Doctor grateful for gains made in for-profit health care, but looks forward to adding not-for-profit elements

Dr. Michael Ciccolo is director of congenital cardiovascular surgery at Children’s Heart Center of Nevada.

Dr. Michael Ciccolo, director of congenital cardiovascular surgery at Children’s Heart Center Nevada, has spent 19 years working to replicate the environment of care in Nevada that he enjoyed in Los Angeles, and with the opening of a 14-bed pediatric intensive care unit at Sunrise Hospital, he can proudly declare that mission accomplished. “Without a doubt, it is an invaluable resource for our community that many members of the community are not aware of,” Ciccolo said. “What a tremendous accomplishment for our home team.”

Describe your medical specialty and what makes it vital for our community.

Congenital heart disease occurs quite frequently, at about 8 in 1,000 live births. Some of these diagnoses are quite severe, very lethal historically and life-threatening. Many of these disorders require surgery or complex diagnostic workup in the early days of life or throughout childhood.

Essentially, all of these specialized physicians — congenital cardiovascular surgeons, pediatric cardiologists, electrophysiologists and fetal cardiologists — require a symphony of highly skilled personnel to care for patients with congenital heart defects. Children’s Heart Center Nevada has more than 100 employees.

The 14-bed pediatric cardiac intensive care unit that recently opened at Sunrise Hospital allows the highest level of care and organization for these patients.

This is quite a milestone. Because congenital heart disease is so common and so serious, this unit is either full or nearly full all time.

What sets your practice apart?

Pediatric cardiologists are in a specialty that requires 14 years of education after high school, including four years as an undergraduate, four years as a medical student, three years as a pediatric resident, and three years as a cardiology fellow.

Since Children’s Heart Center Nevada is primarily made up of pediatric cardiologists and pediatric heart surgeons, we have a practice of highly specialized and highly focused doctors. We treat patients of all ages with congenital heart disease.

Our practice is a monopoly serving patients all over the state. Our pediatric cardiology center boasts 18 pediatric cardiologists and 2 certified congenital cardiovascular surgeons. We are the only practice in Nevada that provides coverage for congenital heart defects.

When did you know you wanted to be a doctor?

I grew up in Iowa City, Iowa, which is the home to the University of Iowa in a community of about 75,000 people. They have a large, pretty old, well-funded medical school. I knew from a young age that I wanted to be a physician. Many of my neighbors worked for the university. Really, University of Iowa was the main employer, as those Big Ten universities are throughout their Midwestern communities. So many of my early role models were neighbors’ dads or moms who were physicians of varying specialties. They served as an impetus to me becoming a physician, particularly a specialized physician.

What brought you to Las Vegas?

Opportunity — the opportunity to have relationships with the right kind of pediatric cardiologists with whom I knew we could build an excellent practice in a rapidly growing community with increasing health care needs.

What challenges come from the local health care industry on both sides of the stethoscope?

There are always challenges within any medical community, whether it is in Iowa, Los Angeles or Las Vegas. One universal challenge is that philanthropy, which supports high-quality health care through endowments and grants, is not easily possible in a for-profit environment.

There are certainly advantages of the for-profit system. We have actually built a very high-quality system within it. However, we will reach a point where it will be necessary to have endowments and philanthropic endeavors in order to bring health care up to the standards that Nevada deserves. In not-for-profit systems universities and large institutions control the landscape, as in Los Angeles. Here, our universities are younger, and it is going to be a while before they can begin to provide the type of specialized physicians that we need to run specialized care.

We at Children’s Heart Center Nevada are physician-owners and stewards who have chosen to work to maximize profitability in order to allow us to set up a university-type practice with all the relevant specialists. We have willingly dedicated our personal incomes to the development of highly advanced health care. However, we will eventually reach a point where philanthropy, endowments and charity will be needed to bring us to the next level. These are the challenges we wrestle with regularly within both the for-profit and not-for-profit systems. This is something that I think about a lot.

What is the best professional advice you have received?

Dr. Tom DeMeester, who was the chairman of surgery at Keck School of Medicine at the University of Southern California, used to tell all the young thoracic surgeons to focus on some aspect of thoracic surgery. Because when you focus on things, you can bring up the quality, and when you bring up the quality, the finances should be there to support you as the patients will be there if it is an important area of study.

Another bit of advice that I think of sometimes is from Ted Turner, the founder of CNN, who said, “Early to bed, early rise, work like hell, and advertise.”

How might an overhaul of health care at the federal level affect what you do?

Any federal overhaul that affects our funding threatens the quality of health care we are able to deliver. If federal support goes up, organizations such as ours are going to use those resources to provide additional care. If federal support goes down, quality may go down. This is a persistent concern.

What is your dream job outside of your field?

My dream job, and this may sound a little bit crazy, would be as an independently wealthy hedge fund manager and investment banker who becomes a philanthropist and focuses on the needs of Southern Nevada.

Whom do you admire?

I admire Dr. Martin Luther King for what he achieved against all odds with courage and decorum. He made quite a contribution to the betterment of American society.

What is your biggest pet peeve?

My biggest pet peeve within health care is the deceptive marketing that either implies quality that may not exist or directs patients when they are looking online at websites that serve large referral institutions.

Where do you see yourself in 10 years?

I hope I will still be working at Children's Heart Center, treating patients with congenital heart disease as well as educating and mentoring the bedside health care staff in Southern Nevada. Also, hopefully I will be working a little bit more with residents and medical students from one of the medical schools here. Mostly, one additional goal that I have is to develop a ventricular assist device and heart transplant program. My new partner, Dr. Juan Lehoux, who came here from New York City, has extensive training and experience in treating heart failure in adults and children, ventricular assist device and transplantation. My hope is that we can find some way to fund that successfully so those services can be available for this community.


This story originally appeared in the Las Vegas Weekly.