Maggie McKay (Host): Welcome to Valley Vitals, the pulse of healthy living in our community, brought to you by Carson Valley Health. We're going beyond the checkup to bring you real conversations with the experts you trust. I'm your host, Maggie McKay. And today, we are talking about rural cardiac health with cardiologist, Dr. Chris Rowan, and cardiology nurse practitioner Alex Hastings. Thank you both for being here.

Alexandria Hastings, APRN: Thank you for having us.

Chris Rowan, MD, FACC: Yeah, thanks for having us today.

Host: Of course. So, why is it important to have cardiology services available in rural areas like Carson Valley?

Chris Rowan, MD, FACC: Well, cardiology, heart attacks and heart disease is the leading cause of morbidity and mortality in the United States right now. And it's higher in rural underserved areas. The risk factors are more prevalent and patients have less contact with cardiologists. And if you want to make a difference in the impact of people's lives, you go to the places where the needs are, and that's places like here in Carson Valley where we have a very vivid need for cardiac services.

Host: And how does enhancing cardiology care impact the overall health outcomes for our community?

Alexandria Hastings, APRN: I mean, first and foremost, access to care. I mean, we serve not just Carson Valley, but even fingers outward, all the way down the areas like Hawthorne and things like that. So, we're being able to provide resources and easier access and treatment to resources that people need.

Chris Rowan, MD, FACC: According to some recent surveys, travel and barriers to health specialty care is one of the biggest problems in rural areas. So, a lot of our patients travel from as far as two and three hours away to get cardiac care here, which is really kind of amazing because otherwise they don't get it.

And when I was with a previous institution, and we stopped serving our rural communities, the answer that I was told was that the patient would simply come to us. And we know that's just not true. A lot of patients have barriers in terms of finances, travel as they get older and they have problems, seeing them lose their driver's licenses. So, being actually there in the communities makes a huge difference in terms of actually providing the care.

Host: So, you are where they live. Is that the idea?

Chris Rowan, MD, FACC: That's correct. We're here in the areas where they live within a couple of miles for the majority of our patients. But we also have outreach as far as two and three hours away, which for some patients could be up to 150 miles one way.

Host: Wow. Tell us about the medical team behind the new cardiology services and what makes them passionate about rural healthcare.

Alexandria Hastings, APRN: Say, for me, I grew up in a super small town in Michigan, population 300. And cardiovascular disease is very prevalent in my family. So when I started in nursing school, when I was in my early 20s, that was kind of my thing, is I was going into medicine because I wanted to be able to take care of patients like they were my family, being able to educate and explain the test results and what medication is and what it means and the importance of that, just like I would to my grandparents and my parents.

Chris Rowan, MD, FACC: And for myself, here in Carson Valley, I'm originally from Reno. So rural healthcare has always been a big focus of mine ever since I took my first position in 2015. And I took that job because we did a lot of rural outreach and I've continued to do that throughout my career and continued to do it here as well as some other outside interests.

The other part of the medical team here, we have our clinical staff. They're all local people. They understand the local community, and all the people who work here. The cardiac services division within the hospital are also local people who understand that the special needs of the rural community.

Alexandria Hastings, APRN: So, being able to love our community from the inside out, basically.

Host: Oh, that's so nice. How does the medical team at Carson Valley Health support patients emotionally during their heart health journey? Because that's a big part of it.

Alexandria Hastings, APRN: I know a big thing for us, it is like our MAs in our front desk, they are very accessible. They answer questions right away. They're very good at communication between the patients and us, just because we are doing a lot of more face-to-face with patient appointment times. They're the ones that are kind of the mediators.

Chris Rowan, MD, FACC: And we tell patients constantly, if you have questions, concerns, or anything like that, get a hold of our team here who can get a hold of us. Because oftentimes, even for me when I see my doctor, I forget something I wanted to ask when I leave the room or they have a question about a side effect of a medication.

You want to have that communication or a way to get a hold of us open five days a week and even longer to make sure that we can get back to the patient so that they just understand that maybe they're not having a side effect or to answer questions about the long-term concerns.

Host: That's so true. I was just at the doctor for my yearly physical. And I take a written list and I still forgot to ask one of the questions. So, hear you totally.

Alexandria Hastings, APRN: Pretty common.

Host: Yeah, in closing, what would you like to add? What would you like people to know?

Chris Rowan, MD, FACC: That we're here and we look forward to seeing them. And we look forward to continue to be a presence here to build cardiology services here at Carson Valley.

Alexandria Hastings, APRN: I would say the biggest thing is that we're continuing to look at the things that are needed here. So, we're working on hopefully getting pacemaker clinic down here. We're working on getting the Coumadin monitoring and management down here. And then, ultimately, hoping to get to where we can do TEEs and cardioversions down here as well.

So, trying to bring some of those bigger, consistent, more monitoring things here on a regular basis, just to kind of, again, keep everything local if we can.

Host: That's great. Well, thank you both for sharing your expertise. We really appreciate your time. Of course, you guys are very busy. So, we appreciate it.

Chris Rowan, MD, FACC: Thank you very much.

Alexandria Hastings, APRN: Thank you.

Host: Again, that's Dr. Chris Rowan and Alexandria Hastings. To learn more, visit carsonvalleyhealth.org.

Maggie McKay (Host): And

Host: as we wrap up another episode of Valley Vitals, make sure to subscribe to our podcast, share and connect with us on social media. Stay tuned for more engaging discussions. This is Maggie McKay signing off from Valley Vitals. Let's move mountains.