Interview with Robert Darling, MD About His Career Path and Clinical Insight

=Q: You’ve had an extraordinary medical career – from serving the President of the United States to leading in emergency and disaster medicine. How has that shaped the way you approach prevention?

A: Caring for the President the United States was an incredible honor which I took very seriously. Caring for him, his family and his cabinet as well as his support staff was a team approach that we took to allow the president to most effectively execute his duties to the nation.

Q: What led you to join the BaleDoneen Method and focus on proactive cardiovascular care?

A: I first learned about the BaleDoneen method about 18 years ago. When I heard it was focused on preventing arterial disease as opposed to treating its effects I was immediately intrigued thinking this is the real future of medicine if we are going to take care of our patients better and hopefully bend down the cost curve of medicine. 

Q: What lessons from your military or government service apply to how we should think about heart attack and stroke prevention?

A: In general, we try to recruit healthy Soldiers, Sailors, Airmen and Marines, who are in excellent physical condition. But often physical appearance or ability to perform exercise at a high level can be misleading and can actually mask serious underlying disease, particularly arterial disease, that is subclinical and can be devastating and cause heart attacks or strokes early if not detected. This is why the BaleDoneen Method would be so advantageous, particularly in a military setting if more widely adopted.

Telemedicine, Access, and Care Delivery

Q: You lead BaleDoneen’s telemedicine practice. What makes this virtual model work so well for prevention?

A: The so-called virtual or telemedicine model of practicing medicine is almost perfectly ideal for practicing the BaleDoneen Method. While the physical examination of the patient is important and should be done on all patients during an in person visit, the history taking, laboratories imaging and other studies can all be obtained via remote means. Additionally, telemedicine can be done 24/7/365 according to both the provider and patient’s schedules. We are no longer relegated to the 7:30 AM to 5 PM Monday through Friday in person visit to facilitate cutting edge medical care.

Q: How do you ensure the same level of connection, trust, and effectiveness in a telemedicine setting as you would in-person?

A: We find that in practice once patients get comfortable communicating with their provider via a good working telemedicine platform, excellent levels of connection, trust and effectiveness can be obtained as good as or better than an in person visit.

Q: How do you see the role of telemedicine evolving in long-term chronic disease prevention?

A: We should soon eliminate the word “telemedicine“ and just call it the “practice of medicine”. The use of telemedicine has become merely just another tool in effectively and efficiently caring for patients. 

Emergency Medicine, Risk Assessment, and Long-Term Care

Q: Having practiced emergency medicine for decades, how do you now think about risk differently?

A: I have been practicing medicine for over 40 years. As a longtime practitioner of emergency medicine, I treated disease; I was never really in a position to prevent disease. That is largely the nature of emergency medicine. That said, having taken care of so many patients with clearly preventable diseases, I have over the past 20 years evolved to trying to prevent disease and I have found the BaleDoneen Method to be one of the most effective means to do so.

Q: What is one clinical sign or risk factor that patients or providers often overlook?

A: Interestingly, erectile dysfunction in men can be an overlooked sign of severe arterial disease, but is often overlooked and treated with drugs, such as Viagra or Cialis. Similarly patients with bleeding gums and underlying periodontal disease have a very significant risk factor or root cause of arterial disease that is often overlooked.

Q: How do you talk to patients who feel “fine” but may be silently at risk?

A: Invariably these patients have heard of so-called health nuts such as marathon runners or physical fitness nuts who look great but whose first symptom of arterial disease was sudden death due to a heart attack or thromboembolic stroke. That will often get a patient’s attention and from there it’s all about education, education, and education.

Education, Mentorship, and The Future of Prevention

Q: How do we better prepare today’s providers to think preventatively, especially in high-pressure clinical environments?

A: Continuing medical education programs, such as the BaleDoneen Method Preceptorship are essential tools in highlighting this challenge.

Q: What advice would you give to physicians shifting from a reactive to a prevention-first mindset?

A: Consider it. Think about the avalanche of preventable diseases, such as heart attacks, strokes, cancer, and how if we could bend the incidence of these diseases down how we could further spread limited resources to those who need them. 

Q: What do you find most rewarding about mentoring or supporting providers through BaleDoneen’s programs?

A: It works. The BaleDoneen Method truly works. And once patients understand this and they consistently practice it, they will never have a heart attack or stroke and they will spread the word. As we lean into understanding and effectively applying artificial intelligence to healthcare, we have the opportunity of a lifetime to really make positive change in the practice of medicine and in our patient’s lives.

Universal Questions

Q: Can you share a story about a patient transformation that still sticks with you today?

A: There are so many. The story of my personal dentist Dr. Brian Smith is most notable.

Q: What do you wish more people understood about preventing heart attacks and strokes?

A: They need to understand the root causes of arterial disease. This is so important, so critical and so poorly misunderstood by the general public.

Q: What motivated you to focus your career on prevention rather than treatment?

A: Read and understand the root causes of arterial disease and then make an appointment with a BaleDoneen provider!