- This is Chris with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr.
Amgad MCCs, chairman of the Department
of College Radiology at Nassau University Medical Center,
and professor at the Donald
and Barbara Zucker School
of Medicine at Hofstra and Northwell Health.
Dr. MCCs, thank you so much for joining us today.
- Thank you for including me.
- Doctor, could you please introduce,
introduce yourself rather,
and tell us a bit about your background?
- Sure. Thank you, Chris.
Uh, my name, uh, as you mentioned, is, uh, Amad Arias.
And again, I'm delighted to be on the Becker's, uh, podcast.
I am, uh, actually a clinical
and cardiac imaging cardiologist here in New York.
I've been practicing in the field of cardiology for, uh,
over 15 years now since completing fellowship.
Presently, I'm the chair of the Department
of Cardiology at Nassau University Medical Center
and have been in this role for the, about the past 12 years.
We are also affiliated with the Northwell Health System,
which is actually, uh, new York's largest, uh, healthcare
provider with over 12,000 affiliated physicians, um,
and many, many hospitals
and facilities of, uh,
of which Nassau University Medical Center is an affiliate.
Uh, I also serve as a professor of cardiology at the Donald
and Barbara Zucker School of Medicine at Hofstra.
Northwell. Just a little bit of background on me.
I did grow up in New York.
Uh, I completed my medical school training at the State
University of New York Downstate Medical Center in Brooklyn,
uh, where I had, uh, great training over there
and got to see a lot and do a lot.
Uh, then I went on to internal medicine residency as well
as cardiovascular fellowship at North Shore University
Hospital, uh, out here on Long Island, uh, New York.
Um, but then I went to Columbia Presbyterian Medical Center
and I did a, uh, cardiac imaging fellowship.
So I do have all those credentials.
Uh, today I'm very active in the cardiology field
with the national cardiology societies,
and, uh, I have authored, uh,
over 200 peer reviewed research papers
and book chapters and cardiology.
And my research interest just to end out with my background,
uh, include the ideal application
and equitable integration
of cardiovascular imaging into the appropriate diagnosis
and management of patients with
and at risk for cardiovascular disease.
- Thank you so much for that, doctor,
and thank you again for lending us your time
and insights today to get started here.
So from your perspective,
what are the top three issues in cardiology today?
- So that's a, a, a great, uh, question
and, uh, you know, when, when I think about cardiology,
cardiology as you know, is a, is a great
and expanding field, and there's always large trials and,
and large outcome studies going on.
And the first thing that comes to mind for me,
especially since, you know, the primary hospital
that I work at is actually a safety net hospital,
which takes care of over 260,000 patients a year
with over 67,000, uh, emergency department visits, uh,
Nassau University Medical Center.
We care for a lot of patients who might be under
or uninsured.
Uh, so to me, one of the top, uh,
I guess three issues in cardiology today is actual
equitable access to the great things, uh,
and the great treatments
and therapies that we have in cardiology.
And one of the biggest, um, you know, issues for patients,
um, is, uh, issues relating
to social determinants of health.
And this is one of the things that I stress to, uh, our,
you know, fellows, students, uh, um, residents, uh,
in training is, you know, you can be the, the best physician
around and prescribe, you know, the, the, uh, cutting edge,
uh, medications, cutting edge techniques for treatment.
But unless the patient can access those treatments, uh,
they, the, you know, everything that you do is gonna be,
you know, for naugh and,
and it's not gonna really improve the patient.
So, you know, one, one of the big issues
that I always stress is social determinants of health.
And that has to do with, you know,
a patient's access in their environment to quality food, uh,
water, air, uh, whether
or not they're able to, uh, access their medications, um,
uh, housing, all of the things that we, you know,
think about in our daily,
or maybe take for granted sometimes in our daily lives,
we have to think about in our patients.
Uh, in fact, there was a one study that came out
that said probably 80 to 90%
of a person's health are related
to social determinants of health.
So this is a big part of, uh, what I stress
and I think a major area, probably not only in cardiology,
but in medicine, uh, in general.
Um, a second thing that sort of this leads me
to is the idea of prevention.
