Podcasts about field one

The High Turnout Wide Margins team recently traveled to Portland, Oregon, for a special workshop on State Associations hosted by the Election Center. While there, we were able to have face-to-face conversations with people working in elections across the country. In this episode, hosts Eric Fey and Brianna Lennon speak with Aaron Ockerman, the Executive Director of the Ohio Association of Election Officials. They spoke about the importance – and power – of state associations, how having a non-election administrator in charge can strengthen an association, as well as the role a state association can play in better preparing election officials, both old and new, for the increasingly complex nature of their jobs.

Jonathan Taylor is key to the whole offense clicking together, and his availability would positive affect everything else! Let's hope the Colts Cruiser is not parked outside Field One at Grand Park tomorrow night! Colts backup CB Chris Lammons has been suspended for the first three games of the regular season for allegedly beating up a guy in Vegas with Alvin Kamara! As we told you earlier this week, Washington and Oregon are coming to the Big 10 for the 2023-2024 season! Learn more about your ad choices. Visit megaphone.fm/adchoices

QUICK LISTEN | "We've got seven Australians in the field, one of those is even an amateur…obviously led by Cameron Smith…Ryan fox, your countryman also a really good shout…” Evin Priest on the ANZAC's competing at US Open Learn more about your ad choices. Visit megaphone.fm/adchoices

This week on a special edition of “Off the Cuff” Justin is joined by Karen, Jackie Cottom, NASFAA's instructional content specialist, and Tony Erwin, FAAC®, Blue Icon's principal consultant, to break down their impressions of Federal Student Aid's (FSA) annual training conference. The team highlighted their main takeaways from a number of sessions and impressions of updated guidance coming out of the department on a host of regulatory issues. Plus, the team dives into some outstanding questions for FSA concerning FAFSA simplification implementation and also highlights their general experience with the virtual conference platform. Have a question or general comment about the conference? Be sure to submit them through our feedback form below.

2022 1127 First Sunday of Advent

Ben Garrett and Steven Godfrey each have a long, tortured history with Ole Miss football.Garrett, though, has taken in every single snap of just the second 6-0 start to a season for the Rebels since the 60s. Godfrey — who, these days, is a national college football reporter — has gotten, at best, a two-quarter look in 2022.No matter. Godfrey has seen enough to heap praise on the job Lane Kiffin has done going on three seasons in Oxford, including 17 wins in his last 20 games as head coach.But he's not just talking about program and roster-building here.Or the yeoman's work Kiffin's done as a next-level brand-builder for a program now completely fashioned in his image.(His dog is now the unofficial mascot!)Kiffin has also completely changed the off-the-field culture, too. Godfrey explained in today's edition of Talk of Champions, a podcast in association with the Ole Miss Spirit.“Greater accomplishment than literally anything Lane Kiffin has ever done with a headset,” he said.But Godfrey didn't stop there.He added, “I really would applaud this staff for the management of the roster here, specifically at quarterback, because we've seen a litany of this. We're seeing this, actually, in bulk across the country, where guys, after four games, groups of guys are saying, ‘I'm good. I'm actually done I'm not going to play anymore.' And telling the coach this.“(The Ole Miss coaches) did it as well as they could in the era that they're in. I was really impressed.”Plus, more thoughts from Godfrey on Kiffin's approach to what could have been a messy Ole Miss QB situation, as well as the seemingly-inevitable coaching change at Auburn.On a scale from 1-10, how worried should Ole Miss fans actually be about the threat from the Plains?Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

A listener calling himself JT called in Monday morning and after admitting to how sad he felt watching Ben Roethlisberger walk off the field for the final time, he asked Boomer about his emotions the final time he walked off an NFL field as a member of the Cincinnati Bengals.

In Grade 11, Tracy was bored and was seen filling out an application to join the ANZ Bank, with a little help (she later found out) she was successful in landing her first bank role. Little did she know that her Journey, in and out of Finance, would lead her to being one of the few Women Leaders in Banking. Currently Head of Third Party with Auswide Bank, Dien chats to Tracy in this episode, about her amazing journey. The lessons she learnt, how resilient, determined she has always been and on top of all of that she maintained an overall positive personality which clearly comes out in the podcast.

