Mentorship, Medicine, and Medical Innovation with Dr. Nadia Giannetti

In the final episode of Doctors Unscripted, the script is flipped as Tarah Schwartz, Vice President of Marketing and Communications at the MUHC Foundation, sits down with host Dr. Nadia Giannetti for a candid conversation about the career, experiences, and values that have shaped her journey in medicine.

Dr. Giannetti reflects on her path to becoming a cardiologist and heart failure and transplant specialist, including the unexpected opportunity that led her to Stanford University and ultimately defined her career. She shares lessons learned from more than 25 years in healthcare, the challenges and rewards of building a world-class heart failure and transplant program, and the importance of seizing opportunities when they arise.

The conversation also explores topics that have resonated throughout the season: mentorship, leadership, work-life balance, and the realities of balancing a demanding medical career with family life. Dr. Giannetti opens up about her own experiences with pregnancy loss, motherhood, and career advancement, while offering advice to young physicians navigating major life and career decisions.

Looking ahead, Dr. Giannetti shares her vision for the future of healthcare, including her growing focus on medical technology, artificial intelligence, remote patient monitoring, and innovations that could transform how care is delivered to patients across Canada.

Whether you're a medical student, resident, practicing clinician, or simply curious about the human side of healthcare, this episode offers a fitting conclusion to a season dedicated to learning from those who have walked the path before us.

To learn more about how the MUHC Foundation supports life-changing research and patient care at the MUHC, visit:  muhcfoundation.com

Transcript

SPEAKER_01 0:08

Hi everyone, and welcome to Doctors Unscripted. Today we are reversing the script a little bit, and I am the one being interviewed by Tara Schwartz, well known to many of you from our foundation here at the MUHC. And the reason for this is this is our final podcast. We've already hit our 10th podcast, and so we decided to flip things around a little bit. So welcome, Tara.

SPEAKER_00 0:35

Thank you so much for joining us today. Thank you, Dr. G Netting. Thank you for having me. So the reason we decided to do this is because you have such a wealth of knowledge, and you've been asking people for the last many, many months about their experiences, and it's time to ask you about yours. Okay. So let's jump right in. First of all, I want to start with this podcast because you've been hosting it for the last 10 months, which was totally and completely outside of your comfort zone. So I want to know how did you enjoy it and what did you learn? Oh my goodness.

SPEAKER_01 1:07

First of all, thank you to the foundation for let for letting me do this and to you, Tara, because when I mentioned to you that I wanted to have the podcast, you were the first one to cheer me on. So I appreciate that. And uh so the the intention of the podcast was uh as a mentorship tool or strategy for people who are considering going to med school, in med school, in residency, or already on staff and and who are looking for a little bit of mentorship. And um, you know, I found over the years, and I still find on a very regular basis, people ask questions outside medicine, right? They'll ask you questions about your life and how you manage to juggle kids and how you decide to become, you know, the specialist that you are. So I'm frequently answering those questions, and and I think there were very important topics that I wanted to cover. And that was the purpose of, you know, selecting the people that were selecting to do the podcast. And so I learned a lot um talking to people, and uh people I've I'm very, you know, I'm so pleased how people were open and responsive, and everyone said yes, of course, and and I loved our conversation. So I learned a lot, and and I've been approached by sort of some junior people over the course of the last few months saying that they've learned a lot too. So I'm very pleased, and this is exactly what I wanted. So thanks for giving me this opportunity.

SPEAKER_00 2:25

Oh, it's it's wonderful. So let's go back into your history. So, some of the questions that you've been answering, like how did you choose your area of expertise? What was that path like for you?

