The International Symposium on Endovascular Therapy (ISET) has been running for 23 years. What makes ISET so popular?
The programme directors of ISET continue to bring innovation to medical education. It is very challenging in today’s environment to maintain the value proposition necessary to attract registrants. This is our primary goal – to be the provider of unique and high quality educational content, which the registrant can use in the next week, and to bring the community together to consider the future of our field, in a multidisciplinary way.
You support the use of live cases for education purposes. How can these be made safe?
To us, the use of live case education provides the most valuable method of educating practitioners about procedures they are doing. These things cannot be taught as well in books, or other media sources. Live case education will always reflect real world therapy, and of course, it becomes a statement on the quality of work and value structure of the team and institution involved.
We maximise patient safety in a number of ways. This include: extensive discussion and review by the whole team in advance of the programme; working with multiple physicians at one time to reduce the multitasking pressures created by live case education; complete informed consent and post ISET debriefings on our own performance. I still most enjoy teaching by the bedside and whether this is on a routine basis with whoever is in the room or to a large group, my performance and approach is the same. It remains a critical method of expanding the role of endovascular therapy. But, being a great physician does not make you a great teacher, and being a great teacher does not make you a great live case operator and teacher. Like everything else, it takes a combination of knowledge, talent, ability to multitask, and comfort with modern media.
The Baptist Cardiac & Vascular Institute developed a multidisciplinary approach back in the 80s. How has it contributed to the success of the institution?
The multidisciplinary culture created in the 80s cannot be overestimated in terms of its value. It has allowed us to be more competitive in the marketplace locally, achieve incredible levels of measurable quality, patient, employee and physician satisfaction, and most importantly prepared us long in advance for increasing the integration required to move forward the field of endovascular therapy for procedures such as complex aortic and structural heart procedures. While this is not something we promote externally, we frequently get comments from patients that everyone is working together for their benefit. From the beginning of the institute we have felt that turf battles were destructive and that collaboration was constructive. This palpable result has led to capital commitment by the institution, and most recently a commitment of US$60 million to expand BCVI and broaden our mission and programmes.
How do you see the endovascular field developing in the future?
Our field will continue to expand as we develop more less invasive and better solutions for vascular disease and continue to increase patient awareness. We are at the threshold of great advances in the imaging environments and the potential to improve the image-guided part of what we do is very important. Our procedures will get less and less invasive and hopefully they will not be devalued as a result.
What are your current areas of research?
Important areas for us include: defining the role of drug elution for peripheral arterial disease, exploring the role of intervention in hypertension and other diseases that we may be able to alter the physiology as well as the anatomy, understanding whether endovascular therapy really has a role in multiple sclerosis, and stroke prevention through medical therapy and interventional techniques. Cell therapy may also become an important part of our approaches to critical limb ischaemia.
Outside of medicine, what are your interests?
I really enjoy boating of any type and have a powerboat. I enjoy fishing with my buddies (non doctors) on the weekends, when we get a chance. In the past, my wife and I have done a lot of cruising on our own boat (Wandering Star was the name), but my time on the water is a little differen. It is the way I get ‘down time’ from the usual pace I am running at. My current boat is called Down Time too. My career has allowed us to travel as well. I also love spending time (not enough) with my two grandchildren. And of course, none of this could have happened without the support of my loving wife Judi. We have been married for 44 years and have known each other since high school.
Fact File
Training
1966–1970 Medical School, University of Miami School of Medicine, Miami (early admission)
1970–1971 Internship, Jackson Memorial Hospital, Miami, Florida (Straight Medicine)
1971–1974 Radiology Residency, The New York Hospital – Cornell Medical Center, USA
1974–1975 Fellowship, St Vincents Hospital/Medical Center, Cardiovascular Radiology, New York
Foreign studies
Sep–Nov 1974 Angiography, Policlinico Umberto Primo, Instituto di Radiologia “La Sapienza”, University of Rome, Italy (Plinio Rossi, director)
Sep–Oct 1973 Pulmonary Radiology and Chest Special Procedures, The Brompton Chest Hospital, London, UK (Ian Kerr, director)
Jun–Aug 1969 Chest Pathology, National Institute of Health Grant, The Brompton Chest Hospital (Lynne Reid, director)
Current appointments
Jul 1987–present Medical director/founder, Baptist Cardiac & Vascular Institute, Baptist Hospital of Miami
Jul 1987–present Voluntary professor of radiology, University of Miami School of Medicine, Miami
Jul 2005–present Assistant professor of radiology, University of South Florida, Tampa, USA
Jan 2000–present Courtesy professor, Biomedical Engineering Institute, Florida International University
2010–present Associate dean for clinical affairs for Baptist Health, FIU Herbert Wertheim College of Medicine
2010–present Clinical professor of radiology, FIU Herbert Wertheim College of Medicine
2010–present Clinical professor, Department of Surgery, voluntary, FIU Herbert Wertheim College of Medicine
Professional societies
American College of Angiology, American College of Cardiology, Fellow American College of Gastroenterology, Fellow American College of Radiology, Fellow American Heart Association, Fellow American Medical Association, American Roentgen Ray Society, Cardiovascular and Interventional Radiological Society of Europe, Member Chesapeake Vascular Society, DC Chapter of Radiology, International Society for Cardiovascular Surgery, New York Roentgen Society, Radiological Society of North America, Fellow Society of Interventional Radiology, Southeastern Angiographic Society Virginia, Medical Society Florida Vascular Society, South Florida Vascular Society, Society for Vascular Surgery.
Awards and recognitions
Listed in Best Doctors in America (1982); Gold Medal Recipient, University of Miami Alumni Association (1997); Best Doctors in America (1998); Diagnostic Imaging Magazine: Radiology’s 20 Most Influential (1998, 2002); Gold Medal Recipient Society for Cardiovascular and Interventional Radiology SIR (2002); member of medical team responsible for repairing vice president Dick Cheney’s popliteal aneurysm (2005); Gold Medal Recipient, Cardiovascular and Interventional Radiological Society of Europe CIRSE (2006); Cordis: Leaders In EndoVascular Education Award (2006); Iron Arrow, University of Miami, U of M’s highest honour (2007); American Heart Association Council on Cardiovascular Radiology and Intervention Distinguished Achievement Award (2008); American Heart Association Awarded the 2010 Cor Vitae Heart Award (2010);America’s Top Doctors 2002; America’s Top Doctors (2007); Best Doctors of America (2007/2008); Florida Super Doctors – South Florida Edition (2008); Best Doctors of America (2009)