Want to help us grow the show? Leave us a Rating and Review!“I just have to thank God that I had that opportunity, and then that I was prepared for it and that there were people rooting for me. And then I had a coach that said, ‘Just do what you do in practice.’”—Willie BanksWillie Banks brings to life his journey toward becoming a legend in the sport of triple jumping. You’ll learn about what sets triple jumping apart from the other events in track and field, how his signature clapping routine got started, and what he thinks the sport needs to grow fans.If you’ve ever been mesmerized by the storytelling of an Olympic GREAT, then you’re sure to love this episode and be ready to Go Be More.(2:10) Willie shares a bit about growing up in a military family and how sports and activities were just a way to tire him out.(6:04) Building a high jump out of mattresses never ends well…(7:16) A seventh-grader gets inspired by a senior in high school who jumps with his sweats on…(10:20) Kicked off the team for doing it his way…(12:10) What does the triple jump have to do with a drinking game?(14:32) A history teacher who knew “a bit” about the triple jump…(16:45) Why the Avocado League had to extend the triple jump pit...(18:22) “My attitude towards growing up black in the United States was tough for me.”(20:08) Developing a whole philosophy of living had to involve three.(22:06) Jon shares what it was like with a Dad in the navy.(24:17) “You have to stick up for your friends and your family and for what is right.” Willie shares when he went up against his teacher.(28:20) Bryan asks about the transition from high school to UCLA.(33:09) The craziness of the USC, UCLA dual meet…(37:12) “Go do what you do in practice,” Willie carries the weight of the meet.(42:36) “I actually wanted to go to Stanford.”(43:32) What Clarence Taylor taught me about triple jumping…(46:04) What happened when Jon started viewing his running performance as art.(48:01) “But if our sport wants to survive, we have to be entertaining.”(50:34) A learning moment—Willie gets good news and bad news as an American record holder in Germany…(53:34) The impact of some drunk Swedes…(57:59) A triple jumper takes a victory lap…(1:03:39) How do we take our sport to the level it deserves to be at?(1:05:25) The need for stars and supporters…(1:09:20) We need more circus and Colosseum…(1:11:24) Here’s why track grew in the ’70s and ’80s…(1:13:56) What happens when individual organizers pay for their own meet and find sponsors and get investors?(1:16:21) “It's a macro version of your triple jump experience that you were creating for the fans, right?” Bryan shares his experience with the Rock and Roll Marathon.(1:21:54) Affinity happens before, after, on, and off the track.(1:26:16) What’s next on Willie’s plate?(1:28:44) What does Go Be More mean to you?(1:31:56) Closing and what’s coming up.If you liked this episode, check out our interviews with 'Mr. Marathon' Tracy Sundlun and former USA triple jumper Von Ware.And, you can now get these show notes sent directly to your email. Sign up here!Recorded August 28, 2020.References:Willie Banks WR Triple Jump - YouTubeWorld Athletics Profile - WorldAthletics.orgGuest:Willie Banks - @williebanksHosts:Bryan Green - @sendaibry, Go Be More BlogJon Rankin - @chasejonrankin, Go Be MoreLinks:Go Be More websiteGo Be More YouTube ChannelFeedbackProduction and EditingCreatives Collective Marketing

