CardioExchange Archive

Dr. James Fang, MD, has recently accepted the position of Chief of Cardiology at the University of Utah in Salt Lake City, and he’ll officially start later this spring. Dr. John Ryan, who also recently took a position at the University of Utah, took this opportunity to ask Dr. Fang about his new job and to reflect on the profession as part of a new feature on CardioExchange.

Dr. Ryan: What moment or person influenced your career the most to date?

Dr. Fang: The most prominent person has been Pat O’Gara. However, I would be remiss if I didn’t also mention Peter Ganz, Lynne Stevenson, and Dan Simon. To me, they represent the pinnacle of academic medicine and personal integrity.

Dr. Ryan: Why do you want to be Chief of Cardiology?

Dr. Fang: I was once asked why would I want to lead any group; the simple answer is to help good people do good things; in this case, I recognized there were wonderful folks at Utah that were looking for someone to help lead them to accomplish their goals. I also saw an opportunity to grow an academic division in an institution that was willing to consider other organizational models in a historically collaborative environment. However, there is no doubt the modern CV division has many challenges in trying to balance fiscal responsibility and clinical productivity with the academic missions of education and research. The challenge becomes even more acute within the current healthcare mandate. I also hope to be able to use my position to direct clinical behaviors that reward quality rather than simple diagnostic and procedural volumes.

Dr. Ryan: How do you think the role of Academic Cardiology Divisions will change over the next 5-10 years?

Dr. Fang: Academic medical centers will evolve into institutes where the clinical, teaching, and research missions will be organized by disease states rather than by the traditional divisions into medicine, surgery, and radiology. This change will mean that Academic CV divisions will be integrated into Cardiovascular Institutes or Service Lines where their missions can be conducted with greater efficiency and collaboration. Traditional divisions of surgery and medicine will need to be absorbed into a singular mission to advance the field of CV medicine, whether from a medical, surgical, or endovascular approach. This approach already exists at many medical centers in a virtual way; I anticipate that fiscal and political integration will continue.

Dr Ryan: What steps should we take to ensure the survival of the physician investigator? Or is that even a worthwhile goal?

Dr. Fang: Survival of the physician investigator is an absolute necessity. Advances in medicine only occur with such committed individuals and institutions. But this takes resources and academic medical centers are complex institutions that often have multiple priorities. In order to assure their survival, the first step is to solidify the commitment of hospital leadership to supporting this mission. Increasingly, academic affiliated hospitals must commit their fiscal resources, that are derived from downstream technical revenues, to be re-invested into the drive to discovery. “Protected time” will continue to be a critical part of this equation.