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High Acuity, High Purpose: A Journey in Interventional Cardiology

Interventional cardiology is a field defined by intensity, precision, and high stakes—but sustaining a long, fulfilling career requires more than technical excellence alone. In this interview, Dr. Jessica Birchem, Interventional Cardiology at Mercy Springfield, reflects on her path from training to private practice leadership, the pivotal decisions that shaped her career, and how she has built a high-acuity interventional practice while remaining deeply committed to family, personal well-being, and mentorship. Her perspective offers practical insight for fellows and early-career cardiologists navigating career choices in a demanding specialty.

Can you walk us through your career journey—from training to your current role—and the pivotal moments that shaped your direction?
I grew up in the Midwest, spending my early years in North Dakota and northern Iowa, and I initially envisioned building my entire career there. I graduated from Des Moines University and then moved to St. Louis for my internal medicine residency at St. John’s Mercy. I went on to complete both my general cardiology and interventional cardiology fellowships at Baylor Scott & White in Temple, Texas.

During fellowship, I was the only woman in my general cardiology class and became the program’s first female interventional fellow. I initially planned to pursue general cardiology, but early in training I realized how much I thrived on the acuity, complexity, and immediacy of interventional work. The challenge and impact were deeply motivating.

At the start of fellowship, my plan was to return to St. Louis. However, as I began interviewing—now as a new mother—my priorities shifted. Time became a central consideration. I wanted to maintain a high-acuity, high-volume interventional practice, but I also recognized that long commutes or coverage across multiple hospitals could significantly compromise time with my family.

During my Midwest interview tour, I somewhat unexpectedly interviewed in Springfield. At the initial interview dinner, Drs. Hawkins and Cochran articulated a vision that convinced me I could have both a busy, high-quality interventional practice and a sustainable family life. That balance ultimately drew me to Springfield, where I have now been in practice for nearly 15 years.

What does a typical day look like for you as a private practice interventional cardiologist?
My day usually starts early. I wake up at 4:24 a.m. to fit in a 5:00 a.m. workout, then review my schedule, make lunch for my boys, and head out the door. We often have 7:00 a.m. meetings, which seem to be increasingly frequent.

On hospital days, I try to round on my first outpatient cath patient and any ICU patients before the meeting. The remainder of the day is spent in the cath lab performing procedures such as right and left heart catheterizations, Watchman procedures, and other interventions. Tuesdays are our dedicated TAVR days.

Cath lab days are inherently unpredictable, particularly when STEMI activations occur. Throughout the day, we manage new consults, and between cases I round on inpatients and see consults alongside our APPs. On assigned days, I also read echocardiograms. Like most physicians, I work EPIC messages and administrative tasks into any available moments.

Beyond direct patient care, what additional responsibilities do you manage in your practice?
In addition to my clinical work, I currently serve as both the Cath Lab Director and STEMI Director, roles that allow me to focus on quality, systems of care, and team performance.

How do you maintain work–life integration in a field known for its intensity and unpredictability?
The intensity and unpredictability of interventional cardiology are part of what draws many of us to the field. That said, I’ve learned that balance does not mean perfection—it means setting boundaries and making intentional trade-offs.

I try to keep work at work whenever possible. Sometimes that means leaving non-urgent tasks for the next day or heading straight to a basketball game in scrubs so I can finish documentation later rather than bringing work home. This approach helps me be present for my family and for myself outside the hospital.

I also believe strongly in scheduling time for self-care, at least once a month. For me, that often means committing to an athletic event so I stay accountable to a training plan—currently, I’m training for a 70.3 triathlon. Learning to say “no” and accepting that I cannot do everything has been essential, even though it remains challenging. Finally, having a supportive tribe of family and friends makes all the difference.

What advice would you give fellows considering private practice interventional cardiology?
Do what you truly love. The hours can be long, but the work is meaningful, procedural, and often life-saving—and that sense of purpose will sustain you. Equally important is finding a group that shares your values and work ethic.

I am the only woman in our interventional group, but the support I’ve received from my colleagues has been invaluable from day one. We prioritize quality, collaboration, and mutual support rather than competition, and that culture has made all the difference in my career satisfaction.