Ep21: Dr. Andrew J. Sauer, Chief of Heart Failure Therapies Division at The University of Kansas Health System

Hills and Valleys is a podcast that uncovers stories from leaders in healthcare, tech, and everything in between. Straight from the heart of Silicon Valley, we give you a look at the good, the bad, and the future, one episode at a time. Brought to you by Potrero Medical.

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About Dr. Andrew J. Sauer

Dr. Andrew J. Sauer is a practicing cardiologist, Associate Professor, opinion leader, accomplished program builder, frequently cited author, and father — devoted to patients suffering from heart failure.

Graduating MD with Distinction in Research, University of Rochester, he completed training in academic internal medicine (MGH, Broad Institute of MIT, Harvard Medical School) and cardiovascular medicine (Northwestern University).

At 33 yrs age, Dr. Sauer was recruited by the University of Kansas to co-found & grow an innovative contemporary heart failure, VAD and heart transplant program. While serving as inaugural Director from 2015-2020, the comprehensive HF & transplant patient survival rates rose to among the highest in the nation—w/ 100% heart transplant patient survival for consecutive years (‘16-‘20; SRTR) & VAD implant nation-leading reduced length of stay (‘17-‘20; Vizient). He also helped his team innovate a high volume and pioneering telehealth – remote monitoring program while earning repeated team awards including AHA GWTG HF Gold Plus, Honor Roll Status; he also co-led KU to become the first CV program in the nation to receive TJC Comprehensive Cardiac Center Certification.

As an expert in heart failure therapies, Dr Sauer has authored numerous articles accumulating thousands of citations; his works have been presented at international scientific sessions including: AHA, ACC, HFSA, HRS, ASE & ISHLT; he has also served as national or global steering committee member for innovations and investigations partnering with Medtronic, Boston Scientific, Abbott, Amgen, among several others. He is frequently sought for consultative input regarding device therapies, emerging technology, and telemedicine innovations as a particular focus.

Dr Sauer is an inductee of the Alpha Omega Alpha and Gold Foundation Humanism in Medicine Honor Societies. Additional honors include: Northwestern Searle Teaching Fellowship; Robert O. Bonow, MD Excellence in Cardiovascular Research Award. 

Follow Dr. Sauer on Twitter @AndrewJSauer or Connect with him on LinkedIn @Andrew J. Sauer

Transcript

[00:00:00] Omar M. Khateeb: [00:00:00] Hi Everyone. This is Omar M. Khateeb Director of Growth, over at Potrero Medical. We have another fantastic guest joining us. I’ve been really blessed this month because I feel like I’m getting, you know, really all star people on our show to sort of share their. stories from the field in leadership in healthcare, we recently had, uh, Kevin Mahoney, who is the CEO of Penn Medicine on, and today you have Dr. Andrew Sauer. Uh, Dr. Sauer comes to us from KU he’s their

[00:00:28] Dr. Andrew J. Sauer: [00:00:28] Division

[00:00:28] Omar M. Khateeb: [00:00:28] Chief  for heart transplantation and heart failure. And I know that I didn’t get that completely right, but our star, thanks for joining us. Can you give the audience a little background on, on who you are and what you do at CU?

[00:00:39] Dr. Andrew J. Sauer: [00:00:39] Thanks again for the opportunity to talk today.

[00:00:41] Um, I’m a heart failure. Cardiologist. I focus on heart fair as a disease exclusively. Uh, I grew up in the Heartland, brassica moved East for some of my training in upstate New York, and then up to Boston and then spent some time in Chicago and ultimately was recruited [00:01:00] here shortly after training in my first year on faculty at Northwestern.

[00:01:04] And, uh, It was sort of a crazy idea, you know, come here to Kansas and, you know, build a comprehensive heart failure VAD. Uh, ventricular assist device, uh, and heart transplant program. And, uh, where we are today is, you know, we’re 89 transplants from the beginning. About four years ago, we’re over 150 ELV ads.

[00:01:26] Uh, and we have really some of the. It really is the most remarkable outcomes in our region. And certainly contesting to say the same for the country. Yeah. Uh, we’ve grown and we’ve built a program that it includes, you know, 15,000 heartfelt encounters. Uh, and 10 locations. We, uh, have grown to really embrace telemedicine and remote monitoring technologies and innovations in the ICU space.

[00:01:52] And I just, it’s just fun to talk about our mission and what we’re doing here. So I’m just fortunate to be able to call myself one of the leaders [00:02:00] that’s been part of this process.

[00:02:02] Omar M. Khateeb: [00:02:02] Absolutely. You know, and I got to say, you know, I, you know, because of my role at Potrero, I interact with a lot of hospitals, top institutions all over the world.

[00:02:10] And I was really impressed because, because they were, and I don’t want to get into the details of it. There are people I spoke with at Kansas, that there are certain clinical, uh, initiatives you guys have started. There are operational, uh, and technology initiatives you started. And I, when I would check with some of these other hospitals, I speak of our top 10, top five of them have not.

[00:02:31] So. You know, I’ve really been impressed with the spirit and culture at K U and you’re a very humble guy, but I’m going to kind of put you on spot here. And I would like to start, start this cause we do have a lot of young people listening to it, a lot of medical students. So I, I noticed something that is very rare, which is you became the chief of this division at, I believe age 33, correct?

[00:02:54] Is that, am I correct in this ed?

[00:02:56] Dr. Andrew J. Sauer: [00:02:56] Yeah.

[00:02:56] Omar M. Khateeb: [00:02:56] So the only other person who I know who’ve accomplished [00:03:00] something. At at, at that caliber was, uh, decades ago. And Ben Carson, uh, became the first or the youngest chief of a division, uh, for neurosurgery at Johns Hopkins. So you don’t hear that very often, especially for a large program, like heart transplantation and heart failure for the audience.

[00:03:18] That’s one of the most prestigious and important program in a hospital, aside from getting the best of the world to do that. It’s obviously something that, uh, operationally and financially is important to hospital. Tell us from the beginning, like where did, where did you start studying in college and medical school.

[00:03:33] And, and how, what

[00:03:34] Dr. Andrew J. Sauer: [00:03:34] do you think

[00:03:35] Omar M. Khateeb: [00:03:35] got you is point to take over a program at such a young age?

[00:03:40] Dr. Andrew J. Sauer: [00:03:40] Well, it helps if you’re going to be the leader of something and, you know, you know, being achieved, you know, that, that term didn’t even get used as a refers to me until a few years after I got here. But when there’s nothing here yet, you know, when you’re the first to something.

[00:03:53] It’s literally like the wild West. I mean, back when the settlers were crossing the Plains and sticking stakes in the ground, you know, when we [00:04:00] came here in 2015, there was really no comprehensive, heartfelt or care for Kansas. Uh, there was a very, there, there wasn’t is a very good heart transplant program across the state line, uh, here in Kansas city.

