Latest / Becker’s Healthcare Podcast / Advancing Cardiovascular Innovation and Leadership in Modern Medicine with Dr. Joseph Rogers

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Advancing Cardiovascular Innovation and Leadership in Modern Medicine with Dr. Joseph Rogers · Becker’s Healthcare Podcast

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This is Scott Becker with the Becker's Health
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Care podcast.
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We're thrilled today to be joined by doctor
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Joseph Rogers.
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And doctor Rogers helps to lead the Texas
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Heart Institute at Baylor College of Medicine.
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He he's also
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one of the internationally
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recognized
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and widely published
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authors and leaders
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in heart failure, heart transplantation,
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and mechanically assisted
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circulation.
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Just a tremendous leader at Baylor College of
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Medicine
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and also an adjunct professor at Duke.
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Doctor Rogers, can you take a second and
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and introduce yourself
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and tell us a little bit about your
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career?
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Sure. Scott, thanks, and thanks for having me
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on today.
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So I think you summarized the things that
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I've done in my career well.
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I started my career at the University of
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Nebraska,
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did my cardiology training at Washington University in
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Saint Louis and stayed on the faculty
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then I moved to Duke and I ran
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the advanced heart failure program there for,
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close to twenty years. And through that journey,
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began,
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experimenting a little bit more in some administrative
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activities,
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served as,
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an the interim chief of cardiology for a
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couple of years at Duke, then I was
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the interim chair of medicine,
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for a year at Duke. And then, I
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became the chief medical officer
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of the health system,
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which was a three hospital system,
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in Durham and Raleigh, North Carolina.
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And then, and did that through the the
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early days of COVID and then, decided that
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I had
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wanted to get back closer to cardiovascular
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disease and,
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I wanted to get back into academics.
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And so when this position opened up to
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lead the Texas Heart Institute,
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I moved to Houston.
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I would say that through that experience, I've
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I've it's I've been so fortunate to be
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able
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to see the very best of academic medicine,
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but also
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have really interesting opportunities
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in leadership
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and then to see and be very, very
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much involved and integrated into,
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the management of health systems.
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It's really been a fascinating
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journey.
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And talk about what brought you to Baylor.
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Baylor, of course, I mean, everybody in cardiology
2:25
knows this or cardiovascular knows this, but not
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the whole world knows this. But Baylor College
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of Medicine is is
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about the premier
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training place, innovation place
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for cardiovascular
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disease in the country,
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with the the the leadership there originally of
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doctor Tabakie
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and so forth. But talk a little bit
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about the Baylor College of Medicine program and
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what brought you to Baylor. Yeah. So I
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I mean, the story actually is even a
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little bit more
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interesting and in-depth than that because,
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so when I moved to Houston, I came
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to run the Texas Heart Institute.
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And the Texas Heart Institute was formed by
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doctor Denton Cooley in 1962,
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and it was
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distinct from Baylor.
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You know, Michael DeBakey was the led the
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surgery department at Baylor. Doctor Cooley,
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led the surgical group at Texas Heart. And
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the Texas Heart Institute was always independent.
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And it was a couple of years ago
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that there were some changes,
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in
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in some
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funding related issues,
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at the Hart Institute, and we realized that
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we were gonna need to find an affiliate.
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But but these two groups had not worked
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together in any real way for a long
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time. And so one of the interesting parts
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of the last couple of years is has
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been
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imagining
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how we bring together,
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you know, two organizations,
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into one real powerhouse
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cardiovascular program. But you're right. I mean, some
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of the
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the most important firsts in all of cardiovascular
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medicine have happened down here
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between the Texas Heart Institute and Baylor, which
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I think is the really
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wonderful part of this story is leveraging that
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rich history and then imagining what this looks
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like going forward.
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And and and what does that history look
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like going forward for Baylor College of Medicine,
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Texas Heart Institute?
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Where are some of the developments in what
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you're excited about?
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Yeah. I mean,
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one of the things that's really
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been fun down here
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is just the spirit of of innovation
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and exploration,
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and,
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and the idea, especially the the THI research
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portfolio, has been very much focused on
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commercialization.
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So some of the things that I think
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are really exciting right now,
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are,
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the BIVACORE Total Artificial Heart. That artificial heart
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has been in,
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development in our laboratories for the past decade
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and was finally made it we made it
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through all the preclinical work, in the animal
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lab and has now been implanted
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in both The United States and Australia in
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11 patients and is going through an early
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feasibility study.
