10-Minute Interview: Chee H. Kim, MD

Dr. Chee Kim is an electrophysiologist with Buffalo Medical Group (BMG) and director of the Electrophysiology Laboratory at Erie County Medical Center (ECMC) in Buffalo, New York. Tell us about your medical background and how you came to work in the field of electrophysiology. What interested you about this field? I completed my fellowships in cardiology and electrophysiology at the University of Rochester/Strong Memorial Hospital in 1995. I served on the faculty at Strong Memorial Hospital until 1998, choosing to go into private practice at that time. I chose electrophysiology because it demands excellence in both intellectual and technical/interventional skills. The instant gratification of a successful ablation was quite addicting. Describe your work as an electrophysiologist at the Buffalo Medical Group and as the director of the EP lab at Erie County Medical Center. Do you split your time between any other institutions as well? I have a strong partner at the BMG and we cover 9 hospitals in the greater Buffalo area. We provide outpatient consults and device follow-ups in the office setting as well as participate in clinical trials. Our hospital services include consultations, device implants, and radiofrequency ablations. My role as director of the EP lab at ECMC is to maintain the high level of excellence in patient care that is provided there by a staff that started with me from its inception in 2002. What is a typical day or week like for you? How do you handle time management? A typical week involves performing elective procedures 4 days/week and office consultation 1 day/week. On any given day, I may travel to 3-4 hospitals performing consultation or inpatient device implants after completion of my regular daily schedule. Time management is always a challenge, and an efficient laboratory and office staff are critical. What do you think are the most important components of a successful EP lab? Anyone who has run an EP lab understands that time management is critical to a successful and productive lab. A nurse leader or administrator whom you can work with closely and that understands these challenges is invaluable. A well-trained staff (responsibility of the director) that takes pride in their work and takes “ownership” of the laboratory are also critical components. What aspects of your job are most challenging? What isn’t? The time investment away from home, to managing your practice in the current environment of diminishing reimbursements, to keeping up with the advancements in your field, to the politics of dealing with hospital administrators and referring MDs, can all be overwhelming at times. Otherwise, it’s a cinch! What is one of the more memorable EP cases that you have worked on? Two recent cases come to mind. The first was a biventricular implant in a patient with a persistent left superior vena cava and a coronary sinus diverticulum. The second case involved scar mapping during sinus rhythm for an ischemic substrate ventricular tachycardia (VT) resulting in multiple ICD discharges. The clinical VT was too hemodynamically unstable to map during the tachycardia. Voltage mapping using a 3D navigational mapping system was useful and successful. What advancements do you hope to see in the field of cardiac electrophysiology in the next 5 years? I hope there is standardization or at least a more uniform and objective method of approach to atrial fibrillation ablations and evaluation of their success. One of the pitfalls of our field is that there is an eagerness for adoption of new technology and procedures into our practices without a more objective evaluation of the use of these advancements in the hands of “low volume or non high volume” electrophysiologists. What advice you offer those just starting out in EP? Make sure to prioritize your family time; otherwise, your work will consume you and your kids will be off to college before you know it.