[00:04:12] Um, but there are state line challenges that make that. Difficult to imagine how every single patient in Kansas is going to get the care they need. So to be fair, uh, you know, being chief is sort of the easy thing to do when you’re by yourself. It’s a much harder thing to do when I’ve got eight faculty members.

[00:04:28] Like I have now I’ve got seven or eight nurse practitioners in our space. We’ve got two surgeons, you know, we’ve and we, we, we sort of, you know, it means something more now. Um, But back to your question, you know, kind of, what’s my story. I grew up on a farm towns in Nebraska. Didn’t really know much about it.

[00:04:46] Yeah. Anything outside of Nebraska? The first time I got on an airplane was when I was 17 years old, our vacations were basically campgrounds, uh, in, you know, in North Dakota or we’d sometimes make a trip out to Colorado. [00:05:00] Um, I still love going up to the mountains. Um, and then, you know, went to college at Nebraska, um, you know, land of the Cornhuskers and Cornhusker football.

[00:05:09] I grew up when Nebraska football was really a dominant thing in the news. Uh, and, and I think, uh, you know, that was the culture I grew up with. Um, I sort of stumbled into med school is honest. True to the story is, um, I sort of found myself at the university of Rochester in upstate New York, uh, because my brother, uh, had at Bausch and Lomb scholarship, he was there as an undergraduate.

[00:05:35] And that scholarship somehow found its way into our tiny little town in Nebraska, Milford, Nebraska. And so, because he was there, I applied and I was rejected or wait-listed by every medical school, including my own state school. Um, and then it came down to, I got off the wait list at my state school and I also got off the wait list at Rochester.

[00:05:55] And because our family didn’t have a lot of means. It turned out that there was enough [00:06:00] federal. Uh, there was enough financial aid for me to basically go to either school. It was going to cost the same. So I looked around and thought, you know, maybe I get out of here and check out the rest of the world.

[00:06:09] Yeah. And moved to upstate New York. Um, and then I, again, sort of stumbled on this guy. He’s a giant in the field. His name is dr. Arthur Moss. He’s passed away a couple of years ago, but it was my first mentor. Um, And, uh, if you know anything about dr. Moss, he is the guy who was the lead author on basically every contemporary, ICD trial, all of the made it, uh, ICD trials.

[00:06:34] And so he got me involved with clinical research and helped me get my first. Publication. Um, still my highlights, my highest side of paper career from 2007 in the journal of American college of cardiology. And then he said, you’re going to go to mass general. That’s where I trained. Um, dr. Moss also famous for training space monkeys.

[00:06:55] Uh, back in the nineties, I was like, this guy knew everybody and he works. [00:07:00] Until he died. He was, we don’t actually know, I don’t know how old he was when he died, but he was, he was up there, um, was very active, um, but all throughout his career and to his eventual death, which was a very quiet, uh, passing. And then, uh, when I was in Boston, I had a great training at mass general.

[00:07:18] Um, and part of the reason why I left Boston was because they, at the time, this is 2010. Uh, there wasn’t a lot of it brace in that city for the, the rise of the mechanical circulatory support devices. It was not really, they weren’t really frontline as a city. Um, and mass general, I think was still waiting to kind of get involved in that space more aggressively.

[00:07:42] And I was really intrigued with what was going on in clinical circulatory, tourist support, which was really taking off in that 2007 to 2010 era. And in Chicago, they had volumes the left ventricular assist device therapies as a city. And so I kind of felt [00:08:00] like, look. Um, I could stay here in Boston and this is assuming they would’ve kept me.

[00:08:04] I mean, we’ll never know, but I could stay here or I could go place that sort of rising. And at the time Northwestern, isn’t it wasn’t exactly the powerhouse that they are today in 2009, 2010, they were definitely taking off, but I wouldn’t say they. We’re contesting with, uh, being a dominant program in the city.

[00:08:23] And now I think they’re pretty widely recognized as one of the dominant centers in the nation and in Chicago. And, uh, I had a lot of great time there, you know, five years of training of training and faculty and. Another part of the story is just, they were going through some turnover. And so the fellowship year, we were recruiting faculty while we were sort of down a number of faculty members.

[00:08:44] So my fellowship year, it was kind of infamous because I kinda got thrown into to a lot more responsibility and autonomy than you would expect in your fellowship year. I was the only fellow in the advanced art flair fellowship at the time. Wow. And so the [00:09:00] training was just like, you know, I was taking donor call all the time and yeah.

[00:09:03] You know, running around, you know, living in the world of that transplant on one hand, it was awesome because I was learning everything I wanted to learn, uh, felt very prepared for my faculty or on the other hand, it wasn’t the best work life balance. Um, but you know, those early years really shaped me.

[00:09:18] And I think that that’s sort of how I got to where I was when I was 33 being offered a chance to run my own program. Um, build it from scratch.

[00:09:27] Omar M. Khateeb: [00:09:27] Interesting. Now, one thing I got to say, you know, um, I’m leaving it in the show notes. You, you have a fantastic, uh, and for me, because of the character limits longer, a LinkedIn page, you, you put out a lot of amazing content, uh, which is, which is surprising in itself because you’re already very busy.

[00:09:44] We find time to be a great storyteller actually. Um, and you put a lot of stuff, you know, not just on the field, but. Uh, you know, work life balances, the, the personal challenges about being a physician at a major program and trying to be a good father. Good husband. [00:10:00] So when you and fellowship, were you married at the time and, you know, tell us a little bit about that because that’s something that a lot of doctors struggle with, you know, including my son, you know, my, my father was a surgeon growing up, so I knew, I knew what that was like.

[00:10:14] Dr. Andrew J. Sauer: [00:10:14] Yeah. Yeah, that’s the, those are all, it was tough questions to address, but they’re important ones. And so I’m a big fan of Bernay Brown. Um, you know, all you have to do is Google her Ted talk and you get a flavor of what she’s about, but she talks about how, you know, the reason why. So every human in existence is searching for connectedness.

[00:10:33] Yes. And we live in a culture of shame. And we live in a culture where people actually don’t feel so great about themselves and they really don’t feel connected. And I think the technology that we have in society is great. And I obviously do leverage technology all the time. Uh, you know, including LinkedIn and Twitter.

[00:10:51] Unfortunately though these things don’t create connectivity. And what creates connectivity in her in her point is, and she’s written about this quite a bit and I, [00:11:00] I follow her stories is reality. Is. People want to be connected and to get to connect to connectedness, we have to be willing to be radically and courageously vulnerable.

[00:11:11] And so a lot of what you see that I put out there. Yeah. I get texts from my friends. I get messages that say, did you really want to put a picture of your kids on LinkedIn? And I say, look, there’s a lot of reasons. But part of it is because. We’re not robots. And the truth is we don’t have these careers that we have half without acknowledging that there are people who stand behind our careers, who understand our mission.

[00:11:34] And our mission is never just about work. And so, you know, without my wife, you know, who I’ve been married to since the beginning of residency, 2007, you know, she’s. Followed me around with all these places we’ve been, and we have a, a marriage, like every marriage, it has ups and downs has seasons that are good.

