The ways 1 cardiology leader is tackling staffing, patient care and resident training

Gopi Dandamudi, MD, never envisioned himself going into leadership when he first began as an electrophysiologist.

Dr. Dandamudi, executive medical director of the Center for Cardiovascular Health at Virginia Mason Franciscan Health in Tacoma, Wash., fell in love with the heart during his anatomy and physiology class in high school. As an undergraduate, he became more interested in cardiology and especially electrophysiology.

"Electrophysiology is one of the few fields in medicine where you can actually cure somebody from an arrhythmia lifetime and not worry about it happening again," he told Becker's.

His first exposure to administration and program building was during his time at Danville, Pa.-based Geisinger. He was later recruited to Bloomington-based Indiana University to run one of its programs and eventually landed in his current position. Dr. Dandamudi said he has found administrative work rewarding because it allows him to take care of communities for generations to come.

"In 100 years from now, Virginia Mason Franciscan Health will still be here," he said. "We'll still be caring for the communities and even possibly my children and grandchildren. There's something very appealing about building something that will last the next 100 years."

Here, Dr. Dandamudi discusses issues facing physicians and some of the greatest areas of growth in cardiology.

Question: What's the greatest challenge facing physicians right now?

Dr. Gopi Dandamudi: Our biggest challenge is the changing environment of healthcare, the pressures that we feel from the payer perspective, trying to work with what we have and in the context of ever-shrinking support systems that we had in the past and learning to do that ourselves. Most of us are trained to think about and take care of the patient, and not about all these external factors. Now these external factors have become bigger and bigger and we're trying to still take care of patients to the same degree that we always envisioned we would. It's trying to balance all this in a complex environment while taking care of the patient.

Q: What concerns you most about the healthcare field?

GD: The thing that we never anticipated, even remotely, is the whole issue of staffing. Especially in the cardiovascular realm where we need the entire team that helps us — from nursing to lab staff — across the entire continuum of care. It's by far our greatest challenge, trying to work with limited resources, and there's no constant. You can't predict a week from now what our situation will be. You really have to flex, to adapt to the changing environment, and somehow manage those patients you promised to take care of in a timely fashion. 

We have been trying to reduce the burden by empowering patients to care for themselves. We use wearable devices so patients can monitor their own rhythms. We educate them on how to care for themselves so they are not immediately running to the emergency room. We are also investigating how to advance care-at-home and hospital-at-home programs across our Pacific Northwest region to keep patients out of the hospital.

Q: What new technology, innovation or research are you most excited about?

GD: We instituted an artificial intelligence program in our cardiovascular service line, which allows us, in real time, to analyze the entire population we're caring for. We can look at which patients would benefit from other therapies and identify instantly who is not on the right drugs or needs different care based on current guidelines. It's an amazing amount of data that we got so quickly. 

The AI can also identify the rate of progression based on all the risk factors for patients and help us better allocate limited resources. It can also help us manage low-risk patients differently and give us an overview of the community's risks. Given the staff shortages issues and the limited cardiologists expected to join the field in the future, we can't feasibly manage patients in the long run. Something has to change, and that's where I see AI helping.

Q: What's something your hospital or system is doing in heart care that you're most proud of?

GD: We started a cardiology fellowship program, which is the fourth program for the entire Pacific Northwest. Between that program and our internal medicine residency program, we are educating the next generation of physicians. I'm also proud of our Mission Control hub, which allows us to coordinate care by knowing in real time where every patient is, what tests are pending and expediting care to reduce length of stay. Then there's our hospital at home, which keeps people out of the hospital and helps them recuperate at home. We incorporate a lot of digital technology, which is helpful. 

Through our virtual nursing program, which recently launched at St. Anthony Hospital in Gig Harbor, we are bringing live cameras into patient rooms. These allow us to talk to patients and treat them virtually before they’re transferred to another site or discharged. I think these are all things we never thought of probably 10 years ago but COVID-19 accelerated. It’s all very exciting for us, especially in the cardiovascular realm

Q: What's the best leadership advice you've received?

GD: It will sound funny when I say it, but building as much real estate between listening and speaking. I tend to talk a lot and formulate strategies and solutions pretty quickly. As a leader, it's incredibly important that you are in tune and focused on what's in front of you. Listening skills, I think, are some of the hardest to learn as physicians; we're always making a diagnosis, treating a patient and moving on to the next one. But leadership is a different skill set. Leaders are managing people, learning to listen, learning to understand what the problem is before you actually come up with solutions. 

Secondly, have a little bit of patience. Whereas physicians were trained to do things quickly, administrators need to take a little more time. They have to learn how to have patience, see the long game and resist instant gratification. It's like fine wine — you have to let it mature for a little bit of time.

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