 --> 00:13:16,885
the American Association of
Medical Colleges predicts

307
00:13:16,885 --> 00:13:20,605
that there's gonna be a
shortage of 124,000 physicians

308
00:13:21,065 --> 00:13:22,085
by 2034.

309
00:13:22,665 --> 00:13:24,885
And in cardiology, this
is very true as well,

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00:13:24,885 --> 00:13:27,125
because as you know, as patients age,

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00:13:27,125 --> 00:13:30,965
cardiological disorders tend
to, uh, manifest and present.

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00:13:31,505 --> 00:13:34,245
And again, another stat is that 25%

313
00:13:34,245 --> 00:13:36,925
of cardiologists are
actually 60 years or older.

314
00:13:37,385 --> 00:13:38,685
And as you can imagine, a lot

315
00:13:38,685 --> 00:13:40,765
of these are gonna be
nearing their retirement age.

316
00:13:40,945 --> 00:13:42,365
And we also know that less

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00:13:42,365 --> 00:13:45,765
and less, um, you know, the
trainees and medical schools

318
00:13:45,785 --> 00:13:48,245
and residency programs
are going into cardiology.

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00:13:48,625 --> 00:13:50,885
So there's really gonna
be a lot of work on,

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00:13:50,985 --> 00:13:52,365
on our hands going forward.

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00:13:52,785 --> 00:13:54,765
And we need to address this by really

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00:13:55,565 --> 00:13:58,045
focusing on medical schools, getting more

323
00:13:58,045 --> 00:13:59,205
and more people interested even

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00:13:59,205 --> 00:14:01,285
before medical school
in the medical field.

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00:14:01,825 --> 00:14:05,245
And the real, uh, importance,
uh, of the need of it.

326
00:14:05,345 --> 00:14:09,845
And, and also the, the real,
um, um, pleasure of being part

327
00:14:09,845 --> 00:14:12,925
of the, uh, medical field, I
think is, uh, is very important

328
00:14:12,925 --> 00:14:14,925
and we have to work on,
on these types of things,

329
00:14:14,925 --> 00:14:17,045
which give me a little, a
little bit of concern as well.

330
00:14:19,085 --> 00:14:21,385
- Doctor, thank you for being so generous

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00:14:21,385 --> 00:14:22,745
with your time and insights today.

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00:14:22,845 --> 00:14:24,745
We cannot wait to share
'em with our audience,

333
00:14:24,765 --> 00:14:26,345
and we look forward to
connecting with you soon.

334
00:14:26,875 --> 00:14:28,545
- Thank you so much for including me

335
00:14:28,545 --> 00:14:29,585
in the Becker's uh, podcast.

336
00:14:29,865 --> 00:14:30,865
I really appreciate it.

337
00:14:33,135 --> 00:14:35,705
- It's so important for leaders
at the top of organizations

338
00:14:35,705 --> 00:14:38,025
to keep learning, stay
sharp, grow their networks,

339
00:14:38,455 --> 00:14:40,905
help our audience better do
this in a more simplified,

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00:14:40,905 --> 00:14:42,785
personalized, and meaningful way.

341
00:14:43,345 --> 00:14:45,785
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00:14:46,295 --> 00:14:48,305
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344
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345
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346
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347
00:14:58,165 --> 00:14:58,905
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