Articles
The Road Less Traveled: Interview with Rural Cardiologist Dr. Bryan Piotrowski
The healthcare industry is undergoing significant transformations driven by regulatory changes, technological advancements, and evolving patient expectations. These shifts are particularly impactful for cardiology practices, which face unique challenges in adapting to new models of care and reimbursement.
One of the most notable changes is the increasing consolidation in the healthcare sector. This trend is reshaping the way cardiologists operate, with many moving from independent practices to hospital-employed positions. Over 70% cardiologists are now employed by hospitals and health systems.
In this Member Spotlight article, MO ACC CONNECT interviewed Dr. Bryan Piotrowski. He is the founder and managing physician of an independent private cardiology practice based in Farmington, Missouri. Located approximately an hour south of St. Louis, his practice was established in 2016. With a foundation of three employees, the practice now boasts a team of 11 full-time staff, including two physicians and two nurse practitioners. Dr. Piotrowski performs a wide range of in-office testing, including ECHOs, vascular and nuclear stress tests, Holters, and MCOT monitors, while also making rounds at Parkman Health Center in Farmington. This balanced workflow of clinic-based care and hospital rounds has allowed his practice to steadily expand and continue providing high-quality care to the local community.
Commitment to Independence and Patient Care
Dr. Piotrowski's decision to maintain an independent practice in an era where many physicians are transitioning to hospital employment is driven by his passion for patient-centered care. He values the autonomy of being able to manage patient care on his own terms, free from the bureaucratic constraints often found in hospital systems. This flexibility enables him to practice medicine as he sees fit, ensuring that patient needs are prioritized and that his schedule is adaptable to both personal and professional demands.
"I love the ability to care for our patients how we want without the unnecessary bureaucracy and pressures from the hospital dictating management of patients and our practice," Dr. Piotrowski explains. This freedom is what has kept him committed to independent practice despite the economic pressures and challenges that come with it.
Navigating the Challenges of Rural Practice
Operating in a rural setting presents its own set of challenges, particularly when it comes to reimbursements. Dr. Piotrowski highlights that practicing in a rural community often means dealing with lower reimbursements, especially when competing with larger hospital systems. Despite these hurdles, he finds the rewards of practicing in a rural setting to be substantial, emphasizing the deep connections he can form with patients and the meaningful impact he can have on their lives.
"Practicing in a rural setting is extremely rewarding. The need and limitations in resources are often underappreciated, but we can make a real difference in our patients' lives," he shares. He feels that the bonds developed with patients in smaller communities are uniquely fulfilling, offering a level of personal connection not always possible in larger city-based practices.
Advocacy for Rural Healthcare and the Legislative Process
Dr. Piotrowski is actively engaged in advocating for rural healthcare, particularly through his involvement with the Missouri Chapter of the American College of Cardiology (MO ACC). He has met with local congressional representatives to raise awareness of the specific challenges facing rural healthcare providers, including issues related to reimbursement and talent acquisition.
"I think we need a stronger voice for positions in the legislative process," he says. "As healthcare providers, we often get caught up in our clinical work, but it's critical that we also advocate for the changes we need to thrive in an evolving healthcare landscape."
Advice for Aspiring Independent Practitioners
For those looking to follow in his footsteps and establish their own independent practice, Dr. Piotrowski offers practical advice: "Starting a practice is very challenging. You need to rely on experienced professionals, and I had to hire consultants to help navigate all the details involved." He also emphasizes the importance of building strong relationships with local hospital systems to ensure collaboration, particularly in rural areas where resources may be more limited.
"Stay dedicated to your patients and the community you serve. If you focus on your patient population and work hard, you can find success," he concludes.
Dr. Piotrowski’s ability to balance the demands of running a practice while ensuring that patient care remains at the forefront of his efforts is a testament to his dedication to the field of cardiology and his community. As the healthcare landscape continues to evolve, he remains committed to providing excellent care while navigating the challenges of independent practice in a rural setting.
