Based on advice of several trusted nurses that I’ve enjoyed working with over the last year and a half, I am writing this post to confirm that I am taking leave at Mt. View, starting on June 20, and discuss the reasons why. To clarify, I intend on continuing to return to Mt. View in the months after June to help my colleague, Dr. Naficy. He is an experienced CABG surgeon and expert at advanced vascular surgery and I can offer no help in these areas. However, he has asked me to mentor him in certain complex cases where his familiarity is less, particularly valve repair or replacement. Someone with his pedigree and talents is a worthy candidate for mentorship. I was very fortunate to have convinced him to come to Las Cruces among the many options that had available to him after completing his advanced fellowship. So it is my honor to be able to help him advance his career. He needs little guidance in terms of his technical skills and knowledge. My main focus has been and likely will continue to be advice on how to best lead cardiac team and optimize their performance. With the proper guidance in the short term, I am convinced that Dr. Naficy can lead the OR and ICU teams to great accomplishments in the long term.
Now as to the reasons for leaving. There is only one – personal family issues have left no option other than to return to the east coast to rejoin my wife and children.
The decision to leave is not in any way related to the episodes of relatively modest disagreements that I had with the hospital administration from time to time. In fact, the administration has been quite supportive of the cardiac program overall. I may not have freely admitted to that fact to anyone over my tenure, which was my amateurish attempt to play politics. It is the job of the director of a program to constantly push for more resources. A true program builder knows the importance of supporting their team and that requires resources. A few months after I arrived and has time to assess the cardiac surgical program, I put together a list of equipment/supplies/resources that was needed in order to perform safe and effective cardiac surgery. That list was long, expensive and contained many things that were quite foreign to Mt View when I asked for them. Over the next 6 months, almost all of those requests were granted. More important, the administration listened closely to the reasons why I was asking for those items, which allowed us to compromise when a less expensive option was available that accomplished the same goal (for example, inhaled flolan vs. nitric oxide). Denten and his team were quite good at listening and trusting the clinical judgment of our team and coming through on the things we really needed. Before you think otherwise (and I know you are), you must realize that this was my 4th job as a chief of a cardiac surgery division. So I’ve worked with a lot of different administrations and have a pretty good idea how to judge this issue.
The decision to leave had nothing to do with any disagreements I’ve had with nurses in the ICU. Any experienced cardiac surgeon knows how important an assertive, competent ICU nurse is to the success of a patient that has undergone cardiac surgery. I can think of at least 5 patients that arrived in our ICU in very serious trouble that would have likely died at other cardiac surgery centers where I’ve worked. In each of these 5 case (and likely many others), a team of ICU nurses worked brilliantly as a well choreographed team to get the patient through. No one becomes this talented at what they do without having strong opinions. In my professional career, perhaps as a side effect of my personality, I’ve had conflicts with ICU nurses quite often. But I believe there is an optimal level of conflict in any professional relationship. If there is no conflict at all, there is false agreement or groupthink. When conflict gets out of control, either the physicians or nurses are obligated to seek out help to bring things back to a more constructive level. Seeking out help to resolve conflict by any means necessary is not a problem at all. In fact, it is the optimal way for strong willed personalities to work together for the good of the patient and the program.
This decision had nothing to do with any of the dumb rumors coming from outside Mt View, the latest one being that I was “kicked out” of Mt. View. The volume of cases and patient outcomes of the cardiac surgical program over the past year and a half have been excellent. We have agreed to publically report the results of our risk adjusted outcomes, so these data will soon be available at the following website for all to see: publicreporting.sts.org/acsd. As any good lawyer’s closing argument might conclude – res ipsa loquitur – our STS record speaks for itself.
I’ve loved most things about working at Mt View but two standout the most: the cardiac OR team and the IMC. I can see it in the eyes of those that I’ve worked with on these teams that the vision for how to do healthcare the right way that we shared was meaningful to you. This is the original excitement about working in a hospital that caused you to sign up for a job that makes you work harder, become more stressed and get paid less than most other jobs. We now know that the spark is still there. Please remain assertive and continue to demand the teamwork and communication from your colleagues that will take care of the patients that trust you with their lives.
