Latest / Becker’s Healthcare Podcast / Rosy Thachil, MD, MBA, FACC, FAMWA, FACVC, Cardiologist at NYC Health + Hospitals/Elmhurst

Transcript

Rosy Thachil, MD, MBA, FACC, FAMWA, FACVC, Cardiologist at NYC Health + Hospitals/Elmhurst · Becker’s Healthcare Podcast

• 0:00
  Welcome to the Becker's Healthcare podcast.
• 0:02
  I'm Mariah Taylor, assistant editor, and I'm thrilled
• 0:05
  to be interviewing Rosie Thachel, director of the
• 0:08
  cardiac intensive care unit and cofounder of the
• 0:11
  Women's Cardiovascular
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  Institute at NYC Health and Hospitals Elmhurst.
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  Doctor Thatchol, thank you so much for joining
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  me today. I'm really excited to learn more
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  about what you're doing at the Women's Institute.
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  But before we dive into that, I'd love
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  to hear a little bit more about you
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  and your background.
• 0:28
  Yeah. Thank you for having me. So as
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  you mentioned, I run the cardiac intensive care
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  unit here, but we also recently cofounded last
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  year the Women's Cardiovascular Institute.
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  And I think this topic is very timely.
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  I know we just came off with heart
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  month, but really cardiovascular health is a year
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  round issue.
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  So we love to talk about it, you
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  know, every month. And this is a institute
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  we cofounded between myself, doctor Gayatri Setia, and
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  doctor Deborah Reynolds. So excited to be here
• 0:52
  and to to to share information about it.
• 0:56
  Absolutely. And as I'm sure you're aware and
• 0:58
  all of our listeners, there's a lot of
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  systems right now that are opening either service
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  lines or institutes or even clinics
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  specifically for different population groups. So I'd love
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  to just hear your
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  opinion and understanding of what's behind all of
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  this movement towards specialized care by population.
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  Yeah. Great question. So at its core, it's
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  about recognizing that health care has historically been
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  built around a one size fits all model,
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  but patients are not one size fits all.
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  And different populations experience disease differently. They face
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  different barriers to care, and often they arrive
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  in the health system through different pathways also.
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  So if you wanna truly deliver effective care,
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  we have to design programs that acknowledge those
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  realities.
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  And cardiovascular disease is a perfect example. It's
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  the number one killer of men and women,
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  yet women have historically been under recognized, under
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  diagnosed,
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  misdiagnosed,
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  and underrepresented
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  in research as well. And so that realization
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  is one of the driving forces
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  behind launching the Women's Cardiovascular Institute at Elmhurst.
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  We wanted to create a program where women's
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  symptoms, risk factors, and life experiences also, things
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  like pregnancy, menopause, are fully integrated into cardiovascular
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  care. So in many ways, specialized care by
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  population group is simply just good medicine. It's
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  about meeting patients where they are and then
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  designing care around the realities of their lives.
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  Absolutely.
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  And what are some of those changes that
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  you're making to your services to meet the
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  needs of women?
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  Yes. Elmhurst serves one of the most diverse
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  communities in the world. Our patients actually represent
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  a myriad of cultures, languages, backgrounds, life experiences.
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  Actually, there are about 250
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  languages spoken within just a small radius of
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  the hospital. So incredibly diverse.
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  And this diversity fundamentally shapes how we think
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  about delivering care. And because of that, we
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  recognized that there was a real unmet need
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  for dedicated women's cardiovascular care in this community.
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  Many women we see are not always aware
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  that cardiovascular disease is their leading health risk.
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  And what makes our program particularly unique is
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  that it sits within a community and public
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  hospital system. So as you alluded to earlier,
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  many women's heart centers are popping up around
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  the country. Many women's cardiovascular programs sit within
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  large academic medical centers in the country.
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  But access to specialized cardiovascular care shouldn't really
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  depend on where you live or your insurance
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  status or the center that you have access
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  to. It's really an equity issue, and so
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  that's why we felt strongly about building this
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  particular program.
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  We also built this program to be comprehensive
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  across the entire cardiovascular
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  spectrum
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  from prevention to critical care. So we have
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  a few initiatives that are embedded in our
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  in our women's heart program. So for example,
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  a postpartum hypertension program, and this program recognizes
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  that pregnancy is often an early cardiovascular
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  stress test. We also have a post CICU
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  clinic, which actually helps our women patients recover
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  after
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  critical illness and in transitioning back to normal
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  life. We also have a breast cancer cardiotoxicity
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  program where we work closely with our oncology
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  colleagues to protect the long term health of
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  the heart. So at the end of the
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  day, the goal is not just to treat
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  disease when it appears, but also to identify
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  risk earlier and close gaps in care that
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  disproportionately affect women. And, you know, perhaps the
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  most meaningful feedback we hear from our women
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  patients is simply, you know, this is the
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  first time I felt somebody really listened to
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  my symptoms, and I think that's when you
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  know that the model is working.
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  Absolutely. That's gotta be lovely to hear. And
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  I'd love to dive into that even just
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  a little bit more,
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  because every system's doing these women's services a
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  little bit differently. So for your service area,
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  what are some of the services that are
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  in the highest demand?
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  Yeah. So I think women's heart in general
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  is in high demand. Right? We know that
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  women's heart women's cardiovascular disease, it's the number
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  one killer.
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  So it's it was a need that was
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  unmet for years. And now we're able to
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  bring that specialized care to this community. And
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  like I mentioned before, we have other specific
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  programs within the umbrella of the Women's Cardiovascular
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  Institute. So the postpartum hypertension program, the post
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  CICU clinic, the breast cancer cardiotoxicity
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  program, the cardio obstetrics program. So really, we're
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  we're really just in the infancy. This program
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  is only one year old, but we're really,
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  really excited to be able to bring this
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  program to this community.
