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Dr. David Slotwiner kneeling on pasture with two border collies

Dr. David Slotwiner: A cardiology chief shares how training his dogs to herd sheep shaped his perspective on leadership

Dr. David Slotwiner kneeling on pasture with two border collies

In the middle of a muddy pasture on a farm in New Jersey, Dr. David Slotwiner, an electrophysiologist and chief of cardiology at NewYork-Presbyterian Queens, calls out to his border collie, Cosmo. He shouts commands like “lie down” and “come by” to get Cosmo to stop, start, and change directions. Their goal: to corral a small herd of sheep into a pen.  

This is a typical weekend for Dr. Slotwiner, who is also an assistant professor of clinical medicine and population health sciences at Weill Cornell Medicine. Sheepherding became an unlikely side passion after he began these visits to the farm to help Cosmo, his family’s border collie, whose aggressive, reactive nature was proving problematic.  

Both Dr. Slotwiner and his wife, Anne, who have always had dogs in the family, suffered multiple bites as Cosmo grew older. “We were encouraged to give him up, but there was no way we were going to do that because he would have been put to sleep,” he says. Determined to help Cosmo, they consulted multiple dog trainers, to no avail. Then, one of them referred the couple to a farm that trained border collies to herd. On their first visit, almost immediately after seeing the sheep, “Cosmo understood how his presence could influence them,” Dr. Slotwiner says. “Within 45 seconds, he was herding them. His personality changed; we realized this gave him a lot of confidence and mental stimulation. It was like he found his calling in life.”

Dr. Slotwiner also became hooked and started to train as a handler. He says his journey with Cosmo has been a test of his communication skills, patience, resilience, and ability to problem-solve — which isn’t so different from what’s required of him on the job, whether he’s leading global efforts in his field to standardize patient data or teaching trainees in the operating room.  

“Whatever leadership role I am in, the parallels are quite remarkable,” Dr. Slotwiner says. “It’s always a constant adjustment trying to be as effective of a leader as I can.”  

Dr. Slotwiner spends his weekends practicing herding on a sheep farm with his two border collies, Cosmo and Luna (pictured in video).

Becoming an ‘Accidental’ Leader by Changing Industry Standards

By his own admission, Dr. Slotwiner says his career goals were never to be the one in charge. Instead, he says he stumbled into leadership the same way he stumbled into sheepherding — as a reflection of his passion for finding solutions.  

For the past two decades, one of the biggest problems he’s been trying to tackle for his field is how to streamline data supplied by cardiac implantable electronic devices (CIEDs) like pacemakers and defibrillators. Because each device maker transmits patient data using their own IT protocols and systems, accessing and processing that information tends to be cumbersome and archaic. Dr. Slotwiner’s interest in solving this issue began years prior to joining NewYork-Presbyterian Queens, while he was working as an associate director of an electrophysiology lab in 2006. He joined an FDA advisory panel for the approval of CIEDs, which deepened his understanding of the regulatory space around the devices just as they were starting to incorporate remote monitoring.  

“I wanted to make sure these devices were being utilized in the way that they were most beneficial,” he says. “That included trying to figure out better ways to manage the enormous amounts of data they were generating, because none of our electronic health records at the time were set up to do that.”  

The first major roadblock was that the four manufacturers who made these devices all used their own proprietary terminology to describe their products’ functions. “For example, most pacemakers have a way of responding to fast heart rhythms, but each company has a different name for that,” Dr. Slotwiner says. “I realized the only real way to manage that data would be to develop a standard nomenclature so that you have a way to communicate this data between different IT systems.” 

“This is a complicated space, and I wasn’t trying to be a leader in it. I just saw a need and was figuring out how to fill it.”

— Dr. David Slotwiner

Dr. Slotwiner spearheaded a five-year effort to standardize about 1,500 terms, a process that required getting industry backing from the major cardiology societies; buy-in and compliance from the device makers, who had to be persuaded that collaborating with competitors would be good for business; and approval of technical standards from an international engineering standards organization.  

The next phase of development is to create interoperability protocols that will allow data to flow seamlessly between the devices, the manufacturers’ data servers, and patient electronic health records. Dr. Slotwiner is currently working on these efforts with HL7 International, a creator of global standards for health informatics, and the World Forum for CIED Management, an international organization he co-founded. He expects bi-directional communication to be possible next year — exactly 20 years from when he first started on this mission.  

“This is a complicated space, and I wasn’t trying to be a leader in it. I just saw a need and was figuring out how to fill it,” he says. “I also realized I had a skill that not many had: the ability to bridge very different groups of people. I like working with engineers, other physicians, basic scientists, and corporate leadership to help everybody see each other’s side. I guess that made me into a leader, because I was passionate and wouldn’t let it go.”  

Embracing Leadership, in the Hospital and on the Farm

An interest in working with all types of people and patients is one of the reasons Dr. Slotwiner — who was an intern, resident, and fellow at NewYork-Presbyterian and Weill Cornell Medicine — came to NewYork-Presbyterian Queens in 2015, initially as the director of the electrophysiology lab before becoming chief of cardiology. He says that back in his training days, “I looked at my chief and thought, ‘That’s the last thing I want to do.’ I started my career focused on clinical care and research, and I thought that would be all I did.”  

But as he gained more experience, he realized that the changes he wanted to effect could only happen if he went into leadership, so he embraced the opportunity to take on the new role when a former colleague reached out. “I knew from my previous job, which was also in Queens, that certain areas of the borough were real healthcare deserts,” he adds. “I knew I was needed and could make a big difference here, and that I was coming back to a place that shared my values around improving the quality of patient care.”  
 

Dr. David Slotwiner and another physician looking at computer in lab.

Dr. Slotwiner joined NewYork-Presbyterian Queens as director of the electrophysiology lab before becoming chief of cardiology.

That doesn’t mean he purports to know exactly what it means to be a good leader, but he sees similarities with his experiences on the farm. Being a rookie dog handler, for instance, has helped Dr. Slotwiner relate better to the younger doctors and medical school students he trains. “When you teach, it’s important to know what it feels like to be in their shoes. You can lose that once you become the expert,” he says. “But to be a novice again at something, I can say without question, has helped me be a better teacher.”  

And on some days, he relies on what he’s learned from working with Cosmo and his second border collie, Luna, to remind himself that ultimately what people — and dogs — respond to are the same.  

“With herding, I had to learn to become confident with Cosmo and the sheep, and that’s something I’ve really been working on,” he says. “They demand calm, confident leadership to get the reaction you want from them, and that’s not so different with humans. Being clear, calm, and comfortable in your own skin as a doctor as you guide patients through treatment is something you learn in medical school, but I had to learn that in my role as chief, too. And I’m still learning.”  

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Dr. David Slotwiner: A cardiology chief shares how training his dogs to herd sheep shaped his perspective on leadership

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