In today’s complex healthcare landscape, being an exceptional interventional cardiologist requires more than technical skill. It demands business savvy, leadership, adaptability, and a deep understanding of where the field is headed.
To explore what it takes to build a thriving, future-ready career, we sat down with three leading figures in endovascular medicine: Drs. Kartik Giri, Arthur Lee, and Craig Walker. Across a wide-ranging discussion, they offered real-world insights on everything from clinical blind spots and practice-building to mentorship, technology trends, and the business side of medicine.
Before diving in, here’s a quick look at who they are:
Double board-certified in Cardiology and Interventional Cardiology
Managing Partner at The Heart House, a multi-specialty cardiovascular practice in New Jersey
Board member of Cardiovascular Associates of America, a national physician-led network
Over 20 years of clinical experience with a focus on complex coronary and peripheral interventions
Leads training programs for fellows and has helped shape practice models for independent cardiologists
Interventional cardiologist at The Cardiac & Vascular Institute (TCAVI) in Gainesville, Florida
Director of Peripheral Vascular Services at TCAVI, with a national and international speaking presence
Certified by the American Society of Hypertension
Specializes in peripheral vascular disease and critical limb ischemia, with a passion for medical education and mentorship
Founder and President of Cardiovascular Institute of the South (CIS), based in Louisiana
Founder and Chairman of New Cardiovascular Horizons, a leading conference in endovascular medicine
Clinical Professor of Medicine at both LSU and Tulane medical schools
Clinical Editor of Vascular Disease Management and member of multiple editorial boards
A pioneering figure in endovascular intervention, known for championing access to care in underserved regions
Together, these three bring decades of experience and hard-won lessons. Whether you're a fellow just starting out or a physician looking to expand your impact, their insights offer a grounded look at what it really means to lead — and grow — in this evolving field.
Is there a specific clinical skill or area you believe should be emphasized more in training?
The physicians highlighted several key areas for further training: guidewire techniques, peripheral and venous disease expertise, patient communication skills, and emotional intelligence in team settings.
Dr. Walker identifies three key areas that need improvement. First, he points out that many fellows graduate without understanding guide wires: “One of the biggest problems is they don't understand guidewires. If I ask what wires they use, they say, ‘I've always used this or that.’ That's like always driving a Model T Ford.” Second, he says there should be more focused training in peripheral artery and venous disease, describing them as “huge problems nationally” that are not receiving “adequate attention in cardiology fellowships.” Finally, he emphasizes the importance of mastering “the art of pleasing patients,” noting that clinicians “spend a lot of time learning the science behind what we do, but maybe not enough about proper communication.”
Dr. Giri offers practical advice for new fellows, stressing the importance of first impressions: “You have to make the simple things look simple. You should be able to do a peripheral angiogram in 10 minutes. If you can’t, your skills will immediately be questioned.” He encourages early-career physicians to build confidence through repetition: “Learn how to walk before you can run. Start with the easy cases, and do them skillfully and well.”
Dr. Lee builds on these technical points by highlighting the need for broader clinical competence. “Interventional fellowships are definitely the time to master the craft and become a good technician,” he says. “But don’t forget the clinical side of medicine — try to learn as much vascular medicine as possible.” He also urges fellows to seek exposure across specialties and to lead with emotional intelligence: “When you go to a new cath lab, be emotionally intelligent. Have self-awareness. Don’t show up like you’re the hot new whatever — respect the nurses, techs, and everyone else you can learn from.”
What are some practical ways to get involved with studies or medical research?
The cardiologists shared practical strategies for getting started in research: begin with case reports, seek out mentors, take advantage of academic settings, explore private practice opportunities, pursue topics of genuine interest, and network confidently at conferences. Their message was clear — success in medical research comes to those who show initiative, think strategically, and step outside their comfort zones.
Dr. Lee suggests starting with manageable projects like case reports and making your interest known. For those drawn to bench research, he advises: "Find somebody who has a lab and come in and be willing to put in the work." Dr. Lee suggests identifying prolific researchers in your field and offering assistance, particularly to "busy operators who might be in the studies, but it's not their primary focus." By helping with patient screening and enrollment, you create a "win-win" situation that can lead to publication opportunities.
