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Professionals Out In Front

The Ten-Minute Interview with... Phil Regas, MSM, RCIS, RRT, CPFT, CFAAMA, FSICP

Tomball, Texas
Phil is the Director of Invasive Cardiology and Cardiac Rehab at Tomball Regional Medical Center in Tomball, Texas, which is located in suburban northwest Houston. He is also the current chairperson of the local chapter for the Society of Invasive Cardiovascular Professionals (Gulf Coast). Why did you choose to work in the invasive cardiology field? I originally started my healthcare career in the respiratory therapy field. While in respiratory therapy training, I became impressed with one of my educators who worked as an exercise physiologist, and also possessed a wealth of knowledge in cardiac electrophysiology and hemodynamics. In 1985, I became an advanced cardiac life support (ACLS) instructor at Memorial Hospital in Easton, Maryland. With my knowledge of cardiology and interest in new programs, I was asked by Scott Friedman, MD (cardiologist), and Gary Jones, RTT, Director of Cardiopulmonary, if I would be interested in helping to start a cardiac cath lab. Can you describe your role in the cath lab? I am currently the director of the cath lab and cardiac rehab programs. In this role, I am responsible for cardiac business development, facility build out, supply negotiations, and the integration of a new cardiac co-management quality arrangement with our cardiologists and cardiac surgeons. What is the biggest challenge you see regarding your role? The new reimbursement challenges with coding, documentation, and case management issues as they relate to hospital and physician alignment are by far the greatest challenge right now. At Tomball, however, we have adopted a “structured report model” to assure improvement of medical necessity/indications documentation. What motivates you to continue your involvement with the cath lab? My passion is the cardiovascular service line. My motivation comes from having seen and worked with very highly regarded physicians and staff, and personally wanting to develop a best-in-class operation in our area. The staff at Tomball are the best in our region. Our physicians are also very skilled and perform many procedures that you will only find done in larger medical centers. When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? I always remember that everything will get better. Many aspects of our lives go through cycles and when I am at a low, I just know that things will eventually change for the better. Do you remember participating in your first invasive procedure? Yes, my very first case was at the University of Maryland’s cath lab around 1989-90. My first case was with Dr. Andy Ziskind, the cath lab medical director. I had never even seen many cath lab cases prior to this first case; however, I had studied on my own before going into the lab. Dr. Ziskind was told I was the “new student” and to take it easy on me. He looked at me and asked if I had ever played a video game. I said yes. Dr. Ziskind then told me what direction the tube was moved by using the joystick. He then asked if I knew what the heart looked like on x-ray. I said yes. Dr. Ziskind then said, “Okay, if you know those two things, place the tube where I tell you and slowly move the heart image so I see the dye go to the end of the heart silhouette.” It seemed easy enough, and with this physician, who was patient and willing to teach, I was able to quickly learn. If you could send a message back to yourself at the beginning of your cardiovascular career, what advice would you give? I would tell myself to participate in my field at a higher level. I would have either joined societies or professional organizations earlier in my career. I would have also tried to network more (however, the Internet did not exist, and networking was much harder at that time). Has anyone in particular been helpful to you in your growth as a cardiovascular professional? I have to give thanks to Gary Jones, RRT, from Easton, Maryland. He gave me my first break and always kept me in mind for growth opportunities. I also have to give thanks to the cardiologists at Trinity Medical Center in Steubenville, Ohio, for allowing me to practice at an advanced clinical level. This group of physicians trusted me and we worked together like a well-oiled machine. I gained quite a bit of “hands on” skills that have allowed me to think as a practitioner rather as a “helper.” I want to thank the cardiologists at the Heart Hospital of Austin, in Austin, Texas. Participating with this team helped me go to the next level of specialty cardiac care. I was also exposed to various thought leaders in the nation and robust research protocols. Lastly, I thank my current cardiologists at Tomball who trust me and work with me as a team in bringing new technologies and procedures to our hospital. Can you tell us about a learning moment you experienced in your career (a big or small moment)? After arriving at the Heart Hospital of Austin, I worked with a physician who was treating a peripheral chronic total occlusion. I had never seen a procedure that was this difficult before, and I was on the verge of thinking the physician was crazy to even consider opening this lesion, along with the way it was being opened. Yet at the end of the case, I could not even tell where the lesion had been and in addition, we did not leave a stent behind. I gained a whole new respect for percutaneous peripheral procedures and the skills needed to make a procedure look so easy. Where do you think the invasive cardiovascular field is headed in the future? I believe that hybrid cath lab/ORs are the future and how hospital-based programs should look at utilizing resources. Many procedures that were once only done in the OR will be done in these newer types of rooms. Phil Regas can be contacted at pregas@tomballhospital.org
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