Dr. Nisarg Changawala
Dr. Nisarg Changawala is a pulmonary physician with Lung Cancer of Nevada, a subsidiary of Comprehensive Cancer Centers of Nevada, which participates in more than 170 clinical trials each year and has played a role in developing more than 60 cancer therapies approved by the Food and Drug Administration. Changawala addresses diseases of the lung, both acute and chronic.
Describe your medical specialty and what makes it vital for our community.
On a given day, I can see a patient with bronchitis, pneumonia, lung cancer and anything in between.
What makes this specialty important is that we are seeing more smokers than ever; numbers are especially going up with the female population. Smoking is closely associated with lung cancer, the top cancer killer. And in our community, there are a lot of casinos, which subjects a lot of folks not only to venues that accept smoking but also to secondhand smoke.
When did you know you wanted to be a doctor?
There was not a definite day or “aha!” moment … but generally, I knew right after high school. I wanted to be in a field where every day could be different. And in the pulmonary world, each patient presents a different challenge. No patient is the same, even if they come in with the same symptoms. For example, two patients may come in with shortness of breath. After we dig in to their additional symptoms and respective family histories, they can have completely different diagnoses.
What is the most important part of your job?
The most important aspect of pulmonary care — and so many other specialties and components of health care — is communicating with patients. You have to be able to clearly explain to them what’s going on. Additionally, they need to be treated as individuals, as there are a lot of unique emotions attached to one’s health, especially in my field.
In the pulmonary world, patients only come see me when they are really not feeling well — they have a shortness of breath and chest pains. Naturally, a lot of concern and emotion can come with not being able to breathe properly. Amid the emotions, you have to be able to communicate clearly with them so they understand the issue at hand and can get better.
Where are you from and what brought you to Las Vegas?
I’m originally from India and came to the United States in 2007. I went to school in West Chester, Pa., where I got my master of public health.
After training in internal medicine and pulmonary/critical care medicine in New York, I came to Las Vegas for an interview with Lung Center of Nevada, which is now a division of Comprehensive Cancer Centers of Nevada. I really liked the people in Las Vegas, accepted a job and moved here in 2015. Compared with New York, I just love the weather here — though June to August can be tough.
What challenges come with the local health care industry, on both sides of the stethoscope?
Getting tests and medications approved through insurance can be a challenge, which is certainly not unique to our city.
Additionally, we live in the world of the internet. Some patients come in adamant about a certain treatment or diet that they should be on.
You must coach a patient through what they should believe and what they should not believe based on their research and what they are actually facing.
What is the latest innovation in treating patients who suffer from lung disease and like illnesses?
In terms of new innovations, last year I started doing a procedure called Endobronchial Ultrasound, or EBUS. It is a minimally invasive bronchoscopic technique in which I use ultrasound to locate enlarged lymph nodes and masses/nodules in the chest. These lesions can be caused by a number of diseases, including cancer. It is an easy, routine outpatient procedure and typically lasts less than one hour. Patients experience little discomfort. To date, I have done more than 100 of these procedures.
What’s the best professional advice you’ve received?
My mentor, Dr. Michael Niederman, gave this advice to me during my fellowship in New York. He said two things: First, “Always finish the job and then move on. Do not leave it for later.” The second piece of advice he gave me was, “If you want things done right the first time, just do it yourself.”
Do you think the role of a doctor has changed over the years?
Yes, the need for a quality physician is that much more important. People have more access to health care information; they are more educated and when they walk in a clinic, they have some notion of the symptoms for specific illnesses. With that said, it is so important to have a physician that can help you navigate through the clutter and tell you exactly what is going on.
Not only does a physician need to make an accurate prognosis, but lay out a plan and follow up properly on that plan. Today’s doctor is that much more of a trusted source of information and, ultimately, action.
How might an overhaul of health care at the federal level affect what you do?
My primary job is to take care of my patients, no matter what happens at the federal level. What happens politically may affect the insurability of specific patients and how much access they have to get the medication or testing they need. Political measures can also affect the affordability of medications and tests as well.
Do you have any ideas about how to fix a system many say is broken?
Some may strongly agree and some may disagree that the system is broken based on their individual experiences. Locally, I do know that there are many great specialists and physicians who provide world-class care and, in many cases, there is no need to leave our community for great care. The best way to contribute to your profession or a broader system is to make the best contributions possible on an individual level. That’s what I, and many of my colleagues, try to do each day.
What is your dream job outside of your field?
I love food and traveling. I envy Andrew Zimmern on the Travel Channel — he gets to travel to different countries and experience different cultures, all while eating amazing food. If someone would pay me to travel the world and eat a bunch of great food, that would be awesome. Who wouldn’t love that?