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I think many of us believe that this
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is a very important,
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addition to the armamentarium
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for patients who have advanced heart failure. And
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if you step back
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and tie that back to the history, the
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first artificial heart that was ever implanted in
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the world was implanted by doctor Cooley,
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in 1969.
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So there's a sort of interesting
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sort of history that weaves its way until
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the present day.
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There's some other really interesting work, Scott, that's
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going on down here. So one of our
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investigators,
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Jim Martin,
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has,
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pioneered a new gene therapy that regenerates heart
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muscle. And the story goes like this,
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when we're born, we essentially have all the
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heart muscle cells that we ever will have
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for our entire life.
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They just get larger as we get older.
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And that's why heart attacks are so devastating,
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because when you kill those cells, they don't
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have any opportunity to regenerate.
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And so what doctor Martin and his laboratory
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have done is
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figured out the stop signal
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that tells those cells to stop dividing
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when we're born,
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and then he's developed a gene therapy
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to turn off the stop signal,
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and that allows the cells to begin dividing.
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And so we are now
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piloting this. We we, again,
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have done a bunch of animal work down
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here. It looked very, very promising, but it's
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now also in an early
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safety study
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in humans. So, you know, it's this kind
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of work that I think is really going
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to be
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transformative. I think we have the opportunity to
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really change the outlook for patients who have
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cardiovascular disease.
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Thank you. And and doctor Rogers, you serve
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in sort of two core roles and really
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a third too.
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You're the president and CEO of the Texas
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Heart Institute.
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You're also a professor of medicine at Baylor.
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Separately, in your spare time, you're an adjunct
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professor at Duke.
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So I guess I'll ask you one question
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first, and then we'll get to serious question.
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Let me know if you're ready for a
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non serious question, doctor Rogers.
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A a a non serious question would be
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welcome.
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Do you cheer for Duke basketball,
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and were you disappointed
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in the Elite eight outcome? Where are you
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at as a Duke fan?
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So I I am,
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a devoted Duke basketball fan.
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And, and it was, that last shot was
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just heartbreaking.
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And and let me ask you this. I'll
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I'll find out how deep a Duke fan
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are you.
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Were you happy or sad to see UNC
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knocked out by High Point?
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Oh, very happy.
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There you go.
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That's a sign of a true Duke fan.
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Like, we we it's like a true Ohio
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State fan is upset about University of Michigan
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winning.
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I I I it is what it is,
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and and and that that is the clear
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sign of a true Duke fan. You have
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to see high point knockout UNC. It's almost
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worse than Duke losing would be UNC winning,
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I take it, as a true Duke fan.
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100%.
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You know, it's it's such a wonderful
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place to live during college basketball season because
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the rivalry is is absolutely fantastic, and it's
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two storied great programs.
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It it and and let me take it
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to different subject on leadership.
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You serve as the CEO and president of
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the Texas Heart Institute.
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What advice or what have you learned through
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leading?
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How do you think about it today? How
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important is it day to day interaction with
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physician leaders to make sure they feel taken
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care of and have the opportunities they wanna
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have at Texas Heart Institute?
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How do you sort of look at leadership?
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How do you divide how you approach it?
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Give us a couple thoughts, sir, if you
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don't mind. Yeah. I mean, it's it's a
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really it's a great question. And,
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from my perspective,
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this has always been about
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a couple of things. One is is is
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vision. Where is this field going? And to
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try to inspire
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people that you work with toward
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a a like vision.
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But it's also
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and then especially now in medicine because it's
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become so
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it's becoming harder and harder to either practice
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medicine or to do research because of some
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of the funding issues
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and just to make people feel valued and
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heard. I I've always thought this is really
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it's about the people. It's about bringing the
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right people
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in,
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supporting them, and making sure that they feel
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like they are their voices are being heard.
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That this is obviously a very smart
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collection of individuals that are practicing, you know,
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in environments like this today.
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So, you know, I I for me, I
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I think it's
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it's really always been about trying to support
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a team.
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I think by the time you take some
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of these more senior
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leadership roles, you have to be at a
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point in your career where they're where you're
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ready to be much more selfless. It's it's
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much more about
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supporting the young people and the, you know,
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the mid career people and probably less about,
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you know, sort of sort of, pushing your
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your own
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national or international
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profile and agenda.