SPEAKER_01 2:35

Yeah. So um, you know, I I'm somebody who who likes, you know, some intensity in my life, let's just say. So choosing cardiology for me was actually a pretty easy choice. And and, you know, cardiology allows you to have sort of some quiet moments sitting one-on-one with a patient. And at the other extreme, the very exciting moments where you run to, you know, a code blue, which is a cardiac arrest and you're doing a full-out resuscitation. So um I love that you're able to do all that in cardiology. Sometimes I cover the coronary care unit and it's very exciting, and sometimes in the clinic, and I do one-on-one with patients and chronic care. So it's sort of a great variety. So for me, that's really uh that was never a question uh to do to become a cardiologist. To become, you know, my specialty is heart failure transplant. And that was um, you know, if I look back, and you know, sometimes things happen in your life, it's unexpected. I was um, I was uh finished my cardiology and I had signed up to do a year of cardiac prevention at the Montreal Heart Institute. And my husband, and I was committed until June of uh, I don't even remember which year exactly, and my husband was uh starting at Stanford in California and uh in September. So we were gonna be apart for a few months. My intention was always going to meet him uh in California, and uh and I wasn't sure exactly what I was going to do. I was doing cardiac prevention at the Montreal Hard Institute, and I found it wasn't necessarily exciting enough. Exciting enough. Was a little bit low-key. So I said, I'm not sure I, you know, and Stanford wasn't really well recognized for this. And one day, you know, out of the blue, I get a phone call, random day, middle of the day, John McCann's chief of cardiology, calls me up and says, Nadia, David Fitchett is just leaving for Toronto. He heads our heart transplant program. Aren't you going to Stanford next year? And I said, Absolutely. And, you know, trying to finalize my program at Stanford. And he said to me, Well, you know, it is one of the you know biggest transplant programs in the world. He says, How would you like to go do transplant and bring it back to Miguel? And and like some light bulb just went off. Like it was just, you know, you know, when they say when you know, you know, I knew instantly that this was what I wanted to do. I did not hesitate. I said, yes. And I'm thinking back to, you know, the podcast where Mark Rogers says, you have opportunities, take them. So I grabbed that opportunity. I said, yes, absolutely. But now it's kind of, you know, January, and I'm supposed to start in July. So of course, you know, innocently, I call Stanford and I say, I'd like to come to do a fellowship in heart transplant at Stanford. And I kind of said, you know, these things are usually about two years in advance. And I thought, oh, okay, this is may not work out as easily as I'd like it to. So, so, but then the the person I was talking to said, you know, the person who's supposed to start in July, we're not sure he's coming after all. So sure enough, another moment. I get a call two days later, and they said, you know, can you have a quick interview with us? Because this person was supposed to come in July looks like he's backing out, and we want to have, you know. So I did a quick interview by phone. At the time, it was all by phone. And um, and next thing I knew, he had balked out, he decided to stay in Ohio, and I got the position. Wow. So it was really unexpected. You know, sometimes things happen, you know, for a reason. I don't know what it is, but it all worked out. And I went to Stanford and I had a chance to have a fantastic opportunity there doing a fellowship in heart failure and transplant. It was not pre-planned. The opportunity came, I grabbed it, and I've never looked back and I've had no regrets. It's been fantastic.

SPEAKER_00 6:29

Wow. I love those kinds of moments. You know, even somebody leaving when you're ready to come in, like all of those moments. All these things are so divine and set up. So you have this wonderful career now, this path that you've chosen. You said that you have no regrets, but there must have been some challenges. Absolutely. So talk to us a little bit. Don't get into the family part because I want to come to that a bit later. So talk to me about just some of the challenges that you did face as much as you loved it.

SPEAKER_01 6:54

As much as I loved it. Look, you know, transplant, love heart failure transplant. Um, you know, I was fortunate around the same time I was there. My colleague who I ended up working with for many years, Renzo Cicheri, was training as a surgical. He was there with his wife, and they were also, you know, he was doing his training in surgical heart failure transplant. We both have sort of big ideas. We're going to come back to McGill and set up this huge program. I mean, there was already a small transplant program. Uh, it's not easy to do that. You don't come back to Canada or to, you know, to Canada and say, hey, we want to do 100 transplants a year, and we want, you know, they did the donors are not there, the resources are not there. So there's a lot of challenges setting up a program. I was very fortunate, you know, with my surgical colleague who brought in a lot of new technologies, new mechanical hearts, uh, really always at the forefront of technology, you know, whatever he could push through to get to our patients because our patients were very desperate. So it's very fortunate for 20, for you know, 25 years to run the heart failure transplant program, not without challenges, not without, you know, lack of resources, patients who are very sick, not enough donors, certainly a lot of challenges, uh, but uh, you know, there's nothing better in terms of rewarding uh as having a patient who's really, really sick, who needs a transplant to survive, who is, you know, having a very, very difficult time, poor quality of life, not knowing if they're going to sort of survive the next six months to a year, and then all of a sudden you know you offer them a transplant, you call them and you say, Hey, we have a heart for you. That is, that has been incredibly rewarding. All these patients that, you know, I followed over the years and um that I still follow uh are very dear to me. Yeah, it's the ultimate gift. So it's been a wonderful, wonderful career. And continues to be. I still I'm still very involved in this, yes.

