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Hello everyone. I'm Ryan Mohamed,
a writer for Becker's Healthcare.

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Thank you so much for joining me today
on the Becker's Cardiology and Heart

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Surgery podcast. As I speak
with Dr. Jorge Sao md,

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Chief of Cardiovascular Medicine at
the Medical College of Wisconsin,

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and the medical Director of the Heart
and Vascular Service line Fred Health.

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It's so nice to meet
you. How are you today?

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I am doing great, thank you.

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Absolutely. Well, to begin,

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could you please introduce yourself and
tell us a bit about your background?

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Yeah, absolutely. Uh, I
am Jorge Sao. I am the,

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uh, chief of the Division of Cardiology
at the Medical College of Wisconsin.

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I also serve as the medical Director of
the Heart and Vascular Service line for

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the Froedert Health System. Uh,

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both Froedert and the Medical College are
part of a clinical integrated network.

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Uh,

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I have been in this position for
the last four years before I was

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the chief cardiology and the co-director
of the Cardiovascular Institute

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at North Shore, um, University
Health System in North Chicago.

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I was there for five years. I
was trained as a cardiologist.

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I am an interventional cardiologist. I
still practice, see patients in clinic.

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I spend time in the cath lab,

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but I spent approximately 50%
of my time administering both

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the division of cardiology and the
heart and vascular service line

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at Trader Health System.

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Amazing. Thank you so much for
that introduction. And you know,

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the first real question I wanted to
ask you is, with all your experience,

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what are the top three biggest issues
in cardiology today, do you think?

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Well, yeah, that's a great
question. You know, we,

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we all know that we have, uh,
significant challenge challenges,

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and we have had many of those
over the years. Obviously,

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those include grow our core
business, uh, cutting costs,

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uh,

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manage the care across the continuum of

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patients, try to bring as much
value to health systems as possible.

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But you're asking for three, probably
more relevant as as of today.

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Um, and I would say, uh, those
that affect not only cardiology,

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but are affecting our, our
healthcare, uh, systems and, uh,

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and those affect cardiology and, and
we're seeing a lot of that. So labor cost,

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uh, it is very important. Uh,
it has been in our system.

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It is all across the country.

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And as labor cost increases
and the margins of

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hospitals and health systems
shrink significantly,

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there is less capital for investment. So,

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um, I would say that, uh,

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for the next many months
we're going to be seeing a,

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I would say, uh,

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lower growth in our cardiovascular
business because of less available

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dollars, uh, which are
being spent now on, um,

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paying, uh, uh, labor,
uh, at, at the higher, uh,

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cost. Um, I mean, that is
true for, uh, for everything,

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for nurses, for techs, for, um,

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everybody that works in the hospital.
Right? Um, and if you add that to,

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you know, to, to inflation,
now we are paying labor,

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um, higher costs.

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Now we are paying also higher prices
for many of the things that we're use in

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the hospital. And, uh, unfortunately
we cannot raise our prices, right? So,

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again, unfortunately hospitals are seeing
that shrinkage of their margins that,

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uh, will affect capital investment. I
would say that that's important. Um,

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uh, another one I would say, uh,

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it is equitable access
of to care. Uh, you know,

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we have great therapies, we have great
drugs, uh, and I could mention, you know,

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some of those that are really
transforming the way we practice medicine.

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Some, some medi medicines that we
give to patients with heart failure,

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hgl T two inhibitors, for
instance, that are, are, uh,

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proving to be just medications
as good as, as, you know,

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20 years or 30 years ago, statins
were to lower cholesterol,

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but not everybody has access to
these medications, right? So, uh,

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what is it that we can do
to, uh, offer, uh, access,

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uh, to those that need it most? So
I would say that that is another,

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another important,
important problem. Um, so,

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um, for me, uh, in, in the months
to, to come in, the year to come,

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it's going to be all
about, uh, having, uh,

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offering access. Uh, but
with the constraints that,

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that I mentioned, uh, before,
right? We would not have,

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we don't have enough staff, We
don't have enough providers,

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and that's going to constrain
our, our, our throughputs.

