Latest / Becker’s Healthcare Podcast / Andrew Tang, MD, Cardiac Surgeon at Medical City Heart & Spine Hospitals

Transcript

Andrew Tang, MD, Cardiac Surgeon at Medical City Heart & Spine Hospitals · Becker’s Healthcare Podcast

• 0:00
  This is Scott Becker with the Becker's Healthcare
• 0:02
  Podcast.
• 0:03
  We're thrilled today to visit with a true
• 0:06
  leader in cardiothoracic
• 0:07
  surgery.
• 0:08
  We're joined today by doctor Andrew Tang. Doctor
• 0:11
  Tang is both a brilliant physician.
• 0:13
  He had got his medical degree from Texas
• 0:15
  Tech,
• 0:16
  in Texas. He's double board certified. He's also
• 0:19
  the author of almost 50 or more than
• 0:21
  50 peer reviewed articles and textbook chapters.
• 0:25
  He also, in addition to being a physician,
• 0:28
  obtains his master's in clinical statistics from Case
• 0:30
  Western Reserve,
• 0:32
  which itself is a magnificent institution.
• 0:34
  Doctor. Tang, tell us about your current practice,
• 0:37
  your move to Texas, and about yourself.
• 0:41
  Thanks, Brad. I,
• 0:42
  you know, I'm I'm originally from Plano.
• 0:45
  Did all my
• 0:46
  undergrad and medical school in Texas. And, my
• 0:49
  wife and I, actually, couples matched in Cleveland,
• 0:51
  and that's where I was for the last
• 0:52
  ten years completing my training in general surgery
• 0:54
  and also cardiothoracic surgery at the Cleveland Clinic.
• 0:58
  So that's where I've been, and, that's where
• 1:00
  I did all my training. And as you
• 1:01
  mentioned, I also obtained a master's in clinical
• 1:03
  statistics during my dedicated research years,
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  which really, I think, helps me understand and,
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  you know, the research and also allows me
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  to kind of,
• 1:13
  you know, help,
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  other people in terms of completing high quality
• 1:17
  research as well.
• 1:20
  Thank you. And when you look at cardiothoracic
• 1:22
  surgery today, there there seems like so many
• 1:24
  things have changed over the years. At one
• 1:26
  time, everybody is doing cardiac bypass surgery,
• 1:31
  then it seems like more stent work.
• 1:33
  What's the evolution today? What are you what
• 1:35
  are the big trends you're watching in cardiothoracic
• 1:37
  surgery?
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  Well, I think that, you know, with technology,
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  there's obviously a lot of excitement, and there's
• 1:45
  obviously a lot of,
• 1:47
  of, you know, benefits,
• 1:49
  for for the patients.
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  But I think one thing holds true, especially
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  in cardiothoracic surgery, I tell patients this all
• 1:54
  the time is that, no matter what the
• 1:56
  there are some things that are tried and
• 1:58
  true and and stand the test of time,
• 2:00
  and then I think one example of that
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  is the lead to LAD. I think that
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  that, you know, single that single bypass is,
• 2:06
  you know, keeping patients alive, keeping our field
• 2:08
  alive. And it also allows us to kind
• 2:10
  of do other things as well, a little
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  bit, you know, things that are a little
• 2:12
  bit more complex, multi component surgeries.
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  So, yeah, I know it's it's, you know,
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  it's funny that you mentioned stents and and
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  and and, you know, and how things have
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  kinda changed a little bit. But now we're
• 2:22
  also seeing it's just like anything else. It's
• 2:24
  just like any other,
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  field. There's there's a pendulum, and it swings
• 2:27
  one way, and sometimes it swings back. And
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  so, actually, I I was just taking care
• 2:30
  of a patient who,
• 2:32
  got transferred in from, you know, another
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  and probably have, you know, lower ejection fraction
• 2:40
  from their from the sun myocardium and have
• 2:42
  some, mitral regurgitation.
