Joey Wahler (Host): It's the heartbeat of the South Hills. So, we're discussing St. Clair Health Cardiovascular Services. Our guest is Dr. Andy Kiser. He's physician in Chief of Cardiovascular Services. This is Curating Care, a podcast from St. Clair Health. Thanks for joining us. I'm Joey Wahler. Hi there, Dr. Kiser. Welcome.

Andy Kiser, MD: Hi, Joey. Thanks for having me.

Host: Great to have you aboard. We appreciate the time. So first, we're talking really about the four Cs, if you will, that are key to your department's success. And first, connection to the community. Now, you've said that's where everything really begins for St. Clair Health Cardiovascular Services. What would just say you mean by that?

Andy Kiser, MD: We're a hospital in the South Hills of Pittsburgh. And a lot of our physicians in the cardiovascular service line either have a significant connection to the community or grew up in the community. So, we feel like we're part of the South Hills region, but just simply because we live here and practice here, but our connection's a little deeper than that. We really want to be the type of service that thinks about taking care of patients in our region to provide the care that they need here locally instead of feeling like they have to go somewhere else. And so, we really beefed up our services at St. Clair over the past seven to ten years to be really a center of excellence for the type of cardiovascular services that people need in the South Hills.

Host: And so, tell us a little bit more, if you would, about why that St. Clair culture of community is so important.

Andy Kiser, MD: We really focus on the patient. There's a sense of teamwork here and culture that tries to put the patient first. And each individual patient is different. And so when a patient shows up to our services, we approach them individually, but with a team. And so, the culture of our network is one that is of collaboration, which is probably one of the Cs we're going to talk about in a second, but a culture of working together to take care of a patient in our region. We like to think of ourselves as really the place that you want to think of when you have a cardiovascular crisis, but also the place that provides long-term cardiovascular care so that you prevent those crises from occurring. So, our culture is one of just not just treating you when you're sick, but trying to keep you from getting sick.

Host: And that's important in this case, isn't it, Doctor? Because so much of heart health is timely screenings, preventative medicine, et cetera, right?

Andy Kiser, MD: More and more every day. A lot of the things that you think about when you think of cardiovascular care is, "I had a heart attack," or "I have to have a new valve put in," or "My heart is beaten irregularly." Those are sort of acute things that happen that you want to address, because it makes you uncomfortable or may even limit your life.

We want to think more along the lines of what the future looks like. And the future looks like things to prevent these things from occurring that bring you to the hospital sort of urgently. Those are medications, medications that help manage your cholesterol. Some of the newer medications may even help prevent some things occurring like valve disease and coronary disease. We haven't even approached some of the opportunities for gene therapy to even prevent this from occurring.

Look, we don't get to choose our parents, but we can manipulate the environment that our genetic sort of outline has provided for us by controlling our weight, controlling our smoking, controlling our exercise, all these things help us live longer and prevent you from needing to see people like me, because I like being here in the South Hills, but if you need to see me, it's usually a problem.

Host: Well said indeed. So as you gave us a little preview of a moment ago, indeed, the next C we're going to discuss is collaboration. How would you say you and your team rally around each case, so to speak? What does collaboration mean in this instance?

Andy Kiser, MD: We have assembled a team of experts here at St. Clair in cardiovascular disease. I can't express how proud I am to be a part of the team that we have, young people, young excellent physicians who are well-trained, but also eager to learn more and more and to be real experts in their field.

That team approaches each patient every day. For example, if you have an arrhythmia, and you need to see Dr. Liu for that, but Dr. Liu needs to do something different with the pacemaker. He may contact me or Dr. Salman to help with that procedure. Coronary disease, you may see a cardiologist, but may need a stent or an open heart surgery, but we talk about that every day. It's a real team collaboration around each patient.

The advantage is we're in a community where we can pick up the phone and call each other and talk about a patient, and we're right here next to each other. So, I walk down the hall, look at the x-rays. We make a decision-- sometimes even in the cath lab-- we'll make a decision about the best care for a patient with two or three physicians standing around talking about what the best option is. That happened just this morning with four physicians in a room deciding what's the best thing to do for this patient. I'm happy to say that this afternoon, the patient's doing great and we made the right decision. And it's that level of expertise, of teamwork and collaboration that doesn't take just one person's education, but a team of people who have excellent education, excellent experience to give the patient really the benefit of a team of wonderful physicians.

