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Fall 2013 - The BEAT Goes On

With the retirement of cardiologists Ray Cheely, MD, and Amarendra Reddy, MD, Heart to Heart takes a look back and a look ahead at one of Raleigh’s pioneering cardiology practices and its physicians.

Listen, I know we will be practicing together, so decide soon.” Cardiologist Ray Cheely, MD, said these words to his colleague Charlie Mangano, MD, during the last year of their cardiology fellowship at The University of North Carolina at Chapel Hill in fall 1978. Dr. Mangano wasn’t sure about where he wanted to practice after completing his fellowship. Another conversation between the two at the Cheely kitchen table in January 1979 sealed the deal.

Raleigh Cardiology (which now operates at WakeMed Heart & Vascular Physicians) opened in 1979 with two physicians (who admittedly knew nothing about how to run a business), one front office employee and one nurse. Dr. Mangano convinced Dr. Cheely that it would be best to set up shop in Raleigh. WakeMed’s heart program had begun, and they could help shape it.

The practice began to grow. In 1980, Dr. Virgil Wynia joined Raleigh Cardiology, and in 1986, interventional cardiologist Amarendra Reddy, MD, joined the team. Dr. Reddy’s practice, Wake Cardiology had been open since 1975. The Raleigh Cardiology physicians and Dr. Reddy enjoyed a positive working relationship and began to share call coverage. The practices eventually merged then moved to WakeMed (Wake Medical Center in those days).

Drs. Cheely, Reddy, Mangano, Wynia and additional cardiologists like Dr. Tift Mann, along with their colleague on the cardiovascular surgery side Dr. Charlie Helton, began serving on multiple WakeMed hospital committees and working with nurses and administrators to create clinical protocols and guidelines for WakeMed Heart and Vascular Services. “Back then, there were no national guidelines set by organizations like the American College of Cardiology,” recalls Dr. Helton. “You had to create your own.”

The first and likely most impactful protocol they created was ensuring that patients worked with a cardiologist first and exhausted all medical options before seeking the services of a cardiac surgeon. Today, this protocol continues to be followed throughout the United States and much of the world.

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Next Phase of Life

This October, Dr. Cheely and Dr. Reddy retire (Dr. Cheely will fully retire and Dr. Reddy will continue to perform some interventional procedures) from Raleigh Cardiology. Collectively, their years of serving WakeMed Heart Center and Raleigh Cardiology patients total more than 70.

Throughout their tenures, Dr. Cheely and Dr. Reddy have significantly influenced the WakeMed Heart Center program as well as their long-term practice colleagues and those who will continue their legacy of putting patients first. Several of them share their insights about these two medical pioneers.

Dr. Ray Cheely: Founding & Shaping Raleigh Cardiology

“Starting in practice with [Dr. Cheely] was the single most important career decision I made,” says Dr. Charlie Mangano, who cofounded Raleigh Cardiology with Dr. Cheely in 1979. “We were like-minded about our career and lifestyle and had 100 percent confidence in each other.” Together, Dr. Cheely and Dr. Mangano developed the culture and cornerstone principles for Raleigh Cardiology. The same culture and principles are still in place today and guide decisions about the practice and patients.

“First, our focus is on providing the best care for patients; it’s the overriding factor in everything we do,” explains Dr. Mangano. “Ray and I believed that if we did our best for patients, everything else would fall into place, and it did.”

Quality of life for yourself and your family is the second founding principle that Drs. Cheely and Mangano created for Raleigh Cardiology. “We saw too many examples of what happened when physicians spent too much time at work and not enough time with their families or just taking needed time off,” says Dr. Mangano. “You’ve got to see your kids – go to the recitals, soccer games and teachers’ meetings. That was important to us and we thought it should be for all of our staff.”

Staff members are the focus of the third founding principle for the practice. “They represented us every day in so many ways,” says Dr. Mangano. “We look at our practice as a family. In addition, we trusted our partners implicitly and knew that if one of us was away, our patients were in good hands.”

