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A Conversation with Sunil V. Rao, MD, FSCAI, FACC
In this issue, Dr. Bhatt talks with Sunil V. Rao, MD, FSCAI, FACC, associate professor of medicine at Duke University School of Medicine and Duke Clinical Research Institute and Cardiology Today’s Intervention Editorial Board member.
After receiving his medical degree from Ohio State University, Rao moved on to Duke University for his residency and fellowship. Today, he continues his work at Duke University, where his primary focus of research is on the radial approach to PCI as well as on transfusion physiology and outcomes of ischemic heart disease, quality assessment and improvement in registries, and clinical trials in interventional cardiology.
Rao has been an investigator on several large, prospective clinical trials in the field of interventional cardiology, including the current state of radial artery access during PCI.
What areas of research and intervention are most interesting to you right now?
Dr. Rao: I’m really interested now in implementation science. We’ve known for years that we have evidence-based approaches to CVD, but the uptake of these approaches has been quite limited. I’m interested in figuring out strategies to implement science and approaches and evidence that we already know. I’m also interested in doing research in quality improvement. I think of poor-quality medicine almost as if it’s a disease state.
What has been the greatest challenge of your career so far?
Dr. Rao: I think if you enjoy your job, challenges make you excited to figure out how to overcome them and you don’t really see them as challenges. A lot of my career has focused on research in an area that has been difficult for the clinical community to accept at certain points. For example, when we first started looking at the safety of antithrombotic drugs and bleeding complications, it was a challenge to try to get the clinical community to understand that bleeding is a risk factor and that we needed to adopt approaches that reduce bleeding risk. I have also done a lot of research on the radial approach to PCI, and it has been a challenge to get U.S. physicians to adopt radial access as a default approach to angiography and intervention. However, we have been somewhat successful. In 2008, the radial approach was used in about 1% of procedures in the United States. As of the third quarter of 2015, it is now up to 33%.
Who has had the greatest influence on your career over the years?
Dr. Rao: I’ve been lucky in that I have had different influences at different stages of my life. Growing up, the biggest influences on my career were my parents, who were both physicians. My mother was a general internist and my father was a pediatric cardiologist. They loved their jobs and I could see that they had a positive impact on their patients’ lives. During medical school, I worked with Harisios Boudoulas, MD. Dr. Boudoulas absolutely loved being a cardiologist and I was interested in how much joy he took from his work. At Duke, the three people who have had the greatest influences on my career are Robert M. Califf, MD, Robert A. Harrington, MD, and Eric D. Peterson, MD, MPH. These three helped me gain the sense for a quantitative approach to cardiology and the importance of evidence-based medicine.
What advice would you offer a student in medical school today?
Dr. Rao: Don’t let anyone get you down on the future of medicine. Being a doctor is one of the greatest careers one can have. One of the challenges we face as physicians is how rapidly medical practice changes. Many physicians who have been in practice for years have been frustrated by changes at the federal level, whether it’s reimbursement or the implementation of electronic health records. I’ve heard some physicians say that they wouldn’t go into cardiology or medicine if they had to do it all over again. My advice is to never be pessimistic about the future of medicine. You just have to be prepared to evolve with it.
What are some of your hobbies outside of practicing medicine?
Dr. Rao: I have a large family, including four children ranging in age from 9 years to 17 years, and I enjoy spending time with them. Having grown up in a Midwestern state where the winters are brutal, we love going to the beach to relax. I also collect vintage wrist watches. I’ve been building a collection over the past 20 years and, at last count, I have 21. I wear each one periodically.