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Welcome to the Becker's Healthcare podcast.

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I'm Mariah Taylor, assistant editor, and I'm thrilled

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to be interviewing Rosie Thachel, director of the

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cardiac intensive care unit and cofounder of the

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Women's Cardiovascular

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Institute at NYC Health and Hospitals Elmhurst.

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Doctor Thatchol, thank you so much for joining

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me today. I'm really excited to learn more

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about what you're doing at the Women's Institute.

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But before we dive into that, I'd love

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to hear a little bit more about you

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and your background.

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Yeah. Thank you for having me. So as

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you mentioned, I run the cardiac intensive care

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unit here, but we also recently cofounded last

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year the Women's Cardiovascular Institute.

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And I think this topic is very timely.

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I know we just came off with heart

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month, but really cardiovascular health is a year

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round issue.

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So we love to talk about it, you

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know, every month. And this is a institute

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we cofounded between myself, doctor Gayatri Setia, and

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doctor Deborah Reynolds. So excited to be here

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and to to to share information about it.

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Absolutely. And as I'm sure you're aware and

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all of our listeners, there's a lot of

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systems right now that are opening either service

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lines or institutes or even clinics

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specifically for different population groups. So I'd love

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to just hear your

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opinion and understanding of what's behind all of

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this movement towards specialized care by population.

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Yeah. Great question. So at its core, it's

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about recognizing that health care has historically been

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built around a one size fits all model,

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but patients are not one size fits all.

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And different populations experience disease differently. They face

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different barriers to care, and often they arrive

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in the health system through different pathways also.

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So if you wanna truly deliver effective care,

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we have to design programs that acknowledge those

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realities.

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And cardiovascular disease is a perfect example. It's

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the number one killer of men and women,

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yet women have historically been under recognized, under

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diagnosed,

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misdiagnosed,

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and underrepresented

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in research as well. And so that realization

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is one of the driving forces

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behind launching the Women's Cardiovascular Institute at Elmhurst.

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We wanted to create a program where women's

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symptoms, risk factors, and life experiences also, things

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like pregnancy, menopause, are fully integrated into cardiovascular

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care. So in many ways, specialized care by

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population group is simply just good medicine. It's

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about meeting patients where they are and then

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designing care around the realities of their lives.

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Absolutely.

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And what are some of those changes that

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you're making to your services to meet the

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needs of women?

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Yes. Elmhurst serves one of the most diverse

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communities in the world. Our patients actually represent

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a myriad of cultures, languages, backgrounds, life experiences.

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Actually, there are about 250

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languages spoken within just a small radius of

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the hospital. So incredibly diverse.

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And this diversity fundamentally shapes how we think

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about delivering care. And because of that, we

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recognized that there was a real unmet need

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for dedicated women's cardiovascular care in this community.

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Many women we see are not always aware

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that cardiovascular disease is their leading health risk.

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And what makes our program particularly unique is

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that it sits within a community and public

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hospital system. So as you alluded to earlier,

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many women's heart centers are popping up around

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the country. Many women's cardiovascular programs sit within

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large academic medical centers in the country.

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But access to specialized cardiovascular care shouldn't really

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depend on where you live or your insurance

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status or the center that you have access

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to. It's really an equity issue, and so

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that's why we felt strongly about building this

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particular program.

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We also built this program to be comprehensive

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across the entire cardiovascular

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spectrum

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from prevention to critical care. So we have

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a few initiatives that are embedded in our

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in our women's heart program. So for example,

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a postpartum hypertension program, and this program recognizes

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that pregnancy is often an early cardiovascular

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stress test. We also have a post CICU

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clinic, which actually helps our women patients recover

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after

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critical illness and in transitioning back to normal

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life. We also have a breast cancer cardiotoxicity

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program where we work closely with our oncology

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colleagues to protect the long term health of

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the heart. So at the end of the

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day, the goal is not just to treat

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disease when it appears, but also to identify

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risk earlier and close gaps in care that

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disproportionately affect women. And, you know, perhaps the

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most meaningful feedback we hear from our women

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patients is simply, you know, this is the

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first time I felt somebody really listened to

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my symptoms, and I think that's when you

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know that the model is working.

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Absolutely. That's gotta be lovely to hear. And

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I'd love to dive into that even just

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a little bit more,

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because every system's doing these women's services a

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little bit differently. So for your service area,

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what are some of the services that are

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in the highest demand?

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Yeah. So I think women's heart in general

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is in high demand. Right? We know that

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women's heart women's cardiovascular disease, it's the number

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one killer.

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So it's it was a need that was

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unmet for years. And now we're able to

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bring that specialized care to this community. And

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like I mentioned before, we have other specific

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programs within the umbrella of the Women's Cardiovascular

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Institute. So the postpartum hypertension program, the post

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CICU clinic, the breast cancer cardiotoxicity

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program, the cardio obstetrics program. So really, we're

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we're really just in the infancy. This program

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is only one year old, but we're really,

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really excited to be able to bring this

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program to this community.

