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Imagine this. You're at the Hyatt Regency Chicago

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immersed in insightful discussions with the health care

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industry's top leaders.

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Welcome to Becker's 12th annual CEO

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and CFO roundtable from November 11th to 14th

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2024.

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Picture yourself networking with over a 1000 executive

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level attendees,

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collecting business cards, and forging valuable connections.

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Feel the excitement as you engage in 4

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days of sessions featuring 400

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elite health system speakers.

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Envision yourself diving deep into critical topics like

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rural health care, digital transformation,

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health equity, and c suite diversity.

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Now imagine being inspired by our celebrity keynotes,

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pro football hall of famers Troy Aikman and

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Emmett Smith, 43rd president George w Bush, and

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author and journalist Jenna Bush Hager. Their stories

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will leave you motivated

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and energized.

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Don't miss this unparalleled

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opportunity.

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Get registered today. Visit beckershospitalreview.com

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and click on the events page to find

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the conference website.

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That's the beckershospitalreview.com

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events page. See you in Chicago.

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Welcome everyone to the Becker's Healthcare podcast series.

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I'm Mariah Mohammed, writer and moderator with Becker's

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Healthcare. And I'm thrilled to have with me

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today, doctor James d Flaherty,

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professor of medicine and director of cardiology and

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quality and outcomes at Northwestern Medicine. Doctor, welcome

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to the podcast. We're very excited to have

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you join us today. To get us started,

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would you mind please introducing yourself and telling

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us a bit about your background?

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Hi. Thanks for having me.

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Again, I'm doctor James Clardy, professor of medicine

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at Northwestern

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University Feinberg School of Medicine and the Blum

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Cardiovascular Institute in Chicago, Illinois.

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I have been on faculty

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at Northwestern

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for about 18 years.

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My primary

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clinical role is in interventional cardiology.

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I've also had a role

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in critical care and heart failure.

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And I spent quite a bit of my

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time on cardiovascular

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quality.

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Wonderful. Thank you so much for giving us

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that background. So with all of your experience

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and current things that you're doing right now,

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what are some of the top three biggest

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issues in cardiology today that you're focusing on?

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I've been in academic medicine my whole career.

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I may have a different experience than

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some of those that are in community practice,

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but I think

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some things touch us all.

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I think if you ask me

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the top three biggest issue, I would say,

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the corporatization

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of healthcare is something that affects us all

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and that's whether you're in an academic system

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or a different health system.

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It can be

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practices that

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are bought by private equity

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or other large corporations.

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I think that's something

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that concerns a lot of practitioners and

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it may lead to a very different

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career than many of us have had.

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I think there's

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issues about autonomy,

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costs, compensation

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the freedom of practice, the way that you

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feel like you've trained to and have done

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in your career. So I think that's

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the big thing that a lot of people

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are talking about.

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I think

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on a practice level, I think physician wellness

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and burnout

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are big topics too.

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These are not new issues but I think

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they're getting more attention rightfully so.

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I think that in any

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rigorous profession,

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sometimes

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personal health and wellness

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can be neglected and I think some places

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are becoming more aware of that and are

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trying to address it in constructive ways.

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And I think a third thing that's

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a big issue in cardiology

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is access to care.

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And that can include

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disparities in healthcare and equities,

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can include

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different delivery methods

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and

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formats.

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But I think

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particularly in Chicago, we've seen this

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where not everyone has the same access to

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a lot of the great things that are

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happening in cardiology.

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At Northwestern we

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have several very

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specific programs that try to address that and

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so that we're reaching

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all corners of our community and not,

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just a select few.

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Yeah. Yeah, absolutely.

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For me, I think access of care is

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definitely something I've been hearing more of from

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health execs. And, you know, I think it's

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such a good thing, and I'm hoping more

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programs and areas of focus would be focused

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on that.

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How do you see heart care evolving over

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the next 18 months or so?