[00:11:53] I have not been as good. And there are real challenges. Um, and then now we’re parents of three kids, [00:12:00] six, four, and two years of age. And the truth is, you know, parenting is this whole new dimension that for me, until, until I was leaving fellowship, basically I hadn’t experienced and. And there are so many plates spinning up in the air between the things we do work and the things we do at home.

[00:12:18] And I don’t know how anybody balances this well, including me. So what I try to do is just be honest about my life. I put stuff on LinkedIn about my debt. I put stuff up about how much did I, tad I put stuff up about, you know, this is the thing I’ve learned from my kids today and how it applies to things at work.

[00:12:36] I’ve, I’ve acknowledged that I’m stepping out of the transplant, medical directorship, and people think I’m totally crazy. And I said, look, five years doing transplant directorships. So I can go do other things that I’m interested in. And so that I can be hopefully a better dad. I don’t think that’s crazy.

[00:12:52] It’s just not what people do at 39 years of age, you know, build a transplant program and then walk away from that leadership role. People think I’m [00:13:00] leaving or that I’m going off to some other place. And it’s really just about trying to find that purpose in life. And I have a why for what I do at work, but I also have a why for what I do at home.

[00:13:11] And I think what I try to encourage people on social media or on podcasts like this. It’s just to say, you gotta be honest with the person that you use. Look at every morning in the mirror and that’s who you need to be accountable to. And are you going to go and go to work and be proud of the fact at your end of life?

[00:13:28] Are you going to be proud of the fact that you wrote 30 more papers or that you got on five more podiums? Or are you going to be proud of the fact that you had the privilege to love some really important people in your life? And, and how did you make a Mark on the world, the world that you live in to make it a little bit better, to create a legacy that lasts beyond your life?

[00:13:46] Because. That’s what we all have in common and deep down in our soul. We have a need to be real with each other and to be connected and to also have a higher purpose for what we do. And it’s not going to be the same purpose at [00:14:00] work as it is at home. And I think that. Um, sites like LinkedIn and Twitter are real opportunities for people to be honest about that.

[00:14:08] And if all we do is show the kind of, you know, Hey, look what I did. If that’s all LinkedIn or Twitter is, um, then I think we’ve become a pretty superficial society. And I think. All I’m trying to do is just get the conversation going. And I think that’s why people follow is because they see that there’s something about this as a little bit different.

[00:14:29] And, and, and hopefully I resonated the people because it’s, it’s trying to be real knowing that social media is still not the best place to be real. Um, Yeah. And there’s a real strategy to what I do. I don’t post about everything, but there’s categories of things I routinely post on. And one of them is sort of talking about how I try to balance work and life.

[00:14:50] And the key word is try cause it’s, I feel all the time, but I try to talk about what that looks like.

[00:14:56] Omar M. Khateeb: [00:14:56] Absolutely. You know, I got to tell you that that’s what you said [00:15:00] is so incredibly powerful. Um, You know, and I, and that was to be honest with you, that that was the first thing that drew me to, to your profile and connect with you.

[00:15:09] Um, is. How vulnerable you are and you, you owned it. You know, for me, my, my family’s middle Eastern, uh, I bet an Arab father and a Turkish mother. So generally very, very strong masculine societies. I grew up on the,

[00:15:22] Dr. Andrew J. Sauer: [00:15:22] on the Mexican border

[00:15:24] Omar M. Khateeb: [00:15:24] and the thing that I realized over the years, you know, so I ended up dropping out of medical school, which was a lot of people wanted to put shame on me about that.

[00:15:32] And I realized, you know, I always talked to my wife about this concept of. Like when we teach kids, like, what is it, what is, what is being a man about? And it’s not this, you know, I’m a tough guy thing all the time. I think that, you know, one of the things I learned

[00:15:47] Dr. Andrew J. Sauer: [00:15:47] is that

[00:15:48] Omar M. Khateeb: [00:15:48] to be really, really strong, you have to be willing to show that you’re weak.

[00:15:52] And you know, for me, it was first talking about when I dropped out of medical school, but I was so inspired [00:16:00] and captivated by the things you posted, because I think medicine has this problem. Um, Across the board of just constantly all celebratory, all strengths and everything, and idea of showing any kind of really weaknesses is looked, looked down upon.

[00:16:17] But in reality, you know, when I say I speak to my friends who are now doctors and residents, I can’t tell you, I don’t know if you’ve noticed, but I’ve sent so many people to your posts and profile, and it’s given them a lot of inspiration that, you know, a couple of them who I know. We’re really inspired by your family posts because they were beating themselves up all the time about not being the perfect a husband or wife while in residency of training.

[00:16:42] So I don’t think you’ll ever know dr. Sauer, how much you influenced and inspired and impacted other people’s lives, read those posts, but the fact that you put them out there and it’s going to live forever. So one day your daughter’s going to grow up and say, you know, early on when this was kind of a taboo thing, my father.

[00:17:00] [00:17:00] Did the brave thing and kind of released a lot of people have the shame from their families, from themselves by writing about our lives and trying to teach people like what that means. So I, I can’t speak highly of about enough and, and I really appreciate you sharing. Yeah. So in that process, let me ask you this as a husband.

[00:17:19] What, what did you learn or let’s put it more as a spouse. What did you, what was the most important thing that you learned through this, through this process of going through residency fellowship and then getting, you know, getting into this role, um, that you can, you can sort of advise others on.

[00:17:35] Dr. Andrew J. Sauer: [00:17:35] You have to see, you have to see this relationship as a partnership.

[00:17:39] Um, My wife stays home. Now she’s a trained counselor and teacher. She’s got, uh, a bunch of accomplishments that she doesn’t get to talk as much about because she’s at home. Um, when she was in Chicago, she took a job. Um, the economy was bad if you remember 2009, I mean,

[00:17:57] Omar M. Khateeb: [00:17:57] very bad

[00:17:59] Dr. Andrew J. Sauer: [00:17:59] problems. [00:18:00] So she was coming out of her graduate school at the same time as the economy was really scary and.

[00:18:05] She took a job, very courageously working in South Chicago, uh, with, um, kids in gangs. Her job was to try to mentor kids. This is South side, Chicago. All right. All the violence. Um, and here she is blonde hair and white girl walking into. Really a community of kids who were in gangs and she had this 1999 Honda civic that ended up starting on fire that year.

[00:18:32] We had to get rid of it that could barely get through yeah, the inner city of Chicago. And she fell in love with these kids. And she had a passion for what she was doing. She would have to go to court to advocate for kids who had just, you know, been part of an assault of some other kid in another gang and explained to the judge why?

[00:18:51] Well, this was an assault. Yes. But the kids were retaliating for the brick that got thrown in that kid’s mom’s house. [00:19:00] And it’s, it’s, it’s, it’s a world that we, most of us don’t understand and certainly with my wife and I, uh, She, and I grew up in a very, um, whitewashed, you know, very protected kind of, you know, sheltered community that didn’t see diversity and, you know, and it doesn’t make it bad.

