HJNO Jul/Aug 2019

dialogue 18 JUL / AUG 2019 I  Healthcare Journal of new orleans   real problem. Suddenly, the attitude changes to, “What can I do?” We think this is very important. Editor I n Louisiana, it’s exciting to be the leader in such an important specialty. What does it mean to be the leader in medical devices, procedures, and getting better outcomes? Walker  I think it means a lot of things. First, it’s a privilege to help work to develop new improved therapies and new diagnostic modalities. It’s really a privilege and it’s a lot of fun, but it’s also a responsibility because wemust try to impart some wisdom to other young doctors who are going to expand the field into the ensuing decades, so we’ve taken that very seriously. We’ve tried to serve as mentors to those coming up in the field, and we’ve tried to create forums such as NCVH where information can be shared and people can improve what they do. Editor  How do you measure quality and success? Walker There are a lot of ways to do that. For me, it’s one patient at a time, and seeing someone whose limb I’ve saved or some- one who has come to me in cardiogenic shock. I once was able to dance with a lady when she turned 100, and that same lady had presented to me with no blood pres- sure and cardiopulmonary resuscitation going on 20 years prior. Twenty years later I got to dance with her on her 100th birth- day. That’s what I mean by one patient at a time, or one family at a time. Sometimes I find myself not treating one person, but a whole family. Sometimes it’s just that one person, but they affect that whole family, just as I mentioned earlier that my father so affectedme. I cannot imagine how things would have been had I not had my father those 26 years that I did have him. I think that would have been such a loss. Finally, we follow obvious standard figures, and the most important of those are publishedmor- tality andmorbidity stats, those in particular published by impartial groups likeMedicare. There we have shown that we have dramati- cally lowered both mortality and amputa- tion rates. All of those things matter to us, but really I think it ultimately gets down to one on one with patients. That is clearly the way that we measure quality and success. Editor  What is some advice you can give to young physicians? Walker  I know there are many physicians who experience physician burnout, but that’s never happened to me. I tell every young physician that they’re in the great- est vocation on earth and that they must never quit learning. Take pleasure in help- ing your patients, enjoy your successes with them, and learn fromyour failures. But right now, we’ve never had a time in the history of medicine where we’ve been able to enact the kind of change that we can enact now. That’s only going to get better with the things we’ve learned about genetics and new techniques and technologies that are coming out. We’re really getting much more effective in diag- nosing and treating patients. One thing I do stress with young doctors is that this is not a job; it really is a vocation. The patient has to be at the front and center of what you’re doing, and as long as one does that, and as long as you can also enjoy the outcomes that you have for your patients, and how that may affect their families, the happier you will be long term. Editor  What is the future of CIS and its role as a leader in cardiology and vascular care? Walker When I wrote themission statement for CIS as a 28 year old physician starting a practice, I wrote those things that we wanted to achieve. They sounded at that moment like I may have been amadman because we were talking about technological superior- ity, research, compassion—all those things that we wanted. But you know, nothing has changed. Our mission statement is really, in a sense, our business plan. We plan to remain patient focused, research focused, teaching focused, and we have gotten into newer areas. Obviously we have always been at the forefront of interventional research and being able to treat patients non-sur- gically via some of these new phenomenal tools that have come out, some of which we have helped to create. Now we have really grown into telemedicine and virtual care, where we are able to extend, via robots and extensive internet connections, our ability to actually interact with patients in under- served areas, or people working outside the country, or on offshore oil rigs. Basi- cally, we’re trying to expand access to care in a cost efficient and effective manner. And I think that’s going to be part of where we go. But without a doubt, we’re going to always be focused on our mission statement because I really believe that as long as we stick to the mission statement of trying to improve care, staying on top of the field, and doing what we love, I think that’s a winning course. n