• 2:44
  You know, there's so many of the things
• 2:46
  that the transcatheter things can you know, that
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  we have from a transcatheter
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  space is gonna need surgery. But,
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  you know, to support her through her immediate
• 2:54
  issues, we actually had to put in a
• 2:56
  micro axial pump to basically help offload the
• 2:59
  left ventricle in order to get her out
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  of, trouble now so that we can eventually
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  get her to a point where she's recovered
• 3:04
  and and is able to actually undergo the
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  surgery that she needs. So, one thing right
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  now is that we've kind of you know,
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  you mentioned one, couple things in our toolbox,
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  and we we've now kind of combined a
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  lot of these things to help patients,
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  to provide them with the care that they
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  need.
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  And and it's not just one it's not
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  just with one trick. We have a lot
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  of different tools now that that allow us
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  to do that.
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  You know, it's it's so it's so funny,
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  doctor Chang, because what you're saying sure resonates
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  with me.
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  It seems like over the last several
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  the last decade or so, we such a
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  such a movement towards stents.
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  And now is I I don't know if
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  it's because I'm aging or the population's aging.
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  I just seem to hear more and more
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  people having different types of more open heart
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  surgery again compared to what I was seeing
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  for a period of time. It it really
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  does. Your your your notion on it being
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  a pendulum
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  seems exactly what we're seeing out here.
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  Tell us a little bit about
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  where you practice
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  and also what you're most focused on and
• 4:00
  excited about for 2026.
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  So I I work for a Medical City.
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  I'm part of a group with, our senior
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  partner, Todd Dewey,
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  and we're part of the system.
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  And, you know, for me, when I was
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  looking for a job, the the most important
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  thing that I was looking for was
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  good senior mentorship, and and I've really got
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  that with, with Todd
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  and and with, Mike McBride.
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  And and I've just been fortunate to have
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  a very good leadership, here at Medical City
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  Heart and Spine with our CEO, Andrew Daniels,
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  as well. When I was interviewing for jobs,
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  you know, I was telling all my friends
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  that it's not it's it's very rare that
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  the CEO of the hospital actually calls you
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  or he writes you a handwritten, you know,
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  card saying congratulations on passing your boards or
• 4:43
  congratulations on the birth of your new daughter.
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  So I'm very fortunate to have
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  great leadership, great partners,
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  and that's allowing me to continue what I've
• 4:52
  already kind of started in my career which
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  is complex surgery. I hope to you know
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  bring back home some of the things that
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  I've learned in Cleveland. You know the clinic
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  was you know, number one in our care
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  for thirty years, and and and I think,
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  there are people who travel from all over
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  the world just to get their care there.
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  And I'm I was hoping to bring some
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  of that,
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  that, you know,
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  that
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  that experience
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  and,
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  the the quality of care to Dallas Fort
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  Worth. And so from my standpoint, you know,
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  I don't really have one specific thing that
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  I focus on because the training that I
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  got allows me to take care of anything
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  under the sun from a cardiac standpoint. You
• 5:27
  know? We just had a patient who came
• 5:29
  in in cardiogenic shock. So
• 5:31
  we put an impeller in her, and then
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  we're gonna work up for multivessel bypass and,
• 5:35
  mitral valve repair replacement. And then we you
• 5:37
  know, the other day, we'll have, you know,
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  someone who comes in with, you know, mitral
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  aneurysmction
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  and then needs a repair or someone who
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  has,
• 5:46
  you
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  know, aortic aneurysm disease and needs, you know,
• 5:50
  needs a root replacement. So I think, from
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  my standpoint, I'm I'm just focusing on getting
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  better each day, and and trying to bring
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  in some, you know, high,
• 5:58
  high quality care, you know. And,
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  there's not one specific thing that I'm necessarily,
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  focused on, but I I will say that,
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  one thing, as you mentioned earlier with technology,
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  it allows us to also fold more patients
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  and and and learn more about disease processes.
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  So for example, one thing that we're noticing
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  is that, you know, even with the advent
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  of TAVR, you know, obviously there are more
• 6:20
  patients who are getting their aortic valves replaced,
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  when they may have been a marginal surgical
• 6:25
  candidate beforehand. And we're seeing,
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  that even for some of these patients despite
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  the fact that they get their get a
• 6:31
  very high quality TAVR,
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  that maybe they're in general, for patients who
• 6:35
  have aortic stenosis, maybe their their lifespan is
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  not the same
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  as for someone who doesn't even after you've
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  fixed they already found disease. And so one
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  thing that we're looking into
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  is, you know, well, how does that actually
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  translate? You know, there have been studies out
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  of Japan that have shown, even for patients
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  who have moderate aortic stenosis, their their their
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  survival curves do separate,
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  when when they when they're diagnosed with aortic
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  stenosis at an earlier age even despite,
• 6:59
  you know, surgical or or, transcatheter valve replacement.