"Microsoft has always been a partner-led company, and we are committed to creating more opportunity for our partners across our businesses." and "This ethos of being partner-led will be there in everything we do". Satya Nadella has said these things, but I am wondering... Lip Service? One of the major factors that brought me to transition my company from a Salesforce Consultant, to a Microsoft Partner in 2011 was the "Partner Ecosystem" story. After almost 10 years with SFDC, during which their relationship with consultants was borderline antagonistic, I was fed up. Microsoft sounded like a breath of fresh air. But their "Partner Ecosystem", particularly for ISVs, has been weighed on the balance... and found wanting. No Bigger Advocate You would be hard-pressed to find a bigger advocate for Microsoft's ISV ambitions than myself over recent years. Having drank the Koolaid and creating I.P back in 2015, as we were all strongly encouraged to do, I had a vested interest in their effort. Many of my posts started out apologetic for my previous encouragement, but ended up positive and hopeful. But, I am starting to lose hope that Microsoft will get it right. Was Saleforce Better? There is no doubt that at the time I came over in 2011 Microsoft's business applications were complete shit compared to SFDC. This was clearly demonstrated by their market share. I took it on as a personal challenge to seek out anyone at Microsoft who would listen, and press annoyingly for change. Over time, my incessant ranting made its way through the grapevines of Redmond, and I was invited to participate in many things. Multiple Partner Advisory Councils, more private phone calls and in-person meetings with Product Managers and leaders than I can count, and an MVP designation. I can honestly say that today, Microsoft has an undeniably better product than Salesforce on every measure other than market share. Not Alone Before I start sounding like some kind of narcissist, claiming to have single-handedly straightened up the leaning tower of Pisa, I was far from alone in this mission. While it is satisfying to see aspect of products or programs that I know I had a direct influence on, many others had similar influence over other critical aspects. Each of us "trouble-makers" have a vested interest in our mutual success. My Biggest Disappointment? Almost every aspect of the ISV effort for Business Applications ISVs has been found "wanting". Up until last year, the various aspects of the ISV efforts have been led by lower level soldiers with little authority, no imagination and no understanding of the ISV business. "Hi, I'm Joe, I'm in charge of this important ISV facet, I just transferred from the MS Paint development team where I have been for the last 15 years. How can I help?" Sorry Joe, but you know less than my dog about this business. Not Guggs Fault After years of watching the revolving door of low-level solders step up to within two feet of their targets, raise their rifles and miss... a General showed up. Steven "Guggs" Guggenheimer, a long-time veteran of Microsoft and self-described "Fixer" was brought in. I first met Guggs at a Partner Advisory Council meeting with about 15 other ISV leaders. He struck me as a no-nonsense guy who planned to get things done. He also struck me as a guy who did not need, or want, our opinions. ISV Connect Guggs' brainchild was ISV Connect. A program developed mostly in the dark, that basically seeks to take a share of ISV's revenue, in exchange for some benefits. It is not optional, it is "Pay to Play". The program was launched in lightening speed with agreements being sent out to ISVs almost immediately who were expected to sign or leave. The minimum tier is 10% of your revenue, in exchange for some benefits from Microsoft that in my opinion are mostly worthless, at least for existing ISVs. If you opt into, and are accepted into, the 20% tier, there was an additional promise of Co-Sell business, meaning Microsoft's own sellers, would pimp your solutions. At a recent Inspire session Guggs, as well as in a few interviews I have done with him,  intimated that some ISVs are happy. I have not met any of these ISVs, and Guggs just announced his eminent retirement. Now what? Back to my post title The Microsoft ISV landscape has become a risky place to be. In order to continue participating, we now have to find another 10% or 20% of margin. For those with paid resellers in particular, this is a huge challenge. If the program was producing 10% to 20% more business for ISVs that would be one thing, but that is not what I am experiencing, nor any other of the many ISVs I have talked to. Another risk is Microsoft's continued encroachment into first-party vertical solutions. If you were not lucky enough to be acquired, like Field One, Microsoft has caused problems for several ISVs as they entered their spaces. Project Management and Marketing are a couple of areas that Microsoft has moved to displace existing ISVs. I was also very suspicious of the entire Accelerators program. Their recent announcement of an Asset Leasing Accelerator sounds pretty damn vertical to me. So what's the play? What is the message we are getting from Microsoft? "Come join our booming ISV ecosystem, where we will take a share of your revenue in exchange for basically nothing, and if you are wildly successful in spite of that, we might just knock you off!" I would like to believe that is not the intent, but as my ex-wife used to tell me, "Actions speak louder than words". Is there still reason for hope? Maybe for a lucky few, but I am not seeing any for the masses at the moment. Let's see what Guggs' successor can do. Update 08/06/2020 I received an email from Guggs after this post went out that included the following: "I’m curious about a few things, but one in particular caught my attention. I can’t remember the time I said the ISV Connect program was “widely successful”.  I’m sure I have almost always said something along the lines of …..some things have gone well and some things we need to do more work on….but can’t ever remember using those words.   I don’t mind you pushing hard on the company or the program, but I would be happier if you didn’t attribute absolute phrases to me unless I had indeed used them….which isn’t really my style." After digesting this, and thinking back, I agree with Guggs, that he did not ever proclaim that the program was wildly successful for ISVs as I wrote above. I apologize for attributing that sentiment to him. He also confirmed in the email that Toby Bowers would indeed be taking over his role as leader of the effort. I have known Toby for probably 5 years now, and hope for the best as he walks into what has been a very challenging issue for Microsoft. Toby has a completely different personality than Guggs, and time will tell if that is more effective at driving the program, and easing the discontent among ISVs. At the end of the day, the buck stops at the leader's desk. To be fair, Guggs came into a pile of shit, and I am aware that a lot of work needed to be, has been, done in the background on his watch. I would like to believe that while ISVs have still not seen the success they should have, Microsoft is closer than before at delivering on that soon. Hopefully Toby can push it over the goal line for us all.

True success does not come from money and opportunity but what you do with them. Robert and Kim Kiyosaki have talked for many years that one of the best reasons to become financially free is so that you can give.  Giving is important because they believe none of us become successful on our own. Today’s guest, Devon Kennard, knows this better than anyone.  On the field, Devon was drafted by the New York Giants in the fifth round of the 2014 NFL Draft and is currently a linebacker for the Arizona Cardinals. Devon has dedicated himself to becoming an advocate for youth mentorship, education, and literacy. His dedication to the younger generation led to the Detroit Lions nominating him as a 2019 Walter Payton Man of The Year nominee.  Off the field, Devon has over $1.5 million in assets under management which does not include his passive real estate portfolio where he operates as a limited partner in commercial deals across the country. Listen as hosts Robert and Kim Kiyosaki and guest Devon Kennard discuss why giving back and being a true leader in your community are so important, but also why financial education is imperative more today than ever before.  www.devonkennard.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Another misconception concerning the Coming of Jesus is what Matthew 24:40-41 says: "Then two men will be in the field: one will be taken and the other left. Two women will be grinding at the mill: one will be taken and the other left." Listen to this Podcast to find out the one who will be taken away is the one who sowed the bad seed in the field of your heart.

