Andrew James Hart, MD,
Place of employment: CBC Group: consulting in blood disorders and cancer, part of Baptist Medical Associates, in Louisville.
Why did you decide to become a doctor?
My mother worked in physicians’ offices when I was a child and would always tell stories about the doctors after work. I always enjoyed science and biology, and I wanted to understand how the human body works. I wanted to be challenged and have the opportunity to solve problems, while feeling like I was making a difference in peoples’ lives and doing something important. I enjoyed leadership opportunities as a Boy Scout and wanted a career that would allow me to develop my leadership skills.
Is it different than what you thought? If so, how?
Medicine is a lot more complicated than I thought it was going to be. The time commitment required is much greater than I anticipated.
What is the biggest misconception about your field?
The biggest misconception is that oncology is very depressing and all of our patients have terrible cancers that will cause their deaths. We see many patients with curable cancers that go on to live very long and healthy lives. We also see people with a variety of blood disorders, most of which are not malignant or life-threatening.
What is the one thing you wish patients knew and/or understood about doctors?
I wish they could understand the length of time and all of the hard work it takes to finally start practicing as a physician.
What is your opinion of Managed Care and how will this affect you and your practice?
Being just out of training, I haven’t had a lot of personal experience with Managed Care yet. I think, in general, that measures intended to reduce costs and optimize the quality of medical care are needed. Preventing cancer by encouraging healthy lifestyles, reducing rates of tobacco use and encouraging screening studies such as mammograms and colonoscopies are critical aspects of this. Oncology is a very protocol-driven specialty, and there are evidence-based guidelines for the treatment of almost all malignancies. If insurers use the same guidelines as oncologists, or if there is data to support a certain therapy, there usually isn’t an issue with reimbursement. However, there aren’t guidelines for everything, there isn’t data to support every possible treatment, and every patient is unique. Justifying treatments for patients to payers can be a frustrating and time-consuming task. On the other hand, if it forces oncologists to carefully examine the data and think more critically about treatment options, this may ultimately improve the quality of care.
What’s one thing your colleagues would be surprised to learn about you?
I played drums in several school bands during grade school and high school.
What’s the best advice you ever received? Who gave it to you?
Dr. John Greer at Vanderbilt University more than once reminded me that a good physician is available, affable and able.
What’s the last good book you read?
The Emperor of All Maladies, by Siddhartha Mukherjee (Scribner, 2010). It’s a fascinating history of modern cancer therapy that would interest anyone interested in science and medicine.
Favorite daytime beverage?
Orange juice, every morning.