Dr. Giri points out that residency and fellowship are ideal times to get involved in research, since “everyone around you is somewhat tied to it.” He stresses the importance of early exposure and challenges the notion that research must be left behind in private practice. “There’s a common narrative that once you leave academic training for private practice, you give up things like research and other academic pursuits just to churn out cases and make money,” he says. “That’s totally false.” In fact, he notes that many private practices are eager to participate in research, and industry partners often prefer them because “it’s just a smoother glide path.”
Dr. Walker adds that research often grows from genuine curiosity. “You may have no initial interest in research and suddenly find yourself publishing a lot,” he says. His advice: follow your passions and pursue the topics that truly interest you — others will naturally get on board. Dr. Walker, who founded New Cardiovascular Horizons in part to “give young physicians a chance to be seen, to be heard,” also highlights the value of conferences for networking. He encourages attendees to make a strong impression by coming prepared: “When that happens, the door is open.”
What new or emerging technologies in peripheral or coronary interventions are you most excited about over the next 3-5 years?
Innovations addressing calcium, thrombus, and restenosis were highlighted as key areas where new technologies are expanding the interventional toolbox. At the same time, all three cardiologists emphasized that access skills are fundamental prerequisites — without the ability to properly access and cross lesions, even the most advanced technologies cannot be effectively utilized in treatment.
All three stress the importance of mastering ultrasound-guided access techniques. Dr. Lee says, “Getting really good with ultrasound and access — retrograde access, alternative access — is really important because that opens the door to procedures and increases the chances of success.” Dr. Giri calls access “the entryway to everything,” adding, “If you struggle with that for 20 or 40 minutes, then you’re probably in the wrong field.”
Dr. Walker notes that emerging access techniques — such as occluded vessel access or direct stent puncture — “open up whole new areas.” He also warns that access complications can “absolutely ruin everything,” no matter how well the rest of the intervention goes.
When it comes to specific technologies, Dr. Walker says he is excited about:
New insights into calcium location and management
Recognition that infrapopliteal disease is often “not atherosclerosis at all, but rather calcium and some intimal hyperplasia”
Drug-eluting technologies
Biovascular scaffolds
Dr. Lee identifies the three biggest challenges in peripheral interventions as “calcium, thrombus, and restenosis,” and says, “A lot of innovations are coming that deal with all three, and those are the things that really help us expand our toolbox.”
What’s something you wish early-career physicians understood about the business side of healthcare?
The specialists underscore the value of exploring different practice structures, which can offer greater autonomy and growth than a traditional hospital employment. They encourage young physicians to stay open-minded about their career paths, actively develop marketable skills, and engage with the business side of medicine from the outset.
Dr. Giri underscores the importance of independent practice at a time when most cardiologists are employed by large systems. “There are very few of us left who are independent,” he says. “Eighty-five to 87 percent of cardiologists are now employed, and I don’t think trainees are getting any exposure to what the other side looks like.”
He believes ownership creates a deeper investment in a practice’s success. “You care more, you want to build it — you're not just a cog in the wheel,” he says. While Dr. Giri initially chose private practice to focus on clinical work, he found the business side unexpectedly engaging. “Over the last several years, I’ve shifted more into the business side of medicine. I’ve learned so much, and it’s been exciting.”
Dr. Walker reflects on hospital economics with some surprise, particularly the cost disparity between outpatient and inpatient settings. “I had no clue how expensive hospitals were,” he says. “Some outpatient procedures I do cost $8,000, but in a hospital, those same procedures can exceed $100,000. We have to figure out ways to change that.”
Dr. Walker adds that he wishes he had learned more about various healthcare business concepts earlier in his career — including billing systems and modern networking tools.
Dr. Lee offers a more tempered view, recognizing the value in not knowing everything at the outset. “There’s something nice about a bit of blissful ignorance — just being idealistic, finding a group based on where you want to live, the call schedule, whether you get along with your colleagues, and based on the procedures and interventions you want to do,” he says.
Still, Dr. Lee notes that in today’s environment — shaped by hospital employment trends and private equity consolidation — young physicians need to understand various practice models. He encourages them to ask practical questions about group structure, recruitment, revenue cycle management, and long-term legacy.
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For physicians looking to grow as leaders, educators, or mentors, what are one or two key skills they should focus on developing?
The cardiologists emphasize that developing leadership skills requires a combination of technical excellence, boldness in seeking opportunities, and leading by example while remaining humble and authentic.
Dr. Walker stresses the importance of being "open-minded and forward-thinking" rather than stuck in routines. He believes leaders must be "technically skilled" while "willing to help and promote others." Most critically, he emphasizes that "a great leader leads by example" rather than by decree, demonstrating honesty and maintaining open communication.