In this episode (brought to you by Maplytics by Inogic), we are joined by Dan Gittler, Principal Program Manager for Universal Resource Scheduling with Microsoft. Dan came from Field One, and in this episode he talks about the history of URS and what is coming in the October 2018 release. History of Universal Resource Scheduling Common use cases for URS Uncommon use cases for URS URS and Unified Interface URS and Canvas PowerApps This episode is a production of Dynamic Podcasts LLC. Subscribe to the  CRM Audio network of podcasts on Apple Podcasts and Spotify.

It was less than a year ago... I was asking Dynamics 365 leaders about the possibility of Dynamics 365 being offered as a "Naked" platform. The strategy, that has been successfully employed by Salesforce.com for years, did not seem like it was on Microsoft's radar. I was told "Never gonna happen". Fast-Forward to a month ago... It happened. Seems Like Yesterday It wouldn't be a post by me, if I didn't first take you down some long-winded path of how we got here, before I get into "here"... and this is a post by me. So we're going to go back in time, to the day before "Dynamics 365" became a brand. The product I am referring to was called Dynamics CRM Online. This was Microsoft's answer to Salesforce.com, a CRM that was Cloud from day one. I won't go all the way back to 2011, when Microsoft clumsily stepped into the ring with Salesforce. Those early bouts were too painful to remember. But even though Dynamics kept getting knocked down, they kept getting back up. From first-round knockouts, Dynamics persevered... progressively making it to three rounds, then five, then eight, up to the occasional draw. For the ardent battle watchers, Salesforce.com is still winning, but their corner must be concerned about the trajectory of Dynamics. Just another acquisition Microsoft was on an acquisition tear a couple of years ago. In a seemingly desperate attempt to shore up their weaknesses against the reigning champion, Microsoft bought a bunch of crap to bolt-on to Dynamics. Since most of these have gone down the drain, how is it that Dynamics is closer now to knocking out Salesforce, than ever before? It is actually because of Field One. Huh? Field One was a third-party solution that provided field service capabilities for Dynamics CRM Online. Were these "capabilities" the secret weapon? Not even close. But there was something unique about the Field One acquisition that ultimately led to a huge light-bulb going off that changed everything. Nativisation I know, I made up another word, deal with it. In the Dynamics world, when it comes to third-party solutions, there is this idea of "Native". What it means is that the solution was built within Dynamics, using Dynamics as the platform. The former Microsoft Dynamics Marketing, Parature and other acquisitions were not built on the Dynamics platform, Field One was. A better known example of a Native solution is ClickDimensions. The evidence is undeniable, Microsoft's success with Native solutions, versus trying to incorporate non-native solutions, is clear. In case I lost you, Native is better. I am sure Microsoft would love to have figured this out, before they had squandered so much capital on non-native options... but some things just have to be learned the hard way. They Know Now With the Field Service example, Microsoft dove into their own development capabilities to build Project Service.. kind of a fork of Field Service, as both share many resources. Coming some time later, but with the same native-built mindset, was Dynamics 365 for Marketing, but I am getting ahead of myself. Let's talk about the "pivot". Pivoting A "Pivot" in the software business is when you change directions. Sometimes you pivot because you are failing, other times you pivot because you see a better path than the one you were on. Dynamics has been a pivoting machine. This includes "re-pivoting", where you pivot back from a previous pivot, like the "Business Edition '" pivot(s)... but I digress. A major pivot that Microsoft made, was to rebrand all of their disparate Dynamics offerings under a new name "Dynamics 365". Sometimes one pivot, leads to other pivots. In this case, for Customer Engagement, in particular, it was the idea of separating apps. Separation Anxiety It starts with licensing. Dynamics 365 included Sales, Service and Marketing as a complete, single SaaS offering. This Field Service thing was a separate add-on solution, so It was priced separately, as was the Project Service offering. Seems like it makes sense to go ahead and separate the other workloads as well, so suddenly Sales and Service are licensed separately. Unfortunately, Sales and Service were not "separated", from either each other, or the underlying platform. No problem, a paper license will solve that! So, if you are keeping up, we now have separately priced workloads. We were hearing from Microsoft that Sales and Service would eventually be physically separated from each other, as well as the platform, but it was