Clinical Component

Navigating the Clinical Component

This is a full-scope interventional cardiology practice built around a daily rotation between outpatient clinic and the cardiac cath lab. Cardiologists split their time evenly between procedural work and clinic care, with the cath lab taking priority when urgent or emergent cases arise. The incoming physician joins a group of five cardiologists supported by five nurse practitioners, a dedicated cath lab team, and fully integrated in-house diagnostic services.

Cath Lab

Lab Configuration

Detail Information
Total cath labs 3
Current platforms 2 GE systems; 1 Toshiba (being replaced)
Replacement system Philips (currently under construction)
Hybrid lab 1 currently operational
Second hybrid lab Coming upon completion of Philips replacement
Cath lab start time 7:30 AM
Cath lab end time ~3:00 PM (call team finishes remaining cases)
Daily procedure volume 8–10 procedures across the program
Annual procedures (2025) 6,121 procedures on 1,869 patients
Annual procedures (2024) 5,688 procedures on 1,785 patients

Both hybrid labs will meet full OR standards for anesthesia, perfusion, and structural heart procedures once construction is complete. Currently only the existing hybrid lab meets those standards.

Cath Lab Support

The lab runs three full procedural crews covering all three rooms. Staff tenure ranges from brand-new to 10–15 years, with a culture that emphasizes low complication rates, technical excellence, and collaboration with physicians. A four-person call team supports after-hours emergency procedures.

Procedures Performed

Coronary

  • Diagnostic coronary angiography
  • Percutaneous coronary intervention (PCI) and stenting
  • Acute coronary intervention including STEMI management

Peripheral Vascular

  • Peripheral angiography
  • Peripheral vascular intervention

Device Implantation

  • Pacemaker implantation
  • Implantable cardioverter-defibrillator (ICD) implantation
  • Loop recorder placement

Currently only two of the five cardiologists perform device implantation. One of those physicians is approaching retirement, making this a high-priority skill for the incoming hire.

Structural Heart

  • TAVR (~52 cases per year; existing program, not expected of incoming physician)
  • MitraClip not currently offered; leadership is open to supporting a physician who can introduce the service

Equipment Available

  • Balloon pumps
  • Impella
  • Atherectomy
  • Cutting balloons and specialty balloon catheters
  • Full peripheral and coronary inventory

Laser atherectomy is not currently available. Advanced EP ablations are not performed; EP cases are referred to Houston and Lafayette.

Clinic

Daily Workflow

Cardiologists rotate between a morning clinic / afternoon cath lab or morning cath lab / afternoon clinic depending on scheduling. The call physician sees any urgent inpatient consults or new arrivals throughout the day.

Detail Information
Clinic volume (non-call days) ~15 patients per day
Clinic volume (call days) ~10 patients per day
Friday schedule Half-day clinic
Exam rooms per physician 3–5 depending on hallway

In-House Diagnostics

All cardiology diagnostic testing is performed within the clinic, preserving revenue and scheduling control for the program.

  • Echocardiography
  • Nuclear stress testing (inpatient and outpatient)
  • Treadmill stress testing
  • Holter monitor testing
  • Pacemaker monitoring clinics (twice weekly)

Study interpretation rotates based on call schedule. Turnaround expectation is within 48 hours. A dedicated ultrasound reading room is available, though physicians may also interpret from office workstations or laptops.

Outreach Clinics

Location Distance Coverage
Sulphur ~15 minutes 3 cardiologists rotate
Jennings ~30 minutes 1 cardiologist primarily
DeRidder ~1 hour 2 cardiologists rotate weekly

Outreach clinic days typically involve approximately 25 patients. Participation in outreach is generally expected for newer physicians. Some long-tenured physicians practice exclusively at the main campus.

Physician Productivity

Current cardiologists generate between 13,000 and 19,000 wRVUs per year, reflecting a high-volume practice with strong procedural activity. The program's annual growth in procedures (from 5,688 in 2024 to 6,121 in 2025) signals continued volume trajectory.

Call Structure

Detail Information
Call rotation after hire 1:5 weekday and holiday
Weekend call Rotating among the group
After-hours cath lab 4-person team available for emergency procedures

One senior physician takes reduced weekend call per hospital bylaws. This does not affect the advertised call rotation for the incoming physician.

Advanced Practice Provider Support

Five nurse practitioners support the cardiology service. Two are dedicated to outpatient clinic; three rotate between hospital rounding and clinic care. NPs are not assigned to specific physicians and operate with significant scheduling autonomy. They do not participate in cath lab procedures but handle consult evaluations, patient workups, outpatient follow-up visits, and weekend rounding coverage.

EMR and Cardiothoracic Surgery Access

The program runs on Epic, implemented October 2024. The clinic also houses a cardiothoracic surgeon, Dr. Lugo, who performs thoracic and cardiovascular surgical procedures. His presence within the same facility gives interventional cardiologists direct surgical backup for complex structural and vascular cases.

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