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Welcome everyone to the Becker's
Healthcare podcast series.

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I'm Ryan Mohammed with
Becker's Healthcare, and I'm
thrilled to have with me,

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with me today, Dr. Martin Meam,
cardiologist at Geisinger.

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Doctor, it's so nice to talk
with you today. How are you?

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Very well, thank you for, thank you for
inviting me to, to, to interact today.

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Yeah, of course. And to begin,

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would you mind just introducing
yourself and telling us a bit about your

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background?

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Yeah. Uh, my name is Martin
Mat Samura. I'm the, uh,

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chief of cardiology for
Geisinger Northeast. Um,

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Geisinger Health System is
a very large integrated, uh,

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delivery health system that spans a very
large region of central and northeast

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Pennsylvania, uh, Geisinger Northeast.

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My area is centered in the
Wilkes Scranton region, uh,

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two moderate sized cities that sit
in the northeast corner of, um, uh,

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of Pennsylvania. I've been here for
eight years in my current capacity.

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Prior to that, I've had, uh, some, uh, uh,

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experience in academia at the University
of Virginia in industry doing drug

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development at Glaxo
McLean in private practice.

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I've sort of done a little bit of, of,

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of just about every kind of work
setting you can do in cardiology.

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Wonderful. Thank you so much for giving
us that background. And to begin with,

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um, the real questions of the
podcast, I guess I should say.

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The first question I
wanted to ask you, doctor,

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are what are the top three biggest
issues in cardiology today that you're

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seeing?

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Yeah, there's so many
issues that, uh, that, uh,

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we in healthcare and
cardiology are dealing with.

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I sort of thought about frameworking
'em from starting at kind of the 30,000

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high level and then, and then dropping
down to the ground floor and, um,

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hopefully this'll be of interest,
you know, on the global level,

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kind of 30,000 foot view. Um,
you know, the, the issue, uh,

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that we're dealing with is, is, is really
the issues that you hear about from,

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from everyone everywhere
these days. You know,

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figuring out how to deliver care in a
cost effective manner to a larger and

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sicker population. And doing that,
uh, doing more with less, you know,

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due to, uh, what everybody's talking
about, the increased, uh, labor costs,

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you know, the cost of supplies and the
scarcity of the workforce, you know,

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all of which became, uh, very apparent
during and, and following the pandemic,

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uh, particularly at Geisinger in
Northeastern Pennsylvania. Um,

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the fastest growing segment of our
population is 65 and older, and that,

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you know, growth is going to continue,
uh, with time due to our, uh, the,

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our specific demographics.

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We continue to improve on keeping
people healthy at the primary care level

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and manage chronic conditions,
which is, uh, fantastic.

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But it obviously means that by the time
they get to us in the specialty clinics

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or hospital, they tend
to be sicker and, um,

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than our traditional patient
population. And again,

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we are asked to care for those
patients, uh, uh, with, you know,

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fewer and fewer resources and,
uh, more and more efficiently.

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So I think that's the, the,

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the high level view on the kind of
local Geisinger Northeast level. Uh,

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because we're a large system spread
over a very large geographic area, uh,

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serving different, uh, uh,
different communities, um,

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we're always challenged with how to
deliver care appropriately and personally,

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uh,

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without spreading ourselves too thin and
being too redundant across our system.

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And I'll give you an example.
In the Northeast, uh,

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I mentioned that we are centered at, in
the Wilkesboro Scranton, uh, market. Uh,

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those are two cities that, um,
sit about 15 miles apart. We,

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um, uh, have made decisions
to, um, offer, um,

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some of our high specialty, um,
uh, procedural, uh, work such as,

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um, uh, structural, uh, heart, uh,
interventions in both of those markets.

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Um, now somebody might argue that in a
different market that doesn't make sense,

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um, that that's redundancy,

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but we know our patients in the
Scranton Wilbury market, uh,

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expect and, and really, uh,

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prefer to get their care in the comfort
and familiar surroundings of their local

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hospital in their local city. So
we've made that decision to, uh, uh,

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have that redundancy in our market,

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but that's always something we're
faced with making those decisions.

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I think that, um, in addition
to that, because our,

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our catchment is very
geographically wide, um,

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we need to find ways to
care for patients that, uh,

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allows us to go to the
patient and, um, and,

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and deliver care where the patients
live. And in our system, we can have, um,

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patients as far as 50 to 75
miles from our, um, core clinics.

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In the past, we've, we've, uh, addressed
this with outreach clinics, but even,

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you know, even outreach clinics
don't address fully, um,

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meeting the patient where they
are. So we've, uh, really, uh,

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tried very hard and we're, uh,

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we're actively trying to leverage
telehealth in virtual health, uh,

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care services to, um, to better
deliver care to our patients. Um,

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I noted that, uh, you, one of
your recent podcasts, you, um,

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had representatives
from Reco Health on, um,

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reco Health is a virtual
cardiac rehab, um, uh,

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company that we entered
into a partnership with, uh,

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several years ago to deliver
virtual cardiac, uh, rehab again,

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where the patient is,
rather than trying to, uh,

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bring the patients to our, um,
bricks and mortar cardiac rehabs,

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it worked very well in the
pandemic and, and post pandemic.

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It's proven to be a much better
way to deliver cardiac rehab, uh,

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where the patients exist. And it's
really proof of principle that, um,

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you can successfully leverage telehealth
and virtual healthcare services to gout

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healthcare that's meaningful
to patients where they are, um,

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even in a ge geographically
diverse, um, system like we are.

