Latest / Becker’s Healthcare - Clinical Leadership 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 - Clinical Leadership 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
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  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,
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  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
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  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
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  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,
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  provided so much national
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  leadership,
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  thought leadership,
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  administrative leadership that that it's really it's it's
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  it they're fun environments to be in because
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  of the opportunity the administrative opportunities that are
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  available.
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  Thank you. And anything else you could share
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  with us that you particularly oh, well, let
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  me ask you this question. Shortages of cardiovascular
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  surgeons, cardiologists,
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  where are we at as a nation in
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  terms of shortages, and and where are the
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  biggest challenges in terms of subspecialties?
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  What do you see as the the the
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  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
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  projected today is that there,
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  will absolutely,
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  in the coming years, be an important shortage
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  of cardiovascular
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  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
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  shifts in the dynamic of care. You you
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  know, so much of the care was surgical
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  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
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  how innovation has driven
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  the specialization
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  in cardiovascular disease. So for example,
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  the advent
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  of,
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  stents
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  for the treatment of coronary disease resulted in
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  this explosion of individuals who got interested in
• 14:01
  interventional cardiology.
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  It's the same kind of thing with the
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  development of percutaneously
• 14:07
  implanted heart valves.
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  There's now this growing group of physicians who,
• 14:13
  specializes
• 14:14
  in the implantation
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  of those devices or pacemaker technology or ablations
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  with electrophysiologists.
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  You know, I think at the end of
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  the day, Scott, what we really
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  need to do is continue to train people
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  in preventative cardiology. And this will never happen
• 14:30
  in my lifetime, but wouldn't it be an
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  amazing place if people actually didn't get cardiovascular
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  disease? And and so many of the developments
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  in the last five years that we've all
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  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
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  get on track, I think,
• 14:52
  with really getting a handle on preventative cardiology.
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  Our challenges
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  in the next decade, I think, will really
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  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
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  based approach. So I think
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  we're lagging behind in implementation
• 15:12
  science.
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  And if we're really gonna bend the curve
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  on cardiovascular
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  disease,
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  we're gonna have to tackle some of the
• 15:19
  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
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  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
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  health.
• 15:49
  No. Yep. Absolutely. And I I tell you,
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  to the GLP one story and discussion,
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  a couple of very close friends have lost
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  50 pounds on GLP ones and and just
• 15:59
  look and feel a billion times healthier. And
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  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.
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  Scott, if I was a business leader, I
• 16:19
  would be so focused on this
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  because of the the implications,
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  for the health care costs.
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  You know?
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  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
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  you're so right, actually. It's it's it's so
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  true, and, you know, it is fascinating to
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  see the impact that it's having. Actually, you're
• 16:42
  seeing this beauty of the capitalist economy.
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  And and, again, I don't mean to you
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  know, people of all kinds of political pains.
• 16:48
  But as you start to see the the
• 16:50
  GLP one companies,
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  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.
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  And I think we've gotta find a way
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  to link that back to healthy lifestyle.
• 17:44
  You know, at at the end of the
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  day, it's still
• 17:47
  a pharmaceutical.
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  There are side effects.
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  And, you know,
• 17:51
  the things that we've preached forever, we really
• 17:53
  need to find a way to drive people
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  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.