The Right Thing to Do

When asked about the quality that makes Dr. Cheely an exceptional professional and person, Dr. Mangano is quick to point out several rather than just one.

“Ray has a keen ability to know what the right thing to do is and how to do it,” says Dr. Mangano. “He does what’s right and good for his family, his partners and staff and his patients. He has a strong belief in God and a sense of fairness that guide him.”

Dr. Helton adds: “He is a skilled professional, and his patients love him as a physician and a friend. Ray Cheely took care of my mother for about 20 years. She thought of him as the Dr. Marcus Welby of WakeMed hospital. She was talking to me about him the day before she passed away at age 97. She wanted to thank him for the kind and gentle care he gave her. I did, too. All of us here at the hospital will miss Ray.”

Sit Down with Your Patients

Dr. John Sinden, an interventional cardiologist with Raleigh Cardiology, shares Dr. Mangano’s opinions about Dr. Cheely’s unwavering focus on his patients. Dr. Sinden recalls that Dr. Cheely has always been extremely thorough when caring for his patients. “He is never in a hurry and he passed on to me that if you take a few minutes to sit in an exam room or at your patient’s bedside, you’re showing your patient that you are fully engaged in their care.”

Dr. Sinden joined Raleigh Cardiology in 1992 and recalls the first time he met Dr. Cheely. It was the weekend before he was to begin the interview process with Raleigh Cardiology and Dr. Sinden flew in from Georgia, fresh off his cardiology fellowship and a teaching rotation.

“Ray Cheely picked me up from the airport in his well-worn Chevy, which was filled with copies of The New England Journal of Medicine. He let me borrow his car for the weekend.”

Dr. Sinden quickly realized Dr. Cheely’s dramatic impact on the practice’s culture. “He set the tone for all of us, and that was to do what’s best for patients.” Dr. Sinden also admired the image Dr. Cheely exuded as well as the level of support he provided to his colleagues.

“If Ray goes to WakeMed’s ED to see a patient at 2 o’clock in the morning, he is dressed in a blue blazer and tie,” says Dr. Sinden. “I remember one night when Ray was on call, he received a call from WakeMed’s ED. He knew from the phone conversation that the patient would need a cath, so he called me to come in to do the procedure. At one point during the procedure, I looked out at the control room window and who was standing there but Ray. After the procedure, I asked him why he came in. He told me that because he took the initial call, the patient was technically his and he felt it was his responsibility to make sure all went correctly. He just has that special kind of thoroughness and follow-through.”

Dr. Sinden, a highly regarded interventional cardiologist in the area, considers himself fortunate to have Dr. Cheely as a role model. “He has a thorough, thoughtful approach to caring for patients,” explains Dr. Sinden. “I’ve learned a lot about how that helps build lasting relationships with patients and their families.”

Dr. Amarendra Reddy: Pioneering the Use of Heart Catheterization in Wake County

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Dr. Reddy performed the first cardiac catheterization procedure in Wake County at WakeMed in 1976. Today, thousands of these life-saving procedures are performed in the WakeMed Heart Center. Dr. Reddy has been at the center of the action in terms of interventional cardiology for more than 35 years. Dr. Reddy’s long-time friend and colleague cardiovascular surgeon Dr. Charlie Helton recalls the early days when the interventional heart program at WakeMed was taking shape under the guidance of Dr. Reddy and another interventional cardiologist, Dr. Tift Mann. “Reddy was the anchor of the program and, together with Dr. Mann, they set the clinical standards for the interventional cardiac program very high,” says Dr. Helton.