Host: Well, you mentioned that next C, once again, beautifully, doctor, in this case, communication. And I guess while you have that expertise, of course, that you mentioned, it's only as good as the way that it's used, and a big key to that is that open line of communication. So, what's the key to having that great chemistry between you all to really form that terrific team that you have?

Andy Kiser, MD: Well, the key is it goes back to the first C, community. We live in this community, but we have a community within the hospital that we thrive in. And we think of each other as colleagues and as friends, and we get along professionally and outside of the hospital. It's just a great place to practice.

And I think that level of comradery enables us to communicate with each other honestly, so that if we don't see eye to eye, we don't approach it with anger, but you approach it with how can we come up with the best solution to this to really benefit the patients? And that's usually, not just like this yesterday or this morning when we had four physicians in a room, but most of the time with each case that we take care of, we get together in a meeting and talk about those patients with a team of sometimes 10 physicians and a team of echocardiographers and nurses and physician's assistants, all getting together to communicate about this. Patient because when a patient shows up, they are seen by different people, and different people get an impression of how well they're doing or what the problem is.

When you pick everybody's opinion and put it together, we get a sort of holistic approach to an entire picture of the patient. And that really helps us make the right decision for a patient, a 50-year-old who needs an operation versus 90-year-old who needs an operation and how to manage those patients differently because they're different patients with the same problem, but we have to approach them differently.

Host: So when we, again, get back to for a moment talking about how that helps the community, certainly when you've got that team effort happening so effectively, so much of the success of what you and yours do is word of mouth on the part of patients, right? When patients see you all collaborating, communicating, those Cs coming into play once again, word spreads in a community, doesn't it? That this is the place to go.

Andy Kiser, MD: It does, but you know, it's not just the patient or the physicians that go out and tell people about how great things are at St. Clair. It is the patients who go out and have a wonderful experience, and we really strive to make sure that the patient experience here is unlike any other place. Again, back to the community, a small community.

We want to make sure that we communicate to the patient exactly what's going on so that we sit down, hold your hand, and make sure that you understand what the problem is, what the options are, and let you and your family make a decision with all the information you need to make, but help guide you along in that decision that you need to make, not tell you what the decision needs to be. We want the patient to be involved in their care as much as we're involved with their care.

But it doesn't stop with the physicians. The nurses are just as involved with that. When you come to St. Clair, the nurses are right there helping you get through whatever you're going through and informing us of what's going on. It is a team of physicians, of technicians, of people in the operating room that really work together as a team to communicate to you, to let you know what's going on and make the right decisions clinically.

Host: We've talked about this theme of C words and we've still got one left. Clinical excellence, right? And so, obviously, the things you've already discussed, you put them all together. That certainly leads to it, clinical excellence. What would you say you look for, Doctor, when hiring people that enables you to foster this kind of a culture? Because it all comes back to making the right choices and who you bring in in the first place, doesn't It?

Andy Kiser, MD: It does. And we've been very fortunate and very blessed to have, like I said earlier, excellent physicians on staff here. And we've recruited excellent physicians. We've got new physicians that are coming in who are right outta training, who bring a level of expertise that helps us all learn every day.

The level of expertise, the ability to bring those people together and create a product or a service line that helps take care of patients is something that we strive to do not just by recruiting, but by what we live and breathe every day. And it's not just bringing in the right person, but it's bringing in a person that wants to be a part of a team that makes a difference and that works together.

I think we have a team that that gets along very well, like I said earlier, but also a team that wants to take us to the next level. We want at St. Clair to be a leader, not just in the South Hills, but involved in making the level of care that you get in this region better. And so, when we work with our colleagues at Allegheny or our colleagues at UPMC, we work collaboratively with them. It's not the competition that one would expect. It's a collaborative network of caregivers that truly want to see the healthcare delivered in our region go up in quality, not at the expense of another, but encouraging everyone to rise so that every patient benefits, not because one's better than the other, but we're all getting better and we all work together to achieve that metric.