[00:19:17] It’s just the world we grew up in. And so for her to jump into that world, um, all I’m trying to say is that this was something really important to her. And when she made the decision to, you know, kind of stay at home, she did that for our kids and for our family. And I have to recognize that there’s been times in our, in our career together where she’s made sacrifices that I didn’t have to make.

[00:19:40] And so part of even my recent decisions to sort of step back from some of my leadership roles have been. In a sense, just saying, you know, I need to make good on my commitment to you, right? That this isn’t going to be just about my career or my goals. She wants to go back to work someday. You know, our kids are so young right now that she kind of feels that she’d like to have them become school aged, [00:20:00] all three of them.

[00:20:00] And we’ve got a two year old now. So we’re still a ways from that. But I think that if I’m really going to make good on my commitment to be a partner. I need to recognize that there’s going to be some things that I’m going to have to set back and put and push aside for me too. And so one of the challenges I think with any partnership and including marriage is you have to have reciprocity and how you negotiate, you know, the agenda for your life.

[00:20:25] What is your family life mission? Do you do have a sense of where you’re trying to go? Um, because if it’s all about the Andrew Sauer show with her off on the side, uh, best not going to create a egalitarian, you know, relationship built on true love and true reciprocity. Um, and, and to be fully transparent.

[00:20:46] This has been a struggle for us. And it’s been a point of conflict and point at times where I think she’s had to find ways not to be become resentful to me because it hasn’t been balanced over the last 10 years. And so, [00:21:00] in a sense, I’m trying to pay that back and it’s, and I, and I want to. And I’m learning, like if we want a healthy relationship for many more decades, then we’ve got to work on how to make sure that there’s, there’s two people who are prioritized.

[00:21:14] And so I’m, I’m a confessed learner of what. Uh, marriages. I am not going to try to tell people that I’ve got that figured out. I think that as you want to know about how marriage works, ask someone who’s been married in 50 years, I’ll try to dig into, you know, how did you do it for 50 years? Because the truth is I’ve got it a decade, a little bit more than a decade that doesn’t make me at all accomplished.

[00:21:38] And there’s been some. High seasons and there’s been some loads, seasons. And, um, you know, I think parenting creates another dimension that can be very refreshing and bring a lot of positive things to marriage. But the truth is we don’t really talk about this because it feels bad to say, but bringing kids into your, in your life is really hard on marriage.

[00:21:55] And, um, How do we talk about that? You know, because it takes the time that was [00:22:00] already so limited and divides it in any way in smaller spaces. And then to take it on top of that, how do you take time to make sure you lead yourself well and take care of yourself. I’ve said this before on social media, self care is not selfish and we have to be willing to talk about the fact that if I need 30 minutes of exercise, everything, which is a recent thing I’ve been doing better.

[00:22:22] That isn’t about me taking care of me for the selfish reason. That actually makes me a better dad, a better husband, a better professional, because if I don’t take care of my body and take care of my brain’s need for the correct endorphins and dopamine hits, then I’m going to turn to the bad. Dope amine kits, you know, and turn to alcohol or turn to work addiction.

[00:22:43] There’s so many things that our brain craves, and if you can fill those cravings with healthy things, uh, I’m learning. That’s what really, what balance is really about is trying to find those healthy hits, uh, to make us feel purposeful and valuable in our area, in our, in our pursuits. [00:23:00] Um, as opposed to the things that are detrimental and can be destructive.

[00:23:03] So, I don’t know if that really helps answer your question, but Oh no, it’s my best attempt at trying to no, no,

[00:23:08] Omar M. Khateeb: [00:23:08] no, no, no, absolutely. Absolutely. I think that the most important things, people need to hear these things, you know, and again, it’s, it’s a lot of things that nobody really wants to talk about, but either as a service and I think this is the positive things of, let’s say social media, there’s a plenty of negative, but as a society, You know, either we continue going on where each person individually figures this out, this out on their own, or we create this sense of, um, um, uninhibited like public mentorship where people can read and just reading something like what you just said or hearing it is enough to get somebody to say, I never thought about it like that.

[00:23:47] And I think the most important thing is that with, you know, a physician like yourself, Is that you’re helping fit people with new glasses. And when you fit people with new glasses and you see the [00:24:00] world a certain way, you can’t unsee it again. Right? So the idea that, you know, admitting that you have weaknesses admitting that you fail, admitting that it’s a process that you’re always learning is a huge weight lift off of water.

[00:24:12] A lot of people’s shoulders. And the amazing part about this. I don’t believe in separation of work and personal life, because you have to have, you have to be happy in both. Otherwise it’s going to leak into the other, but the beautiful thing about this, and I’ve, I’m sure you’ve seen this in your life, finishing it in mind is that when you work on it in one area, it enriches and nurses everything else.

[00:24:32] So

[00:24:33] Dr. Andrew J. Sauer: [00:24:33] your ability to be a good partner with your wife,

[00:24:34] Omar M. Khateeb: [00:24:34] I’m certain has resulted in you being a great leader in your

[00:24:38] Dr. Andrew J. Sauer: [00:24:38] hospital

[00:24:38] Omar M. Khateeb: [00:24:38] with your colleagues, et cetera. Would you agree?

[00:24:42] Dr. Andrew J. Sauer: [00:24:42] Well, they bleed together for sure. The moments where things are not going good at home. I’m not the best professional. I mean, there’s no doubt they correlate exactly and overlap.

[00:24:51] In fact, sometimes when I see people on my team who are clearly having a hard time, I’ll say, let’s, let’s talk. And one of the first questions I ask is what’s going on at [00:25:00] home? Can we just talk about it? Because if, as a leader, as exactly as a faculty, a mentor, to some of the faculty and I, and I’ve got other people that mentor me, you know, when things are.

[00:25:12] Going well at work, sometimes there’s something going on at home that needs to be privately, at least acknowledged so that we can figure out how to help with that. I’ve seen that a lot of times in my own career and in those who are responsible for mentoring, you know, when I just ask them the hard question of.

[00:25:28] Can you tell me what’s going on at home. Sometimes you find out that there’s some major stuff going on and I don’t even know the details. And that’s the other thing is just as we try to find kindness for each other in the workplace, when you look at somebody who. Is acting a way that you can, we can all agree.

[00:25:45] It’s didn’t right. Isn’t professional. Isn’t appropriate. If you could step back and just ask, is it possible that this has nothing to do with me? Is it possible? Is it possible that this person is acting this way? Because there’s other things that [00:26:00] are consuming how their brain is processing and, and. Maybe I can just step back and be a friend and it just it’s it’s empathy.

[00:26:09] And it sounds trite to say it means having empathy for others, the ability to consider what it’s like to be in someone else’s position requires that you actually know their position. To actually even consider that. And most of the time we have no idea what that person is going through for all kinds of good reasons and privacy and things like that.

