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Q&A with Michael Lim

by Nancy Ryerson, Staff Writer | July 18, 2013
From the July 2013 issue of HealthCare Business News magazine

Michael Lim runs the award-winning cardiology center at Saint Louis University Hospital. Recently, he shared with DOTmed Business News the challenges of putting together an innovative program and how he feels health care reform will hit his facility.

DMBN: Tell me about yourself and your background. How did you get to where you are today?
ML: Today, I’m the co-director of the Center for Comprehensive Cardiovascular Care (C4), and director of the division of cardiology at St. Louis University. The C4 was just established a few months ago. I’ve been director of this division for almost three years now. From a standpoint of what I do in my spare time, I’m an interventional cardiologist. So I was trained to perform angioplasty, put in stents, and do things for people to improve their heart health by catheter. I’ve been here at SLU for almost 10 years. I came from the University of Michigan where I received my training in general cardiology and interventional training.

DMBN: What has the process of developing the Center for Comprehensive Cardiovascular Care been like?
ML: C4 in a nutshell represents a merger between cardiac surgery and cardiac medicine. Traditionally, cardiac surgery falls under the realm in academic hospitals as part of the department of surgery, that’s the way it’s always been developed. Cardiology in similar institutions falls under the auspices of internal medicine. Those distinctions have not necessarily been helpful. There’s been a significant development in lesser invasive procedures, highlighted by transcatheter aortic valve replacements, but there are multiple opportunities where patients can receive significant cardiac procedures without having a traditional operation. There are surgeons that have developed their training to offer that skill set, as well as cardiologists who can offer that same skill set. So from a standpoint of trying to offer the best appropriate options for advanced cardiac care to patients, we don’t need or gain benefit from having a split between two departments in our faculty. We actually do a lot better if we get referrals for patients, offer them procedures and do so without having to worry about how one procedure goes to a different department.

DMBN: What are the challenges of building the program?
ML: There are always challenges in developing something new. I gave you the easy part, which is the idea. The challenges are in the execution, and so the first challenge is to spread the word about what we’re doing and how that’s different from what you would get at another place. Because there’s a tremendous number of names out there, whether they’re associated with heart hospitals, or heart or cardiac institutes, or something along those lines, and our name doesn’t necessarily tell you why we’re distinct, so that’s part of the challenge. The other challenge is that true integration between cardiac surgery and the medicine part of cardiology hasn’t flourished or been prominent within traditional medical schools in this country. There’s always been a sort of partial integration. That partial integration has to do with how difficult it is to break down long-standing traditions within the school of medicine.

DMBN: How is health care reform impacting your hospital?
ML: One unique thing about our hospital is that the physician group is part of St. Louis University, and the hospital is owned by Tenet. There are two separate bodies that [have ideas about] what needs to happen to adapt or understand health care reform. I think a lot of physicians at hospitals face this. Even if the university owns the hospital, the hospital is run by a separate administration, so there are always different ways of looking at things. I think the first challenge is trying to understand our combined strengths and combined weaknesses with respect to anticipating changes in health care reform. That means getting on the same page.

Click here to see the pictorial for Saint Louis University Hospital

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