I have really enjoyed my time on the road (on the commercial side) where I had great exposure to different ways of working, including setting up cardiac imaging departments in Europe, consulting across the U.S., and building new state-of-the-art cath labs and radiology departments.

When consulting at Lenox Hill in Manhattan, I took an active role negotiating the purchase of the cath labs and operations of the radiology department. This triggered my decision to go back to clinical setting. I was tired of looking through the window and not being a part of the show. Watching the changes and challenges in health care, I just had to get back in.

Why did you choose to work in the invasive cardiology field?
The choice to go into a cath lab stemmed from the desire to learn and do more for patients. The cath lab offered a place where doctors, nurses and technologists worked together as a team. At that time, I was lucky enough to work at the Gray 3A cath lab at Mass General Hospital. This was a research lab working on thrombolytic therapy, valvuloplasty and pediatrics. I had the chance to work with outstanding physicians and a great nurse (Sandie) that took on a 20-something-year-old technologist and opened my world to a satisfying and great career. I am still on the ride.

Can you describe your role in the CV lab?
My role is that of an administrator for the operations of invasive cardiology. I have three great managers that are in the trenches day and night.

My main focus is negotiating the purchase of all equipment, including capital equipment, and saving the hospital dollars. This is done primarily through working with my chief of cardiology, Dr. Mark Josephson, and my medical director, Dr. Joseph Carrozza. My primary goal is to effectively and efficiently operate the invasive division and take care of our great staff.

What is the biggest challenge you see regarding your role in the CV lab?
My biggest challenge these days is to try and keep the staff happy. Without them, all of the state-of-the-art equipment means nothing, because as they say, you are only as good as your people. I consider myself very fortunate to have a terrific staff and I do not want anything to change in that respect. So I find myself talking and thinking about perks, recruitment, retention, compensation and benefits.

What motivates you to continue working in the CV lab?
Motivation to do this job comes easy. The work speaks for it self delivering the best care to our patients at all times. Working with my three managers and staff, and seeing their dedication to good patient care and outcomes drives me every day.

What is the most bizarre case you have ever been involved with?
When working for XRE, the CEO sent me to assist in opening a brand-new diagnostic cath lab. When I arrived I realized none of the staff had ever worked in a cath lab before. The cardiologist informed me that one of the conditions he had made with my CEO before buying the lab is that I would teach his new and inexperienced staff how to work in a cath lab. Luckily, three of the nurses had worked in CCU and the x-ray technologist had worked in angiography, so at least we had a good foundation on which to build. I found myself setting up manifolds and tables, scrubbing in, panning, and assisting with catheter exchanges. Other company reps were a bit surprised to see the applications person actually doing cases. The first day, we did 7 cases, and each day for the next few weeks we did cases until the staff felt competent in taking over. The great perk was that this lab was in an ultimate vacation destination. After a day™s work, I, the dealers, and the engineers that sold the equipment went to a gorgeous house on the beach that was provided to us for the duration of the training. (Not a bad silver lining.)

When work gets stressful and you experience low moments (as we all do), what do you do to keep your morale high?
I have two people I turn to that can help me get grounded. They are Dr. Joe Carrozza, the Cath Lab Medical Director, and Joanne Casella, Director of the Department of Medicine. They usually give me good advice and advise me to let it go.

The other thing I do is go to the gym and work out.

Are you involved with the SICP or other cardiovascular societies?
I am involved in The Alliance of Cardiovascular Professionals (ACVP) as a member, as well as being on the Board of Directors. I serve as the Management Council Chair. This is a proactive organization that offers sound management courses to its members. With a leadership of 10 other individuals representing 3000+ members, we are able to impact change and provide education, which is exciting and valuable for future advancement, growth and understanding. I also belong to a small group of cath lab managers called Cath Lab Leadership. This is a group where we get together, help each other out and share our successes and problems. I also participate in American Heath Care Radiology Managers: mostly delivering lectures regarding vendor negotiations and turf battle issues.

Do you remember participating in your first invasive procedure?
My first day in a cath lab was a bit overwhelming. (I was a radiology tech). I thought, How will I ever learn this hemodynamic monitoring? Everything was very hands on: monitoring, scrubbing, assisting, and at that time, learning how to administer medications. I remember asking the cardiologist if he would fire me. He laughed and said, Don™t worry, you™ll learn, because we will teach you. Luckily, cath was in its infancy at that time, and I learned on the job, while it was growing from diagnostic into a therapeutic pathway for patients.

If you could send a message back to yourself at the beginning of your cath lab career, what advice would you give?
The message I would send myself would be to do it the same way. I have loved every bump and turn of this ride.

Where do you hope to be in your career when it is time to retire?
Maybe to become a Vice President in an Academic Teaching Hospital. I really do not plan on retiring.

Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
Two people have really helped me gain knowledge in this field. Dr. Robert Leinbach of Mass General Hospital provided me with a beginning. Dr Sunny Lawrence (Children™s of Los Angeles) refined my knowledge and opened to me the world of congenital heart disease. These two physicians were my teachers and I think of them often.

Where do you think the invasive cardiology field is headed in the future?
I believe the future of invasive cardiology is to become the operating room of the future and the primary vascular imaging suite for the hospitals. I have seen so many changes over the past 30 years, from Sones diagnostic cases to the evolution of valve replacement into a procedure in the cardiac cath lab. We still have a long journey ahead.