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Hard to know without a crystal ball, but

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I think we have

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some indicators

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that I mentioned about

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that from the business side of medicine and

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in cardiology that may impact it. I think

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we've seen

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a

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rise of,

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APPs or advanced practice providers whether they be,

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nurse practitioners

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or physician assistants

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taking

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on a lot of the role

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that may have been the domain

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of physicians in the past.

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I think that's going to continue to accelerate

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and flourish both in

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the outpatient practice, but also in inpatient care

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and in procedural areas.

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We've added AVPs

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in the past year or 2 in our

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credit cap lab

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and

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they perform some of the functions

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that traditionally have been the role of fellows.

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So

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I think that's going to be more and

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more. I think there's

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going to be an impact of changes in

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some of the incentives for ambulatory

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care centers in terms of

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what procedures,

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surgeries

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may migrate outside of the hospital system based

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on

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pay incentives and margins.

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That's probably not gonna affect

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me and particularly where I work because

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we're in a very big

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academic health system,

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but it could affect those out in more

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traditional community practices.

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I think you see a lot of buzz

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about

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unions

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and I wonder with all the frustration

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about the lack of voice among

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clinicians and these different

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pay and practice models, we've already seen it

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on

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the trainee level, residents and fellows.

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I'm from Buffalo, New York and

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the residents are currently on strike, I saw

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pictures of them picketing.

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Now traditionally,

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many thought that

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this could never happen, that striking and unions

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would never touch our profession. It's certainly been

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around for years,

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practices like nursing and other things.

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I wonder if there'll be more momentum

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or unionization of different groups of physicians

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to address some of the

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practice control

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needs, compensation

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plans, things like that. So,

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I don't know how far that's off, but

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I think it's in our future.

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Yes. Thank you so much for giving us

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that insight. Is there anything that,

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you're seeing in the news or anything you're

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doing personally that's making you excited

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about today or anything that's making you nervous?

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This is a great time to be in

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cardiology,

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whether you're in imaging,

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whether you're in intervention,

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cardiac surgery, there's really

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a lot of great things happening,

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on the technology side.

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On the pharmaceutical side, there are diseases and

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treatments that weren't available 10 years ago in

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the valve space treating some

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infiltrative cardiomyopathies.

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There are advances in the advanced heart failure

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and transplant space,

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ways to save and prolong lives and get

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people to therapies they need.

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There's

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a lot of enthusiasm for

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artificial intelligence in the ways that that could

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ultimately

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impact practice

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maybe for a beneficial way, improve things, make

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some work easier.

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More to follow on that. I think there's

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a lot that's out there that's not yet

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realized but might be. So I think there's

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a lot of really exciting stuff going on.

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And I

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think because of that,

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we're able to treat

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a large population of people

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more effectively.

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People have shorter lengths of stay

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in general,

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you know, better outcomes, more longevity.

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And a lot of it is due to

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research

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technology,

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pharmacology

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devices,

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including valves and other things. So they're really

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exciting times. It's

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one of the joys of being in this

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profession

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is being a part of

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cutting edge stuff and just watching it go

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from idea to practice.

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That's still fun regardless of

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the headaches that people may experience on the

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administrative side.

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As an interventional cardiology,

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I'm trained not to be nervous,

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but I think for the practice,

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if you're

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just coming out now, if you're I'm in

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the middle of my career and I've been

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treated very well where I am, but if

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you're just coming out, there's one unanswered question

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on what your career may look like versus

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the people that maybe you've trained or mentored

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you. And

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I could see young

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professionals being nervous

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about about all these unsettled things that may

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await them in the in the few in

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the upcoming years.

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Yeah. Wonderful. Thank you so much for those

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final thoughts, doctor. This has definitely been an

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informative discussion. So, again, I wanna thank you

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so much for coming on Beckers HealthCare, especially

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for the first time. I'm gonna look forward

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to connecting with you again soon.

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Thanks for having me. I appreciate it.