not clear at that time, how that would be accomplished. The CDS Pivot The CDS Pivot, among other things, provided the means for Microsoft to untangle Sales and Service from the platform. I am not sure at the time of this writing, where they are on the separation of Sales and Service from one another, but at least they got the twins out of the mother. And what is the mother? CDS (Common Data Service). CDS is the underlying "Naked" platform upon which Sales, Service, Field Service, Project Service and the new Dynamics 365 for Marketing are installed upon. These "apps" as we now call them, are the "First-party" apps, the ones that Microsoft owns. But wait a minute... did I say Naked? The Naked Platform Today, as a result of all of this pivoting, we now have a new option. We have the ability to provision the Dynamics 365 platform, without any first-party apps... a naked platform. Okay, it is not completely naked. It includes what is known as CRM Prime, think of that as some basic building blocks. Things like Accounts and Contacts as record types (entities), as well as functional things like Activities, etc. But no Sales specific things like Leads, Opportunities, Quotes, Orders, and Invoices for example. Almost naked. But it does include the XrM development "engine", meaning you can build whatever you want on top of those basic blocks. This platform is available under the name PowerApps, and in particular "Model-Driven" PowerApps. The license required to utilize it is called the PowerApps P2, and it costs $40/month/user. If you are thinking that this sounds a lot like that thing they said they would never do less than a year ago, you would be right. It's called a pivot. Who Cares As a customer, with Sales related needs for example, you might be wondering, what's the point? Obviously you need the robust Sales capabilities of the first-party Sales app, otherwise CDS is just a glorified Rolodex. That would be a fair read. In the large majority of cases, I see the first-party apps as being the appropriate starting point. Why on earth would you spend the money to have someone build all of that on the naked platform, if it already exists? It would not be to save money, that's for sure. The first-party apps are highly evolved, sophisticated solutions. It would not be economically viable to attempt to replicate them, to save a couple of bucks. But what if your needs are unique? I know, everybody thinks their needs are unique. From talking to thousands of customers over the years, I can tell you, what most of you think is unique, is just configuration. But occasionally, you will find that situation where the first-party app will require so many development level changes, that there is not much left of the first-party app. In many of these cases, I see where it would be more economically viable to "roll your own" on CDS. Protection Pivot So Microsoft's first thought when all this came about was "OMG, Customers might build their own solutions and not buy our First-party apps". So up until very recently, it was a requirement that to get CDS, you had to buy one of their first-party apps. To me this seemed like a lack of confidence in the value of their first-party apps. Salesforce is not lacking any confidence, they have had a platform-only license for years, and it has not hurt their first-party apps. In fact, it probably drove many first-party app sales. As they thought this through, it seems Microsoft came to the same conclusion, and we had another "pivot". Mix and Match For the customer, it is not a "one or the other" option. Sure, you can go with pure CDS and build everything from scratch. But what if the first-party Sales apps works great for you... but the "Service" app does not? No problem, the PowerApps license is included with most of the First-party apps. Meaning you can use the Enterprise Sales App for sales, but build you own unique service app on CDS. BTW, they both are running on the same underlying database, meaning your same Accounts, Contacts etc.. PowerApps is PaaS I don't know that I have heard Microsoft refer to Model-Driven Powerapps on a bare CDS as a "Platform as a Service" (PaaS) offering, but that is what it feels like to me. Just one more area where Microsoft is leading with "Platform". Like I said, for certain customers, this will be huge, for most it will be "So What".  But one camp that is drooling at the mouth is ISVs. Powered by PowerApps is Microsoft's answer to Salesforce's Force.com platform. A quick internet search for "Powered by Salesforce" will return a bunch of ISV solutions. Most of these solutions are vertically specific, highly targeted applications. This is an area where Microsoft would like to land some punches, and PowerApps is a new fist. I foresee, in the very near future, "Powered by Dynamics 365" will return similar results. Specific Vertical applications, for which the requirements were not contemplated by the first-party apps. So we start a new championship bout, the announcer says "Let's get ready to ruummble"... ding, ding  .