[00:26:30] So I think sometimes leadership and being good professionals and being good colleagues with each other is recognizing that the stuff going on at home always bleeds over to the work and the stuff going on at work always bleeds into what’s going on at home. You know, one of the reasons why five years for me as a transplant director has been enough is because there’s a real psychological burden that comes with carrying the load of all the regulatory responsibilities that come with transplant.

[00:26:58] And the truth is I was having a hard time [00:27:00] sleeping at night, worrying about the program. Like it’s one of my children. And that’s an honest confession that I’ve talked about publicly, that I’ve talked about here that talked about at home. And the reality is it doesn’t matter how good of a job we’re doing.

[00:27:12] I’ll never be satisfied and thinking that we’ve done enough as a leader, if even one patient is hurt. Uh, in a, in a way that could be prevented by me as a leader. And so when your, when your name is on the program, you feel this responsibility for everything that happens in the program, even when you’re not even there.

[00:27:31] And what I realized is that this was coming home with me. And I would wake up in the middle of the night and I wouldn’t have to go sleep in another room because I couldn’t sleep and I’d be waking her up and she’d be like, what’s the deal. And I go, I don’t even know how to explain it. I’m just worried.

[00:27:45] And I’m just stressed and I’m just, I kind of consumed by the different challenges we’re facing as a program. And, and I said, you know, I don’t know that I’m ever going to be able to get beyond this for as long as I’m holding. Uh, the sense of responsibility [00:28:00] for all of it. And so learning as a, as an internal review of myself as a reflection is that this was going to have to come to an end at some point.

[00:28:09] And so we recognize that as a family, well, before my organization, nice that I was going to be doing that. And I think that’s, that’s the bottom line of smile. The true boss is the boss at home, which is not just my wife, but it’s the boss. I look at it in the mirror. That’s who you answer to. You know, you can’t look at your life as I answer to my employer.

[00:28:30] And that’s what I do know. You answer to yourself first, your family second, and you answer to your employer third. And if your employer and their expectations of you is not in line with your family mission, you’re in the wrong place. And maybe you just need to reconstruct what the job looks like for you.

[00:28:48] That doesn’t mean you’ve got to leave. That doesn’t mean he got abandoned, abandon your employer, but you do have to be willing to have hard conversations and say, This isn’t really within the realm of what I’m trying to do. And I think we have to resolve this [00:29:00] boundary conflict and figure out how to go from here.

[00:29:03] Um, because you’re never stuck. Anybody who says they’re stuck is playing the I’m stuck. I’m a victim card. And I don’t know why you gotta be a victim of what you created in your professional career. You can choose something different either internally within your own organization. Or elsewhere, it all begins with your why, your purpose, your family mission.

[00:29:24] So that’s, that’s how I’m thinking about it. I didn’t get there yesterday. This has been a process and, and so much of my career has been accelerated on hyper-drive for the last five years. I’d like to say sometimes the next five years, I’d like to maybe go the pace that you’re supposed to go at 39 and not be in the hyperdrive pace.

[00:29:41] And that’ll be an accomplishment in and of itself. If I can pull that

[00:29:44] Omar M. Khateeb: [00:29:44] off. No, absolutely. I hear you sometimes. Sometimes it takes life, um, to kind of remind about what’s important. And I love what you said earlier in this interview about when you’re on your death bed, are you going to feel better [00:30:00] that you published X amount of more papers or one on podium, you know, or you know, or, or, or the kind of family that you built.

[00:30:07] And I think that the, you know, the one thing theme that I’ve noticed, you know, in your posts and, and I was expecting in this interview is that. You have the sense of curiosity and ability to ask? Very good and hard questions. I think that the quality of her life is reflected in the quality of questions you can ask.

[00:30:23] You can ask yourself, like, will

[00:30:25] Dr. Andrew J. Sauer: [00:30:25] I actually be a lot happier if

[00:30:27] Omar M. Khateeb: [00:30:27] I go for this position or I do these kinds of things, because those are the questions. I think a lot of people don’t really want to ask themselves because if they really dig in, they realize that they’re chasing things to impress people that they never liked to get things that they never really wanted.

[00:30:43] And then they spent a whole life doing that and they look back at their life. Oh my God. I didn’t know. Spend any time with my children. I could have been a much better spouse.

[00:30:53] Dr. Andrew J. Sauer: [00:30:53] And I think that

[00:30:54] Omar M. Khateeb: [00:30:54] especially I’m coming, you know, talking from Silicon Valley,

[00:30:57] Dr. Andrew J. Sauer: [00:30:57] there’s plenty

[00:30:58] Omar M. Khateeb: [00:30:58] of stories here in the [00:31:00] Valley of this thing of, you know, uh, entrepreneurs and billionaires about sacrificing family lines and everything.

[00:31:07] That’s fine for them, but that should not be the standard that we look to do in this country. Me personally, I’m a first generation American. I’m very proud to live in this country. We also have responsibility as, I mean, you’re a father. I’m going to be a future father, not soon, but you know, soon enough, um, then we have to be good parents and leaders in our community because we’re essentially nurturing and developing the next generation.

[00:31:32] That’s going to make. Our communities better make the world better, et cetera. So that’s part of our responsibility. It’s not the selfish responsibility of just individual, uh, individual goals and career, you know, so I think that the way he discussed and combining those things is, is really quite inspiring.

[00:31:48] Um, you want to shift and then just, you know, cause I think I it’s something that I know that a lot people are interested in hearing more about, but you know,

[00:31:56] Dr. Andrew J. Sauer: [00:31:56] Todd, tell us a little bit about

[00:31:58] Omar M. Khateeb: [00:31:58] some of the big things that have [00:32:00] happened at youth program. I know that in a year of COVID I think last month you guys did over 23 heart transplantations,

[00:32:07] Dr. Andrew J. Sauer: [00:32:07] which is

[00:32:07] Omar M. Khateeb: [00:32:07] remarkable, but talk to us a little bit about some of the things that you guys did in the program.

[00:32:13] What’s what’s your vision for it?

[00:32:15] Dr. Andrew J. Sauer: [00:32:15] Yeah, one of things we’re proud of here is we didn’t know what was going to happen with Kobe, just like nobody knew. Um, and just like every program across the country, when. When, when institutions stopped doing elective procedures, we did as well. The pandemic had not really reached Kansas or Kansas city the same way they had reached the West or the East coast.

[00:32:37] And so here we are in March and April shutting down elective procedures, shutting down clinics. Converting everything to telemedicine. At one point we had 90%, one of our encounters, uh, today’s converted to zoom meetings. Um, and we were able to do that. Cause we were already doing telemedicine. We have a large state geographically.

[00:32:57] And so with our, with our [00:33:00] outreach efforts, we had already been doing telemedicine and we were ready to go. This, the pandemic just converted the financial and economic Michael, uh, gears that needed to be converted so that this could be, you know, scaled. And, and I am very proud of our system. We scaled up to telemedicine within two weeks, really?