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And then finally, I think
on the ground level, um,

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a a big issue in cardiology these days
that we don't necessarily talk about in

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detail, uh, as much is
protecting providers from
burnout. And, and, you know,

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burnout these days can come from
some very unexpected sources. I,

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I think as an example, you know,

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you can focus on the nature of how
communications occur between providers and

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hospital personnel patients. Um,

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obviously it's becoming more and
more electronic and we're interacting

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more and more with our patients
by electronic portals. Um,

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and this has allowed us to cut labor
costs by replacing staff functions with

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really more efficient electronic process.

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And I think this has really morphed
into other areas such that, um,

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providers these days are faced
with a lot of electronic work, uh,

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in such diverse areas as credentialing,
scheduling, you know, cme,

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uh, keeping up with, um,
administrative tasks.

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And I think it's important to
recognize that as a source of burnout.

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Cuz in the past, even when I was
starting out in cardiology, you know,

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you could kind of gauge how
overwhelmed the provider is, um,

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uh, uh, with administrative tasks by,
you know, the line of, of staff outside,

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uh, his or her door waiting to to, to,
you know, have things executed, signed,

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what have you. And also the
pile of charts on the, on their,

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on their desk these days. You know,

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it's really hard to assess the
enormity of the electronic pile of

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work that providers are dealing with
on a day-to-day basis. And I think if,

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if it's not attended to and
monitored very carefully,

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it can really be a source
of, uh, of, of frustration,

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stress and burnout for providers. So
we're really actively, uh, addressing,

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uh, that issue and, and attempting to,
to, to, to address that in creative ways.

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Yeah, absolutely.

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Thank you so much for giving us that
insight and what you're thinking about the

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three biggest issues in
cardiology today for you,

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how do you see heart care evolving
over the next 18 months or so?

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You know, I think as, as everyone in in,

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in healthcare in general sees the next
18 months as being very challenging,

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that, um, we're gonna be, uh,

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expected to change the way in which we
utilize labor and react to the constant

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pressure of having to do more with less.

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And this is really medicine across
the board, not just cardiology. Um,

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it's gonna mean changing,
you know, in particular,

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it's gonna mean changing some
of the characteristics of, um,

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of things that are sacred
to providers. You know,

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the the physician patient relationship.

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I think it's gonna become
more digitally based,

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and I think we're gonna have to really
rethink the way we maintain and foster

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patient relationships as we increasingly
connect with our patients through

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digital methods, uh, and, and,

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and adapt those methods to best
connect with and serve our patients.

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I think that is probably
the, the, the most, uh,

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dynamic issue that, um,
is going to, uh, uh,

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evolve over the next year and a half.

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Yeah, absolutely. Thank you so
much. And Dr, before I let you go,

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a couple last things. What
are you excited about today?

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And also what is making you nervous,

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whether it's something that you're working
on or something that you're seeing,

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cardiology, anything like that?

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Yeah, I'll, I'll focus on the excited
<laugh>. Um, I, I think that, um,

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we are in a really neat, um,

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time in cardiology because I think that
genetics and precision medicine are

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going to really explode and take center
stage in the coming five to 10 years.

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You know, I think, uh, using,
using, uh, oncology as an example,

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we've seen over the last
decade how, you know, genetics,

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understanding the genetic basis of
clinical disease and tailoring therapies

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based on those genetics has just
absolutely revolutionized, um,

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oncologic care and care
of oncology patients.

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And I see the same thing happening,
uh, in cardiology in the,

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in the coming five to 10 years,

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where we will understand
better the genetic basis of
some of the diseases we've

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been treating for decades. And that
will both allow us to, uh, predict,

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um, outcomes and pathology
and the need for, um,

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aggressive therapy for patients. Uh,

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it will allow us to better counsel
patients on the heritability of

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diseases that is screening, you know,

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screening siblings and screening children
for diseases that afflict parents.

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And really most exciting, I think
there's, uh, in, in many pipelines,

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uh, drugs in development that are aimed
at the genetic basis of, as I said,

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drug, uh, uh, diseases that
we've traditionally treated
on a more generic basis,

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such as as heart failure, um,
and, and rhythm abnormalities.

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So I think that is really the most
exciting and, um, and, and, and, uh,

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exciting aspect of what's coming in
cardiology in terms of what's, you know,

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makes me nervous. I, you
know, there's, as we've,

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as we've sort of touched on
and others have touched on,

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there's just unprecedented industry
headwinds that are challenging healthcare

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across the board because of, of
the, the, the big things, you know,

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increasing cost of labor, uh,
supplies and drugs and the, uh,

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decreasing scope of, of our
workforce. I think that that is, um,

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something that's going to
require us to, you know,

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think outside the box and be very
clever and very, um, uh, proactive, uh,

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to find solutions to, um, uh, to, uh,

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remedy those headwinds because I don't
think they're changing in the near

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future.

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Thank you so much for those
final thoughts. Did you
have anything else to add?

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I don't think so. I think
that's it. Thank you.

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Okay. Perfect. Yes. Well, thank you
again so much for those final thoughts.

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Doctor, this has been an
amazing discussion. So again,

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I wanna thank you for coming on Becker's
Healthcare. We really do appreciate it,

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and I look forward to
connecting with you again soon.

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Same. Thank you very much.