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Welcome everyone to the Becker's Healthcare podcast series.
I'm Ryan Mohammed with Becker's Healthcare, and I'm thrilled to have with me,
with me today, Dr. Martin Meam, cardiologist at Geisinger.
Doctor, it's so nice to talk with you today. How are you?
Very well, thank you for, thank you for inviting me to, to, to interact today.
Yeah, of course. And to begin,
would you mind just introducing yourself and telling us a bit about your
background?
Yeah. Uh, my name is Martin Mat Samura. I'm the, uh,
chief of cardiology for Geisinger Northeast. Um,
Geisinger Health System is a very large integrated, uh,
delivery health system that spans a very large region of central and northeast
Pennsylvania, uh, Geisinger Northeast.
My area is centered in the Wilkes Scranton region, uh,
two moderate sized cities that sit in the northeast corner of, um, uh,
of Pennsylvania. I've been here for eight years in my current capacity.
Prior to that, I've had, uh, some, uh, uh,
experience in academia at the University of Virginia in industry doing drug
development at Glaxo McLean in private practice.
I've sort of done a little bit of, of,
of just about every kind of work setting you can do in cardiology.
Wonderful. Thank you so much for giving us that background. And to begin with,
um, the real questions of the podcast, I guess I should say.
The first question I wanted to ask you, doctor,
are what are the top three biggest issues in cardiology today that you're
seeing?
Yeah, there's so many issues that, uh, that, uh,
we in healthcare and cardiology are dealing with.
I sort of thought about frameworking 'em from starting at kind of the 30,000
high level and then, and then dropping down to the ground floor and, um,
hopefully this'll be of interest, you know, on the global level,
kind of 30,000 foot view. Um, you know, the, the issue, uh,
that we're dealing with is, is, is really the issues that you hear about from,
from everyone everywhere these days. You know,
figuring out how to deliver care in a cost effective manner to a larger and
sicker population. And doing that, uh, doing more with less, you know,
due to, uh, what everybody's talking about, the increased, uh, labor costs,
you know, the cost of supplies and the scarcity of the workforce, you know,
all of which became, uh, very apparent during and, and following the pandemic,
uh, particularly at Geisinger in Northeastern Pennsylvania. Um,
the fastest growing segment of our population is 65 and older, and that,
you know, growth is going to continue, uh, with time due to our, uh, the,
our specific demographics.
We continue to improve on keeping people healthy at the primary care level
and manage chronic conditions, which is, uh, fantastic.
But it obviously means that by the time they get to us in the specialty clinics
or hospital, they tend to be sicker and, um,
than our traditional patient population. And again,
we are asked to care for those patients, uh, uh, with, you know,
fewer and fewer resources and, uh, more and more efficiently.
So I think that's the, the,
the high level view on the kind of local Geisinger Northeast level. Uh,
because we're a large system spread over a very large geographic area, uh,
serving different, uh, uh, different communities, um,
we're always challenged with how to deliver care appropriately and personally,
uh,
without spreading ourselves too thin and being too redundant across our system.
And I'll give you an example. In the Northeast, uh,
I mentioned that we are centered at, in the Wilkesboro Scranton, uh, market. Uh,
those are two cities that, um, sit about 15 miles apart. We,
um, uh, have made decisions to, um, offer, um,
some of our high specialty, um, uh, procedural, uh, work such as,
um, uh, structural, uh, heart, uh, interventions in both of those markets.
Um, now somebody might argue that in a different market that doesn't make sense,
um, that that's redundancy,
but we know our patients in the Scranton Wilbury market, uh,
expect and, and really, uh,
prefer to get their care in the comfort and familiar surroundings of their local
hospital in their local city. So we've made that decision to, uh, uh,
have that redundancy in our market,
but that's always something we're faced with making those decisions.
I think that, um, in addition to that, because our,
our catchment is very geographically wide, um,
we need to find ways to care for patients that, uh,
allows us to go to the patient and, um, and,
and deliver care where the patients live. And in our system, we can have, um,
patients as far as 50 to 75 miles from our, um, core clinics.
In the past, we've, we've, uh, addressed this with outreach clinics, but even,
you know, even outreach clinics don't address fully, um,
meeting the patient where they are. So we've, uh, really, uh,
tried very hard and we're, uh,
we're actively trying to leverage telehealth in virtual health, uh,
care services to, um, to better deliver care to our patients. Um,
I noted that, uh, you, one of your recent podcasts, you, um,
had representatives from Reco Health on, um,
reco Health is a virtual cardiac rehab, um, uh,
company that we entered into a partnership with, uh,
several years ago to deliver virtual cardiac, uh, rehab again,
where the patient is, rather than trying to, uh,
bring the patients to our, um, bricks and mortar cardiac rehabs,
it worked very well in the pandemic and, and post pandemic.
It's proven to be a much better way to deliver cardiac rehab, uh,
where the patients exist. And it's really proof of principle that, um,
you can successfully leverage telehealth and virtual healthcare services to gout
healthcare that's meaningful to patients where they are, um,
even in a ge geographically diverse, um, system like we are.