[00:33:18] And that was system-wide that wasn’t just cardiac. It wasn’t just heartfelt. It was every disease. Every specialty was. All in on telemedicine. And then we did it like everybody else did we shut down our elective procedures. We stopped doing just about everything, but emergency care because nobody knew what was going to happen.

[00:33:34] But we sort of sat on the ground here in Kansas and Kansas city waiting for the surge. And it never really hit us at that time. We’re sort of still in it. Now we were sort of like the final, the final region of the country to get hit. And we’re still being hit. We have still an 11 or 12% test positivity rate.

[00:33:50] We were just still higher than what they see. A lot of other places. Um, and so we’ve never really had those big surge, but we’ve had this kind of smoldering burn that has never [00:34:00] ended. And yet we’ve had to learn how to do our work. And so some of the early signals unfortunately showed that what we suspected, which is patients were avoiding care with hard flare.

[00:34:09] They were avoiding care with their, with their heart attacks and their myocardial infarction. There was sun desperates. We saw this in New York. There’s a lot of deaths that weren’t COVID deaths that were deaths due to avoiding or delaying care. And so we realized pretty early on, I would say behind that April, you know what we got to get back to it.

[00:34:26] We can’t really just sit here and wait for bad things to happen. So we started proceeding and I think that it was courageous of our teams to recognize that there are safe ways to deliver care. Well in the middle of a pandemic. And so in may, we did five transplants in July. We did five transplants in August.

[00:34:44] We had four transplants, we’ve done seven to 11 VADs every month. This time, you know, we’re now at a point where we’ve done, I think just shy of 40 VADs and just shy of 30 transplants anywhere September. And this is a program that last year 23 [00:35:00] transplants and 40 VADs give or take for the entire year. And so.

[00:35:04] I think part of this has been our courageous charge toward, you know, what the patients still need care and they got to land somewhere. And what if they land? What if they don’t make it to us? And so if they’re going to be here, we’re going to take care of them. And not one transplant patient has contracted COVID.

[00:35:19] We had one patient who, yeah, we had one patient who contracted COVID. As she was about to get transplanted and we were able to safely delay her transplant, let her kind of recover, make sure she tested negative. And then two weeks later we transplanted her. That’s

[00:35:34] Omar M. Khateeb: [00:35:34] unbelievable.

[00:35:36] Dr. Andrew J. Sauer: [00:35:36] Yeah. So innovation is required here and courage and being willing to take on the team load because the big struggle we’re facing now is.

[00:35:43] The volume has somewhat exceeded our capacity as a team to feel like, to feel at least like we can really, you know, always feel we got all our hand handle on and all the pieces that are firing, but the system and has continued to provide the resources we need. And we continue to [00:36:00] have exceptional outcomes.

[00:36:01] We’re very proud here at the university of Kansas health system that we still have the nation’s lowest length of stay. For index implant, hospitalization for that as well as index hospitalization, the transplant. When you look at all the Visiant, um, Peers on academic medical centers and people have asked, how are we doing that?

[00:36:18] And that’s a complicated question, but there’s a lot of strategy that goes on. And we believe that when you set the pace for the implant or the transplant with the right kind of set up, uh, the surgical outcomes are more likely to be successful. And the longterm outcomes are likely to be more successful when patients go home earlier with less complications.

[00:36:37] And initially a lot of people said, well, you guys are small and you’re not really doing that much volume. And it’s. You’re just, you know, more resourced than your volume. And so that’s how you’re doing it. But when you’re getting into the 50 bags a year and 30 to 40 transplants a year in volume, you’re now in a combined volume in the top 10, 15% in the nation.

[00:36:54] So it’s kind of hard to say that we’re cherry picking our way through good outcomes at this point. You know, it’s really [00:37:00] something special about our team and that’s, that’s what we’re trying to get the message out about.

[00:37:04] Omar M. Khateeb: [00:37:04] Yeah. And I think, you know, one, you know, and I see again, I. It’s not just you there’s, there’s, uh, you know, dr.

[00:37:11] Carter, dr. Wallace, dr. Flinders people that I’ve spoken with Kansas, and, you know, at least paying attention online. I love about the culture that yeah, I’ve seen so far in caves. Medical center

[00:37:22] Dr. Andrew J. Sauer: [00:37:22] is very,

[00:37:23] Omar M. Khateeb: [00:37:23] very entrepreneurial and startup. And part of it is just a sense of curiosity, how we can do things better.

[00:37:29] And I, I hope that more medical centers can be inspired by that, because again, You know, in the startup world and in Silicon Valley. Yeah. There’s plenty of the companies where you can say, Oh, they have more resources. They have less than everything. But the best part is to put those things away and say, yeah, maybe those variables are at play, but we’re still curious, how is this company or this person executing on these things because you can always learn.

[00:37:52] And the mental model you have in your head. Even if it’s 99%, right. There might be that just 1% you can get that from somewhere that just adds and makes [00:38:00] it better. And I think that Kansas is a great example of, of an institution doing

[00:38:03] Dr. Andrew J. Sauer: [00:38:03] that. Well, we have a culture here that I think were mission focused.

[00:38:08] You know, our mission is to see every patient in Kansas and the Kansas city Metro have access to the very best hard Fedor therapies available any or in the world. That’s on my website, that’s on my social media page. I talk about it all the time. It’s when you have a mission, when you have a, why you let that guide everything you do from down and below as to how you’re.

[00:38:27] How do you structure your teams and then also what projects you take on? So if you look at the things we’ve done in innovation research, remote monitoring has been an area where we’ve been national leaders. We’re the number one enroller for the pivotal guide heart fire study with avid on CardioMEMS in terms of total enrollments in both the single arm and the randomized arm.

[00:38:46] We hope to see data coming out in 2021 with some of the preliminary results from that. Trial, um, you know, people didn’t expect us to take that space, but we did. And we did because it fit our mission. Our mission is to cast as [00:39:00] wide net over the state of Kansas and remote monitoring is great technology for us to leverage, to help our patients.

[00:39:06] Um, you know, we’re looking at innovations in the, in the acute, uh, hardware space. We’ve been one of the first sites to do, um, The innovation in and looking at central venous hypertension, looking at how cardiorenal syndrome works, you know, partnering with Nevine coupler. Who’s who’s most well known for door to unload with the Impella mechanical circle tours or device, and, and much of what he’s doing in the basic science space in that.

[00:39:31] But, but we also one of the first studies to implement an early feasibility device, um, you know, looking at the Procardia device, which is really an innovative, innovative way to look at mechanical unloading and cardiorenal syndrome. I know we’ve been talking with you guys in Portrero about some opportunities looking at what’s going on in the bladder and looking at, uh, the different technologies in the cardiorenal space.

[00:39:52] And so, yeah. I think there’s a lot of opportunity for innovation and sort of what our niche is sort of, not necessarily at the [00:40:00] primordial stage or the bench stage. Although we do have some bench research going on in my group now we’re excited about doing pragmatic, you know, real world questions that fit our population that fit our mission.

