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The Making of a Better Cardiologist

Family traditions are usually a welcome gift passed down through generations. However, some traditions, such as heart disease, aren't so welcome.

Robert (Bob) O'Brien's father passed away at an early age from a heart-related illness. So Bob decided to find a way to change the future for his family by establishing the Robert and Casey O'Brien Heart and Vascular Fellowship through The Foundation for Barnes-Jewish Hospital.

"I have inherited a few of the conditions that are part of the heart disease umbrella," Bob says. "We felt by establishing a fellowship, we were giving to a specific purpose and outcome versus making a less defined donation. We hope a fellowship is one more tool to help create a better cardiologist and to provide better care for the patients they serve."

A fellowship is a training program that physicians undertake after completing residency training. It provides specialized training in a specific area of medicine or surgery. The O’Brien Fellowship provides a focused training experience in another institution either inside or outside the United States that enables trainees to expand knowledge and skills gained at Washington University School of Medicine and Barnes-Jewish Hospital.

 

REMOTE EXPERIENCE OFFERS FAR-REACHING BENEFITS

Since Bob and his wife, Casey, established their fellowship in 2011, four physician fellows have been awarded funds to experience unique training. One former fellow, Kathryn Lindley, MD, established a Women and Heart Disease Program at Barnes-Jewish Hospital that focuses on several key cardiology issues, including heart disease and pregnancy.

 

Most recently, Tracy Hagerty, MD, traveled to Alaska through the O’Brien Fellowship to study cardiovascular disease in Native American Indians and Alaska Natives. Considering Barnes-Jewish serves patients from around the world with dozens of cultures and beliefs about medical care, Dr. Hagerty’s experience is valuable and timely.

Dr. Tracy Hagerty sits in front of her computer

While training in Alaska, Tracy Hagerty, MD, learned the importance of understanding cultures and beliefs to better care patients.

"The diverse population in Alaska defies generalization,” Dr. Hagerty says. “Each group has a distinct ancestry, language, food and culture. I learned a great deal about the impact of lifestyle on cardiovascular health. I saw first-hand the challenges of maintaining a traditional lifestyle under the growing pressure and availability of less healthy alternatives.

"My experience reinforced the importance of understanding the culture, traditions, beliefs, and lifestyle choices of the people we are serving."

During Dr. Hagerty's five-week stay in Alaska, she visited Nome, which is situated in the western part of the state. As the hub of the Bering Strait region, Nome has a population of 3,700, two grocery stores, two gas stations, a post office, several gold mines, a few paved roads, an airport, and miles of tundra for bears to roam and locals to pick blueberries. A newly constructed hospital serves 15 villages in the region with its small inpatient unit, four ER beds and a clinic area. Twice a year, patients there can see cardiology specialists visiting from Anchorage.

Dr. Hagerty says the innovative health care ideas that allow for the care of those living so remotely was eye-opening. While in Nome, Dr. Hagerty offered a teaching session to nurses and participated in a video teleconference with a patient in a distant village needing a higher level of care.

 

PLANES, BOATS AND PROCEDURES

She says one of her training highlights was a visit to the village of Teller, the only village accessible by road—a dirt road—from Nome. With no running water, and transportation only by foot or four-wheelers on the unpaved roads, medical care was a challenge. Dr. Hagerty witnessed how local community health aides provide basic medical triage and care, sometimes through video teleconferencing with providers in Nome.

 

"Procedures performed in Alaska take on a different meaning because of the significant challenges in coordinating care for many who live hundreds of miles away in remote areas only accessible by plane, or during the summer by boat,” Dr. Hagerty says.

Through these experiences, she began to understand the barriers to providing traditional health care—whether in Alaska or in cities around the country.

"To understand why patients take their medication or not, embrace or ignore advice, or even return to a clinic or hospital for a visit or a procedure, we must view this through the context of their lives, their beliefs, their access to care, and their financial ability to make the changes we're proposing," Dr. Hagerty says. "Through my medical career, I want to explore how we can better partner with our patients to achieve a healthy life."

Dr. Hagerty recognizes the rare opportunity she was given to follow her passion and learn through the O’Brien Fellowship. "I'm incredibly grateful to the O'Briens for this experience," she says. "Their generous gift allowed me to reach far beyond the borders of St. Louis, the Midwest and even the "lower 48," as Alaskans call it. My time in Alaska offered a breadth and depth of experience that I had not and probably could not have anticipated."

Bob and Casey meet with all the resident physicians who receive the O'Brien Fellowship.

"You can feel Dr. Hagerty's passion for helping people," Bob says. "Through the fellowship, our hope is that new physicians like Dr. Hagerty have opportunities to gain skills from other hospitals and become a resource for other physicians. In addition, we've learned that this unique fellowship opportunity helps Barnes-Jewish Hospital attract the best and brightest into the cardiology fellow program. That benefits all of us."

To learn more about supporting or creating a fellowship, please contact Mary C. Hendricks, CFRE, at 314.362.3499, or email [email protected].


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