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Absolutely.

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And kind of on the other side of

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things, I'm sure you're very aware that it's

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really hard to recruit specialty physicians. And right

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now, our nation is facing a shortage of

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all types of specialty physicians. But even within

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cardiology, it can be difficult to find specialty

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cardiologists.

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So what are some of your strategies that

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you're using to help recruit physicians in so

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that you have the right specialties at your

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center?

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Yeah. So I I fundamentally, it starts with

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building teams that kind of understand the needs

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of the communities we serve and the women

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we serve and then bringing together physicians with

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complimentary expertise. Right? So, you know, I mentioned

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a slew of programs that are sort of

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embedded under women's heart. And And one of

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the reasons we can do that is because

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we have diversity within our women's heart leadership.

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So if you look at the leadership of

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our women's cardiovascular institute, doctor Gayatri Setia, doctor Reynolds,

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and myself, we each bring different areas of

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focus within cardiology and those niches are very

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complimentary.

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So when you combine those perspectives, it allows

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us to build a program that truly spans

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the full spectrum of cardiovascular care for women

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from prevention and risk assessment to complex and

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critical illness. And equally important to that is

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the work we do we do with other

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specialties and other colleagues. It's not done in

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silo. Right? Women's cardiovascular health intersects with many

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other specialties across the health system, so we

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collaborately we collaborate closely with our OBGYN colleagues,

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our oncology colleagues,

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experts in lifestyle medicine, and, of course, our

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primary care medicine colleagues also. And I think

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that multidisciplinary

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structure is essential because women's cardiovascular health often

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unfolds across many life stages,

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pregnancy, menopause, potentially cancer survivorship, and so many

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other situations.

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So when these specialties are all interconnected, we

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can actually provide more coordinated, thoughtful, and patient

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centered care.

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Absolutely.

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And I'd love to kind of go back

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to something you said at the beginning about

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how your service area has I think you

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said about 200 different languages that are spoken.

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How are you meeting the needs for patients

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who don't speak English as a first language?

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Yeah. So fortunately, we have, you know, a

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lot of ancillary support services. For example, our

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translation services, they're very, very robust. So we're

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able to, you know, sort of bridge the

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gaps in communication that way. And we really

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try very hard to provide culturally sensitive care,

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particularly within our, you know, women's heart clinic

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where we've got so many different women speaking

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not only different languages, but coming from different

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backgrounds, different cultures,

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bringing their diversity of pathology also. So it's

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really important to be sort of culturally sensitive,

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in in our care delivery.

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Absolutely.

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Now let's look a little bit to the

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future. I'd love to hear two things from

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you. The first is, what is the next

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step for the Women's Institute?

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Yeah. I think this is only the beginning.

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I think our existing pathways under the Women's

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Heart Institute, we would love to sort of

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grow those, you know, whether it's the post

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CICU clinic or the breast cancer cardiotoxicity

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program,

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our postpartum hypertension program. We would actually love

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to expand these clinics, and, really, that's sort

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of our goal in the next year or

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two expansion.

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But I think it's also a really exciting

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time, right, for,

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precision medicine technology.

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There's so much we can integrate into this

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women's cardiovascular program and this is really just

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a start.

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Absolutely.

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And kind of with that, I'd love to

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hear your guess as to how you think

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specialized care by population might change in the

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next five years.

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Yeah. I think this is a very timely

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question. I think we're entering a phase where

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specialized care will become more integrated,

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more preventative perhaps, and and definitely more data

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driven. I think we're gonna see programs that

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move earlier in the disease timeline. Right? Focusing

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more on the risk detection prevention rather than

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just waiting until patients either present with an

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event or with advanced disease. I think there

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will also be greater integration between specialties.

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Cardiovascular care is increasingly intersecting with obstetrics, oncology,

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endocrinology,

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critical care.

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So I think this is really important, especially

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as we're thinking about women's heart across the

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lifespan

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and across the spectrum of care. And I

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think third, technology is gonna play a role

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in the future. We're gonna be using data,

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digital health, AI perhaps,

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population level analytics to identify patients who might

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otherwise fall through their cracks. But at the

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end of the day, I think one thing

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that won't change or or shouldn't change, I

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should say, is the core mission. Right? Equity

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and access to specialized care for women.

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I I just wanna highlight that, you know,

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our program specifically,

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I think it demonstrates that, you know, these

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sort of innovative

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population focused cardiovascular care programs, they don't have

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to exist only in the large academic centers.

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Right? It can and it should exist in

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community hospitals and public and municipal systems where

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the need is actually often the greatest. And,

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ultimately, the goal is simple. Right? Making sure

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that every woman and every patient, regardless of

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their background or circumstance, receives care that truly

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reflects their needs.

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Absolutely.

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Well, this was been so amazing. I love

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hearing everything about what you're doing with your

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Women's Institute. So thank you for taking the

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time to share with us today and thank

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you to our listeners for joining us. Of

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course. Thanks for having me.