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  Absolutely.
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  And kind of on the other side of
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  things, I'm sure you're very aware that it's
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  really hard to recruit specialty physicians. And right
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  now, our nation is facing a shortage of
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  all types of specialty physicians. But even within
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  cardiology, it can be difficult to find specialty
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  cardiologists.
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  So what are some of your strategies that
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  you're using to help recruit physicians in so
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  that you have the right specialties at your
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  center?
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  Yeah. So I I fundamentally, it starts with
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  building teams that kind of understand the needs
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  of the communities we serve and the women
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  we serve and then bringing together physicians with
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  complimentary expertise. Right? So, you know, I mentioned
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  a slew of programs that are sort of
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  embedded under women's heart. And And one of
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  the reasons we can do that is because
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  we have diversity within our women's heart leadership.
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  So if you look at the leadership of
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  our women's cardiovascular institute, doctor Gayatri Setia, doctor Reynolds,
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  and myself, we each bring different areas of
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  focus within cardiology and those niches are very
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  complimentary.
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  So when you combine those perspectives, it allows
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  us to build a program that truly spans
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  the full spectrum of cardiovascular care for women
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  from prevention and risk assessment to complex and
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  critical illness. And equally important to that is
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  the work we do we do with other
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  specialties and other colleagues. It's not done in
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  silo. Right? Women's cardiovascular health intersects with many
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  other specialties across the health system, so we
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  collaborately we collaborate closely with our OBGYN colleagues,
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  our oncology colleagues,
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  experts in lifestyle medicine, and, of course, our
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  primary care medicine colleagues also. And I think
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  that multidisciplinary
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  structure is essential because women's cardiovascular health often
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  unfolds across many life stages,
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  pregnancy, menopause, potentially cancer survivorship, and so many
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  other situations.
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  So when these specialties are all interconnected, we
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  can actually provide more coordinated, thoughtful, and patient
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  centered care.
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  Absolutely.
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  And I'd love to kind of go back
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  to something you said at the beginning about
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  how your service area has I think you
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  said about 200 different languages that are spoken.
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  How are you meeting the needs for patients
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  who don't speak English as a first language?
• 7:18
  Yeah. So fortunately, we have, you know, a
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  lot of ancillary support services. For example, our
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  translation services, they're very, very robust. So we're
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  able to, you know, sort of bridge the
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  gaps in communication that way. And we really
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  try very hard to provide culturally sensitive care,
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  particularly within our, you know, women's heart clinic
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  where we've got so many different women speaking
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  not only different languages, but coming from different
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  backgrounds, different cultures,
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  bringing their diversity of pathology also. So it's
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  really important to be sort of culturally sensitive,
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  in in our care delivery.
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  Absolutely.
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  Now let's look a little bit to the
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  future. I'd love to hear two things from
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  you. The first is, what is the next
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  step for the Women's Institute?
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  Yeah. I think this is only the beginning.
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  I think our existing pathways under the Women's
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  Heart Institute, we would love to sort of
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  grow those, you know, whether it's the post
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  CICU clinic or the breast cancer cardiotoxicity
• 8:11
  program,
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  our postpartum hypertension program. We would actually love
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  to expand these clinics, and, really, that's sort
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  of our goal in the next year or
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  two expansion.
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  But I think it's also a really exciting
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  time, right, for,
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  precision medicine technology.
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  There's so much we can integrate into this
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  women's cardiovascular program and this is really just
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  a start.
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  Absolutely.
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  And kind of with that, I'd love to
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  hear your guess as to how you think
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  specialized care by population might change in the
• 8:39
  next five years.
• 8:41
  Yeah. I think this is a very timely
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  question. I think we're entering a phase where
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  specialized care will become more integrated,
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  more preventative perhaps, and and definitely more data
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  driven. I think we're gonna see programs that
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  move earlier in the disease timeline. Right? Focusing
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  more on the risk detection prevention rather than
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  just waiting until patients either present with an
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  event or with advanced disease. I think there
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  will also be greater integration between specialties.
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  Cardiovascular care is increasingly intersecting with obstetrics, oncology,
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  endocrinology,
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  critical care.
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  So I think this is really important, especially
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  as we're thinking about women's heart across the
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  lifespan and and across the spectrum of care.
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  And I think third, technology is gonna play
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  a role in the future. We're gonna be
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  using data, digital health, AI perhaps,
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  population level analytics to identify patients who might
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  otherwise fall through their cracks. But at the
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  end of the day, I think one thing
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  that won't change or or shouldn't change, I
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  should say, is the core mission. Right? Equity
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  and access to specialized care for women.
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  I I just wanna highlight that, you know,
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  our program specifically,
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  I think it demonstrates that, you know, these
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  sort of innovative
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  population focused cardiovascular care programs, they don't have
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  to exist only in the large academic centers.
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  Right? It can and it should exist in
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  community hospitals and public and municipal systems where
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  the need is actually often the greatest. And,
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  ultimately, the goal is simple. Right? Making sure
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  that every woman and every patient, regardless of
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  their background or circumstance, receives care that truly
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  reflects their needs.
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  Absolutely.
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  Well, this was been so amazing. I love
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  hearing everything about what you're doing with your
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  Women's Institute. So thank you for taking the
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  time to share with us today and thank
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  you to our listeners for joining us. Of
• 10:18
  course. Thanks for having me.