Host: Couple of other things for you. First, your passion certainly shines through here in a big way. Where does that come from? Where does your passion for this approach originate? I think you sound a lot like a coach, right? Talking about things like communication and teamwork and sticking together and always trying to come out with the best possible result. Do you have an athletic background? Where would just say this all originated for you?

Andy Kiser, MD: Well, I played a little sports in high school. It wasn't that big a deal. But you're right, teamwork is a big part of what we do. My enthusiasm, and I think the enthusiasm of our service line, is not on what we have done or not on what we can do, but it's what we can do, and what we do in the future, where we can take our service line. And then, when we elevate our care at St. Claire, like I said, it elevates everybody in the region. We can do more than what we're doing. It's not that we can do transcatheter valve or MitralClip or some of the things that we are so proud of being able to do. It's the fact that we want to do that, but do that in a bigger way. We want to be bigger and better than we were yesterday. And we think that doing things like training residents, doing clinical trials, expanding our service line to do things that we haven't been able to do, some of the imaging modalities, some of the heart failure modalities. All these are things that help us become a center that you can go to with confidence when someone's sick, be it you or your family. And it makes us enthusiastic about coming to work. It does. Because we love our job, we love the people we work with. But most of all, we're enthusiastic about just being better.

Host: I think it sounds like a great place to work, and I didn't even go to medical school, Doctor.

Andy Kiser, MD: We can arrange that.

Host: Okay. Never too late, my mom always used to say, right?

Andy Kiser, MD: That's right.

Host: Last thing in summary here, St. Clair Health Cardiovascular Services, the heartbeat of the South Hills, as we mentioned earlier, has a nice ring to it. So, what is next on the horizon? You touched on it in a broad sense a moment ago. Are there one or two things in particular that patients could look forward to that you're going to be rolling out in the near future?

Andy Kiser, MD: I think that we offer everything here at St. Clair except heart transplant and durable mechanical support, like an implantable artificial heart, that any other center would offer. Our exceptional care is the communication, the collaboration, and community that we've established. And that's what makes us-- different is the wrong word-- but exceptional in what we do. I think that you can get those types of things at other hospitals in the region, but I think that we're exceptional at making sure that we're communicating, collaborating and put the patient first in a community type setting in the hospital here and just outside in the South Hills.

Our future, what excites me about the next step is some of the clinical trials that are coming along that we can get involved with that bring cutting edge care to you at your doorstep. You don't have to go to Cleveland Clinic anymore or to New York to have some of the things done. Some of these trials, we can do right here. For example, I'm involved in the first polymer valve to ever get clinical approval in the world. I'm involved in that and I'm right here in Pittsburgh at St. Clair and running a trial in India to help accomplish that type of thing. These are the level of things that we're doing. Dr. Pray is doing some wonderful things with heart failure. Dr. Bashline is working on pulmonary embolism, and we're just finishing part of a pulmonary embolism trial right here. Dr. Liu is involved in two trials looking at brand new cutting-edge technology to treat arrhythmias.

Currently, we have a team of experts that help get us to where we are, Dr. Burkey, Dr. MacDougall, Dr. Shogry, Dr. Marcucci, all these legends in our South Hills. They have started something that we are just continuing. Dr. Woelfel, the cardiac surgeon who was here before I came. And now, we're here and we just continue to mount on what excellence we had before and expand on that and take it to the next level. So, we want to be the next level. We want you to drive by St. Clair, see a great big sign that says Heart and Vascular Institute, and have utmost confidence in whoever you see, you're going to get excellent care from start to finish.

Host: Well, folks, we trust you are now more familiar with St. Clair Health Cardiovascular Services. Doctor, sounds like you're doing some literally groundbreaking and even mentioned international work as well. Keep it up, you and yours. A pleasure. Thanks so much again.

Andy Kiser, MD: Joey, thanks for having us. Thanks for listening to what we've got to offer.

Host: Absolutely. People need to know about it. It sounds like it's an awful lot, and that it's all great stuff indeed. Well, to learn more, we invite you to please visit stclair.org. And to schedule an appointment with Dr. Kiser, please call 412-942-5728. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. And thanks so much again for being part of Curating Care, a podcast from St. Clair Health.