Latest / Becker’s Healthcare Podcast / Jeffrey Marshall, MD, Chief of Cardiology at the Northside Hospital Heart Institute

Transcript

Jeffrey Marshall, MD, Chief of Cardiology at the Northside Hospital Heart Institute · Becker’s Healthcare Podcast

0:02
- There's a small circle of people who truly
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- understand what it takes to lead a health
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- system right now. The decisions are enormous.
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- to pressure test their thinking.
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- Becker's fourteenth annual CEO and CFO roundtable
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- brings together more than 1,500
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- executive level attendees
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- and nearly 400 speakers for four days built
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- around growth, financial sustainability,
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- workforce strategy, and the leadership questions that don't
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- have easy answers.
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- Join us November second through the fifth in
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- Chicago.
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- For the agenda and event details,
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- visit beckershospitalreview.com
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- and click on the events tab in the
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- upper right.
0:51
- Welcome to the Becker's Cardiology and Heart Surgery
0:54
- podcast. I'm Mariah Taylor, assistant editor, and I'm
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- thrilled to be speaking with Jeff Marshall, retired
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- chief of cardiology at the Northside
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- Hospital Heart Institute.
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- I am so excited for you to join
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- me and to learn more a little bit
1:08
- about what your career was in cardiology.
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- But before we dive into all my questions,
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- I would love if you could introduce yourself
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- and tell us a little bit about your
1:16
- background.
1:17
- Yeah. Thanks, Moriah. I really appreciate you doing
1:20
- this.
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- I am recently retired,
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- as of the August
1:25
- 31.
1:27
- And,
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- I actually did all my training in,
1:30
- Virginia,
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- trained under some really great mentors, Hermes Kantos,
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- George Veterevek, and Mike Cowley. And then I
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- went to Emory University. I've been in Atlanta
1:40
- since 1991.
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- And, I really had about four different jobs
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- in Atlanta over the last thirty five years,
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- the last of which was the pinnacle at
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- Northside Hospital Heart Institute. But I ran
1:54
- the cardiology service and the cath lab at
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- the Atlanta VA.
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- I was in a private practice,
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- up at Northeast Georgia,
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- Medical Center,
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- for,
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- about fifteen years, and then we entered a
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- PSA
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- and were employed up there. And then in
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- 2019,
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- 12 of us,
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- left,
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- that job and came to Northside, a five
2:19
- hospital system, and we
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- helped to,
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- increase the volume and rebuild and,
2:28
- upgrade cardiology at Northside Hospital Heart Institute, which
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- has been,
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- a lot of fun.
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- Amazing.
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- You've had such a rich career in cardiology
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- that spanned several decades, and I'm so excited
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- to kinda learn from your experience and share
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- everything that you've learned along the way for
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- those leaders who are still in it.
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- But I'd love to kind of start with
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- looking back over the decades. You've done a
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- lot of building and leading for cardiovascular
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- programs across
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- Georgia
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- and spent the last seven years at Northside
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- Hospital Heart Institute really building out their program.
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- So looking at all of that experience, what
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- moment or milestone
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- stands out as the most defining for you
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- personally?
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- Well,
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- you know, all
3:15
- all organizations
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- are are slightly different, you know.
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- One of my mentors told me all dogs
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- have fleas. You know? It's,
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- there are good things and bad things about
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- every organization.
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- And, if I had to pick a moment
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- over the last thirty five years,
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- I think the one, thing that stood out
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- most
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- was kind of when we,
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- left our jobs in Gainesville and came to
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- Northside. Northside's a five hospital system
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- that's excellent in lots of things, babies
3:51
- and cancer and orthopedics.
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- And,
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- cardiology
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- hadn't quite grown as much because they didn't
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- have open heart surgery. And when they obtained
4:00
- a hospital
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- that had open heart surgery,
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- the 12 of us at the end of
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- a contract decided to to to,
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- join Northside. And I think
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- it made a huge wake of positive and
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- negative public opinion. And,
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- looking back at it,
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- some of it was, kinda comical, but it
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- was just kind of a
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- business decision that did make some waves,
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- certainly in Atlanta.
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- But the reason for doing it was just
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- kind of a better opportunity and a chance
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- to grow something,
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- for a health care system
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- that's really expanding,
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- in,
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- the suburbs of Atlanta.
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- Absolutely.
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- Now even outside of the traditional hospital roles,
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- you've held a number of leadership roles in
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- major cardiology organizations,
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- including governor of the Georgia ACC chapter, chairman
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- of the Georgia Composite Medical Board, and even
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- president of SCAI.
