How Dr. John Anthony Pacelli Vitarello Is Helping Americans Fight Heart Disease

Dr. John Vitarello is a medical doctor and fellow of cardiovascular disease at the University of Virginia.

He graduated from Columbia University with a degree in Nutrition before embarking on a career in medicine.

While in graduate school he performed clinical research with prominent weight loss specialists including Dr. Louis Aronne, the founder of The Obesity Society. After earning his medical doctorate from Georgetown University and completing medical residency at Beth Israel Deaconess Medical Center in Boston, he began his training in Cardiovascular disease at the University of Virginia.

Having been recognized for his continuous contributions to the medical field, Dr. John Vitarello has been published in various peer reviewed journals and his research on hypertension in US adults was presented at the American College of Cardiology Conference in 2021.

 Vitarello plans to establish a cardiometabolic clinic that focuses on weight management, diabetes, high cholesterol, and high blood pressure. With a commitment to improving the lives of his patients, he continues to make a positive difference in his local community and the medical field as a whole.

What are you currently doing in this space?

Fellowship refers to subspecialty training that doctors may choose to pursue after completing their medical doctorate and general training. Fellowship in cardiovascular disease is at least a three year commitment in the United States.

My responsibilities are to care for patients admitted to the hospital and see patients once they leave the hospital in my outpatient clinic. Common reasons that patients are admitted to a cardiology service in the hospital include heart attacks, heart failure, and arrhythmias.

There are different subspecialties for a cardiologist. There are interventional cardiologists who open up blocked arteries electrophysiologists who treat abnormal heart rhythms. My future area of expertise is preventative cardiology, which identifies and mitigates people’s risks of developing heart disease. Those risks are namely high blood pressure, high cholesterol, high blood sugar, and being overweight. I will be a doctor specializing in cardiology.

What inspired you to become a doctor and a cardiologist?

One of the inspirations for becoming a doctor happened at the age of nine when I was diagnosed with epilepsy. Encountering the medical system at a young age, from the perspective of a patient, is not something that most adolescents experience. The people that took care of me during this time were some of my most important role models. They were a large part of the impetus for me to go into medicine.

What defines your approach to patients?

One very helpful phrase is, “we have two ears and one mouth.” It is important to listen to what the patient is saying. It should always come back to the patient. Medicine has grown to be very sophisticated with tests and informative pictures we can take of the heart. However, at the end of the day, it is the patient who can help give us the information we need to take care of them. Before I advise patients, I want to get a sense of what they’re experiencing. Chronic disease can have a big impact on people’s lives, and a significant impact on mental health. I let patients share what is most important in their experience. It is the most effective way to establish a patient-physician relationship.

What are the keys to being productive that you can share?

This should strike a chord with millennials and Generation Z people who have grown up with technology. I carry two smartphones, one for business and a personal smartphone. A phone can be an asset or a distractor. There are always distractions pulling and tugging us away from our focus of attention. Smartphones connect us with so much information at our fingertips which can make us better doctors. But there are also a lot of distractors. One key to my productivity is to try to minimize the number of distractions I have from devices. Whether it’s a device I’m wearing or my phone, productivity is achieved by mitigating those distractions to better focus on the task at hand.

What is the long-term goal for your career?

My idea is to have a cardiometabolic clinic. In 2013 I was in New York, doing my master’s in nutrition. I learned about pharmacotherapy for weight loss. I worked at a weight loss research center at Weill Cornell. There were two important lessons I learned during my training. The first lesson is that weight loss is extremely difficult, no matter how well-resourced or motivated people are. Second, people who are being treated and are losing a lot of weight are noticing improvements in other aspects of their health. It’s not just feeling and looking better. They take less blood pressure medicine and their blood sugar is more controlled. That’s when the idea hit me that I want to focus on trying to mitigate these risk factors for heart disease.

My long-term career goal is to change this paradigm. As doctors, we should be focused on a more holistic approach. Addressing obesity will help patients tackle the problem. We should deploy our growing armamentarium to help patients lose weight and mitigate the other risk factors for heart disease. The number one killer in America for a very long time has been cardiovascular disease.

How do you measure success? 

The most rewarding part of my job is when I get to have a very good relationship with a patient and I’m able to change their life in a positive way. After a patient experiences a serious medical illness they are at a crossroads. It is a really scary place to be. As an example, a man who’s been smoking his whole life and hasn’t focused much on eating a heart healthy diet may suffer a cardiac arrest. At that crossroad, can he continue what he did before or will he understand that he has an opportunity to make a change? Perhaps he will quit smoking. I consider success to be the rewarding feeling you get when you help guide someone to make a big change in their life and they become more fruitful.

What’s the most valuable lesson you’ve learned through the course of your career?

I am at the beginning of my career, in a sense. I am in a place right now where I’m taking more advice than I’m giving.

What advice would you give to others who are considering entering the Cardiology field?

It has been a tough few years for health care workers. If you ask people how they feel about working in health care, they’ll tell you that they have a lot of frustrations. But despite that, it’s still a great profession. I would tell anyone coming into the field that it’s a sacrifice. It takes ten years to be a cardiologist. After completing college, you go to four years of medical school, complete three years of residency, and another three years of fellowship. Along the way, you move multiple times, take multiple exams, and work a lot including weekends, early mornings, and late nights. Cardiology attracts motivated career-oriented people. Sometimes we’re a victim of our own ambitions. It is important to take some time to pace yourself.

What are some of your favorite things to do when you’re not working or treating patients?

I love spending time with my wife and my family and friends. The pandemic has really demonstrated the importance of having strong social connections. The lockdowns isolated people. Two years later, there’s still a little bit of weirdness about traveling to see others. Friendships and our connections with family create resiliency. It is so important to nurture relationships above all. I believe people are the most important factor in our happiness.

In fact, Harvard did a generational study confirming the impact of relationships on people. It started in the 1930s or 40s. It was scientists studying Harvard men. The surveys expanded to include women and people who live around Harvard. These people were tracked over time from generation to generation. When they looked at what had the biggest influence on an individual’s happiness, it was personal connections.

How would your colleagues describe you?

Colleagues would describe me as outgoing. I think it is so important to try our best to have active social lives and build important relationships for our happiness. I am a curious person. I think curiosity is the cornerstone of a good position. We have to ask questions if we don’t know the answers. The best doctors who are well established in their careers, still ask questions. And that’s what makes him a great doctor. I nurture my curiosity, especially now as a trainee. I try not to be embarrassed that I don’t know something. I’d be described as curious, outgoing, and inquisitive.

How do you maintain a work-life balance?

Having a work-life balance is very tricky while in training. We work six days a week, which is prohibitive to maintaining a work-life balance. It can be plentiful for those who use it well. The key is to be a planner. Our perception is that we have no time. It simply takes a lot of careful planning.

What is a piece of technology that helps you the most in your daily routine?

The piece of technology I use most is my watch. With good time management, I can plan things to do outside of work. I believe being on time is a lost art form which I believe is extremely important. Some patients travel great distances across rural Virginia to see me in a cardiology clinic. I endeavor to be on time for my patients. Being on time makes a big impact on patient relationships.

What is one piece of advice you have never forgotten?

One piece of advice I’ve never forgotten is to be patient and to weigh all the information before making a decision. Do not rush to judgment, or what we call it anchoring. The most important part about being a doctor is to be a good diagnostician. One has to wait and have all the facts at their fingertips before diagnosing patients.