[00:40:12] And then we try to scale things that other people. And maybe not have the appetite to scale or programs, ultimately don’t know how they’re going to scale. And one way we do that as, since we’re such a team focused group, you know, we sort of, kind of decide as a group, what we’re going to take on. And if we take it on, we tend to be able to scale in ways that other centers can’t.

[00:40:32] Quite easily do because we’re all kind of rowing in the same direction. Um, and that’s sort of, again, another thing that makes us unique, because how do you do the things we’ve been able to do, um, in Kansas where there hasn’t historically been as much resources. They’re just, they’re just, yeah. Art is, is, you know, a very, um, you know, Medicaid here in Kansas is like the poorest Medicaid in the country and it’s up there, you know, we don’t have.

[00:40:54] Bottom was put a cash. Uh, we don’t have the ivory tower brand, uh, at this point. [00:41:00] Um, so how are we doing this? I’ll say it in one word team, we actually sit down and come up with an agenda as a team, without a dictator telling the team what we’re going to do. And people kind of say, you know, let’s find consensus on this and we’ll go do it.

[00:41:16] And then we. Say, since we used agreed, we were going to do this, we’re going to do this. And we do it at every line. So all the physicians in my group, all the nurse practitioners, the VAD team, the transplant team, we kind of wrote together. We’re like any big family. We have our fights and our conflicts and our spats.

[00:41:31] And we have our personalities and our personality, borderline personality disorders that anybody can have, you know, but we’ve got, we’ve all figured out how to kind of work around that and come together. When, when big decisions are about to be made.

[00:41:45] Omar M. Khateeb: [00:41:45] That’s really, really inspiring to hear. And I think again, you know, I think I keep going back to it that there’s this

[00:41:52] Dr. Andrew J. Sauer: [00:41:52] startup

[00:41:53] Omar M. Khateeb: [00:41:53] mentality there.

[00:41:54] And what I mean by that is, you know, I love that you use this idea of team because you know, [00:42:00] my, my greatest mentor who is a giant in the world of surgical robotics, uh, he was at intuitive surgical and Missouri. His name is Chris sells. You know, his thing when it came to team is that he wanted a very diverse.

[00:42:13] Team in terms of people who have a bias towards leadership, people are biased towards finances, towards marketing. So then when you have all these people looking at one problem, you have a variety of ways of solving it. And I love that you guys are able to do that at KU because without the oversight of, let’s say, you know, you know, executive, you know, influencer or anything, people have the freedom to really say what, what might be a good idea.

[00:42:39] And there might be someone who’s very junior. Who sees that one thing that everybody is else is not perhaps seeing. And I think that’s really valuable. Um, we, we have, you know, I’m trying to be very, uh, good on time. Cause I know that you have, you have meetings, so we gotta. Little about 10 or 11 minutes left.

[00:42:56] So what I would like to get into, cause I know that if I don’t get through [00:43:00] some of these questions, my audience is going to be really upset with me. So we have this rapid fire question. So I’m going to ask

[00:43:04] Dr. Andrew J. Sauer: [00:43:04] you a question.

[00:43:05] Omar M. Khateeb: [00:43:05] You can answer it as quickly as you’d like, or you can take as long as you’d like for it.

[00:43:09] Dr. Andrew J. Sauer: [00:43:09] Does that sound good? Yeah. Well, okay. I’ll try to be quick since it’s rapid fire. Yeah.

[00:43:13] Omar M. Khateeb: [00:43:13] So, so the first, first question is you mentioned your, your, your great, great mentor. Who’s who’s a giant in the field of cardiology. What was the most painful yet? Memorable thing he’s ever told you?

[00:43:27] Dr. Andrew J. Sauer: [00:43:27] Well, I’ve got a couple of mentors like this, but in particular, he was willing to tell me that I wasn’t cutting it.

[00:43:34] You know, he was willing to tell me the hard critique, you know, get out the red pen and paper. Uh, and you know, so how many rounds of manuscript review I went through for that first paper in my career, which is still my most cited papers, probably my best paper I’ve ever written.

[00:43:50] Omar M. Khateeb: [00:43:50] I wish there was that

[00:43:51] Dr. Andrew J. Sauer: [00:43:51] paper called by the way, long QT syndrome in adults.

[00:43:55] I’ll leave that in the show

[00:43:56] Omar M. Khateeb: [00:43:56] notes for people to look up.

[00:43:58] Dr. Andrew J. Sauer: [00:43:58] Yeah, 2007 in [00:44:00] Jack. And it’s an important vapor because it’s the first time that the adult subset with a, not a rare, totally rare genetic disease, but. Um, you know, long QT syndrome is relatively uncommon, but it was the first time the adult population had by itself and looked at and describe in terms of how patients do based on their genotype and their phenotype.

[00:44:20] Anyways, the reason I referenced this is because that paper must’ve been revised 50 times over a summer and he could have done the easy thing he could have. It would have been much easier for him as my mentor to say, You know, let me just take this and finish it and we’ll get it across the finish line.

[00:44:37] But he forced me to continue to address his problems with my writing style or with the way I was approaching the presentation of the data. And I was a second year medical student, right. So I had a resident. Yeah, I had no idea what I was doing. And so it would be and much easier for him to get this. He knew this paper was going to be important.

[00:44:58] It was his paper, but [00:45:00] he forced me to take ownership of it to be accountable to it and to take that first author position, he expected me to do the work and so good mentors, not only see you for what you could do and see you for your potential. But they walk you through how to get there and go to the next level.

[00:45:16] And they don’t tell you what you want to hear. They tell you what you need to hear and see. So, you know, I can reference Chris at mass general, I could reference Sanjeev Shaw at Northwestern. These were two other people who, the same qualities, they would just not accept me for being mediocre when they knew I could be.

[00:45:36] Excellent. And, you know, and if you’re going to be mentored, you have to be willing to be humble enough to take those kind of critiques. And sometimes they can be scathing and can be harsh and can even leave you in an emotional distraught position for, for a few hours. But that’s the best thing you can get from your mentor is the hard truth.

[00:45:58] And so if you’re [00:46:00] asking for advice for how to find a mentor, find someone who tell you the truth about yourself, who sees you for your value, but asks you to go that much farther and shows you the way those are the people that you have to attach to. And if you look at me as a success, and I don’t know that that’s the case, but if you look at me as a success, ask yourself, how did he get there?

[00:46:18] And I’ll tell you. Mentors is how I got here and listening to the people in my life who gave me the heart advice I needed to hear and really taking that into consideration because. That’s how you, that’s, how you rise in the, in this society where people are constantly shaming and putting guilt on you or telling you things that are really based on their agenda and not what’s best for you.

[00:46:39] Gotta be very careful with the advice you get. So find the right mentors and you’ll find a pathway. Absolutely.

[00:46:45] Omar M. Khateeb: [00:46:45] And I’m just going to reiterate what you said about, you know, the, the importance of finding mentors, especially for all the medical students and residents who are listening and some of whom I’m talking and trying to guide a little bit.

