Welcome to the Becker's Healthcare podcast.
I'm Mariah Taylor, assistant editor, and I'm thrilled
to be interviewing Rosie Thachel, director of the
cardiac intensive care unit and cofounder of the
Women's Cardiovascular
Institute at NYC Health and Hospitals Elmhurst.
Doctor Thatchol, thank you so much for joining
me today. I'm really excited to learn more
about what you're doing at the Women's Institute.
But before we dive into that, I'd love
to hear a little bit more about you
and your background.
Yeah. Thank you for having me. So as
you mentioned, I run the cardiac intensive care
unit here, but we also recently cofounded last
year the Women's Cardiovascular Institute.
And I think this topic is very timely.
I know we just came off with heart
month, but really cardiovascular health is a year
round issue.
So we love to talk about it, you
know, every month. And this is a institute
we cofounded between myself, doctor Gayatri Setia, and
doctor Deborah Reynolds. So excited to be here
and to to to share information about it.
Absolutely. And as I'm sure you're aware and
all of our listeners, there's a lot of
systems right now that are opening either service
lines or institutes or even clinics
specifically for different population groups. So I'd love
to just hear your
opinion and understanding of what's behind all of
this movement towards specialized care by population.
Yeah. Great question. So at its core, it's
about recognizing that health care has historically been
built around a one size fits all model,
but patients are not one size fits all.
And different populations experience disease differently. They face
different barriers to care, and often they arrive
in the health system through different pathways also.
So if you wanna truly deliver effective care,
we have to design programs that acknowledge those
realities.
And cardiovascular disease is a perfect example. It's
the number one killer of men and women,
yet women have historically been under recognized, under
diagnosed,
misdiagnosed,
and underrepresented
in research as well. And so that realization
is one of the driving forces
behind launching the Women's Cardiovascular Institute at Elmhurst.
We wanted to create a program where women's
symptoms, risk factors, and life experiences also, things
like pregnancy, menopause, are fully integrated into cardiovascular
care. So in many ways, specialized care by
population group is simply just good medicine. It's
about meeting patients where they are and then
designing care around the realities of their lives.
Absolutely.
And what are some of those changes that
you're making to your services to meet the
needs of women?
Yes. Elmhurst serves one of the most diverse
communities in the world. Our patients actually represent
a myriad of cultures, languages, backgrounds, life experiences.
Actually, there are about 250
languages spoken within just a small radius of
the hospital. So incredibly diverse.
And this diversity fundamentally shapes how we think
about delivering care. And because of that, we
recognized that there was a real unmet need
for dedicated women's cardiovascular care in this community.
Many women we see are not always aware
that cardiovascular disease is their leading health risk.
And what makes our program particularly unique is
that it sits within a community and public
hospital system. So as you alluded to earlier,
many women's heart centers are popping up around
the country. Many women's cardiovascular programs sit within
large academic medical centers in the country.
But access to specialized cardiovascular care shouldn't really
depend on where you live or your insurance
status or the center that you have access
to. It's really an equity issue, and so
that's why we felt strongly about building this
particular program.
We also built this program to be comprehensive
across the entire cardiovascular
spectrum
from prevention to critical care. So we have
a few initiatives that are embedded in our
in our women's heart program. So for example,
a postpartum hypertension program, and this program recognizes
that pregnancy is often an early cardiovascular
stress test. We also have a post CICU
clinic, which actually helps our women patients recover
after
critical illness and in transitioning back to normal
life. We also have a breast cancer cardiotoxicity
program where we work closely with our oncology
colleagues to protect the long term health of
the heart. So at the end of the
day, the goal is not just to treat
disease when it appears, but also to identify
risk earlier and close gaps in care that
disproportionately affect women. And, you know, perhaps the
most meaningful feedback we hear from our women
patients is simply, you know, this is the
first time I felt somebody really listened to
my symptoms, and I think that's when you
know that the model is working.
Absolutely. That's gotta be lovely to hear. And
I'd love to dive into that even just
a little bit more,
because every system's doing these women's services a
little bit differently. So for your service area,
what are some of the services that are
in the highest demand?
Yeah. So I think women's heart in general
is in high demand. Right? We know that
women's heart women's cardiovascular disease, it's the number
one killer.
So it's it was a need that was
unmet for years. And now we're able to
bring that specialized care to this community. And
like I mentioned before, we have other specific
programs within the umbrella of the Women's Cardiovascular
Institute. So the postpartum hypertension program, the post
CICU clinic, the breast cancer cardiotoxicity
program, the cardio obstetrics program. So really, we're
we're really just in the infancy. This program
is only one year old, but we're really,
really excited to be able to bring this
program to this community.