Rays Fan & ESPN Basketball Analyst Dick Vitale had some very angry, passionate words for Rays Owner Stu Sternberg following the team shedding payroll and players the past few weeks.

Session 43 Dr. Venkat Gangadharan is a community based Interventional Cardiologist. We discuss his interests in cardiology and his thoughts about the specialty. He also gives his opinions on the latest changes in our healthcare system regarding reimbursement cuts as well as turf wars between specialties. Also, check out all our other podcasts on the MedEd Media Network, including The Premed Years Podcast, The MCAT Podcast, The OldPreMeds Podcast, and The Short Coat Podcast. [01:08] Interest in Cardiology Knowing he wanted to be a cardiologist right on his second year of medical school, Venkat did what he could to figure out. By the time got into residency, his mind changed and considered things like pulmonary critical care or cardiology. Then he got the chance what the cath lab was like and got to see what they do when they treat heart attacks. And he got sold right then. He's the type of guys that likes instant gratification in terms of treating patients. He wants to see them get better right then and there. So he found doing cardiology and interventional cardiology was the way to go. He knew he wanted to do interventional cardiology by his second year of cardiology fellowship. He recalls applying everywhere across the U.S. He thinks it was the toughest thing being one of the several thousands trying to get the same position. He has interviewed in at least ten different places. It was so difficult for him that he finally ended up matching in a program at the last minute. He decided to take it and to him it was the greatest decision ever. "No matter how competitive you are, you're one among several thousands that are trying to get the same position." What he really likes about cardiology is the physiology behind it. Plus, it required some amount of critical thinking and problem solving. But at the end of the day, there were define medications for certain purposes. There are risk factors you know you could treat. And the problems had definitive treatment modality and cure to some extent. Basically, he's fascinated by how the heart works. [04:40] Traits that Lead to Becoming a Good Interventional Cardiologist Venkat cites some traits in order for one to become a good interventional cardiologist such as being dedicated and hardworking. You need to be analytical and be able to think on your feet. In the cath lab and you have a patient's life in your hands, there are probably a million different decisions running through your head. With so many things running through your head, you just have to choose the right one and make sure the patient gets through it no matter what. With heart attacks, for example, the chance of people dying from it is so low nowadays. Everybody has got a chance. Compared to back in the days during the infancy stage of interventional cardiology, there were no facilities to treat people. There was no place to send them. “With the technology we have, there's not one person in the country that should not have the chance to live at the hands of a cardiologist.” That said, you have to be able to think outside the box. You have to be analytical and mechanical. Venkat explains that interventional cardiology is all about physics and the give and go. Additionally, having that adrenaline junkie kind of mentality is an edge. When you're taking an emergency call, you will have to wake up in the middle of the night to have of your faculties all ready to go. Drive to the hospital. Then have all of your fingers ready to go to and adept to put a stent or fix a blood vessel to fix a person's life. You need to love the rush for you to be able to mental faculties to take care of that problem in the wee hours of the night. [07:22] Private Practice versus Academic Setting Venkat explains the reason he chose private practice was being the easiest choice at that time. There are far more private practice physicians at that time than there are academic positions. Second, you have to have a certain mentality and persona to be an academic interventional cardiologist compared to a private practice physician. "I wouldn't say it's money driven per se, but I would say it plays a huge role in the decisions you make when it comes to the job you pick." As a private practice physician, you have the ability to dictate your own life as well as the ability to treat your own patients. You have the ability to learn things at your own speed without having to answer to anyone else but your own practice. These were what Venkat was looking for. [09:07] Types of Patients and  Typical Day in His Life As an interventional cardiologist, Venkat sees everything from valvular heart disease to atherosclerotic vascular diseases. It's truly mind boggling that the amount of coronary disease that is out there and how young a person can be by the time they get affected. Venkat finds it humbling to be doing intervention in a 34-year-old when you're the same age as he is and living the same kind of life he is. For him, this is eye-opening and it makes you realize how life is short and you need to take good care of yourself. So when he things sees on the screen, it makes him think twice. It's surprising to see how bad people's arteries could be at such a young age. As a private practice physician, Venkat says it's tough being just an interventional cardiologist. So he also practices a lot of general cardiology and interventional cardiology, But his mind is always focused on what he can do to fix something. He gets to the hospital around 6 or 6:30 in the morning and do some rounds. If anyone comes in with a heart attack or he's on call, he drops whatever he's doing and go and save that life. Then he goes to the office or clinic and trying to recruit patients to your practice so you can maintain a lifestyle and a career. "It's very rare in private practice to find a position where you just do interventional cardiology." You have to be ready to handle any situation presented to you. Venkat takes emergency calls about three to four times a week. Being a young doctor, his practice is made up of only two interventional cardiologists. He usually gets a call about three times a week. But not all private practice is like this. The larger the private practice, the less call that you're going to take. From a general cardiology perspective, he takes calls once a week and he does one week in the month. Initially, when he started out, it was pretty rough not realizing it was this much work. But Venkat explains that you will get used to it. [12:21] Work-Life Balance Venkat thinks having that work life balance is a million dollar question. Over the past three years, he had thought about what life was like outside of his work and the balance he had between work and his home life. He has a two-year-old son who misses him all day long. There are plenty of days he'd feel bad about coming home late or working as much as he does. But at