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- How did these roles outside of the hospital
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- change how you led inside it?
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- Well, you know,
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- I think that,
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- depending on how you think, it's a blessing
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- and our opportunity to actually
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- lead,
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- several venues, and each opportunity is is kind
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- of different.
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- And those things outside
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- of
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- in inside or intramural within the hospital,
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- actually, I think give you the proverbial ten
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- thousand hours that you need
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- to know on how to interact with people,
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- how to motivate people and build a culture,
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- and how to
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- get everybody on the same page so that,
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- you know, folks are all
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- rowing in the same direction, if you will.
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- Doing things outside the hospital,
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- even folks outside the country. And so you
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- actually probably learn
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- more from those experiences, and you learn more
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- from those people than you actually probably put
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- in.
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- I think one of the keys of of
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- leading anything, whether it's,
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- kind of being a joint leader of your
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- household or whatever, is you have to kind
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- of be
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- a servant leader. You can't ask anybody in
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- the organization
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- not to do something that you already haven't
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- rolled up your sleeves and,
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- done the blood, sweat, and tears to do
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- yourself. Because
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- if that's not the case, then you don't
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- know exactly
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- what you're asking somebody else to do. And
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- I would just say,
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- at this point in my life, it's been
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- an absolute honor to be involved with Skye
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- and the American College of Cardiology,
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- the Georgia Composite Medical Board, and lots of
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- other
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- organizations.
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- And like I said, I probably learned way
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- more,
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- from the folks in those organizations
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- than I actually gave back to the organizations.
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- And I think that's
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- that's important for
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- everybody to to recognize that oftentimes,
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- you get a lot more than you give.
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- Excellent.
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- Now looking throughout your career, how has the
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- relationship
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- between hospital administration
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- and cardiology leadership evolved over the years?
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- Well, you know, about a third of my
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- time I spent in academics, about a third
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- in private practice, and a third of my
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- time I spent employed.
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- And,
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- all of those organizations,
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- and different forms of organizations, while somewhat similar,
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- can also be distinctly different. And
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- I would say that
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- the relationship
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- between cardiologist
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- or any
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- specialty
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- cardiac surgery,
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- infectious disease, whatever, has come under pressure because
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- of really financial pressure from CMS and insurance
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- companies.
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- You know, before I went into practice, there
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- really were some
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- some golden years where
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- people could kinda hang a single shingle and,
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- because maybe there was too much fat in
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- reimbursement,
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- people could kind of build their own mousetrap.
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- That's not the case anymore.
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- Single hospitals and and and and solo practitioners
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- are really under a lot of pressure financially.
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- And if you don't have a good relationship
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- with your administrative
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- dyad, and I do believe dyads are the
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- best method,
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- to manage,
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- clinical
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- entities,
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- then there's then there's gonna be excess friction.
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- There's always some friction because
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- as physicians, not only are we maybe,
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- if you will, the owners
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- of the clinical practice,
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- I e, the medical, legal, and,
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- the care that we provide.
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- But we're also kind of the people that
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- are sewing buttons every day. That's not the
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- case if you own a
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- a manufacturing
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- company that makes widgets. Right? If you're the
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- owner,
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- you can sit at the top and tell
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- people how to make widgets. In in in
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- medicine,
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- the physicians are still sewing those buttons or
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- making those widgets
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- and trying to lead. So your relationship with
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- administration
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- is key,
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- and it's changed because of the pressures
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- on on on reimbursement,
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- I think. And I'd say that,
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- as soon as physicians
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- are removed from that decision making process,
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- medicine will be in big trouble. Unfortunately, I've
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- had the opportunity to work with some great
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- administrators
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- from, my times,
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- in Virginia
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- and Emory
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- and Gainesville
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- and certainly at Northside Hospital Heart Institute.
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- Amazing.
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- In a similar vein to that, what's your
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- advice for mentoring the next generation of cardiologists
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- in an environment that has much more regulatory
10:09
- and volume pressures than the older generations based?
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- Well, I I think that people have,
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- maybe gotten wiser or have a different view
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- on life.
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- The younger generations.
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- I think appropriately,
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- I even see in my kids, but certainly
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- in,
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- younger cardiologist because that's what I know,
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- that if you will, the ability to
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- work
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- hard but also,
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- be a family person is really important.
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- But you can't forget
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- you can't forget that being a physician
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- is really hard work.
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- We are, blessed with the opportunity to have
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- that
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- kinda,
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- special relationship with patients inside the four rooms
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- in an exam room where people will, you
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- know, bear their problems and their souls to
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- you.