Absolutely.
And kind of on the other side of
things, I'm sure you're very aware that it's
really hard to recruit specialty physicians. And right
now, our nation is facing a shortage of
all types of specialty physicians. But even within
cardiology, it can be difficult to find specialty
cardiologists.
So what are some of your strategies that
you're using to help recruit physicians in so
that you have the right specialties at your
center?
Yeah. So I I fundamentally, it starts with
building teams that kind of understand the needs
of the communities we serve and the women
we serve and then bringing together physicians with
complimentary expertise. Right? So, you know, I mentioned
a slew of programs that are sort of
embedded under women's heart. And And one of
the reasons we can do that is because
we have diversity within our women's heart leadership.
So if you look at the leadership of
our women's cardiovascular institute, doctor Gayatri Setia, doctor Reynolds,
and myself, we each bring different areas of
focus within cardiology and those niches are very
complimentary.
So when you combine those perspectives, it allows
us to build a program that truly spans
the full spectrum of cardiovascular care for women
from prevention and risk assessment to complex and
critical illness. And equally important to that is
the work we do we do with other
specialties and other colleagues. It's not done in
silo. Right? Women's cardiovascular health intersects with many
other specialties across the health system, so we
collaborately we collaborate closely with our OBGYN colleagues,
our oncology colleagues,
experts in lifestyle medicine, and, of course, our
primary care medicine colleagues also. And I think
that multidisciplinary
structure is essential because women's cardiovascular health often
unfolds across many life stages,
pregnancy, menopause, potentially cancer survivorship, and so many
other situations.
So when these specialties are all interconnected, we
can actually provide more coordinated, thoughtful, and patient
centered care.
Absolutely.
And I'd love to kind of go back
to something you said at the beginning about
how your service area has I think you
said about 200 different languages that are spoken.
How are you meeting the needs for patients
who don't speak English as a first language?
Yeah. So fortunately, we have, you know, a
lot of ancillary support services. For example, our
translation services, they're very, very robust. So we're
able to, you know, sort of bridge the
gaps in communication that way. And we really
try very hard to provide culturally sensitive care,
particularly within our, you know, women's heart clinic
where we've got so many different women speaking
not only different languages, but coming from different
backgrounds, different cultures,
bringing their diversity of pathology also. So it's
really important to be sort of culturally sensitive,
in in our care delivery.
Absolutely.
Now let's look a little bit to the
future. I'd love to hear two things from
you. The first is, what is the next
step for the Women's Institute?
Yeah. I think this is only the beginning.
I think our existing pathways under the Women's
Heart Institute, we would love to sort of
grow those, you know, whether it's the post
CICU clinic or the breast cancer cardiotoxicity
program,
our postpartum hypertension program. We would actually love
to expand these clinics, and, really, that's sort
of our goal in the next year or
two expansion.
But I think it's also a really exciting
time, right, for,
precision medicine technology.
There's so much we can integrate into this
women's cardiovascular program and this is really just
a start.
Absolutely.
And kind of with that, I'd love to
hear your guess as to how you think
specialized care by population might change in the
next five years.
Yeah. I think this is a very timely
question. I think we're entering a phase where
specialized care will become more integrated,
more preventative perhaps, and and definitely more data
driven. I think we're gonna see programs that
move earlier in the disease timeline. Right? Focusing
more on the risk detection prevention rather than
just waiting until patients either present with an
event or with advanced disease. I think there
will also be greater integration between specialties.
Cardiovascular care is increasingly intersecting with obstetrics, oncology,
endocrinology,
critical care.
So I think this is really important, especially
as we're thinking about women's heart across the
lifespan
and across the spectrum of care. And I
think third, technology is gonna play a role
in the future. We're gonna be using data,
digital health, AI perhaps,
population level analytics to identify patients who might
otherwise fall through their cracks. But at the
end of the day, I think one thing
that won't change or or shouldn't change, I
should say, is the core mission. Right? Equity
and access to specialized care for women.
I I just wanna highlight that, you know,
our program specifically,
I think it demonstrates that, you know, these
sort of innovative
population focused cardiovascular care programs, they don't have
to exist only in the large academic centers.
Right? It can and it should exist in
community hospitals and public and municipal systems where
the need is actually often the greatest. And,
ultimately, the goal is simple. Right? Making sure
that every woman and every patient, regardless of
their background or circumstance, receives care that truly
reflects their needs.
Absolutely.
Well, this was been so amazing. I love
hearing everything about what you're doing with your
Women's Institute. So thank you for taking the
time to share with us today and thank
you to our listeners for joining us. Of
course. Thanks for having me.