[00:46:55] Get on LinkedIn, get engaged and be seen because you can get access to some of [00:47:00] the greatest mentors you, your wildest dreams can think of just because you’re on there. And very few people decide, Hey, I’m going to message him and see if I can. Yeah, I’m on the phone for just five minutes for advice. I think that’s such, such a good, good guidance.

[00:47:13] So next question

[00:47:14] Dr. Andrew J. Sauer: [00:47:14] I have for you.

[00:47:16] Omar M. Khateeb: [00:47:16] Um, is what book do you gift to other people most often and why?

[00:47:23] Dr. Andrew J. Sauer: [00:47:23] Um, the first 90 days is one of them. Um, and I think, you know, That is a great book. If you are a transitioning in the leadership role or if you’re changing settings or if you’re changing leadership role. And there’s a lot of really pointed advice coming out of Harvard business school, basically, you know, talking about the science behind what defines success in leadership and how the first 90 days of any leadership role, uh, you have to have a different strategy than what you would be on 90 days.

[00:47:53] And certainly by beyond whatever position you’re in, um, Another book I like is, [00:48:00] um, uh, you know, in terms of gifting, I’m, you know, I’m big fan of, um, you know, some assignments and stuff, you know, in terms of finding why, um, again, Bernay Brown on talking about, um, you know, dare to be brave. And these, these are the kinds of things that I would, I would recommend.

[00:48:18] And I like to read diverse type of, uh, of collections. Jim’s, you know, I think it’s good to pick up a few classics on occasion right now. I’m rereading the old man in the sea, you know, and the long drawn out story of really not a giant fish. Um, and then reading about how earnest Hemingway actually, and live that life in Cuba.

[00:48:39] You know, and there’s a lot of symbolism in that book, you know, and again, people think, Oh, what can I learn from a classics? But I, I’m a big fan of picking up a couple of those. Um, you know, Peter Drucker, I’m a huge fan of his work. And a lot of the stuff he did, um, as one of the fathers of management and he has a lot of good one liners, you know, and things that aren’t necessarily his, but I think he made big [00:49:00] and made branded like, you know, first things first, I’m a real big fan of that.

[00:49:03] You know, nothing is really more important than that. First thing, the second things are second for a reason. And so really, if you just fill your day with first things, you know, there’s plenty of those hanging around and you’ll be able to organize your day in a more logical way.

[00:49:17] Omar M. Khateeb: [00:49:17] No, absolutely. Absolutely.

[00:49:19] And I think that’s a great, I’ll leave these, uh, the links for some of those books in the show notes, but yeah. Uh, I think reading is such an important thing. We, we benefited, uh, both you and I from. Learning how to read very effectively and efficiently through medical school. But I think it’s such a powerful thing.

[00:49:34] And I mean, I’m talking from my life. There’s so many books that I purchased and read many years ago that I got something out of and I reread them and I got a whole lot out of it. So they have that magical quality. Yeah. So my last question for you before you go, is this, I want you to imagine that.

[00:49:51] Dr. Andrew J. Sauer: [00:49:51] Throughout the United States

[00:49:52] Omar M. Khateeb: [00:49:52] at every single hospital, there’s going to be a billboard for a whole year. And every single person that goes into that [00:50:00] hospital nurses, doctors, residents, patients are going to

[00:50:05] Dr. Andrew J. Sauer: [00:50:05] see this billboard,

[00:50:06] Omar M. Khateeb: [00:50:06] what message would you put on that billboard for that entire

[00:50:09] Dr. Andrew J. Sauer: [00:50:09] year? And this would just be for my institution for every institution,

[00:50:14] Omar M. Khateeb: [00:50:14] every single one.

[00:50:15] So this is your opportunity to. Um, see the idea and, and, and inspire action throughout the United States in the medical community. What, what, what would that billboard say

[00:50:27] Dr. Andrew J. Sauer: [00:50:27] and take your time?

[00:50:28] Omar M. Khateeb: [00:50:28] That’s a, it’s a, it’s a tough question, but to take, take your time to think that one,

[00:50:35] Dr. Andrew J. Sauer: [00:50:35] honestly, I think it would be why are you here? Um, I think. We spend a lot of time in the weeds, um, in our team meetings and our decision making meetings, um, when we’re even in the bedside care, uh, discussions that we have where we’re talking about sort of the, how and the what and the details and the facts, but at the core of every heart [00:51:00] decision needs to be the why.

[00:51:02] And so if you’re a patient, you see that billboard and you see, why are you here? Patients should be asking, you know, what am I trying to get out of this experience? You know, it helps when you talk to your physicians and your nurses and your care team, if you know what your goals are as a patient and equally as important, it helps when you’re trying to talk to patients about what you can do for them.

[00:51:23] There’s so many times where you’re like, are we doing this to you? Or are we doing this for you? And at the core of that, Detailed question is the why, you know, not everybody has the same goal. Uh, not everybody wants to live longer. I spent a lot of time with people who die, who have bad heart flare, who don’t want a transplant, don’t want advanced therapies.

[00:51:44] They don’t want to be in a trial. They may not even want to take some of the common medications. That doesn’t mean that they’re weird. They just have goals that are different than others. And so just being able to ask that question, why are you here? There was something really global about [00:52:00] that, you know, that I think as you’re walking into a, uh, to a hospital or into an institution, if you see that you think, and what am I doing here?

[00:52:08] Why am I here? What am I trying to get out of this meeting or out of this encounter? Um, cause I just think that’s something that’s really important to me is asking people, you know, I liked that word. I like that question because the motivation for doing things is sometimes just as important as doing things.

[00:52:27] Or not doing things. Absolutely.

[00:52:29] Omar M. Khateeb: [00:52:29] Actually, it’s a simple question, but definitely simple questions, reveal very

[00:52:34] Dr. Andrew J. Sauer: [00:52:34] simple solutions to

[00:52:35] Omar M. Khateeb: [00:52:35] very complicated problems. So I, I love that. I can think of a better way to wrap up. So, um, I’m going to leave in the show notes. How have you been finding, I know that your last name’s spelled S a U E R so people can find you on LinkedIn and on Twitter.

[00:52:47] What’s your Twitter handle?

[00:52:50] Dr. Andrew J. Sauer: [00:52:50] Uh, Andrew J Andrew J sour at, yeah, at Andrew J sour. Yeah. God, it’s my full name. Perfect. We’ll leave it in the show notes so people can

[00:52:58] Omar M. Khateeb: [00:52:58] follow you and check out more [00:53:00] of your posts and content really appreciate you coming on on, and sharing your story. And we’re looking forward to seeing you produce more inspirational content and things that really helped change the way people think and view the world.

[00:53:11] So thank you so much for joining us.

[00:53:13] Dr. Andrew J. Sauer: [00:53:13] Yeah. Thank you. And some of the questions were a little harder than I thought, but I was not fun. Meaning we’ll talk today. So thank you so much for your time.

[00:53:20] Omar M. Khateeb: [00:53:20] Absolutely. I know we’re going to have to have you back on soon, so definitely do that.

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