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  So that's something that we're looking into,
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  you know, with with Todd and Bruce Bowers,
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  being here, you know, we
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  this institution is one of the leading experts,
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  in aortic valve disease and was one of
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  the first,
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  places in the country to actually implant, TAVR
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  in The United States.
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  So so fantastic. And you're having this great
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  career. And talk about being a lifelong learner.
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  I love that you went back or did
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  it while you were working,
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  a master's degree in clinical statistics.
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  Talk about that and that commitment to constantly
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  improving and how important that is for emerging
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  physicians and emerging leaders.
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  I think, you know, there there's this misconception
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  that for amongst,
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  some of the, you know, the the laypeople
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  or the patients, whoever it might be, that,
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  once, once someone's out of medical school that
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  they really don't have to study in in,
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  every day. Even after residency, even after fellowship,
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  every day is a learning day. You know,
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  There's always a chance to improve. There's always
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  a chance to get better.
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  And that comes from
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  having good mentors.
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  So
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  I got my master's in clinical statistics through
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  an NIH grant paid for by Eugene Blackstone.
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  And Doctor. Blackstone has actually, you know, he's
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  he's, actually had several retirement parties but yet
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  somehow is still working. And so he's he's
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  kind of an example of someone who always
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  tries to, you know, continue to learn and
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  continue to get better. And and, you know,
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  a lot of my mentors back in Cleveland
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  also, you know, were the same way. They
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  despite having busy clinical practices,
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  they were always trying to learn more and
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  and get better. And and I think that
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  that's what keeps you,
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  that's what keeps you, one, relevant, but also,
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  two, I think it keeps you humble too
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  because it's the the day that you decide
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  that you don't need you don't need to
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  learn anything else. I think it's the day
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  that you you stop growing as a person
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  and growing as a physician. It's also the
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  day that, I think that the that the
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  patients are at a disservice because if we're
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  not looking to get better, then then that
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  means that we've already fixed everything that we
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  can fix. And we know that's not true.
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  Heart disease is still the number one killer
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  in The United States.
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  And, you know, we still have, you know,
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  surgical
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  complications that can happen. And and so there
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  are things that we can learn in terms
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  of how to,
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  prevent those things and also in terms of
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  how to,
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  you know, adequately address those things should they
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  happen. And and and I think that,
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  you know, being here with doctor Dewey and
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  and with,
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  you know, Andrea, we have a good team
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  where we are encouraged to continuously look at
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  ways that we can improve our system processes,
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  for example.
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  So right now, I think that,
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  we live in a difficult,
• 9:31
  environment to practice clinical medicine. I know a
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  lot of people around the country and, you
• 9:35
  know, other hospital systems
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  feel, you know, especially after COVID, still still
• 9:39
  have this lingering
• 9:41
  burnout effect. But, you know, one thing that
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  I was looking for was a place where
• 9:45
  everyone was, you know, hungry to continuously,
• 9:48
  get better and continue to,
• 9:50
  provide high quality care. And and that's something
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  that I think is encouraging whenever any new
• 9:54
  grad is looking for a job. You wanna
• 9:55
  find a place that's not, you
• 9:58
  just resting on morals and then kind of,
• 10:01
  just continuing status quo, but you want to
• 10:03
  find a place that is growing. You know,
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  Dallas Fort Worth market is is, one of
• 10:07
  the fastest growing cities, which means there's a
• 10:09
  lot more patients who are gonna be coming
• 10:10
  in who need health care. And so we've
• 10:12
  already expanded our hospital capacity,
• 10:15
  by at least 20 ICU beds, and and
• 10:17
  that means that we got more patients to
• 10:19
  take care of and and and, you know,
• 10:20
  more things to do. And,
• 10:23
  that's that's encouraging because, as a young surgeon,
• 10:25
  you wanna continue to be operating.
