Matters of the Heart: Spotlight on Physician Services Group Cardiologist

As we approach the end of American Heart Month, we wanted to highlight a cardiologist in our Physician Services Group (PSG). Dr. David Swett, who began his practice at Austin Heart in Marble Falls, Texas, in 1997, is one of 426 cardiologists and 3,900 HCA Healthcare-employed physicians in PSG. Austin Heart is partnered with HCA Healthcare and our affiliate St. David’s Healthcare.

Dr. Swett, once named the physician with the highest satisfaction in the organization, discusses his experience as a cardiologist in his community in this Q&A. Read on…

What is the cardiology practice like at Austin Heart in Marble Falls, Texas?

It’s very busy – particularly since it’s a small community and people know you. You bump into people on the street, in the stores and whatnot, so you’re kind of always available. I like the small town atmosphere – the people are fantastic, everyone’s interesting…it’s a nice experience.

I’m available seven days a week and the practice is open five days a week. Currently, I am the only full-time cardiologist, but I have a very accomplished physician’s assistant (PA) also working here. Cardiologists from the central office rotate in and out, as well.

What is Austin Heart’s mission?

Its mission is to serve the community and provide high-quality cardiology care for a rural area. We’re about an hour and 10 minutes outside of Austin.

How does working in a rural community – less than 7,000 people – compare to working in a larger city?

You really get to know your patients, I’ll tell you that. You meet them on the street, you meet them in the stores, and chances are your kids went to school with their children…so you get to know them much more intimately and socially as well – it’s a completely different experience.

I’ve worked in a big city on the East Coast, and as many times as you’ve met your patient in the office or in a clinic setting, you never really sat next to them at the football or basketball games or shopped with them in stores. So it certainly is a different environment.

How many patients do you typically see every week?

Between my PA and myself, probably around 150 a week and that’s not including monitoring their heart conditions through devices such as holters (records heart beats), echoes (records/analyzes sound waves to create a moving image of the heart functioning) and nuclear imaging (produces images of the heart using radioactive tracers to help cardiologists diagnose conditions.) It’s actually a very busy practice!

What are the strengths of your practice?

The main strength of the practice is the model that the doctor lives in the community where he serves the people, as opposed to someone coming from 100 miles away to be in a clinic two or three times a week. So that’s the beauty of our practice, and I think, a large part of its success.

And the patients definitely know that – they know you live in the neighborhood. Patients even know where I live and have actually come to my house looking for refills on prescriptions. Yes, it’s unconventional, but it’s also part of the benefit of being here. They really recognize you as part of the community.

What do you love most about what you do?

The best thing about practicing cardiology are the patients. The patients are absolutely wonderful; they are appreciative, and it’s sort of a retirement area so there are a lot of older folks. They all have these marvelous stories.

I’m constantly coming home after work and telling my wife about someone I met at the office and, you know, a World War II veteran, a Korean War veteran or someone who has had some amazing experiences. I just saw an 85-year old lady who recently went cave diving in the Yucatan Peninsula. Amazing stories. That’s the best part!

What about your practice and patient-care makes it stand out?

I spend time talking to my patients about what we can do better: ‘Are we satisfying your needs?’, ‘What can we do for you today?’ We leave every patient encounter with a message saying, ‘If you need anything, just give me a call’ and ‘what can I do right now for you that we haven’t already addressed?’

Every corporation does patient satisfaction surveys and I took my model from Southwest Airlines. I think you get a different response if you have the captain of the plane standing at the exit way and asking people, ‘How was the flight?’ and, ‘Thank you for your business’, as opposed to getting an e-mail on your computer and asking patients to please rate our practice, you know?

We also hand out these little emergency cards with information on what to do in case of an emergency, how to get ahold of me, and how to deal with other physicians. We try to make those sort of things very personal and I think it pays off.

Touch on the importance of cardiology practices in the community and how they are changing lives on a daily basis.

One of the very interesting things that has happened in medicine in my career is the networking that goes on. I think it’s safe to say patients who live in Marble Falls, Texas – this small community on the hill country of central Texas – has access to the very best cardiology in the country by virtue of the fact we’re connected to HCA Healthcare, one of the nation’s leading providers of healthcare, and its affiliate St. David’s. We have instant communication by phone and computer with other experts at St. David’s in Austin, and patients have access to their high-quality care within a 15-20 minute helicopter ride.

That’s one of the things that’s been really transformative in the last 30 years of cardiology that I’ve witnessed, in that, rural towns really can have – if partnered with the right hospital system – high-quality care.

Is it a challenge to have work-life balance?

I think every doctor faces that balancing problem and everybody solves it in their own way.  But I think physicians in most practices know the job is all-encompassing, time-consuming and it takes a large chunk of your life. But that’s the commitment you made when you become a doctor. Many of my patients and doctors in the neighborhood, community and two neighboring counties have my cell phone number, as well as all of the emergency rooms. That’s part of the hardship, but the good part is I enjoy what I do, I have good partners, and I get to live in a very beautiful part of the country.

Is there anything else you would like to add about cardiology?

It’s a rapidly evolving subspecialty. It’s always exciting because problems you thought you couldn’t fix, six months later, you can! That’s one of the nice parts – being able to offer patients new therapies and treatment options.