the end of the day, being a young physician and knowing this is your career, this is the time to make a living. This is the time to earn for your family. After which, you can decide what's going to work for you and where you want to spend your time more. [13:33] The Path to Interventional Cardiology Residency and Fellowship Training Once out of medical school, you decide to make an internal medicine residency. When he was applying, he looked for decent cardiology fellowship knowing it was what he was going to do. The likelihood of you getting into the cardiology fellowship at the residency program you trained at is better than one than you'd get at another place. This is followed by another three years of cardiology fellowship. At this time, you're introduced to cardiac catheterization and different aspects of interventional cardiology. Also around the second year, you also make the decision if you want to become one and start applying to interventional cardiology fellowships. The difference between interventional cardiology fellowship applications and the general cardiology fellowship applications is that many of those programs are paper applications. This means you have to seek them out. Find out what their application process is. Do every step you can and apply. Then follow up several times if they've received your application. "Try to hone in on the programs that you really want to be a part of." Things they would usually look at are your degrees of research you've done during fellowship, your progress in testing during fellowship and training, and where you trained which goes a long way. As to why he thinks matching into interventional cardiology is so competitive, Venkat believes it's one of the more rewarding cardiology fellowships. The number one killer of people in the world is heart attacks. And interventional cardiology is essentially designed to treat those. So the amount of people applying to be an interventional cardiologist are far more than the people applying to be an electrophysiologist or a nuclear cardiologist. And for electrophysiology in particular, the testing is very difficult. It requires someone to be very cerebral and a mentalist to handle that kind of profession. [16:18] Bias towards DOs, Subspecialty Opportunities, and Turf Wars Venkat actually has not seen any bias towards DOs. In his own practice, he has a partner who is a DO. He took a very long way to become what he is today. But he's a successful interventional cardiologist. "At the end of the day, the MD and the DO designation is just a designation. The person you are is the physician that you are." Venkat adds that you can be an MD and be an awesome physician. You can be a DO, and still be an awesome physician. He really doesn't think this has any weight in terms of whether you have a chance of being an interventional cardiologist or not. It's about what you do with the time you spend and the training you spend that makes who you are. In terms of subspecialty opportunities after interventional cardiology, Venkat explains there is a new development in structural heart disease. In the country, there's only a handful of programs that are accredited structural heart disease fellowships. The ACC and the AVIM have yet to recognize a designated fellowship for this. Coronary heart disease is not the only thing that plagues people, Peripheral vascular disease is also what plagues people. So there are specialized fellowships to do a training in endovascular work. Venkat explains that as interventional cardiologists, they're actually an interventional cardiovascular physician. So the vascular aspect of things is largely untapped and majority of that training can be obtained after a fellowship. Venkat also admits having turf wars brewing between cardiovascular and vascular surgery. When it comes to peripheral vascular disease, it's a turf war between a vascular surgeon, an interventional cardiologist, and an interventional radiologist. He adds there are programs out there with long, trusted interventional radiologist to do the procedure or long, trusted vascular surgeon to do the procedure. As interventional cardiologists, they are making the push to take that on themselves. "The breadth of peripheral vascular disease is so poignant in this country. There's opportunities everywhere." But Venkat says that you won't see many private practice interventional radiologist or private practice vascular surgeons doing a lot of endovascular work. Majority of them have some sort of academic affiliation. You will see a lot of private practice interventional cardiologist doing all of that work. [20:10] Working with Primary Care and Other Specialities Venkat wished primary care physicians knew the breadth of disease they see and the complicated nature of disease present in their patients. He really wished they would understand the medications they use to treat these conditions. Unfortunately, Venkat lives in a place where managed care is a strong push in the area. By this. primary care physicians are limited in the medications they can offer their patients. Many of them end up changing the medication he places his patients on. Or they deny the stress test or deny the arterial ultrasound the patient needs to gather some more information for their complaints. It actually blew his mind when he first got there. But that was the reality. And in the three years there now, he still couldn't grasp the idea where primary care physicians are literally dictate a patient's life regardless of the symptoms the have. "I still couldn't grasp this idea where primary care physicians are literally dictate a patient's life regardless of the symptoms the have." Venkat describes it's like the patient has to show up in the hospital to get the real care they deserve. They go to their primary care physician because six times out of ten, they're going to get denied. This is saddening. Venkat says he had to rescue people at death's door when they could have been rescued two years earlier. Other specialties he works the closest with include pulmonary and critical care, infectious disease, and nephrology. [23:28] Special Opportunities Outside Clinical Medicine Venkat explains that the more senior you become as an interventional cardiologist or cardiologist even, the opportunities outside of medicine start to open up. When you're a part of a large hospital system and you have a good relationship with the hospital administration, most of those avenues are open for you. One of his partners is the chief of internal medicine in the hospital as well as the chief of cardiology at the hospital. It's a rotating door when it comes to that position. "Cardiologists are often taken in high regard because we have our fingers in every aspect of things." Other cardiologists have also migrated to other industries. His mentor has left interventional cardiology practice of 45 years and is now engulfed in an industry that promotes one of the products he helped design and bring to market. So you have the opportunity to migrate over to an