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No. And I and I love that. It's
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so much about supporting, especially if you're gonna
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be in a group with lots of other
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a plus leaders.
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You can't try and be the alpha and
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be the alpha amongst alphas. You have to
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be in a a mix of a supportive
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role. You have to be well respected in
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what you do. Right. But also very good
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at lifting others because everybody's a star, really.
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You've got a lot of stars there. Yeah.
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No. I mean, you're you're exactly right, Scott.
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And, you know, a lot of these people
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will
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the other thing is to make sure that
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they have opportunities
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to continue their growth
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because so many of these people have the
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talents,
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and the skill sets to take on other
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leadership roles. And one of the jobs that
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we have is actually to train people to
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go and and and carry the flag and
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and and assume leadership roles in other places.
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Right. And and how when when people
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leave to go elsewhere
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and are great leaders there,
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what is your temperament on that? Like,
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if somebody leaves and they're taking a step
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up, not necessarily competitive program, are all or
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are all programs competitive
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even if they're not in the Texas area?
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So somebody goes to take a chairmanship or
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chairwoman chip
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at a program 500 miles away.
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Obviously, you keep a nice relationship. You applaud,
11:39
and you see that person go excited for
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that person or some some mix of all
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those things. Well,
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yeah. It's it is a mix. I think
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you've hit the nail on the head. I
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mean, so many times you've developed a a
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relationship with that individual and
11:54
but but having said that,
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you know, that that is the greatest success
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you can ever have in academics,
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is that you have prepared
12:03
someone. You've provided the opportunities for them to
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really grow into a job that they that
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they wanted.
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And so I've always thought and and if
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you go back into the history of the
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Texas Heart Institute and Baylor and Duke, I
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mean, these are organizations
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that have really,
12:20
provided so much national
12:23
leadership,
12:24
thought leadership,
12:25
administrative leadership that that it's really it's it's
12:28
it they're fun environments to be in because
12:31
of the opportunity the administrative opportunities that are
12:33
available.
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Thank you. And anything else you could share
12:37
with us that you particularly oh, well, let
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me ask you this question. Shortages of cardiovascular
12:42
surgeons, cardiologists,
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where are we at as a nation in
12:45
terms of shortages, and and where are the
12:47
biggest challenges in terms of subspecialties?
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What do you see as the the the
12:50
biggest challenges or or or not?
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Yeah. No. I I think that there if,
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the way the way that this is being
12:58
projected today is that there,
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will absolutely,
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in the coming years, be an important shortage
13:04
of cardiovascular
13:05
specialists. It remains the number one killer
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of Americans.
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And, and and so,
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you know, we we need to continue,
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advancing the the number of trainees that we
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are, you know,
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that we're running through our programs.
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The there are some really interesting
13:26
shifts in the dynamic of care. You you
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know, so much of the care was surgical
13:31
in the past. A lot of that is
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being sort of taken over by cardiologists
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at this point.
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So so I think that there are opportunities
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for us to continue growing our programs, but
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to con it's been fun to watch how
13:45
how innovation has driven
13:48
the specialization
13:49
in cardiovascular disease. So for example,
13:52
the advent
13:53
of,
13:54
stents
13:55
for the treatment of coronary disease resulted in
13:58
this explosion of individuals who got interested in
14:01
interventional cardiology.
14:03
It's the same kind of thing with the
14:05
development of percutaneously
14:07
implanted heart valves.
14:09
There's now this growing group of physicians who,
14:13
specializes
14:14
in the implantation
14:15
of those devices or pacemaker technology or ablations
14:19
with electrophysiologists.
14:21
You know, I think at the end of
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the day, Scott, what we really
14:25
need to do is continue to train people
14:27
in preventative cardiology. And this will never happen
14:30
in my lifetime, but wouldn't it be an
14:32
amazing place if people actually didn't get cardiovascular
14:35
disease? And and so many of the developments
14:38
in the last five years that we've all
14:41
witnessed
14:42
are amazing, like the GLP one agonists and
14:45
and reductions in weight and and the health
14:48
benefits associated with that. We're now starting to
14:50
get on track, I think,
14:52
with really getting a handle on preventative cardiology.
14:57
Our challenges
14:58
in the next decade, I think, will really
15:01
be around how do you take what we've
15:02
learned about those drugs and begin applying them
15:05
really in a in a population
15:08
based approach. So I think
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we're lagging behind in implementation
15:12
science.