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Yes. Thank you so much for sharing that
insight. And to go more in depth about,

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you know, cardiology and heart health.

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How do you see heart health evolving
over the next 18 months or so?

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Well, again, it, it depends, right?
Uh, and I am speaking more as a, as,

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as a health system, as a division, as
as a division of cardiology. So what,

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what I think it is that, uh,

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we will be spending a lot of
hours trying to figure things out

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on, uh,

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providing the right
care in the right place,

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um, the right time for patients,

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definitely doing this
at the lower cost, uh,

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with a very constrained workforce. So I,

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I think that is going to occupy
honestly, a lot of our waking hours.

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We, we, we are currently doing that.

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There is tremendous demand for
our services, uh, in, you know,

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southeast Wisconsin. Freighter
health System is a sy of,

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of, of quality. We were, uh,

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we are ranking the top five
health systems with invis for,

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for heart and vascular. We're definitely
in the top decile as a health system,

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uh, invi.

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We re recently were also ranked
one of the top 20 hospitals by

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Watson on IBM for
cardiovascular care, et cetera.

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So patients really want to see
us. Now, the, the question is,

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do we have enough capacity in terms of

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the space and, and,

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and the team members that are
part of our, our care team, uh,

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to, to provide the care that patients are
requiring? And as I said before, it's,

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it's not only nurses, it is, it is
technicians and anesthesia, for instance.

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It's, it's critical for us. So, uh,

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as we have all these stations
and all this procedure,

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all the procedures or heart
surgeries that we want to do,

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we're struggling finding, um,
being able to staff our, uh,

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procedural platform, our ORs are, um,

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C B I cs, uh, so we can
accommodate the, the,

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the patients and, and the demand
that exists for our service.

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Thank you so much for sharing that.
And before I let you go, doctor,

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last thing I wanted to ask you is what
are you most excited about right now?

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And also what is making
you nervous in the field?

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Yeah, you know, uh, I am,

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I am very excited about
cardiology in general, right?

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I would say it's probably the specialty
within medicine that it's always

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inventing itself. It's the area in,

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in medicine that it's always
focusing a lot of innovation.

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So we have fantastic therapies
that we can offer our patients,

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whether it's heart
transplant, whether it's ecmo,

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whether it's complex coronary
interventions, whether
it's structural procedures,

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electrophysiology procedures.

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We have newer drugs that are making our
patients with heart failure live longer

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and so forth and so on. So I think,
um, this is a wonderful time,

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uh, to be practicing medicine in
terms of the innovation that we have

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at hand and the innovation that
continues, continues to be,

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uh, developed. Uh, so that,

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that is exciting and I really feel
privileged to be working in this space.

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The, the things that give me anxiety are
still, are, uh, economic certainties,

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right? As I just pointed
out. Um, I, I think that,

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uh, we can only be as good as, uh,

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our health systems are doing
well financially as we can

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control costs in. So,

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in such a way that our hospitals and
systems and medical groups and medical

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schools continue to
meet their margins. Um,

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so some of the economic
certainties honestly, are, are

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things that, uh, worry me most. And,

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and one of my passion is just
to be able to provide health

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care, uh, to all right. And, uh,

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we see that there is still a
lot of inequity in the, in,

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in access to care in general. Uh,

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so offering optimal care to

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all members of our communities is
something that I am passionate about,

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and I just hope that we can
continue to move the needle in that,

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in that direction.

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Absolutely. Well, this was such
an insightful conversation,

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and I wanna thank you so much for
sharing your final thoughts, Dr. Cato.

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That is all the time I have for you.

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So I wanna thank you again for speaking
with me and to both listening. Uh,

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if you wanna hear more about Becker's
Healthcare, please visit our website,

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becker hospital review.com.
Thank you so much, Doctor.

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Thank you. Bye-bye.