Latest / Becker’s Healthcare - Clinical Leadership Podcast / Marc Sakwa, MD, Chief of CT Surgery, MemorialCare, Chief, CV Surgery, MemorialCare Heart & Vascular Institute; Medical Director, Adult CV Surgery, MHVI at Long Beach Medical Center

Transcript

Marc Sakwa, MD, Chief of CT Surgery, MemorialCare, Chief, CV Surgery, MemorialCare Heart & Vascular Institute; Medical Director, Adult CV Surgery, MHVI at Long Beach Medical Center · Becker’s Healthcare - Clinical Leadership Podcast

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  It is so important for leaders at the top of organizations to keep learning,
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  stay sharp, grow their networks,
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  help our audience better do this in a more simplified, personalized,
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  Join the community free of charge@www.my dot becker's hospital
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  review.com and we'll see you there.
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  Welcome everyone to the Becker's Healthcare podcast series. I'm Ryan Mohammed,
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  she her pronouns with Becker's Healthcare.
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  I'm thrilled to have with me today Dr.
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  Mark Akwa from the Memorial Care Heart and Vascular Institute. Doctor,
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  it's so nice to talk with you today. How are you?
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  I'm good. How are you?
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  Good, thank you so much. Well, to begin,
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  would you mind please introducing yourself and telling us a bit about your
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  background?
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  Yes, thank you. My name is Mark Squa.
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  I am currently the chief of cardiothoracic surgery at Memorial Care Heart and
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  Vascular Institute,
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  as well as the medical director of the adult cardiovascular surgery program for
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  the Memorial Care Heart and Vascular Institute at the Long Beach Medical Center.
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  I've been here since two, early 2020,
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  and I came from Detroit from the Beaumont Hospital System.
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  I was the chief of cardiac surgery at Beaumont for many, many years.
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  I was actually at Beaumont in Detroit for 35 years.
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  We're working together with our cardiologist.
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  We were a top 20 US News and will report program.
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  In 2020, I saw an opportunity to join Memorial Care,
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  which seemed like a nice segue for that time of my life,
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  and I decided to come to California. My interests, uh,
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  in cardiac surgery, obviously I do everything,
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  but I'm mostly interested in minimally invasive approaches for cardiac surgery.
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  Not only coronary bypass,
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  but valve surgery and have done probably over 2000 to 3000
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  minimally invasive procedures,
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  which puts me near the top of the list in terms of experience probably in this
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  country.
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  Wonderful. Thank you so much for that introduction. And to begin,
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  what are the top three biggest issues in cardiology, cardiology today?
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  Any that you're facing? Anything that you're reading about continuously,
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  anything like that?
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  Well,
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  I'm gonna answer this based on what my personal opinion is on the three biggest
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  issues. And as a heart surgeon,
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  it may be different than what some of the cardiologists would think.
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  I think number one is that as heart surgeons,
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  we are seeing a population of patients that are now older that are sicker.
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  They have many more comorbidities than we used to see in the past.
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  And the reason for that is that medical management has improved, uh,
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  significantly as well as there being less invasive catheter technologies
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  that have sort of delayed some of the onset of heart disease or at least
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  been able to treat patients when they're younger so that when they require
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  surgery, now they're a little bit older and sicker than they have been.
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  So that would be number one. I think. Um,
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  number two is, uh, the,
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  with the onset of the new technology,
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  it's kind of our ability to disseminate the knowledge and to
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  train younger surgeons that can perform these less invasive either catheter
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  procedures or for me, less invasive surgical procedures for patients.
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  So the ability to train the next generation of heart surgeons is, uh,
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  a bit of a challenge and something that we need to do so that we can provide
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  these less invasive approaches to more and more patients.
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  And third, for me, uh, presently out in California is, uh,
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  being able to, uh,
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  achieve access for patients who have significant problems that require
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  intervention and being able to work with insurance companies to
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  allow patients to go to places and offer some of the newer
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  technologies and some of the newer less invasive procedures.
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  So allowing patients access to these procedures is extremely important and a bit
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  of a challenge.
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  Doctor,
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  could you go into more detail about consumers being unaware of
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  procedures,
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  especially because it's so important for them to be their own advocate?
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  Sure.
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  So I'm not certain that many patients are aware
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  that there's multiple options available to them when they get a diagnosis.
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  For example, when they were diagnosed with valvular heart disease,
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  let's say particularly aortic stenosis,
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  and they require a procedure to treat that,
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  I'm not sure patients are aware that there's not only less invasive technology
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  to do catheter approaches,
