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Healthcare podcast series. I'm Ryan Mohammed, writer and
moderator of Becker's Healthcare. I'm thrilled to have
with me today doctor Margo Casai, director of
transcatheter bowel therapies at Allana Health Minneapolis Heart
Heart Institute and registered yoga teacher. Doctor, welcome
to the podcast. We're very excited to have
you join us today. To get us started,
would you mind please introducing yourself and telling
us a bit about your background?
Yes. Well, thank you for having us, first
of all. My name is Mario Grisel. As
you said, I'm an interventional,
cardiologist at the Allina Health Minneapolis Heart Institute.
A little bit of my background, I trained
in Europe and Germany,
did,
at least part of my,
yeah, board training there, and then moved over
to United States. Did a lot of fellowship
training at Mayo Clinic, had then
my first, private practice job
at,
Dean Clinic in Wisconsin, and then
was recruited to the Minneapolis Heart Institute
around
2016.
In my interventional world, I,
certainly do the the regular interventional cardiology,
operations or,
services, but my focus is on structural heart
disease,
mainly in the world of transcatheter
valve therapies like TAVR, MitraClip.
We also do pulmonary treatments and and the
WATCHMAN device.
Wonderful. Thank you so much for giving us
that insight into, you know, your background and
what you're currently doing.
What what would you say are the top,
three biggest issues you're following in cardiology today?
Yeah. I was thinking about it. And,
you know, one thing that I have noticed
over the last couple years, which it did
not seem to be an issue before, at
least not in my career, was retention of
talent.
I think that we always had almost no
issues in,
onboarding
really talented cardiologists
of all subspecialties.
But over the
last years and of course many, many reasons
for that,
the retention of that talent has been
one issue.
That personally concerns me simply because I think
our generation then
certainly is responsible for
holding the torch forward for the next, I
don't know, 15, 20 years and,
of course,
creating and
retaining the success of an institution.
So that was
one,
aspect
that worries me or
seems to be a challenge.
The other thing,
I'm also
part of a training program,
for a Master's of Health Administration here at
our university
in Minnesota.
And as we go through the training,
we obviously talk a lot about value based
care and
there I feel like we have still a
lot to do and
we can talk about it. Is it coming,
not coming? How quick is it coming? But
as we think that it is coming and
coming maybe quicker than we think, I'm not
sure that we are
ready for that. And I say that from
a provider level. I think from an administrative
level, I'm sure a lot of people have
thought about it,
but I think it is something that is
being discussed maybe in C suites and other
levels.
But I'm not sure that we as providers
really know what that means and how we
can,
service can help with that
and make it a success.
And then the third one that I was
thinking about is,
and it has to do maybe with the
first one, the retention, is really the burnout
that we see in physicians and how they
are
valued or not feeling valued. And I think
especially
around COVID, after COVID,
I've seen that in our group and other
groups as well. And I think that worries
me that,
physicians traditionally
may not speak up about it enough and
and and hold it to themselves. And,
I I feel that this is also something,
yeah, one of the the the three major
issues that I see.
Yeah. Yeah. Definitely. Thank you so much for
giving us that insight.
If we could look into the the near
future here, how do you see hard care
evolving
over the next 18 months or so?
Yeah. What what I what I see us
doing
more than before
is actually also involving,
especially here in Minneapolis, some of our
more diverse
neighborhoods. And I think
many
and traditionally,
there has been a neglect and many people
have realized that.
But I think I'm very proud of of
our group, our foundation,
our health care organization, also to to reach
out to our
very diverse neighborhoods and make sure that that
everybody gets same kind, and access to
high level care,
that we and others here provide. And I
think that's something I see,
you know, really being
fostered here, and I'm excited about that. And
when we go back to
value based care, I also see that there
is a little bit more movement in really
bringing
everybody to the table. And I say that
in a sense of us providers, health care
systems, but also
especially in interventional cardiology,
thinking about how vendors, how manufacturers of devices
can maybe be put at the table
to have, some responsibility
in the sense of value based care. I
always feel like, as I said, the more
training you do, the more education you get,
that this difference between,
the nonprofit,
part of health care, which we are, and
the profit part, which, of course, the vendors
are, there's a disconnect. And I think
that disconnect is so striking
that we have to find a way of
collaborating. It cannot be that one is responsible
for that and the other one is just
responsible for the stock market. I think
hopefully, we can we can find a good
way of of bringing really everybody,
to the table.
Yeah. Thank you so much for giving us
that that insight there.
Doctor, before I let you go, the last
thing I really wanted to ask you is,
what are you most excited about today? And,
also, what is making you nervous? Whether it's
something you're seeing in the news or something
you're currently doing within your position.
Yeah.
What what I see,
really exciting is that despite all the negativity
that I probably brought in here for a
while,
I see that we still have
so much talent,
coming from medical schools, from internal medicine programs,
applying to our fellowship programs, whether that is
general cardiology,
intervention cardiology,
advanced heart failure, imaging,
electrophysiology,
it is just amazing to see that despite
you know, certain maybe negative developments,
the talent is there. People are excited to
go into this field,
and it is wonderful to work with,
the young talents and and to to bring
them on their way. So that's that's definitely
something that that I'm super excited about.
I mentioned it before. What I'm I'm,
somewhat worried about is really, I think, the
connection of burnout and and at the same
time, this this underlying feeling of being undervalued.
Right? I think that in in stressful
situations like we many health care systems are
that
there's a reflex of a very much top
down approach and then understandably so it's easier
to make decisions that way.
But unfortunately,
you know, dozens
and maybe even hundreds of physicians with with,
you know, lots of experience and and probably
valuable input
are are then neglected and it they feel
undervalued. And I I can I can tell
that, you know, in in in
across the state, it's not just one institution?
You you can feel it when you when
you have conversations with the physicians across the
state, across the nation,
that there's this feeling,
that the value is not there, that the
burnout gets higher. And so that's why I'm
worried about over the next,
18 months and I hope we can
actually combine it somehow that we really have
exciting
new talent coming in and that we all
work on, you know, reducing the burnout so
that that we can retain the talent and
at the same time really give access to
care for whoever,
needs it.
Yeah. Yeah. Absolutely. Well, thank you so much
for those final thoughts, doctor. This definitely been
an informative,
discussion. So I wanna thank you so much
for coming on Bexus HealthCare for the first
time on the podcast, and I look forward
to connecting with you again soon.
Thank you so much. Thanks for having us.