Dr. Helton credits Dr. Reddy with convincing him to stay in Raleigh. “When I first got here, I met [Dr. Reddy] in an interview,” explains Dr. Helton. “We were originally in the same group. Reddy took me into the [catheterization] lab, which was not exactly a joke but it was close.” In the mid-70s, WakeMed’s catheterization technology essentially was a 16mm movie camera. Dr. Helton, who came to Raleigh on a temporary basis from a large teaching hospital in Minnesota, was impressed with the work that Dr. Reddy was doing with such “antiquated” equipment, and eventually Dr. Reddy convinced him to stay in Raleigh. “He told me we could create our own program and make our own lab and we did,” says Dr. Helton.

Always Concerned about Patients

It’s clear to Dr. Helton that Dr. Reddy’s focus is always on his patients. “He worries and worries and worries about his patients,” says Dr. Helton, who also recalled a particular example of Dr. Reddy’s patient focus. The Reddys and Heltons decided to take a trip together to Asheville, N.C. “I didn’t have any patients in the hospital at the time, but Reddy did. Reddy had this big bag of change,” recalls Dr. Helton. “There were no cell phones back then, so we had to stop every 30 minutes or so for Reddy to call WakeMed from pay phones to check on his patients. He worried that we were out of range for long distance calls and kept calling WakeMed at different intervals throughout the whole trip.”

Character & “Constitution”

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“In a world of high pressure and high tension, Reddy remains a consummate gentleman,” says Dr. Helton. “He is impeccably honest and there are no political boundaries as far as he is concerned. Young (and older) guys from all practices ask him for help and opinions in the cath lab and he is there for them. Reddy is an excellent mentor for new staff coming into the cath lab.”

As an aside, Dr. Helton is also incredulous about Dr. Reddy’s ability to “withstand the heat.” “I once watched him eat a pizza that was literally covered in jalapeno peppers, and he still remained standing. It was unbelievable.”

Influencing Interventional Interest

Dr. Brian Go joined Raleigh Cardiology in 1999 as a cardiologist fresh out of fellowship at the University of Texas. When on a tour of the WakeMed Heart Center during his interview, he was introduced to Dr. Reddy who had just finished up in the catheterization lab. “Dr. Reddy was coming out of a difficult case,” explains Dr. Go. “He was going on about the challenges of it. I wasn’t an interventionalist at the time, so I really didn’t fully understand the details, but I still remember his enthusiasm and zeal for what he was doing. He still has that today. I’m sure he has just as much passion and conviction for what he is doing as when he first set foot in this hospital.”

Dr. Go’s commitment to saving lives evolved into his becoming an interventional cardiologist. Both Dr. Reddy and Dr. Reddy’s patients influenced his decision to do an interventional fellowship. “I would round on Dr. Reddy’s patients and they would bring up how Dr. Reddy had saved them in the middle of the night, even if it was 10 years ago, explains Dr. Go. “They carried the reassurance with them that it didn’t matter when they got sick, Dr. Reddy would be there for them. I realized I wanted to help people in that way, too, so I decided to do interventional training.”

The Best Advice

Both Dr. Go and Dr. Helton agree that Dr. Reddy is a great resource for solid clinical advice. “He just has good clinical judgment; everyone asks his opinions,” says Dr. Go.

Reddy, Set, Go!

Known among his colleagues for his “Reddyisms,” Dr. Go recalls Dr. Reddy saying once, “We need to get a doctor named ‘Set’ so we have ‘Reddy, Set, Go’ in the practice.” And his favorite icebreaker before starting a case: “Are you ready? I’m Reddy!”

Passing the Torch

The founders and early pioneers of Raleigh Cardiology – Drs. Cheely, Reddy, Mangano and Wynia – have attracted top talent to carry on the practice’s patient-focused philosophy. Drs. Go and Sinden, along with Raleigh Cardiology’s 11 other cardiovascular specialists and four physician assistants have learned from the best and will continue to seek new knowledge and innovations to provide the best possible care to their patients. In Dr. Sinden’s words: “Raleigh Cardiology will continue to grow, but we are not about being the biggest. We will continue to be focused on providing superior patient care and that’s where we will see our growth.”

Thanks to you, patients who seek heart and vascular services at WakeMed continue to be in great hands.

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