Today, said York Hospital cardiologist Dr. Lawrence Petrovich, cardiology has specialists, sub-specialists and even sub-sub specialists. It’s a very different world from when he arrived in York 40 years ago, the only board-certified cardiologist in the Seacoast.
In the time since, he worked to bring the first catheter lab to the Seacoast, installed the first heart stent, put the first dual-chamber pacemaker in a patient and grew a practice that today includes 12 cardiology providers practicing in York and Wells in Maine, and Portsmouth and Newington, New Hampshire, and treating 11,000 patients annually.
Petrovich was the first specialist at a hospital that now employs numerous specialists from oncologists, to obstetrician/gynecologists, pulmonologists, urologists, plastic surgeons, thoracic surgeons and more. President Jud Knox said Petrovich played an outsized role in that evolution.
“I think he stimulated a whole new level of quality of medical care on the specialty side but it’s even broader than that,” Knox said. “He didn’t come to create a turnaround, but because of his expertise and the approach he brought, it had that effect. His presence is so strong and respected, and his clinical expertise so great, he attracted physicians – a higher caliber of physicians.”
In honor of Heart Health Month, Seacoast Sunday takes a look at the legacy of the area’s first heart doctor.
“When I came here in 1978, this hospital was too small for a cardiologist,” Petrovich said. “It seemed almost silly. I wanted to go to Maine and I was interested in the coast, and York was welcoming. I also wanted to go someplace where I was wanted as opposed to where I was a threat. And at the time, almost every little place you look at, cardiology was a threat.”
A graduate of the University of Illinois at Chicago Medical School, Petrovich went on to become a cardiology fellow at Baylor Medical School in Houston, Texas. Baylor at the time was one of two medical schools where heart catheterization and heart surgery started, he said. He became involved in the nonsurgical clinical cardiology program.
He came to York Hospital, then a small, general practice hospital, at the request of then-President Martin Ulan. “He came from a big hospital and was aggressively looking for a cardiologist, and the internists at the time were accepting of that,” Petrovich said.
He said in the late 1970s, “things were very conservative. There was no cardiology practice between Portland and Boston and they thought that’s how it should remain. Portsmouth, Dover, Exeter, Southern Maine, nothing. I was the first board-certified cardiologist.”
In order to come, said Petrovich, he required the hospital to purchase an $18,000 echocardiogram machine (using high-frequency sound waves to provide a picture of the heart) and to hire a technician, Bob Nast, who over the years maintained what would become an expanding amount of sophisticated equipment. “To his credit, Marty didn’t blanch at my demands,” Petrovich said.
Not long after his arrival, he said, Wentworth-Douglass Hospital in Dover, New Hampshire, expressed interest in having him consult, and before long he was doing procedures at Portsmouth Hospital. “I ended up hiring another doctor to work with me, because I couldn’t go to three places,” he said. Still, he remembers those first years as “a slow start. I think nobody would have believed that York Hospital would be the place where we could innovate. But that started to change.”
He expected from the start that he would be unable to pursue catheterizations, then a relatively new procedure he had trained to perform while at Baylor. In that procedure, a thin tube is inserted into the body and heart to determine where there are blockages.
“I really felt I would have to give it up,” he said. “The predominant feeling was that you shouldn’t be doing that in a small hospital. There was some number (of patients) you should reach first. That is not something I agree with or that there is any science to support.” By the mid-80s, he ended up sending patients to Central Maine Medical Center in Lewiston for the procedure, but wanted a cath lab in the Seacoast.
“I was bemoaning this to Jud (who became president in the early 1980s) and he said, ‘Why don’t we do it ourselves?’” Petrovich said. At the time, there were no cath labs between Portland and Boston. Knox, said Petrovich, “put together a huge effort” to secure a Certificate of Need for one from the Maine Department of Health and Human Services.
“At the hearing, there were three busloads of people, docs from Tufts who supported it, even two surgeons from Maine Med who supported it,” he said. The hospital received the Certificate Of Need in 1986, “and we’ve had three labs since then.”
He had always been interested in electrophysiology, stimulating the heart during arrhythmia or irregular heartbeats. Early on, he was implanting pacemakers but by the mid-90s, he was implanting automatic implantable cardioverters and defibrillators (AICD) through a catheterization procedure. The AICD remains implanted in the heart, senses when it’s going into arrhythmia, and shocks it into a regular rhythm. “That was huge for us,” said Petrovich.
At the same time, cath labs were being used for angioplasty surgery. In this procedure, the catheter is placed in the heart, and when it encounters a block in an artery, a balloon opens up the artery so a stent can be inserted.
Today, he said, “when someone comes to the hospital with a heart attack, within 60 to 90 minutes, we can get a cath in there,” he said. “People go from a heart attack to all of a sudden being fine. They often go home in a day or two.”
In 2012, the physicians and staff in his private practice Seacoast Cardiology Associates, which by then had a second location in Newington, became York Hospital employees. Today, many cardio patients in the Seacoast will be treated by York Hospital cardiologists.
Knox, Petrovich said, “has been the force behind fighting the establishment to keep the place surviving, to add these major services. He’s a fighter and he’s a winner.” And Knox sees Petrovich as the professional magnet, someone who has worn many hats over the years, including president of the medical staff, and director of both the hospital’s intensive care unit and its Heart Institute.
During these many years, Knox said York Hospital grew a reputation as a place to practice, thanks in large part to Petrovich.
“When you look at the growth of the specialists, the general physicians, and the services provided, Larry was an important part of that,” Knox said. “I’m not suggesting he recruited all of the docs, but the standard of care and quality that physicians saw in him was attractive.”
Petrovich said he is still practicing, but working more on the administrative side. Looking back, he said, “I couldn’t imagine it would go this way. I didn’t think this was going to be a big enough place to manage all that we have.
“Those early days when we were on the leading edge, that was kind of fun. When I think about the fact that we really did do that and that and that, I’m grateful.”