Q1: Tell us about yourself.
I have been a practicing cardiologist for more than 20 years and have been part of Indiana University Health for the last three years, partly in Bloomington and partly in Fort Wayne. My primary role for IU Health Bloomington is advanced cardiac imaging, whereas my primary roles in Fort Wayne are preventative cardiology and program development. Outside of medicine, I live in Fort Wayne with my wife of more than 30 years, and we’ve raised two successful kids who are off doing good in the world. I enjoy the outdoors and nature and am very thrilled to contribute as a board member for ACRES Land Trust here in northeast Indiana, southern Michigan and northwest Ohio. And, like everyone else… I love pickleball.
Q2: What does a normal day look like for you?
In Fort Wayne, most days are a mix of seeing office clinic patients, interpreting heart studies and working on program development. As far as the heart studies we offer, I interpret our echocardiography, nuclear stress testing, cardiac MRI and cardiac CT as well as Holter monitors. I leverage my IU Kelley School of Business MBA in the cardiovascular service line development here in Fort Wayne. We are creating from the ground up here, yet within the context of a large and established health care system. Therefore, the vision of what the program will look like and resources available to affect the vision are neither totally novel nor locally established.
Q3: If you could name one thing you enjoy most about IU Health, what would it be and why?
IU Health sought the input of the care team members to create an ethic, embodied in a combination of Vision, Values and Promise that are widely visible and consistently messaged throughout IU Health as “the IU Health Way.” These elements are genuinely the guiding principles of what we do. By applying this ethic upfront to our team creation, we have assembled a wonderful group that I truly enjoy working with and for. I look forward to expanding our team with staff who embrace the IU Health Way.
Q4: What differentiates IU Health from other health care systems?
While its footprint in northeast Indiana is small (but growing), IU Health is the largest health system in the state of Indiana. It’s also the most recognized by national rating services, such as U.S. News and World Report.
Indiana University Health has the association with Indiana University. As such, health care education is an important component of what we are charged with. For me, education is one of those activities I value and really enjoy. IU School of Medicine has campuses both in Bloomington and Fort Wayne, as well as other sites throughout the state. While they are separate entities, IU Health planning always must consider the impact and value of what we do in relation to the School of Medicine, as well as the other IU schools: Nursing, Medical Imaging, etc.
The association with Indiana University and our IU Health Values, Vision and Promise statement also positions us at the forefront of innovation in care delivery, exploring such models as Hospital at Home and value-based care, among others.
Q5: Where do you see the Business of Medicine headed?
The history of how the U.S. health care system got to where it is now is interesting and complex, but what is plainly clear is that from an economic perspective, it is not of high value (value = quality/cost). From a financial perspective, it is not sustainable (impending insolvency of Medicare, for example). In addition, there is inequitable distribution of health care access. Compounding these problems, there are growing shortages of key health care providers, including physicians and nurses.
There are big challenges and changes coming. The short answer is a transition to value-based care, but that encompasses many evolving concepts including a shift of care away from the hospital, the incorporation of personalized data through wearables, an increase in non-physician delivered health care and an emphasis on preventative care, to name just a few. Both Indiana University and IU Health recognize these realities and are actively innovating to continue to deliver higher value care.
Thinking of an office visit, for example, whether coming to see me or any other medical provider, there are patient tasks that will translate into the encounter providing higher quality care: (1) Come prepared — list questions and concerns; bring a current medication list (meds, doses and schedule) or the bottles themselves; obtain accurate, updated information that pertains to you or your family history. (2) Arrive at the advised time. (3) Take notes and repeat key concepts back to the provider to assure you understand the information. (4) Ask questions. There are more, but if these few items were actually practiced and not casually dismissed as if unimportant, there would be a real opportunity to improve care and value. The office visit is already so short that time optimization is key. If time is taken from the visit by unpreparedness, the patient has lost the time that could have been devoted to more in-depth diagnostic considerations or valuable education. It is much safer and wiser to over-prepare.
Q7: What is so remarkable about cardiology?
Somewhere around 100,000 time per day, this remarkable muscle beats to circulate your blood. Unlike other muscles that get downtime during rest and sleep, there is no extended downtime for the heart. As remarkable as our advances in technology have been, technology still cannot beat the God-given, natural heart in durability or reliability. It is an exceptionally impressive organ, yet it is subject to a variety of disease and injuries. But cardiologists and researchers have made incredible advances in medications, procedures and devices that extend health, reverse some disorders, and provide significantly longer and higher quality of life than just a few decades ago. The cardiology community adopted evidence-based approaches to care and are a curious and productive lot, and that combination bodes well for many more important advances in the near future.
Q8: What is Preventative Cardiology?
At IU Health Northeast Region, our main focus is preventative cardiology. This in part acknowledges that we do not yet have a complete service line here. But preventative cardiology is a subspecialty within the larger domain of cardiology, with a focus on maintaining heart and blood vessel health. Putting a heart artery stent in a patient to treat a critical blockage, for example, is an important aspect of cardiology, but that is interventional. To the extent possible, preventative cardiology seeks to limit the progression of disease that would require the stent to ever be needed. This is accomplished by individual risk assessment and personalized approaches to lifestyle, testing and medications. It applies to all ages, much younger than typically recognized, including even teens, and to advanced ages beyond 90 years, and to those without known heart disease as well as those with advanced heart problems.