Dr. Giri encourages young physicians to "be bold" and proactive about leadership opportunities, noting that many practices have leadership voids waiting to be filled. "This isn't the military where you have to put in a certain amount of time before you're allowed to speak or be heard," he explains, adding that his practice has "opened up slots for younger doctors" specifically to provide leadership apprenticeships.
Dr. Lee connects leadership to his "three A's: ability, affability, and availability," advising physicians to "push to where you're a little uncomfortable so that you can get better." He cautions about balancing ambition with credibility: "You don't want to get too far ahead of your skis," while encouraging doctors to "make it known" if they want leadership roles. "Ask for opportunities," he urges, "but don't be afraid to go for it." He adds that “sometimes you don't know what you can do unless you try it, and it's okay to not succeed.”
If you could give your younger self some career advice, what would it be?
The physicians advise focusing on high-prevalence but under-treated conditions like peripheral and venous disease, which offer both clinical and career opportunities. They also emphasize the importance of thoughtful decision-making, strong communication, and professionalism — both in practice and online.
Dr. Walker emphasizes the importance of focusing on high-prevalence, underserved clinical areas. “I would tell people to look at the incidence of disease and who you're trying to help. Peripheral artery disease and venous disease are incredibly common — and we're ignoring them,” he says. He notes that venous disease, in particular, has “a higher incidence than all cancers, coronary disease, peripheral artery disease, diabetes, and a few other things combined.” Dr. Walker adds that this clinical focus can have practical career advantages: “Everyone who has come through a peripheral fellowship with me has gone on to become the busiest physician in their practice.”
Dr. Giri echoes this perspective, encouraging trainees to consider peripheral training over more saturated subspecialties like structural heart disease. “There’s a dearth of talent entering the cardiology space in this area,” he says, pointing to strong demand and opportunity. Dr. Giri also offers personal advice on decision-making: “Sleep on decisions and emotions. Take a night before you react. I’ve learned that now — but if I had known it 20 years ago — I’d be much better off.”
Dr. Lee offers a candid reminder about professionalism in the digital age: “Don’t drink and post on social media. That’s definitely something I would have told myself.” He also highlights the value of communication skills, particularly listening: “Listen more and speak less. There’s a reason you have two ears and one mouth. Make it count when you talk, but listen more.”
Which conferences, events, or organizations do you recommend for interventional cardiologists?
Dr. Walker:
Upcoming dates: May 27-30, 2025
Location: New Orleans
Features: Live cases, networking, research opportunities
"It's a big meeting. It's got a lot of live cases, but I think more than anything, it has camaraderie,” says Dr. Walker. “It's a chance to meet people, to network, to get to do research and other things."
Dr. Lee:
Dr. Lee also highly recommends NCVH’s Annual Meeting, crediting it with opening many doors throughout his career. He also recommends:
NCVH regional meetings in places like Chicago, Baton Rouge, and others
New York Endovascular Summit hosted by Dr. Prakash Krishnan
Dr. Giri
"It's literally an entity designed to shine the light on independent practices throughout the country and look out for our interests,” says Dr. Giri who serves on the board of directors. “Hospitals have their lobbies. The strategics have their clout, and we really don't. So this is a unifying voice for independent medicine."
Before we wrap up, a fun one: what’s on your must-watch list — any favorite movies or shows?
"I love the classics of any genre, but nowadays, I watch TV series more,” says Dr. Lee, noting his enjoyment of Friday Night Lights and Yellowstone, including 1923, the prequel series. “I binge-watch series, and I actually prefer it. The entertainment lasts longer [than a movie], and there's more time for character development." Still, when he does sit down for a movie, his go-to favorites include Star Wars, Indiana Jones, and The Green Mile.
Dr. Giri is a fan of a popular thriller. "My favorite movie of all time ever and will never change is, The Silence of the Lambs,” he says. “I just love that movie. It changed me. I think I would like to be a profiler, honestly, if I wasn't a cardiologist.” He also loves Hoosiers and the comedy, Get Him to the Greek.
Dr. Walker, a fan of classic films like Roman Holiday, notes a recent change in his viewing habits. "I had a son later in life and I got into some of these movies like Cars with Lightning McQueen and Despicable Me. There's so much humor in them and so much real brilliance that comes out in these."