Um, just recently, actually this morning, in, in one
of these emails that we get from a lot
of the cardiology societies, there was this, um, uh,
statistic that I came across that even as of November
of 2023, the American Heart Association did a survey where
still more than half of Americans, 51%
of Americans still don't know
that cardiovascular disease is the number one killer,
despite it being so for the past century or so in the us.
So that, that to me is, is, is relatively shocking and,
and actually concerning
because as you know, in, you know, in cardiology,
we're very good to treat a patient once they present
with a heart attack or a stroke or anything of that sort.
But I make it my duty,
and I stress this again, in, in teaching
and in training, that prevention is really a major part of
what we need to be doing
and prevention from everything relating to all
of the contributors to cardiovascular disease, like,
for example, hypertension, diabetes,
and of course the, the classic ones
that we all know about sedentary lifestyle, obesity.
It's shocking to me that the obesity numbers keep growing
obesity and overweight.
Right now, I think, uh, it's about 38 to 40%
of the worldwide population is obese,
and they expect this to go above 50% over the next 10 years.
So all of this is, is, is very important,
and these are all the things that we look at.
Another sort of contributor to prevention
or something that we need to keep in mind with,
which we've done a little bit of research on, has
to do with mental health.
I think this is one of these overlooked things.
Uh, and when I say mental health, I mean depression,
anxiety, loneliness, all of these things contribute
to your cardiovascular health.
And unless we pay attention to them sleep,
your sleep hygiene is also another big, uh, factor.
So all of these things I try to stress, you know,
when I see patients on a daily basis, I try to stress all
of this to them that my job is not just to take care
of you when you come to the hospital,
but my job is to keep you out of the hospital
by helping you prevent the development
of cardiovascular disease.
And then just to round it out, the third issue that sort
of comes to mind, or,
or I think is very important is, um,
everybody knows about artificial intelligence.
And, uh, obviously there are drawbacks
and worries about artificial intelligence,
but I firmly believe that as a medical practitioner
and as a cardiologist,
artificial intelligence can actually help us in our daily
activities, and they can do so
by maybe lessening the time consuming tasks that we have
to take care of, but at the same time, then freeing us up
to spend more face-to-face time with our patients
where we can actually deliver
a humanistic approach to medical care.
So those are the three, you know, top things
that I think are, uh, you know, uh, big issues in cardiology
and, and in medicine and the medical field overall.
- Thank you, doctor. I know you covered a ton
of ground there and very important ground.
Certainly. Uh, next thing I wanted to ask you is just
how you see heart care evolving.
In particular, you mentioned the social determinants
of health, so if you have an examples of how, uh,
your health system is addressing those,
uh, please let us know,
- Uh, exactly, so that, that, uh, social determinants
of health, uh, as we mentioned,
are the daily factors in a patient's li uh, life,
which can either hinder, which a lot of the times they do
or, uh, make it easier for them to access care,
to follow treatment guidelines and things like that.
So one, one of one of the evolving things
that I think are very important is this idea
of personalized medicine.
So our health system is very big about, you know, social,
social work, making sure a patient, uh, will be able
to access their medications.
As I mentioned to you, we do take care of a, a fair amount
of patients who are underinsured.
Um, and it's the type of thing where, uh, as simple as what,
what other people take for granted, which is being able
to pick up, you know,
your medication from your local neighborhood CVS,
there might not be, for example, a CVS accessible
to a particular patient.
So we'll actually go ahead
and make sure to set up a transitions of care, uh,
operation, where we'll be able to either get the medications
for the patient before they leave the hospital through our,
um, you know, our hospital, uh, pharmacy,
or we'll make sure that the patient will be able
to get the medication on the outside,
making sure they have the, uh,
appropriate insurance coverage or,
or being able to pay for it.
There are a lot of, uh, reduced, uh, cost, uh,
prescription programs out there.
The other thing is, you know, just paying attention to,
you know, healthy lifestyles.
Uh, as you know, a lot of areas are called, uh,
what we call food deserts, which means there's lack
of available healthy options for, uh, food.
And what we'll try to do is try to point out to patients
that, you know, listen, it might not be so good to go
to the fast food restaurant down the road.