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- And that requires
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- that you have to work hard to fulfill
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- your side of taking care for the of
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- them.
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- So no matter what the, regulatory pressures or
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- the volume pressures are, you have to remember
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- that you're primarily there to take care of
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- patients the best that you can. And I
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- always
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- tell people,
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- to use,
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- the my mama rule. What would you do
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- for my mama if she were the person
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- sitting in front of you? And if you
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- never forget that and put quality as job
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- one,
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- young physicians are not gonna have any problems.
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- They're all way brighter than us older folks,
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- and they're gonna do great.
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- That's great advice.
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- One of the things that I think is
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- so interesting about cardiology
11:45
- is how quickly the industry is changing and
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- advancing. There's all kinds of cool technologies and
11:50
- procedures that seem to be coming up almost
11:52
- every single year. But I'd love your opinion
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- on what trend in cardiology today do you
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- think is overhyped, and what's one that isn't
12:00
- getting enough attention?
12:03
- Well, I I think the answer to both
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- of those is artificial intelligence.
12:08
- It's certainly being overhyped
12:11
- by the media.
12:12
- I don't think that, you can remove the
12:15
- human element in caring for an individual patient
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- in that sacrosanct
12:20
- exam room or cath lab or operating suite.
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- Everybody is uniquely
12:27
- different.
12:28
- So AI is being overhyped by the media,
12:31
- and it's never gonna do, I don't think,
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- the work of physicians
12:36
- or nurse practitioners
12:38
- or PAs or any other health care folks.
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- They are really
12:43
- actually
12:44
- tools that physicians and health care providers should
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- be using
12:50
- to make health care more efficient,
12:52
- to help patients understand what's happening to them.
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- And so that's the hype side. I think
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- what's not getting enough tension
13:01
- is that there is a huge almost assault
13:06
- on the financial side of how AI is
13:10
- reimbursed.
13:11
- You know, physician reimbursement,
13:14
- the physician fee schedule
13:16
- is a single pie.
13:18
- It's not getting larger. Although I I hope
13:21
- that groups like
13:23
- the ACC,
13:24
- and the health affairs committee can move congress
13:28
- and government to change that,
13:31
- what happens is that this software as a
13:33
- service
13:35
- eats into that pie,
13:38
- and not many people recognize that. That if
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- the pie is being eaten into
13:43
- by something that you do
13:46
- or something that software as a service does
13:48
- independently
13:49
- at $900
13:50
- a click, let's say,
13:52
- what happens is that erodes the pie
13:55
- so that physician reimbursement
13:58
- is adversely affected. And very few people know
14:02
- about that tsunami that's out there that we're
14:05
- all gonna have to face, and we're gonna
14:07
- have to get our hands around that and
14:08
- come up with some innovative solutions so that
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- we don't,
14:13
- you know,
14:15
- kill the goose that laid the golden egg.
14:18
- That is such a great bait to bring
14:21
- to everyone's attention.
14:23
- Now with the last question, I would love
14:25
- to know if you had to leave hospital
14:27
- executives with one lesson about leaving a cardiology
14:30
- service line, what would it be?
14:33
- It's a single word.
14:36
- Well, maybe two words. Listen and watch.
14:39
- Listen to what the physicians and the people
14:41
- on the front line tell you are the
14:44
- problems,
14:45
- and don't sit
14:47
- in your, you know, fancy corner office
14:51
- and,
14:52
- not come watch what people do.
14:54
- I have found that I've been,
14:56
- blessed to work with administrators
14:58
- that would, you know, come to the cath
15:01
- lab or or come to clinic and see
15:03
- what's actually going on.
15:05
- I think the best
15:07
- CEOs
15:08
- in the business in health care are the,
15:11
- physicians or administrators
15:13
- that every day they're walking around the hospital.
15:16
- They know the people,
15:18
- that are working in HR by name. They
15:20
- know the people cleaning the beds by name.
15:23
- This is a people
15:25
- business.
15:27
- Our job is to care for folks
15:30
- and give them a highest quality care. And
15:32
- the only way to know about that
15:34
- is to show people that you care.
15:36
- I know it's kind of a trite saying,
15:38
- but the people that I've had the opportunity
15:41
- to work with,
15:43
- they they don't really care how much I
15:45
- know.
15:46
- They really wanna know that I care, and
15:48
- that's what executives
15:50
- need to learn.
15:52
- Such great advice.
15:54
- Well, thank you for being here today and
15:56
- sharing a bit about your career.
15:58
- It it was it was an honor. Thank
16:00
- you for having me. Have a great day.