Cardiologist Dr. David Aguilar on turning challenges into opportunities, benefits of diverse experiences

David Aguilar, MD, professor of medicine and a cardiologist at the Gill Heart & Vascular Institute, recently moved to Lexington, Kentucky, from Houston, Texas, where he was a faculty member at the Baylor College of Medicine as well as the University of Texas Medical School and School of Public Health.

We recently caught up with Dr. Aguilar about his education and career, the challenges and opportunities he has experienced as a Hispanic physician, and the importance and benefits of incorporating diverse experiences and viewpoints.

Tell us about you and your career. 

I’m a noninvasive cardiologist with specialized training in echocardiology. I was born in Pasadena, Texas. I’m of Mexican descent. My mom was from Mexico, and my father was from a town on the Texas-Mexico border. I went to Texas A&M for my undergraduate work and from there went to the Baylor College of Medicine. Once I finished my medical school training, I left Houston and went to Boston to complete my training in internal medicine and a cardiology fellowship at the Brigham Women’s Hospital, a Harvard medical teaching hospital. I did that for seven years and then met my wonderful wife. We had two children and decided to move back to Texas, where I’d been on faculty at the Baylor College of Medicine and the UT Medical School and School of Public Health.

I also work on clinical research, studying a variety of topics, but predominantly focusing on cardiometabolic diseases such as diabetes and obesity. I study mechanisms that contribute to disease, as well as strategies that may lower the burden of heart and vascular disease.

What brought you to UK HealthCare? 

This stage in my career provided a nice opportunity to reflect on where my wife, also a physician, and I were in our careers and explore new challenges and directions. My wife had a great job opportunity at UK, and I looked at it as a chance to expand on my research in Texas, which had focused on cardiovascular disease and some of the comorbid illnesses that are also quite common in Kentucky, such as diabetes and obesity. Our children had also graduated from high school, so it was a nice opportunity to try something different.

My wife, Emily [Sedgwick], is the executive chief medical officer at UK. As a dual-career couple, advancement opportunities have come at different times in our careers. This was a time where I could help support her in her pursuits while still having tremendous opportunities myself. It’s a give-and-take that happens over time, so if I could help her, I was more than happy.

If you could go back five or 10 years in your career, what would you say to your younger self? 

Even going back further, 10 or 20 years, I would probably say to take risks and try to address big problems. Swing for the fences, as they say; go big.

My mom was a migrant worker who immigrated to the U.S. and had a middle school education, but she was probably the smartest person I have known. She was a role model in always trying to help others and being kind. My father joined the military service from high school. I think that many of us from different backgrounds may sometimes wonder if we are good enough or if we deserve to be here – what they call imposter syndrome. I would remind my younger self that these are natural feelings and that I do deserve to be here. I would also remind myself that baseball players who get on base one out of three times become all-stars, so you can miss a couple of times and it’s OK. Those periods of anxiety may be a little uncomfortable, but if you can reframe those feelings, this is where improvement occurs.

What is one work or life experience that you appreciate for the lessons you learned?

I think one of the best life experiences I had was my internal medicine and cardiology training in Boston. It was very different geographically and culturally from where I grew up. I met remarkable people who became lifetime friends, and I think my training was really influential in my career and in my ability to believe in myself. It’s also where I met Emily, so that was great.

How do you foster self-growth outside of work?

I enjoy spending time with my family. I think it helps me grow personally. It reminds me of what’s important and grounds me. I also enjoy reading; it provides an outlet and different viewpoints on different topics.

What are you most curious about in life?

I feel very passionate about learning and about medicine. I’m curious about new treatments for diseases. I love to learn about cardiology, about new ways that we might be able to prevent diseases and the factors driving disease processes, including socioeconomic and physiological factors. Sometimes I joke that if you can’t find me, then I’m off somewhere reading a medical journal!

What is the most courageous thing you have done?

When I moved to Boston; that was a big step for me. Before I went to interview for my residency, I’d flown one time to Washington, D.C., in high school, but other than that I hadn’t traveled outside of Texas. I was fortunate to be accepted into the internal medicine training program, so I thought I should try a new adventure.
I don’t think I’d seen snow before moving to Boston, and I learned that I could drive my old car in the snow and it was perfectly fine. More seriously, I learned that we all have common, shared experiences. Whether we’re from Houston or Boston, we may have different accents – we may have different ways of saying “going to the park” – but in general, we have shared experiences and learn from each other, and I learned that I could succeed.

What inspires you most in life?

I really think it’s the idea that I’m in a position where I can help others. I don’t think there’s anything more important than when I sit down with a patient and talk about their health. That’s a very special relationship; it’s a privilege to take care of someone and learn about their life. We all have periods of vulnerability, such as an illness, and to realize that someone has entrusted you with their care is a huge privilege and responsibility. That person sitting across from you is someone’s parent, child, brother, sister, friend. A lot of people have entrusted you to do your best to help them, so that inspires me to be better in taking care of patients.

I also have the privilege of performing clinical research, where we start thinking about how we can help populations and improve care, health and quality of life. It’s also very important to me to help my colleagues, either in day-to-day patient care or in their career. We’re all a team, so how can we help each other be better? That really is my inspiration.

If you could make any one change in the healthcare industry, what would it be?

It would be improving access to care, and improving health education and literacy. The COVID pandemic has highlighted health inequities that persist in the health care system.

In our own work with diabetes and its relationship to heart disease, we have seen tremendous health inequities. We used to refer to Type 2 diabetes as “adult-onset,” because people would get it as adults, but now there’s a significant number of teenagers who develop Type 2 diabetes. The rates are not extremely high, but they’re twice as high as they were 10 years ago. When we look at the racial and ethnic distribution among these teenagers, we realize that certain ethnic groups have much higher rates of Type 2 diabetes. We have to address these inequities by improving socioeconomic factors, health education and appropriate access to preventive care for all.

When I was at the UT School of Public Health, I was surrounded by genetic experts, and I learned a lot from them; but I always reminded them that someone’s zip code seems to be much more powerful than their genetic code for cardiovascular disease. We really have to address these issues.

What has your journey been like as a Hispanic physician?

It has had its challenges and opportunities. When I was training at the Brigham Women’s Hospital, there were very few Hispanic physicians in the program. Sometimes I would be mistaken for someone who worked on the housekeeping staff, but I always looked at it with positive intent – people at that time and place may just not have previously met a Hispanic physician. I might help them get a towel and then go back and reintroduce myself as their physician for the next few days. I feel that if we can remind people with kindness and respect, it can be an important learning opportunity.

As a Hispanic physician, I have very much enjoyed taking care of Hispanic patients. It has been a great experience to take care of patients of similar backgrounds who sometimes only speak Spanish. It is a wonderful feeling to connect with them, occasionally laugh with them, and understand some of the nuances that may be missed with a translator. It often provides for a much more meaningful experience.

What do the UK HealthCare Living DIReCT values (diversity, innovation, respect, compassion, teamwork) mean to
you?

I think it’s so important that the institution directly states these values. By doing this, it becomes part of strategic decisions and goals. When I look at those words, I think of the importance of empathy in how we work. These words stress the importance of understanding others, embracing diverse backgrounds and viewpoints, and then incorporating those viewpoints into a team. How do we take advantage of the diversity that we have? How do we build the diversity that we need? How do we use that information as a team? Because this will drive innovation.

I am so impressed with UK’s devotion to improving the care and health of people in Kentucky. If you ask anyone about our purpose, they’ll say it’s to improve the care of people in Kentucky, and I am excited to be part of that team.