SPEAKER_00 8:50

And I just want to ask you, what about being a woman? Because you were a glass ceiling breaker in many ways, taking positions that had not been taken by women before. So, how did that play into your career?

SPEAKER_01 9:01

So, you know, it's never been an issue, if I may say. So I'm very fortunate that, you know, as I said, I got that phone call from John Cairns and uh to allow me to lead this program. And then David Eidelman, Dr. Eidelman at the time when he was chief of medicine, uh, asked me. Uh, I was, you know, I would think I was maybe three months or two months pregnant. I wasn't showing, but I knew I was pregnant, uh, asked me to take over uh as chief of cardiology. And um and that was really an incredible break for me. I was the first woman cardiology at cardiologist at the McGill University Health Center. Uh, and I owe that to, you know, my male colleague. And I must say, in all sincerity, that I've I've had nothing but support from my male colleagues. I'm very, you know, I'm very fortunate to work in an environment like this where I honestly don't think it ever worked against me. I think that the other challenges are probably what you're gonna bring up, which is more sort of family and having children, that kind of thing. But being a woman, I don't think has ever prevented me from achieving my goals. And I think I've been very fortunate at at McGill and the MUHT to have colleagues that have been very supportive.

SPEAKER_00 10:11

And it impacts so many women because when you break a glass ceiling, you break it not just for yourself, but for every woman who comes after you. So you've done very important work, not just on a cardiology front, but breaking those glass ceilings. Thank you. Thank you. Thank you. So let's segue into family because you have this beautiful, robust family that's a big party of life. And I know that in each podcast, yes, more you know, mostly when you have the women on, but you do talk about that. And you've mentioned that sometimes you have to make choices to have children later because of where you are in those studies and your academic career, and if you're going into healthcare. So, what was that like for you into like you just mentioned you got this wonderful opportunity and you were two years pregnant to old anybody yet? So, how did you impact children?

SPEAKER_01 10:52

And look, so I think, and and I, you know, I tell women this to please take this seriously because fertility is an issue, and it was an issue for me, not so much getting pregnant, but I did have you know several miscarriages along the way. So I did not have the family the way I expected. I I wanted three kids in five or six years. That was my plan. I started, you know, after my fellowship, I was just over 30. Uh, and uh, you know, I had my first child. I was pretty straightforward, but then, you know, it took a while to move forward. And uh, and I think it's it's uh it's because I was older and you know, I did read your book. Can't help falling. Tara has a wonderful book, and I could relate to some of his. You were very open in your book about uh the challenges of miscarriages, which I did. And I think that's where things are different for a woman and a man. So um, so I was, you know, I was uh very, very fortunate. I have a very supportive husband. Uh, and uh, you know, I had my first child, I wanted my second child, but it, you know, it was happening, but it wasn't continuing. So, and you know, it's hard. You have a miscarriage and you come to work the next day, you know, your male colleagues are just kind of going around their, you know, their random day, and you're, you know, so I did have some some struggles there. Um, but I wanted this very badly, as did you when you your book comes out. And so um I was very fortunate to end up having, you know, over the course of 11 years, four kids, uh, which was really my ultimate dream was to have four kids. Uh, and uh, you know, uh, so it all worked out, but not as I planned. And uh I I'm thrilled, you know, I have like three boys and a girl. And and for me, having both for the family and the and the and the career is is absolutely essential. Okay, I wouldn't want it any other way. Having having both is absolutely essential, but it wasn't easy. And I think if I were to say, where's the difference when you ask me the question about being a woman? I I was treated, in my opinion, equal to my male colleagues. It never prevented me from doing anything. But you're the one who's bearing the kids and going through that. So there is so your life is a little bit different from that point of view. You can't be like a man because you're not. So um those struggles really, you know, become more the woman's struggles. So um, and I didn't really because I was starting, uh I arrived here from Stanford actually pregnant and and showing again. So the poor patients were like, oh, you're the new doctor, that's great. But you're pregnant, when are you leaving? So I think I took six weeks off for my first for my son. Then I took probably something like eight weeks off for my daughter. And uh, and then when I had my twins, uh, there were just sort of two of us working in the clinic, and believe it or not, we delivered at the same time. And uh, and she wanted, you know, her her her matern leave, and I was running the program, so I don't even think I took that much time off. I had a fantastic nanny. So I think in retrospect, what I would do differently is probably take a little bit longer math leave. Uh, and um I did have a wonderful nanny, couldn't have done it without her. To this day, she's still with us, okay? She's part of our family. But if I were to do anything differently, I would uh I would probably start my family earlier and not wait for the fellowship and exams to be over. So start at a younger age and maybe take a little bit longer, you know, maternity leave.

