Staff Training, Referrals, and Prevention: What Builds a Cardiology Practice That Lasts

Dr. Bart Denys, an interventional cardiologist with Cardiovascular Institute of the South, has spent three decades building a cardiology practice and shares what drove its growth: training staff as clinical partners, building trust with referring physicians, and shifting toward earlier risk detection instead of reactive intervention.

In the latest episode of In Circulation, CVL’s podcast exploring the future of cardiology, Pam Pratt, VP of Practice Management for CVL, sat down with Dr. Bart Denys, an interventional cardiologist at Cardiovascular Institute of the South (CIS). The two built a practice together for more than a decade, and the conversation ranged from how he trains staff to how he builds referral relationships to how early he tries to catch disease risk.

Train Cardiology Staff to Act as Clinical Partners

Many practices, Dr. Denys argues, haven’t changed how they operate in 20 years, even as the language around patient care has. He describes the same visit sequence he saw decades ago: a nurse rooms the patient, the physician comes in and then leaves, telling the patient, “the nurse will be right with you.”

His fix starts with how staff are trained and trusted. “They’re an extension of you,” he said. At CIS, medical technicians and LPNs are trained to ask patients substantive questions before he enters the room, and one of his nurses always keeps a clinical reference tool open to look up current treatment criteria on the spot.

Senior physicians, he said, “are very difficult to change… they’ve always been the leaders.” He believes the shift needs to come from newer physicians, guided by mentorship: “Someone has to tell that physician, ‘It’s okay [to] dictate outside the room. Come inside the room, be present. Talk to that patient.'”

The Financial Case for Moving Toward Prevention in Cardiology

Dr. Denys traces a financial shift reshaping cardiology. Stent reimbursement, once around $1,500 three decades ago, has fallen to roughly $300 today, he said. That decline, paired with a lifestyle shift among younger physicians, has made interventional and structural heart fellowship positions increasingly hard to fill.

His response has been to move earlier in the disease timeline. For example, rather than waiting for a positive calcium score, he uses carotid ultrasound to flag vascular risk in patients in their twenties. “It’s like a faucet that’s wet,” he explained. “It takes a long time before you have crud around it. The calcium score is the crud. But we want to fix it when it’s wet.” That earlier intervention point, combined with wellness messaging built around risk instead of procedures, has become a differentiator in his market.

A Referral Message Built on One Boundary

When Dr. Denys entered a new market, he told primary care physicians, “I am a cardiologist, and I only treat cardiac problems.” Unrelated conditions went straight back to the referring physician. “That little thing was magical,” he said. Within six months, his referrals doubled, because it removed the fear that referring meant losing the patient permanently.

He pairs that approach with consistent, personal community presence: volunteering with local organizations, staying reachable by personal cell phone instead of routing calls through layers of front-desk staff, and treating his own hobbies, including work as a car mechanic and a sheriff’s deputy, as informal referral channels. “If they know you,” he said, “they will come to [your] office.”

Extending Access Without Extending Physician Headcount To meet demand without adding physicians, Dr. Denys’s practice built a cardiac walk-in clinic staffed primarily by nurse practitioners under physician supervision, aimed at ruling out acute disease without a trip to the emergency room. He started it after watching patients sit in the ER for hours with chest pain that turned out to be nothing serious. “You have chest pain; we will get you an EKG. We have a rapid troponin that we can check,” he said. It’s also become an unexpected source of new patients.

He’s candid that training nurse practitioners for office-based work takes real investment, since most build confidence in hospital settings with direct, one-on-one supervision. His approach prioritizes structured onboarding, including several days shadowing in clinic, plus internal courses on pharmacology and emerging treatment areas.

The Takeaway for Physicians Evaluating a Cardiology Platform

Dr. Denys closes the conversation with his advice for physicians heading into the next decade: “Never accept the status quo.” For a physician deciding whether to affiliate with a national platform, this conversation shows what physician leadership looks like: building a care team, shifting toward prevention, and staying rooted in a community, all while backed by the infrastructure a platform like CVL provides.

Interested in exploring a career with a CVL partner practice? Discover opportunities across our physician-led network and connect with our recruitment team to find the right fit for your goals and lifestyle. Leading a practice and considering a partnership? Connect with our team to learn how affiliating with CVL supports physician-led growth without giving up clinical autonomy.

Want more insights from leading cardiologists and industry experts? Tune in to the In Circulation podcast to hear how cardiology leaders are shaping the future of outpatient care.

FAQs: Practice Building, Staff Training, and Prevention in Cardiology

How can cardiology practices reduce physician burnout by restructuring staff roles?

Practices can train staff, including medical technicians and LPNs, to handle medication questions, refills, and patient intake conversations before a physician enters the room. Treating staff as an extension of the physician rather than clerical support shifts non-clinical work off the physician’s plate, lowering burnout without adding headcount.

Why is cardiology shifting focus from procedure volume to prevention and wellness?

Declining reimbursement for interventional procedures combined with a generational shift toward lifestyle-focused careers is pushing cardiology earlier in the disease timeline. Tools like carotid ultrasound can now flag vascular risk decades before a calcium score would appear.

How do cardiologists build referring physician relationships in a new market?

A direct message to primary care physicians that a cardiologist treats only cardiac problems and returns patients for unrelated care removes the fear that referring means losing the patient permanently. Combined with visible community involvement and personal phone access instead of layered front-desk screening, this approach builds trust and referral volume over time.

How can nurse practitioners help cardiology practices expand patient access?

Nurse practitioners can extend a cardiology practice’s capacity without adding physicians, particularly for urgent, same-day needs like ruling out acute chest pain. Under physician supervision, they can triage patients quickly, which reduces unnecessary emergency room visits and creates an additional entry point for new patients evaluating the practice.

How does Cardiovascular Logistics support physician-led practice growth?

Cardiovascular Logistics combines physician autonomy with national infrastructure, letting affiliated practices retain clinical leadership and local decision-making while gaining operational support for staffing, technology, and growth strategy. This model supports care-team building, prevention-focused practice models, and community-rooted growth without requiring physicians to carry every administrative function alone.