Mar 17, 2025
Show Notes:
After
graduation, Angelo Milazzo returned to his home state and attended
medical school at the State University of New York at Stony Brook.
He developed an interest in cardiology and decided to pursue
post-graduate training in pediatrics and pediatric cardiology at
Duke University. Angelo completed his post-graduate training in
2002 and joined the Department of Pediatrics as an Assistant
Professor of Pediatrics.
A Growing Practice and Becoming Chief Medical
Officer
In 2002, he was offered the opportunity
to start a pediatric cardiology practice in Raleigh, North
Carolina. The practice grew from a one-man operation to a practice
with about 30 physicians across various specialty areas. In 2017,
Milazzo became the vice chair for practice for the Department of
Pediatrics at Duke Health, which has grown to 250 clinical faculty
and 50 research faculty. Angelo then became the Chief Medical
Officer for the Duke Health Integrated Practice, overseeing all
physicians who practice at Duke Health. This role allows him to
take the best of his administrative leadership within one clinical
department for children's care and spread it across the entire
enterprise.
The Economics of Health Care and the Business of
Medicine
Angelo's hands-on administrative
experience and managerial experience have led him to become
interested in the didactic aspect of his career. He believes that
his administrative experience and managerial skills have allowed
him to excel in various aspects of his career, including pediatric
cardiology. Before the pandemic, Angelo enrolled in business school
and completed his MBA in just under two years. He was interested in
the economics of healthcare and the business of medicine, but also
enjoyed the perspective of classmates from various industries and
walks of life. Today, he is a practicing pediatric cardiologist,
spending about 40% of his time in clinical practice and 60% of his
time in administrative work. He is also interested in health equity
research and is part of a project funded by the CDC.
What it Takes to Be a Physician Leader
Angelo explains that, to be a great physician leader, one must
first be a great clinician, and this takes so much more than just
medical knowledge. He believes that engaging with patients and
families is a privilege and that this energy and insight can inform
his managerial work. He has had the privilege of mentors in
medicine and being taught by amazing clinicians, which has allowed
him to feel comfortable with fraught conversations. He explains how
his managerial experiences and administrative experiences make him
a better clinician. He has had to negotiate with professionals from
different backgrounds and training perspectives, enriching his
perspective and broadening it. This constant bilateral
communication within him allows him to enhance both sides of his
career.
The Executive MBA Program
Experience
Angelo talks about the value of his
Executive MBA program, and how he appreciates the practical aspects
of the program, such as lectures, video calls, and team meetings.
However, he also highlights the value of teamwork and learning from
professionals from different industries. He shares his capstone
project, which involved working with a delivery firm in Eastern
Europe, a firm far from his daily work. The team consisted of
professionals from various industries, including military, micro
brewing, airline, and healthcare professionals. The challenges
faced in his work were unique but universally applicable, and he
learned valuable lessons from the experience. He also talks about
systems used during a public health emergency, the A3 structure and
how it is used for improvement projects, and the journey of
improvement.
The Performance Improvement Journey
Angelo talks about management principles adopted in health care and
the performance improvement journey that began with the
introduction of a standardized electronic health record in 2013 and
the adoption of Epic, which is now used by two-thirds to
three-quarters of major health systems in the country. This allowed
for a common set of data mining tools to collect clinical
information and understand success or failure around quality
initiatives. The organization's new leaders, including those from
other health systems and academic centers, were committed to this
continuous improvement environment. By the time the CMO became vice
chair in 2016, they were ready to bring these principles into their
department. Now, almost a decade later, the organization has built
a culture where everyone wants to be a quality improvement
scientist. They have developed an academy to train healthcare
professionals to become quality improvement scientists, which
involves a rapid boot camp that teaches principles over a
concentrated period of time. Many of these projects have been
presented at regional, national, and international levels, covering
various medical specialties, from complicated heart surgery to
solid organ transplant to medical genetics to obstetrics and
gynecology.
Influential Harvard Courses and
Professors
Angelo mentions three courses and
professors that have resonated with him at Harvard: Arthur
Kleiman's course on Illness Narratives, Professor Dante Della
Terza’s Divine Comedy class, and Gregory Nagy's Heroes for Zeros
class. Angelo's course with Professor Kleiman was about the idea
that hearing patients talk about their illness is a form of
storytelling, which he uses in his work. He also mentions Professor
Nagy’s use of a clip from Blade Runner, a sci-fi noir film, in his
class. He believes that this class spoke his language and that he
was in the right place for him. Angelo also mentions missing the
Michael Sandel Justice course, which he later took through the
Harvard EdX program.
Timestamps:
01:29: Angelo Milazzo's Journey After Graduation
05:29: Transition to Administrative Roles and Business School
09:48: Balancing Clinical Practice and Administrative Roles
14:30: Learning from Business School and Applying Lessons
26:11: Implementing Continuous Improvement in Healthcare
36:40: Influential Courses and Professors at Harvard
Links:
LinkedIn: https://www.linkedin.com/in/amilazzomd/
Featured Non-profit:
The featured non-profit of this episode of The 92 Report is recommended by Julie Cotler Pottinger who reports:
“Hi. I'm Julie Cotler Pottinger, class of 1992 the featured nonprofit of this episode of The 92 report is every library. Every library helps America build support for libraries and also helps us fight book banning in our communities. I'm proud to be the National Ambassador this year for every library under my pen name, Julia Quinn, and I've been working real hard all year to help them raise money and awareness. You can learn more about their work at www.everylibrary.org and now here's Will Bachmann with this week's episode.”
To learn more about their work, visit: https://www.everylibrary.org/