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Welcome everyone to the Becker's Healthcare podcast series.
I'm Mariah Mohammed, writer and moderator with Becker's
Healthcare. And I'm thrilled to have with me
today, doctor James d Flaherty,
professor of medicine and director of cardiology and
quality and outcomes at Northwestern Medicine. Doctor, welcome
to the podcast. We're very excited to have
you join us today. To get us started,
would you mind please introducing yourself and telling
us a bit about your background?
Hi. Thanks for having me.
Again, I'm doctor James Clardy, professor of medicine
at Northwestern
University Feinberg School of Medicine and the Blum
Cardiovascular Institute in Chicago, Illinois.
I have been on faculty
at Northwestern
for about 18 years.
My primary
clinical role is in interventional cardiology.
I've also had a role
in critical care and heart failure.
And I spent quite a bit of my
time on cardiovascular
quality.
Wonderful. Thank you so much for giving us
that background. So with all of your experience
and current things that you're doing right now,
what are some of the top three biggest
issues in cardiology today that you're focusing on?
I've been in academic medicine my whole career.
I may have a different experience than
some of those that are in community practice,
but I think
some things touch us all.
I think if you ask me
the top three biggest issue, I would say,
the corporatization
of healthcare is something that affects us all
and that's whether you're in an academic system
or a different health system.
It can be
practices that
are bought by private equity
or other large corporations.
I think that's something
that concerns a lot of practitioners and
it may lead to a very different
career than many of us have had.
I think there's
issues about autonomy,
costs, compensation
the freedom of practice, the way that you
feel like you've trained to and have done
in your career. So I think that's
the big thing that a lot of people
are talking about.
I think
on a practice level, I think physician wellness
and burnout
are big topics too.
These are not new issues but I think
they're getting more attention rightfully so.
I think that in any
rigorous profession,
sometimes
personal health and wellness
can be neglected and I think some places
are becoming more aware of that and are
trying to address it in constructive ways.
And I think a third thing that's
a big issue in cardiology
is access to care.
And that can include
disparities in healthcare and equities,
can include
different delivery methods
and
formats.
But I think
particularly in Chicago, we've seen this
where not everyone has the same access to
a lot of the great things that are
happening in cardiology.
At Northwestern we
have several very
specific programs that try to address that and
so that we're reaching
all corners of our community and not,
just a select few.
Yeah. Yeah, absolutely.
For me, I think access of care is
definitely something I've been hearing more of from
health execs. And, you know, I think it's
such a good thing, and I'm hoping more
programs and areas of focus would be focused
on that.
How do you see heart care evolving over
the next 18 months or so?
Hard to know without a crystal ball, but
I think we have
some indicators
that I mentioned about
that from the business side of medicine and
in cardiology that may impact it. I think
we've seen
a
rise of,
APPs or advanced practice providers whether they be,
nurse practitioners
or physician assistants
taking
on a lot of the role
that may have been the domain
of physicians in the past.
I think that's going to continue to accelerate
and flourish both in
the outpatient practice, but also in inpatient care
and in procedural areas.
We've added AVPs
in the past year or 2 in our
credit cap lab
and
they perform some of the functions
that traditionally have been the role of fellows.
So
I think that's going to be more and
more. I think there's
going to be an impact of changes in
some of the incentives for ambulatory
care centers in terms of
what procedures,
surgeries
may migrate outside of the hospital system based
on
pay incentives and margins.
That's probably not gonna affect
me and particularly where I work because
we're in a very big
academic health system,
but it could affect those out in more
traditional community practices.
I think you see a lot of buzz
about
unions
and I wonder with all the frustration
about the lack of voice among
clinicians and these different
pay and practice models, we've already seen it
on
the trainee level, residents and fellows.
I'm from Buffalo, New York and
the residents are currently on strike, I saw
pictures of them picketing.
Now traditionally,
many thought that
this could never happen, that striking and unions
would never touch our profession. It's certainly been
around for years,
practices like nursing and other things.
I wonder if there'll be more momentum
or unionization of different groups of physicians
to address some of the
practice control
needs, compensation
plans, things like that. So,
I don't know how far that's off, but
I think it's in our future.
Yes. Thank you so much for giving us
that insight. Is there anything that,
you're seeing in the news or anything you're
doing personally that's making you excited
about today or anything that's making you nervous?
This is a great time to be in
cardiology,
whether you're in imaging,
whether you're in intervention,
cardiac surgery, there's really
a lot of great things happening,
on the technology side.
On the pharmaceutical side, there are diseases and
treatments that weren't available 10 years ago in
the valve space treating some
infiltrative cardiomyopathies.
There are advances in the advanced heart failure
and transplant space,
ways to save and prolong lives and get
people to therapies they need.
There's
a lot of enthusiasm for
artificial intelligence in the ways that that could
ultimately
impact practice
maybe for a beneficial way, improve things, make
some work easier.
More to follow on that. I think there's
a lot that's out there that's not yet
realized but might be. So I think there's
a lot of really exciting stuff going on.
And I
think because of that,
we're able to treat
a large population of people
more effectively.
People have shorter lengths of stay
in general,
you know, better outcomes, more longevity.
And a lot of it is due to
research
technology,
pharmacology
devices,
including valves and other things. So they're really
exciting times. It's
one of the joys of being in this
profession
is being a part of
cutting edge stuff and just watching it go
from idea to practice.
That's still fun regardless of
the headaches that people may experience on the
administrative side.
As an interventional cardiology,
I'm trained not to be nervous,
but I think for the practice,
if you're
just coming out now, if you're I'm in
the middle of my career and I've been
treated very well where I am, but if
you're just coming out, there's one unanswered question
on what your career may look like versus
the people that maybe you've trained or mentored
you. And
I could see young
professionals being nervous
about about all these unsettled things that may
await them in the in the few in
the upcoming years.
Yeah. Wonderful. Thank you so much for those
final thoughts, doctor. This has definitely been an
informative discussion. So, again, I wanna thank you
so much for coming on Beckers HealthCare, especially
for the first time. I'm gonna look forward
to connecting with you again soon.
Thanks for having me. I appreciate it.