industry and be a speaker and teach the world about what you do. [24:55] What He Wished He Knew and What He Likes the Most and Least Now knowing what the process is like to get better framed in what he does, he wished he probably should have sought out an extra fellowship at the end of his one year of interventional cardiology. Had he known the amount of opportunities out there, he probably would have given it a better shot. Secondly, although a private practice physician, he wished he had given academic interventional cardiology a strong push at the time he was making the decision for a job. He never knew it was this busy. But he's a young guy so he's pushing through it. What he likes the most about being an interventional cardiologist is doing procedures. He loves working with his hands. He loves the adrenaline rush of fixing a heart attack. For him, waking up at 2 am is not difficult. If he could save a life and they'd walk out the door the next day, alive, he feels he has done his job for the day. "To me, the procedural aspect of this whole profession is what makes the best thing everyday." What he likes the least, on the other hand, is the bureaucratic aspect of it. Running a private practice or trying to develop a career as a private practice physician is very difficult. Unless you have the business know-how or the business acumen, it's difficult to make yourself well-known in the community that has several people just like you. But it does teach you what the business of medicine is like. "One of the things we lack as residents and fellows is that nobody ever told you what the business of medicine is like." Reality is that everything costs money. Everything you do, you need to earn something from it. And you need to be happy doing what you do in a day in and day out basis. So you need to find a place that gives you the opportunity to grow as a physician. But it should also give you the security that you know this job is going to keep you happy for years to come. [28:00] Major Changes Coming in the Field One of the major changes that is likely coming over the next year or two is that CMS is bundling payments when it comes to cardiac procedures and cardiac diagnosis. For instance, myocardial infarction which used to be differentiated in terms of medications and procedures are now going to be bundled under one big heading called myocardial infarction. So the payment you're going to get is going to be far less than what you've gotten in the past. Over the last five years, Venkat explains how the field has been largely affected by the reimbursement and the cut in reimbursement. They've lost almost 40%-50% of what the normal reimbursement would be for a regular procedure. So it's not becoming more cutthroat in their field to do more work, find more patients, and treat more disease since you're not making as much as you used to. This is going to get worse as time goes on, Venkat suspects. Eventually, private practice is likely going to dissipate depending on where you live and hospital-employed physicians and hospital-employed practices are going to predominate in this country. The reason for this is because hospitals are able to negotiate their deals with insurance companies and pharmaceutical companies than a private practice will. So if you want to make a decent living, you might end up becoming a hospital-employed physician.As for Venkat, he's holding up for as long as he could but he's aware that it's just around the corner. "Hospital-employed physicians and hospital-employed practices are going to predominate in this country." [30:40] Reduction in Reimbursements CMS stands for Center for Medicare and Medicaid Services. Venkat personally thinks it doesn't make sense to reduce the reimbursement. At the end of the day, these procedures are being done by physicians who are taking the time out of their night to stay awake in order to save a person's life. The procedures continue to stay arduous. They don't get any easier. Although there's technology available to treat these conditions, these procedures don't happen in 30 minutes. It takes an hour or as long as four hours. So the work, stress, and the difficulty of your general lifestyle continue to exist and never change. Hence, reducing the reimbursement for these procedures is fostering an idea that medical management is better than risking your own life trying to do something. Venkat has seen a lot of his partners who were interventional cardiologists 30 years back when things were great. It changed the way they practice based on the reimbursement they're getting. He raises this question that, "why would you go and try to do something whether to save a person's life or to be good at what you do, when the government and insurance companies don't feel like it's necessary and don't feel like you should get paid for it?" Venkat thinks this kind of mentality is coming out a lot in newer graduates. The older generation is also catching up to it and realizing they can't make as much as they used to. So it's throwing a big stress in many of these private practice groups. "The idea of newer graduates to think that they're going to get paid like they did 30 years ago, it's never going to happen." Venkat's advice to the younger generation is that if you want to be an interventional cardiologist, you're doing it because you love what you do. Don't do it for the money because it's happening everywhere. [33:22] Final Words of Wisdom If he had to do it all over again, Venkat admits he would still have chosen interventional cardiology - 120%. For students thinking about becoming an interventional cardiologist, Venkat explains that cardiology is a specialty that is going to continue to grow. It will continue to become the most prevalent disease in this entire world. If your heart is in cardiology and you truly believe that you want to help people and the adrenaline rush is what you live for, interventional cardiology is the way to go. You're going to love working with your hands. You're going to love the equipment they use. And it's only getting better. You can do things with heart arteries that people couldn't even fathom 30 years ago. The things your'e going to be doing is just unimaginable. Research keeps happening and happening. So if you love cardiology and you love what you do and you live for excitement, you're not going to be disappointed. [35:02] Last Thoughts Venkat is the first cardiologist on this podcast. I hope to bring you many other subspecialties within cardiology so you can get a great picture of what cardiology looks like for you, possibly in the future. Our goal is to find all these different specialties and talk to them and find out what their job is like. So as you're going through your training, you get a better picture of what life for you will look like. You will hear what physicians like about their specialties and what they don't like about it. This will help guide you on your journey to choosing your specialty. Links: MedEd Media Network

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