SPEAKER_00 14:23

So, what what advice do you give young women then?

SPEAKER_01 14:26

I tell them that once they've decided that they want to have kids and they have their partner to have kids with, I don't think there's any point in waiting. Yeah, so don't wait. Not if you know, you can't wait. And and and I and I don't think, you know, I mentioned the podcast, and I'm very happy that Victoria Mandalaris was very open about this. Okay. Yeah. So she was she was very open about this, which I appreciated. And I I think I said to her, um, I think it falls a bit on deaf ears. And I think particularly women who've always been successful and who've always been in control of their, you know, of their destiny, right? You work hard, you get into medical school, you work hard, you get into your residency, you work hard, you get into your fellowship, everything kind of seems to fall into place, and you feel this great sense of of control of that part that you're not in control as you know.

SPEAKER_00 15:16

But I think it's like even regardless of of the field that you are in, I think we are as women who are successful women in whatever fields we're in, we're always waiting for that right moment that's right when this is done, or I got this job, or I get this promotion, or I'm in this place in my life. And I think your advice to not wait applies to everybody. It's it's great advice for anyone who needs to hear it.

SPEAKER_01 15:38

And I'm happy that Victoria spoke about, you know, freezing eggs is certainly not something that we, you know, that was available for me at, you know, years ago, obviously. Uh so I so to me, having having my life presently and I'm, you know, I'm thrilled with where I am, it's really the combination of the career and the family, and having obviously a very supportive husband who's there for me, who has the same perspective and sees the same way.

SPEAKER_00 16:04

It's important to see people who have both. Yeah. Because if other women are coming up and we don't see examples of people who have it, we don't know that it's attainable, right? That's right. That hold, you know, if you can see it, you can be it. That's right. That's why it's so important. That's right.

SPEAKER_01 16:25

This podcast is being brought to you by the MUHC Foundation. The MUHD Foundation funds cutting edge research at both the MUHC and its research institute, and supports excellence in patient care for millions of Quebecers. You can follow them on social media or take a look at their website at www.muhc F O U-N-D-A-T-I-O-N.com, MUHC Foundation.com.

SPEAKER_00 16:58

All right, so we talked about what some women might be asking you, but what do young healthcare workers want to know? Like you you touched on it earlier in the interview, but like what are they coming to ask you? Like what are the biggest questions? What are the biggest concerns?