15:14
And if we're really gonna bend the curve
15:16
on cardiovascular
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disease,
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we're gonna have to tackle some of the
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more systemic
15:21
challenges that that Americans face with regards to
15:24
access to health care, access to healthy food,
15:28
access to healthy places to exercise.
15:30
And so there's a lot of work that
15:32
we need to do, and physicians, frankly, are
15:34
not well trained to intervene in some of
15:37
these more
15:38
community
15:40
focused needs that our patients really are going
15:42
to have to navigate
15:44
if we wanna obtain and achieve
15:47
national cardiovascular
15:48
health.
15:49
No. Yep. Absolutely. And I I tell you,
15:51
to the GLP one story and discussion,
15:54
a couple of very close friends have lost
15:56
50 pounds on GLP ones and and just
15:59
look and feel a billion times healthier. And
16:02
you and I know if on average our
16:03
nation lost five to 10 pounds,
16:06
we would drop health care cost. Is it
16:08
just this
16:09
but everything.
16:10
Diabetes,
16:11
heart structures, knees, joints, everything
16:14
would would be helpful on average. But, no,
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I think it's it's fantastic.
16:18
Scott, if I was a business leader, I
16:19
would be so focused on this
16:22
because of the the implications,
16:24
for the health care costs.
16:26
You know?
16:27
Unless you're unless you're a business leader who
16:29
owns a bakery, then you would not be
16:31
as focused on
16:33
it. No. But I but I I think
16:34
you're so right, actually. It's it's it's so
16:37
true, and, you know, it is fascinating to
16:39
see the impact that it's having. Actually, you're
16:42
seeing this beauty of the capitalist economy.
16:45
And and, again, I don't mean to you
16:46
know, people of all kinds of political pains.
16:48
But as you start to see the the
16:50
GLP one companies,
16:52
the telehealth providers go around the traditional establishment
16:55
to sell GLP ones, to sell ZEP pounds,
16:58
and to start bringing those prices down to
17:00
affordable prices. It's gonna take a while. We're
17:02
still at a spot where in Europe, they're
17:04
paying a fifth of what we're paying. The
17:06
insurance companies are still gonna be paying whatever
17:08
they're paying, but
17:09
the the private market, the direct market is
17:12
starting to move in the right direction,
17:14
and then it becomes much more accessible to
17:16
everybody.
17:17
You know, it it it may may not
17:19
be perfect brand in drugs, but the semi
17:21
gluteids and so forth. But, really,
17:23
fasting evolution is just sort of see a
17:25
who moves my cheese type of movement,
17:28
and so much of health care starts to
17:29
go out of the traditional systems
17:32
and so forth. Well, you know, while the
17:33
traditional systems remain
17:35
overwhelmed and quite busy, but it is a
17:37
fasting evolution that we're starting to see.
17:40
And I think we've gotta find a way
17:42
to link that back to healthy lifestyle.
17:44
You know, at at the end of the
17:45
day, it's still
17:47
a pharmaceutical.
17:48
There are side effects.
17:49
And, you know,
17:51
the things that we've preached forever, we really
17:53
need to find a way to drive people
17:56
toward
17:57
eating differently,
17:58
exercising
17:59
more, sleeping well.
18:02
So I think the GLP ones are a
18:04
remarkable
18:05
part of the story.
18:07
It we have to round it out, I
18:08
think, to really achieve health. But but you're
18:11
so right, though, because you could cheat your
18:13
GLP one
18:15
by drinking
18:16
too much sugary beverages. You could cheat it
18:18
and screw up your your counts so you
18:20
sort of start to crave stuff again if
18:23
you're not careful with over sugaring over other
18:25
things. And there there's also discussion now. You
18:28
gotta be careful that you're getting the right
18:30
weight loss, that you're not just losing muscle
18:32
mass. You gotta be very careful to, like,
18:34
you know, make sure you're exercising and doing
18:36
some weights and doing some other things as
18:38
well. Doctor Rogers, it is a fantastic pleasure
18:40
to visit with you today. I enjoyed it
18:43
very much, Scott. I I wanna thank you
18:44
for taking the time. I just had a
18:46
chance to be at the Baylor College of
18:47
Medicine. Cannot tell you how impressed I am
18:50
with Baylor and what it does in the
18:52
Texas Art Howard Institute.
18:54
Really just remarkable
18:57
remarkable and impressive.