Thomas Waggoner, DO, FACC, FSCAI, FSVM, RPVI, was drawn to clinical research by a simple idea: “knowing that we can do better.”
As Director of Cardiovascular Research at Pima Heart and Vascular, Dr. Waggoner has spent years building research into a busy community cardiology practice, giving patients access to new devices and therapies while helping move cardiovascular care forward. In a recent conversation with Iterative Health, he shared what he has learned along the way, from getting the right team in place to choosing studies, winning over physician partners and building a program that can grow.
This conversation has been edited for length and clarity.
What originally drew you to clinical research?
Dr. Waggoner: The biggest thing is knowing that we can do better. What you learned in fellowship 20 years ago, there may be something better now, or new tools available to you. The marriage of science and innovation has really exploded over the last 15 to 20 years in structural heart and interventional cardiology.
What really drew me into research was knowing that we could do better, not being stuck in that science bubble, but leading the edge of it. You’re bringing new technologies forward and helping change guidelines. To know that you can change somebody’s life through innovation and research is really moving.
For a cardiologist starting research today, what needs to be in place to do it successfully?
Dr. Waggoner: You have to have a good team around you. You need good clinical research coordinators (CRCs), a good clinical director and the right infrastructure. The strongest thing you can do is build a robust team that is there to support you, because the easy part is doing the procedure. The hardest part is getting the patient to the procedure and then ensuring the follow-up happens.
Getting that patient through the system safely with a new device is incredibly important, and so is having clean data. That data is ultimately what companies are relying on when they evaluate these therapies and devices.
As a program grows, how should a practice decide which studies to take on?
Dr. Waggoner: Start by setting clear goals. You might say, “We want to launch a research center at X, Y and Z sites. We’ll start with five trials over the first year.” Start with the low-hanging fruit. Don’t tackle a first-in-human trial right away. Communication with your leaders and stakeholders is important. Be clear about what the goal is and have a pro forma that says, “This is what we believe we can do.”
Most importantly, understand the population you’re trying to enroll. If you’re predominantly a vascular practice, don’t enroll in heart failure trials. If you’re predominantly a coronary practice, don’t enroll in trials that don’t fit that population. Understanding your patient population is key.
What would you say to a physician who wants to do research but doesn’t yet have the support of their partners?
Dr. Waggoner: It only takes one person to pick up that pickaxe. Once you create that first fissure, the energy you create starts to build. That’s essentially what happened here. Once you’re successful, success begets success. That’s key. If you have an interest, don’t be bashful. Don’t hesitate to talk to your partners and say, “I’m willing to go above and beyond.”
Once you’re successful in research, it’s a domino effect. You’ll get more trials, then you can pull in more investigators and build out different subspecialties. Be courageous enough to pick up that pickaxe and be the first one to strike the iceberg.
Can a physician start small, within an existing clinic footprint?
Dr. Waggoner: Yes, you could probably do it within your existing clinic footprint. You may have to work during off-hours so you’re not disrupting your partners’ busy clinics. You could start on a day when the clinic is half full or space isn’t otherwise being used, and have a good coordinator or two. I think you can absolutely start that way. Once you’re successful, you can pull in the other partners. Once they see the blueprint and know it can be replicated, I think they’ll be ready to jump in.
Can practices use existing clinical staff to get research off the ground, or is a dedicated CRC important?
Dr. Waggoner: I would absolutely invest in a good CRC. Start with one trial and a good CRC. If you’re successful there, pull in another investigator and add another trial.
As you looked to grow, where has partnering with Iterative Health (IH) helped?
Dr. Waggoner: We knew we had the ability and the potential to have a large, platform-wide research entity. We knew we had the potential to enroll very well, and once you enroll well in one trial, obviously you’re going to get more trials. The resources that IH has brought have been really important in helping us transition our existing trials and start new ones, particularly on the pharma and device sides. That collaboration has made the process quicker for us.
When your startup is shorter, you’re going to enroll quicker and close that trial to accrual sooner. That puts you in a position to launch additional trials. It’s a domino effect, and it starts at the very base level with that collaboration.
What would you want community cardiologists who are considering research to understand?
Dr. Waggoner: You don’t have to be a big university to do research. The reality is that there’s a lot of opportunity in both medtech and pharma in cardiology.
Being on the leading edge of that science bubble is something I think we need more of. We need more people to take leadership roles in local research programs, move the needle forward and help patients by expanding device and therapy indications.