SPEAKER_01 17:10

A lot of it is uh, well, you know, people are concerned about the public healthcare system and whether they, you know, people you know, I think you have to choose your career that you can, you know, you can be passionate, do what you want, but you have to be realistic. Uh, we're not, you know, this is a socialized healthcare system, so there's things you're going to have and things you're not going to have. And when you go to a big US center, which most of us do, and I and I would highly encourage people to do that extra year. Like to me, that extra, you know, I spent just under two years at Stanford, those extra two years define my career. I hear a lot of people who say, I'm so tired of training. You know, I don't want to do an extra year or two. Yeah, but that extra, you've done all these years of training. That extra year or two is going to define your career and give you opportunities you wouldn't otherwise have, right? So people often ask me, is it worth doing those extra years? And I would say, absolutely it is, because it can define your career. So these are things people ask me. You know, chronic care versus acute care versus patient clinic versus outpatients, inpatients, all these kinds of things. People have questions about, you know, should I, you know, sit in a dark room and read echoes all day? Should I learn a new technology, or should I do a disease-based, you know, in my mind, learning a new technology is great. But in in three, four, I've seen some of my colleagues do this. They learned how to do new technology, which is great for two years, but by year three and four, everyone can do that new technology. So it's better to be sort of disease focused, really do a deep dive on a disease and use the technologies to help you in the disease area, right? Uh, that's sort of a little bit my approach uh when I when I speak to people. Um so, so you know, a lot of those kind of career type discussions, uh, you know, should I take mad leave? Should I um, you know, uh yeah, how long and will it impact me? Will it affect me? And then leadership, because I have had, you know, I've been chief of cardiology and I'm associate physician in chief. Should I take those extra courses? I was impressed with Mark Roger, who said that he takes a course every year. I have not been, you know, that diligent. I have taken some leadership courses along the way for these positions in administrative uh roles, but um, but I think those are important too, those sort of extra courses along the way. Um, so so there's a lot of those kinds of discussion. To be honest with you, a lot of it often it's women. And and I do, I'm somebody who likes to, you know, I'm happy to mentor people, men and women, and to give, you know, I people opportunities. So I do hire, you know, in the research program every summer. I hire a few people and a lot of them want to go to med school in the future. So I like to give people opportunities to come and work in a medical environment. Um, so so a lot of it are the discussions, you know, around along those lines. Okay.

SPEAKER_00 19:47

You've talked about how much you've enjoyed your career to date and how rewarding it has been, you know, that beautiful moment when you can give this incredible gift. What do you see as Dr. Giannetti for the next 10 years? Like what were you looking toward? What are you hoping for?

SPEAKER_01 20:03

So for me, I I you know, I think I've pretty much decided that. And uh I'm you're gonna share it now? Yeah, sure. I'm happy to share it now. So um, first of all, I'm again, you know, I'm thrilled with this podcast because I think we've left the library behind. And for those, you know, there is a menu or library behind for people who have wanted to, you know, hear topics discussed, whether it's, you know, Larita Sri talking about moving from, you know, out west to Montreal, not speaking really much French, okay, or people who've done sort of been involved more in innovation or more procedure-based things, people who have leadership roles. So I'm hoping that people would look back at this podcast and be able to choose topics that they're interested in. As for myself, um, I'm really interested in MedTech innovation, and that's my future. So I am co-founder of a MedTech Venture Studio with a few colleagues. And um, and the idea there is that after 25 years, because I've hit my 25, actually 26 years working in the healthcare system, I realize that we have to make changes. There's lots of gaps in the healthcare system that need to be filled. Um, you know, I told you I wasn't interested so much in prevention 25 years ago. Now I realize that we have to be involved in prevention. Otherwise, it's impossible for the healthcare system to remain the way it is because costs are becoming out of control, you know, cost of healthcare. So I'm interested in medtech innovation that includes keeping patients at home, uh, you know, more television uh from the distance. People shouldn't have to fly from Pavagnatuk or Shibugamu to come to see me for a 15-minute appointment. I want to bring my tools to them so I can have a full appointment. So I'm working in technology to do that, you know, a vest that will listen to your heart and lungs remotely so I can examine you from a distance as an example. Uh using AI that would change healthcare profoundly. Yes. So that is, you know, that is something that I have created with a team of engineers and is now being Tested, it's been the health canada approval to test so I can actually listen to you from a distance. There's also AI models that can interpret the heart sounds. So if you go to a family doctor who's not used to you listening to heart sounds with the VEST, VEST will interpret the heart sound and say, hey, this sounds like aorticnosis. You need to go to see a cardiologist. You know, these kind of things. So you using AMI modeling. So that's just sort of one of the, you know, one of the things I'm looking at. So using artificial intelligence to for diagnosis and monitoring, follow-up, these kind of things. I think we have to change the way we deliver deliver health care. We have to take the health care to the patients, not bring everybody in to the cent to the system. Home hospital, that kind of concept. I'm working on technology for that, because once you bring in, remember, we have an aging population. And once you take somebody who's who's a little bit frail and you leave them in a stretcher for 48 hours, they're going to have a hard time mobilizing again. Okay. And you're you're going to have to get physiotherapy to help them out. So we have to get patients back to their home environment as quickly as possible. So we're working on technologies like that. So I'm really excited. So for me, the future is going to be in health innovation. And again, you know, bringing in students and residents and mentoring people in that field. For me, it's the is the combination of experienced clinicians, engineers, business people, and hopefully bring, you know, bring something back to Nigel and the institution as we are doing this. So that's my future, and I'm very excited about that.

