In September, Miami Transplant Institute named Hari Mallidi, MD, chief of cardiac surgery and program director of heart transplantation and mechanical circulatory support at MTI, as well as director of the Jackson Heart Institute in Miami.
Dr. Mallidi told Becker's he was drawn to Miami Transplant Institute after hearing about the voluntary pause of its adult heart transplant program. In March 2023, the Miami Transplant Institute's heart transplant program abruptly halted its adult heart transplant program to undergo review by the United Network for Organ Sharing. Investigators visited the transplant center — which is jointly run by Jackson Health System, a public safety-net system based in Miami, and the University of Miami's UHealth — in April after complaints about poor patient outcomes, including infection and death, following heart transplants, as well as a complaint about poor patient selection for the hospital's left ventricular assist device procedure. In July, the program was cleared of deficiencies and was reactivated.
Dr. Mallidi has been leading the program for almost a year. Here, he talks about the challenges he faces and his best leadership advice.
Question: What challenges are you expecting to face in the next year, and what are you doing to prepare for them?
Dr. Hari Mallidi: In cardiovascular care, the challenges are always related to meeting the needs of the community and the careful implementation of new technology to meet those needs. As part of the safety-net system, the expenses and costs associated with the latest technology don't always justify the investment from a system or population perspective. We have to be careful to balance where we invest our limited resources to get the biggest bang for the buck for the patients we take care of. We have to admit that there are some areas we won't focus on expanding right away. There are areas such as aortic surgery, end-stage heart failure care, and some of the more complex care for patients where there is a real need. There are niche areas within cardiac surgery in South Florida that are well served, so we don't need to expend limited resources chasing after them. The challenge, from a broad perspective, is identifying where the opportunities are and trying to best use the available resources to tackle those opportunities and provide the care that our community needs.
Q: If you could change one thing about the healthcare field, what would you change?
HM: A challenging aspect of healthcare that makes it very inefficient right now, and that impacts the cost of care, is the demand for pre-authorization for more advanced therapies. The way hospitals, physicians and patients interact with payers, especially private payers, is very challenging and often leads to delays in care. Thankfully, these delays usually don't result in poor outcomes, but they certainly don't help achieve better outcomes.
Q: What is some of the best leadership advice you've received?
HM: It's important to have a clear idea of what you want to accomplish in your role. Whatever the scope, it should be clear in your mind. Establish your style of leadership early on. There are different styles and personalities, and it's useful for leaders to spend time understanding the type of leader they are. Engaging with a leadership coach or receiving training related to leadership can be beneficial. Personally, I find it helpful to be a good listener, especially when starting somewhere new. Before you can think about what needs to be done, it's good to understand what is being done well, where opportunities for improvement exist, and to be flexible in adapting your plan to the available resources and the strengths and weaknesses of the program you're leading.