And then finally, I think on the ground level, um,
a a big issue in cardiology these days that we don't necessarily talk about in
detail, uh, as much is protecting providers from burnout. And, and, you know,
burnout these days can come from some very unexpected sources. I,
I think as an example, you know,
you can focus on the nature of how communications occur between providers and
hospital personnel patients. Um,
obviously it's becoming more and more electronic and we're interacting
more and more with our patients by electronic portals. Um,
and this has allowed us to cut labor costs by replacing staff functions with
really more efficient electronic process.
And I think this has really morphed into other areas such that, um,
providers these days are faced with a lot of electronic work, uh,
in such diverse areas as credentialing, scheduling, you know, cme,
uh, keeping up with, um, administrative tasks.
And I think it's important to recognize that as a source of burnout.
Cuz in the past, even when I was starting out in cardiology, you know,
you could kind of gauge how overwhelmed the provider is, um,
uh, uh, with administrative tasks by, you know, the line of, of staff outside,
uh, his or her door waiting to to, to, you know, have things executed, signed,
what have you. And also the pile of charts on the, on their,
on their desk these days. You know,
it's really hard to assess the enormity of the electronic pile of
work that providers are dealing with on a day-to-day basis. And I think if,
if it's not attended to and monitored very carefully,
it can really be a source of, uh, of, of frustration,
stress and burnout for providers. So we're really actively, uh, addressing,
uh, that issue and, and attempting to, to, to, to address that in creative ways.
Yeah, absolutely.
Thank you so much for giving us that insight and what you're thinking about the
three biggest issues in cardiology today for you,
how do you see heart care evolving over the next 18 months or so?
You know, I think as, as everyone in in,
in healthcare in general sees the next 18 months as being very challenging,
that, um, we're gonna be, uh,
expected to change the way in which we utilize labor and react to the constant
pressure of having to do more with less.
And this is really medicine across the board, not just cardiology. Um,
it's gonna mean changing, you know, in particular,
it's gonna mean changing some of the characteristics of, um,
of things that are sacred to providers. You know,
the the physician patient relationship.
I think it's gonna become more digitally based,
and I think we're gonna have to really rethink the way we maintain and foster
patient relationships as we increasingly connect with our patients through
digital methods, uh, and, and,
and adapt those methods to best connect with and serve our patients.
I think that is probably the, the, the most, uh,
dynamic issue that, um, is going to, uh, uh,
evolve over the next year and a half.
Yeah, absolutely. Thank you so much. And Dr, before I let you go,
a couple last things. What are you excited about today?
And also what is making you nervous,
whether it's something that you're working on or something that you're seeing,
cardiology, anything like that?
Yeah, I'll, I'll focus on the excited . Um, I, I think that, um,
we are in a really neat, um,
time in cardiology because I think that genetics and precision medicine are
going to really explode and take center stage in the coming five to 10 years.
You know, I think, uh, using, using, uh, oncology as an example,
we've seen over the last decade how, you know, genetics,
understanding the genetic basis of clinical disease and tailoring therapies
based on those genetics has just absolutely revolutionized, um,
oncologic care and care of oncology patients.
And I see the same thing happening, uh, in cardiology in the,
in the coming five to 10 years,
where we will understand better the genetic basis of some of the diseases we've
been treating for decades. And that will both allow us to, uh, predict,
um, outcomes and pathology and the need for, um,
aggressive therapy for patients. Uh,
it will allow us to better counsel patients on the heritability of
diseases that is screening, you know,
screening siblings and screening children for diseases that afflict parents.
And really most exciting, I think there's, uh, in, in many pipelines,
uh, drugs in development that are aimed at the genetic basis of, as I said,
drug, uh, uh, diseases that we've traditionally treated on a more generic basis,
such as as heart failure, um, and, and rhythm abnormalities.
So I think that is really the most exciting and, um, and, and, and, uh,
exciting aspect of what's coming in cardiology in terms of what's, you know,
makes me nervous. I, you know, there's, as we've,
as we've sort of touched on and others have touched on,
there's just unprecedented industry headwinds that are challenging healthcare
across the board because of, of the, the, the big things, you know,
increasing cost of labor, uh, supplies and drugs and the, uh,
decreasing scope of, of our workforce. I think that that is, um,
something that's going to require us to, you know,
think outside the box and be very clever and very, um, uh, proactive, uh,
to find solutions to, um, uh, to, uh,
remedy those headwinds because I don't think they're changing in the near
future.
Thank you so much for those final thoughts. Did you have anything else to add?
I don't think so. I think that's it. Thank you.
Okay. Perfect. Yes. Well, thank you again so much for those final thoughts.
Doctor, this has been an amazing discussion. So again,
I wanna thank you for coming on Becker's Healthcare. We really do appreciate it,
and I look forward to connecting with you again soon.
Same. Thank you very much.