SPEAKER_00 23:31

Well, you sound very passionate about it. And as you're speaking, I can almost see it happening because, like you said, it has to happen. It has to go along the way we've been going. Wow, that's very, very exciting. So some exciting and big changes ahead for not just you, but for the healthcare system, hopefully. Well, hopefully, that's the plan. Yes. As I wind down into my last question, I wanted to kind of say something in case some of the people who are listening to this podcast don't actually know you, because I doubt everyone who knows you knows this. Okay. But Dr. Giannetti is as nice and kind and generous and funny as you hear her on her show. Like she really, really is all of those things. You must be an absolute gift to every patient you have. That's very sweet. Such a great colleague. And I'm I'm so pleased that I got to witness this amazing podcast just to hear all of the work that you've been doing. And now to hear it from your, you know, your own lips, it's it's wonderful. So as I enter my last question for you on this absolutely wonderful year of, you know, interviewing guests and sharing all this wonder wonderful information. What are your Dr. Giannetti, Dr. Nanni Giannetti, what are your parting words for the people who have been listening to this podcast over the last year? Oh, that's a tough one.

SPEAKER_01 24:44

Okay. Well, look, it's a very good question. So my parting words are um, I think there are answers out there if you have questions, and there are mentors out there. And certainly what I've learned is a lot of people are willing to give up their time to mentor. And I think the podcast is just sort of the tip of the iceberg of what uh what you can learn by talking to colleagues who've been in practice who have had experience. So um don't be afraid, you know, to ask questions, ask for advice. You don't have to listen to everything, but maybe, you know, get the perspective of people who have experience. Um, and there are opportunities out there to get involved and um, you know, to learn sort of maybe hands-on as well, even for pre-medical students. We have a lot of experiences. So, so I do hope people do, you know, I know people have listened to the podcast, but I do hope it stays alive and people go back and look at those specific topics that they're interested in. I'm happy if anyone approaches me and says, you know, and this is what happens now, people will say, Well, I'd like to know more about this. And I say, Well, listen to Don Vinn's podcast, or, you know, listen to Natalie Diane, because that's exactly the topic she covers. So um, so I hope we keep the conversation open. And uh, and uh and that's yeah, that's basically it. So thank you so much, Tara and the foundation uh and everyone who's given me this opportunity. Over to you, Dr. Gianetti, to close out the final episode of Doctors Unscripted. So I'd like to thank our listeners over the last 10 months. Uh, it's been really great to get your feedback and your comments and uh to to continue the discussions with you offline, which is what we often do. Uh, thanks for all our speakers who've shared their stories and have been very open about uh some of their challenges and their experiences. I really, I'm really thrilled that you were there to share with us. And I'd like to thank our wonderful producer, Robin Flynn, for making all this possible over the course of the last 10 months. Thank you very much, Robin. Thanks everyone. Have a great day and see you in the corridors. We also would appreciate it if you could take a moment to rate the show or leave a review. Thanks so much for listening.