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  And how do you balance
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  one of the things I do see is
• 10:33
  that physicians that aren't learning and trying to
• 10:35
  get better,
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  it's not that they stagnate, and some are
• 10:39
  very, very good at what they do.
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  But you also would get burnt out if
• 10:44
  you just keep doing the same thing over
• 10:45
  and over without learning and constantly learning.
• 10:49
  On the other hand, it takes tremendous energy
• 10:50
  to keep on getting better and keep learning.
• 10:52
  How do you balance that with with making
• 10:55
  sure you're able to stay focused and not
• 10:57
  burn out and stay after it and so
• 10:59
  forth? I mean, it it seems like you
• 11:01
  gotta do both. You you gotta do great
• 11:02
  work. You gotta keep learning. And you have
• 11:04
  to have enough space for yourself to to
• 11:06
  keep on regenerating or or
• 11:09
  or or recovering. And how how do you
• 11:10
  sort of balance all that?
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  I think,
• 11:14
  for me personally, it you know, I I'm
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  I'm grounded by my family, by, you know,
• 11:19
  my wife, who's also a physician and is
• 11:21
  my biggest supporter.
• 11:24
  And I think having a life outside of
• 11:26
  the hospital is extremely important.
• 11:28
  Knowing that you personally can't handle everything,
• 11:31
  knowing that you there are just you have
• 11:33
  limitations here, you know, you're a human being
• 11:35
  first and foremost. And even though we are
• 11:37
  in a field where we are expected to,
• 11:41
  to to fight death and to,
• 11:44
  to basically be,
• 11:47
  an immovable force,
• 11:49
  in in an otherwise
• 11:51
  chaotic world, I think you also have to
• 11:53
  realize you have enough humility to realize, yeah,
• 11:55
  I'm I'm just I'm just not just a
• 11:57
  man. I'm just a human being. I'm flesh.
• 11:59
  I'm bones. And so you have to know
• 12:01
  that you have certain limitations and that everything
• 12:04
  isn't up to you. And and you just
• 12:05
  do the best that you can. And and
• 12:07
  I think that, that mentality is is tough
• 12:10
  to maintain at times because, again, there is
• 12:13
  such a high demand for you to to
• 12:14
  to be perfect, basically. And I think you
• 12:16
  just have to know that you you do
• 12:17
  what you can and you continues and the
• 12:19
  only way is to strive for perfection, but
• 12:22
  not actually but knowing that it's unattainable, but
• 12:24
  you you keep striving for it. And I
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  think for me,
• 12:28
  you know, I I have a lot of
• 12:29
  friends who are in the field as well
• 12:30
  that I can rely on and
• 12:32
  people I train with who we, you know,
• 12:34
  we still text and we still kind of
• 12:35
  talk to each other. And I think that's
• 12:37
  important because it's it's hard to kind of
• 12:39
  keep everything to yourself and just kind of
• 12:41
  stew on things. But sometimes you need to,
• 12:43
  you know, talk with your colleagues, talk with
• 12:44
  your mentors. I still text with, you know,
• 12:47
  a lot of my attendings back in Cleveland
• 12:48
  frequently, and I'm very fortunate to have trained
• 12:51
  at a place where, number one, you know,
• 12:53
  you have the world's leading experts, who are
• 12:55
  phenomenal surgeons, but also, two, they're they're good
• 12:57
  people. And and I think, again, having great
• 12:59
  senior mentorship, but, you know, my my office
• 13:01
  is right next to Todd's, and I will
• 13:02
  frequently just pop over and say, hey. What
• 13:04
  do you think about x, y, and z?