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  but there's also surgical approaches that can be done less invasive.
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  And there's not a lot of programs that offer the surgical aspects.
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  Many programs offer catheter base,
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  but very few programs will offer the surgical approach.
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  Yet if you look at our literature,
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  there's lots of data now that confirms that not only patients do better with
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  minimally invasive approaches, smaller incisions, quicker hospital stays,
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  they get out the intensive care unit faster,
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  but the overall cost of their procedure.
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  And insurance companies have not looked into this enough to know that this is an
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  option for patients and that if they refer patients to programs like ours at
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  Memorial Care Long Beach,
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  that we offer these procedures in the surgical realm as well as in the catheter
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  based approaches.
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  Yeah, absolutely. And what would you say professionals need to know,
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  uh, about minimally invasive procedures right now?
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  Well,
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  I think that most of the professionals should realize that these are available,
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  that they're not experimental, that, uh,
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  they are better for patients in terms of their quality of life.
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  They're equivalent, if not better in terms of outcomes. They're,
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  uh, proving to be more cost effective.
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  And I think most importantly,
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  I think that they should realize that there are surgeons who do this and do this
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  on a regular basis with lots of experience who can produce these excellent
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  results and they need to, can consider sending these patients to those programs.
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  And for you, how do you see heart care evolving over the next 18 months or so?
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  I know that healthcare is always changing. Um, so do you have,
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  do you see any foresight vision for, you know, how it's gonna evolve?
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  Well, I think it's pretty apparent that with the new technologies,
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  we're moving further away from more complex ways to treat patients to less
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  invasive ways.
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  We're moving towards more catheter-based approaches to treating not only corn
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  artery disease, but valvular heart disease.
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  And we're also looking at new technologies and ways to do surgical procedures
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  through small incisions, if you will,
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  keyhole type incisions so that people can have pretty much the same surgical
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  procedure but done in a less invasive way,
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  which is improving their quality of life for earlier recovery and getting back
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  to their quality of life that they experienced before they had to go through
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  surgery. So I think over the next 18 months,
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  we're gonna continue to evolve in this direction,
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  employing these new technologies in a less invasive way.
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  Yeah, absolutely. And before I let you go, doctor,
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  the last thing I wanted to ask you about is what are you excited about today?
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  And also is there anything that making you nervous,
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  whether it's a project you're working on or something you're seeing in the
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  field, anything like that?
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  Well, what I'm excited about and I'll continue to stress is,
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  is the ability to perform surgery through small incisions
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  in a less invasive way.
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  I've been doing this for about 20 years now and have made it the basis of my
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  practice. And I'm in the process of, uh,
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  training my colleagues so that at the Memorial Care program in Long Beach,
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  we continue to have a very large effort towards
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  surgery being done in these less invasive ways.
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  And what's exciting for us is we see all people, particularly elderly people,
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  getting back to their activities, their pickleball, their bike riding,
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  getting back to their quality of life and what they were doing much,
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  much quicker, and doing it in a much, uh,
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  more efficient and better way for them.
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  They're feeling better and it's a good thing for them in terms of how they're
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  recovering from these procedurals. In terms of what makes me nervous, uh,
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  I still am concerned about physicians knowing what is available at
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  other institutions,
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  knowing that they can refer patients to programs that have
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  these technologies and the ability to perform these procedures.
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  I'm concerned that there's, uh, not enough access to insurance companies to,
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  uh,
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  ha allow patients the opportunity to seek out these programs and at least
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  get an opinion. And I think as we look forward,
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  insurance companies are gonna need to step back and look at perhaps these less
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  invasive treatments are not only better for patients,
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  but are more cost effective in the long run for their companies.
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  So these are the things that, um, make me a little concerned,
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  but I think w are extremely important for us to look at for the future.
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  Absolutely. I completely agree. Thank you so much for those final thoughts.
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  Doctor, this has been an amazing discussion.
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  So I wanna thank you so much for coming on Becker's Healthcare and I look
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  forward to with you again soon.
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  Thank you very much. I appreciate it.
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  Of course.