Ian

Law

MD

Meet Ian Law, MD

Ian Law, MD, is division director of pediatric cardiology at University of Iowa Stead Family Children’s Hospital. His clinical practice and research focus on the management of arrhythmias in children and adults with congenital heart disease. This includes the diagnosis and management of syncope, supraventricular tachycardia, and ventricular arrhythmias.

Why pediatrics?

My parents had seven kids in eight years. It’s not quite as impressive as it seems; I have an identical twin brother. I grew up around kids, so pediatrics seemed like a natural fit.

Describe your path to becoming a physician.

As a freshman at the University of Iowa, I walked into a room of pre-med students where an adviser was outlining the required courses to take—which classes in what order. There was one seat left in front.

While everyone else had pens that clicked to change to different colors of ink and highlighters, I came in and asked the student next to me, “Can I borrow a piece of paper and a pencil?” As the speaker would emphasize a point, you’d hear clicks across the auditorium and then the sound of everyone scribbling notes. That’s when I thought, “Maybe I’m not supposed to go into medicine.” I didn’t think I was as organized as those students, and I didn’t own a multicolored pen.

I decided to switch my major from pre-med to biomedical engineering. It was also where I met my wife (she was a biomedical engineering student, too). But after completing my undergraduate degree, I thought, “Don’t give up on your dreams.” I took the MCAT [medical college admission test] and did well enough to get into Iowa’s Carver College of Medicine. When I interview people [for a position], I am always intrigued by those who take the road less traveled—because I took the road less traveled, and it’s probably what got me into medical school. It turns out that there is a great mesh between electrophysiology [diagnosis and treatment of heart rhythm disorders] and biomedical engineering.

During my residency and fellowship training, I had a great mentor at the University of Michigan. He not only taught me about pediatric cardiology and electrophysiology, but also emphasized, “We are not treating diseases; these are children we are caring for.”

What would you like people to know about our pediatric cardiology team?

When I came to the University of Iowa in 2000, the interventional electrophysiology program was relatively small with less than 10 procedures performed per year. My No. 1 goal was to provide the best care possible for every child with an arrhythmia. I wanted to be able to tell parents with confidence, “We can take care of this. We have the necessary expertise, equipment, and team.” We did 80 procedures the first year I came. Now we are doing close to 200 per year.

Our electrophysiology program has grown well beyond what I expected. But it is not just about the number of children and adults that come here. We have been entrusted with caring for patients with complex diseases; we have a tremendous responsibility.

We have a team here that is really quite remarkable and provides care comparable to the largest centers across the U.S. This past month, we did a procedure that was a first of its kind, and we did it on a child with complex heart disease.

More than half of the procedures we do to treat arrhythmias do not use radiation. For children, that makes a huge difference because radiation exposure is cumulative, especially in children who undergo multiple catheterization and imaging procedures. We have the lowest percentage of cases using radiation of any of the hospitals in our Midwest consortium [group of hospitals]. The radiation-free procedures are not any longer; they are just safer.

It’s now the expectation at University of Iowa Stead Family Children’s Hospital to minimize or eliminate radiation exposure. This would not be possible without the commitment of our team. We transformed the concept of using minimal to no radiation during procedures from something that is novel to something that is expected.

How has pediatric cardiology changed?

Pediatric cardiology used to focus primarily on children because a good portion of our patients did not survive into adulthood. With the advances in medical care over the past few decades, there are now more adults who have congenital heart defects than children. We follow many of these patients throughout their lives. We have a great responsibility to make sure that they do not fall through cracks after finishing high school or college. The adult congenital heart disease population grows by 5 percent per year. It is also amazing to think that many of the procedures that used to be performed in the operating room are now performed in the catheterization lab, allowing patients to go home the next day.

What is the hardest part of your job?

The hardest part? You can’t save everybody. There’s no disease worse than one that takes a child from a parent. Even with all the technology we have, we can’t save every child. Those are tough conversations to have. No one looks forward to that. But a big part of what we do is supporting patients and families even when the outcome is not what we wanted. With our palliative care program, we ask, “What can we do to support you?”

What is the best part of your job?

This is why I do it. [Picks up framed picture drawn by a child] This patient had several procedures done in Kansas, but her arrhythmia kept coming back, so she came here. She wrote, “Thank you for fixing me. I’m sorry I won’t get to see you anymore.”

The gratitude of patients and families is extraordinary. I would take a hug from a patient or a parent any day over a paycheck (do not tell that to my boss).

I also enjoy being part of a team that is making advances and leading the field of electrophysiology. We are not only affecting patient care here, but our techniques can also be used across the nation to improve patient care. To be able to do that is pretty remarkable.