• 13:05
  And and having that outlet really helps, especially
• 13:07
  when you're a junior surgeon because you don't
• 13:09
  know everything. You come out, on top of
• 13:11
  the world, and you quickly realize there's still
• 13:13
  still so many other things that you just
• 13:14
  never had to deal with, never had to
• 13:16
  see, till you're an actual attending. Then you
• 13:18
  realize, okay. Yeah. There there's a lot more
• 13:20
  to it than just cutting and sewing. There's
• 13:22
  a lot more to it than just, you
• 13:24
  know, putting in the valve. There's a lot
• 13:26
  more to it than just, you know,
• 13:28
  managing the patient post op. And and I
• 13:30
  think that,
• 13:31
  if, if people are blind to that, then
• 13:34
  then they will quickly be reminded of it
• 13:35
  because reality will set in. And I and
• 13:38
  I knew coming out that, you know, it
• 13:40
  was really important for me to find a
• 13:42
  good fit, in terms of finding a good
• 13:44
  practice. And,
• 13:45
  I think part of that is just, no
• 13:47
  having great mentorship from back home, talking with,
• 13:50
  you know,
• 13:51
  the likes of doctor Keane, doctor Madera, doctor
• 13:53
  Golov, all those guys. They they basically doctor
• 13:55
  Murthy, they all they all were very,
• 13:58
  instrumental in my training and also and also
• 14:00
  how I would,
• 14:01
  build my practice because, you know, they've done
• 14:03
  it. So they've kind of told me that
• 14:05
  the things that they've learned.
• 14:08
  Thank you so much. Let me ask you
• 14:09
  one final question.
• 14:11
  Any advice you would give to emerging leaders,
• 14:13
  emerging physicians?
• 14:16
  I think collaboration.
• 14:18
  One the other part that I really love
• 14:20
  about being here is that we have a
• 14:23
  great collaborative relationship with,
• 14:25
  our intensivists, our cardiologists,
• 14:28
  our interventionists. And and and, you know, I
• 14:30
  think,
• 14:31
  one thing that
• 14:33
  really is been encouraging here
• 14:35
  is that
• 14:36
  we pick up the phone. We call each
• 14:38
  other without hesitation,
• 14:39
  you know, no matter what time of day,
• 14:42
  and we bounce ideas off of each other.
• 14:44
  And, you know, like I said earlier,
• 14:46
  there's not one tool. There's not one thing
• 14:48
  that's gonna help help a patient.
• 14:50
  You know, open heart surgery isn't the answer
• 14:52
  for everyone. And, you know, scents aren't the
• 14:54
  answer for everyone, and tafers isn't necessarily the
• 14:55
  answer for everyone. And just having a a
• 14:57
  collaborative team, I think, is the most important
• 14:59
  thing. And we have that here at Medical
• 15:00
  City. You know, we
• 15:02
  know each other by name. They're we know
• 15:03
  each other's families.
• 15:06
  I I don't have to worry that, oh,
• 15:08
  you know, I don't wanna call so and
• 15:09
  so because they're not gonna wanna hear from
• 15:11
  me because I'm just a junior guy. No.
• 15:12
  But if if doctor Bowers,
• 15:15
  has if I need him for anything, he's
• 15:17
  just a phone call away. He's one of
• 15:18
  the leading cardi conventional cardiologists in the country,
• 15:20
  and and he talks to me as if,
• 15:22
  you know, I've been his partner for twenty
• 15:24
  years. And and so I've I've been fortunate
• 15:26
  to to be in a position where I
• 15:28
  can, you know,
• 15:29
  rely on other people for their expertise.
• 15:32
  And,
• 15:34
  I think that,
• 15:35
  you know, it's easy to get siloed into
• 15:37
  your own field, into your
• 15:39
  own space,
• 15:41
  but there's so many people who have,
• 15:44
  you know, great experience, but also they they
• 15:46
  themselves are also pushing the envelope and
• 15:49
  trying new things. And so it isn't until
• 15:51
  you you kinda talk to them and you
• 15:53
  that you realize, okay. There's maybe a better
• 15:55
  way of doing this. There's there's other things
• 15:57
  that we can do to help these patients.
• 15:59
  And so, we're very fortunate that we have
• 16:01
  a really good heart team approach here,
• 16:04
  where,
• 16:05
  you know, it it really is kinda one
• 16:07
  unit.
• 16:10
  Doctor. Tang, what a remarkable career and leadership.
• 16:13
  Congratulations
• 16:14
  and thank you for joining us today on
• 16:16
  the Beckers Healthcare Podcast. A true pleasure for
• 16:19
  us. Thank you very, very much for joining
• 16:21
  us. Thank you so much for having me
• 16:23
  and, happy holidays.
• 16:24
  Happy holidays. You too. Thank you so much,
• 16:26
  Doctor Tang.