Advocate highlights changes in cardiology, practice issues

Samuel Wann, MD, talks about health policy challenges and urges colleagues to stay focused and not get discouraged.

Despite the many challenges physicians face in the medical field today, one leader and medical advocate urges colleagues to stay positive, reinforce the goals of young medical students and put the patient’s needs first.

“There are too many challenges, and it’s easy for us to be negative because of the payment and regulatory issues we bear,” said Samuel Wann, MD, chairman of the department of cardiovascular medicine at Wisconsin Heart Hospital and a private practice cardiologist with the Wheaton Franciscan Medical Group, Milwaukee.

Wann, Today in Cardiology’s section editor for Health Policy, Patient and Practice Issues, suggested physicians concentrate on the positives of the medical profession.

“Don’t be distracted by transient things,” he said. “Patients still want doctors to take care of them. We’ll get over the social issues, and if we relate well to our patients and our patients advocate for us, then we’re OK.”

Challenges in the field

The cardiology field is in the midst of revolutionary changes, according to Wann. The field is growing with effective preventive measures, particularly statins. The incidence of acute coronary disease has started to plateau. Wann questioned how cardiologists are going to “map that” in terms of the number of angioplasties performed, diagnostic procedures needed, the changing disease spectrum.

“Cardiology is really changing and adapting from being a procedurally oriented specialty to a more preventive specialty,” he said.

Amid the changes arise some challenges: the changing workforce, evolving medical practices and the need for electronic medical records and more accountability. The administrative burden of medical practice is growing, as well. Infrastructural needs are increasing and receiving the necessary tools to continue providing patient care is going to be a major challenge for the next decade or two, according to Wann.

Another challenge that is also a hot topic among cardiologists, according to Wann, is the Deficit Reduction Act of 2005; it affects everyone in medicine, he said.

“We need to control costs and at the same time perfect our quality of medicine,” he said. “How we are going to adapt, the need for more universal coverage and how we are going to contain the continued costs that are escalating is important not just for cardiologists and physicians, but for everyone.”

Medical students also bear the burden of facing pressing issues with regulators, insurance companies and governments in addition to the added stress of MCATS. “Don’t discourage young people getting into medicine; medicine is rewarding,” he said.

Wann’s journey

Originally an anthropology major from Indiana University (1968), Wann attended medical school (1971) and completed his internal medicine training there. After finishing a cardiology fellowship at Indiana in 1977 under the guidance of “the father of echocardiography,” Harvey Feigenbaum, MD, Wann served as an assistant professor of medicine at Indiana and started the echocardiography program at the Indianapolis Veterans Administration Hospital. He also worked in the cardiac magnetic resonance unit at the Royal Brompton Hospital in London, and upon his return to the states, began his private practice in cardiology with Wisconsin Heart and Vascular Clinics. Wann also is a clinical professor of medicine at both the University of Wisconsin and the Medical College of Wisconsin.

Wann’s clinical interests have varied over the years, spanning the areas of echocardiography, nuclear cardiology, cardiovascular MRI, noninvasive cardiac imaging and CT angiography.

One of his major achievements is establishing the Foundation for International Medical Exchange, a nonprofit group that works to improve cardiac care in several central European and Asian countries. The Foundation has allowed more than 30 Russian cardiologists, surgeons and nurses to travel to the United States to observe Western medical practices.

Last year, Wann co-directed a three-day post-graduate symposium in Milwaukee called CT Angiography for the Cardiologist, which attracted over 800 physicians from around the world. The now annual CT Angiography for the Cardiologist meeting was held this past April in Chicago.

Wann has contributed to more than 200 publications and remains involved in numerous medical organizations. He is a master of the American College of Cardiology and chairman of the ACC Advocacy Committee and the ACC Medical Directors’ Institute. He is a member of Alpha Epsilon Delta and the recipient of the Best Teaching Service Award by the Medical College of Wisconsin.

“I’ve been lucky to have been involved with a lot of different activities,” Wann said. “Taking care of patients and still being involved in medicine, teaching and interacting with peers is important. Not everyone gets the opportunity to do that, but I recommend everyone try.”

CTA course

Last month at the Wisconsin Heart Hospital, Wann taught a hands-on coronary CTA course for 12 cardiologists from around the country to help fulfill the ACC’s competency statement.

“It’s a lot of fun to have other cardiologists come to our hospital and have that personal interaction,” he said. “It is a chore to get off of my regular duties as a practicing cardiologist, but it is a great honor.”

Wann also volunteers as a primary care physician at the Greater Milwaukee Free Clinic, where he cares for working but uninsured patients. In his spare time, he and his wife Mary enjoy skiing, hiking and traveling.

His future endeavors will include getting more involved with medical education for both practicing cardiologists and fellows. He is also interested in participating in long-distance learning and venturing into nontechnical medical writing with a focus on health policy and political issues.

“At the end of the day, we may complain, but cardiology is a lot of fun. It is an important job and it needs to be done. I know I don’t want to retire,” Wann said. — Tara Grassia