Maybe you try to drive for another, you know, mile or so
and try to go to a more healthy, um, option.
And, uh, you know, everything from, from all
of those things I think are very important.
Uh, and I think this is an evolving area,
and the more the medical, uh, field pays attention to this,
the better outcomes we are gonna obtain in the treatment
and care of our patients.
- Thank you for outlining that, doctor,
and looking a little bit more into the future.
So this two part question,
what are you excited about right
now and what makes you nervous?
- So my excitement has to do with, uh, again, AI
that I mentioned already
and the whole idea
of all these great technological advancements.
So I call this gadgets.
Um, and this can be anything from telemedicine, uh,
allowing us to reach the patient, uh, in their place, uh,
without them having to come to the hospital, to the idea
of remote monitoring
and evaluation of the plethora of, uh, patient wearables
that, uh, a lot of patients now have access to.
I, uh, I will mention to you that I, that, uh,
very few patients these days don't have either some kind
of smartwatch or some kind of fitness tracker,
which allows them to track their heart rate.
Some of them will actually give you pulse oximetry,
which is the oxygenation.
So I think these are great advancements that we need
to be able to harness, uh, the details
and the idea of all of these.
And the other thing that excites me is,
and this is really the reason why I went into cardiology.
Cardiology is one of these areas where there are always
large multicenter randomized trials looking at
how we can improve our treatments, our uh, devices,
how we deliver care to patients.
And, uh, this is really why I went into cardiology
because I am, uh, I always like to see
that we're progressing the field.
And, and again, that's, I think a, a duty of the medical,
uh, you know, medical professionals is to always try
to figure out better ways of treating our patients.
In fact, we're gonna be at the American College
of Cardiology meeting in Atlanta coming up, um, in April.
And we, we have some of our
own research that we're presenting.
Uh, so we're very excited.
And of course there's gonna be a lot
of other cutting edge trials coming out over there.
So a lot of excitement going on.
But with the same time, I think you mentioned, uh, some
of the nervousness or the concerns that I might have,
and they, they sort of relate to
what I mentioned in terms of the excitement.
Uh, I know we talk about ai,
we talk about all these patient wearables.
I think data security and privacy issues are very important
because as we all know, um, you know, uh, issues
of data compromise and,
and things like that are really out there.
And more and more of the cardiology societies,
because there's all these wearables,
but in fact, there's also implantable devices
that transmit data.
So making sure that these are secure
and our data is going to where it needs to go as opposed
to leaking somewhere else is very important.
That gives me a little bit of concern, as well as the fact
that, again, the lack of knowledge of importance
of prevention, of cardiovascular disease out there,
I think is striking, even though it's everywhere.
And, and also the equitable access to this care also, um,
uh, concerns me a little bit
because, uh, it's, it's really prevalent out there.
Cardiology is very prevalent.
We have an aging society, and unless the knowledge
and the foresight to know
that this is a major issue is out there,
then these patients won't reach the care that they need.
Combine that with what I think is also another concern
that I have is the workforce crisis in cardiology.
Um, there, there was a statistic that I came across,
the American Association of Medical Colleges predicts
that there's gonna be a shortage of 124,000 physicians
by 2034.
And in cardiology, this is very true as well,
because as you know, as patients age,
cardiological disorders tend to, uh, manifest and present.
And again, another stat is that 25%
of cardiologists are actually 60 years or older.
And as you can imagine, a lot
of these are gonna be nearing their retirement age.
And we also know that less
and less, um, you know, the trainees and medical schools
and residency programs are going into cardiology.
So there's really gonna be a lot of work on,
on our hands going forward.
And we need to address this by really
focusing on medical schools, getting more
and more people interested even
before medical school in the medical field.
And the real, uh, importance, uh, of the need of it.
And, and also the, the real, um, um, pleasure of being part
of the, uh, medical field, I think is, uh, is very important
and we have to work on, on these types of things,
which give me a little, a little bit of concern as well.
- Doctor, thank you for being so generous
with your time and insights today.
We cannot wait to share 'em with our audience,
and we look forward to connecting with you soon.
- Thank you so much for including me
in the Becker's uh, podcast.
I really appreciate it.
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