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Leaders & Legends: Manfred Sandler

Some of the best ideas come along when we least expect. Lt. Manfred Sandler was 23 years old, serving compulsory time in a South African military hospital when he embarked on an idea. 

Quickly, he scribbled in a notebook plans for a medical center that made sense to him, drawing up the design to best serve medical personnel and patients. Everything would flow centrally, with a nurse station in the middle. Each floor would encompass different levels of care: acute care, cardiac care, and a designated cath-lab and surgical areas. 

Upon finishing the sketch, he looked it over. 

The plans had come to him in a flash of inspiration, though Sandler is no architect. Manfred Sandler is a man of science. Harkening back to this inspirational moment, he refers to it as a vision or – laughing with a smile – “a delusion of grandeur.”

“It was just something that was on my mind,” reflects Sandler more than three decades later. “I had this idea that one day I was going to open a heart hospital.”

At the time, he knew nothing of Gwinnett County – only that he wanted to leave South Africa to further his career as a doctor in America. He certainly had no inkling that the sketch he’d just drawn in his book would decades later bear striking resemblance to the Strickland Heart Center: a 40,000 square-foot, state-of-the-art facility he’d play a huge part in making a reality for Gwinnett County residents.

“I used to just sit and wonder,” Sandler says. “At the time, I was just drawing pictures. I would look and think about the flow of hospitals and ask myself if I could just have one building that was devoted to the heart, that was all heart, what would it look like?”

‘The physician I am today’

Born in Johannesburg, South Africa, Dr. Sandler knew from an early age he wanted to be a doctor. He didn’t know what specialty, but his time spent as the son of two pharmacists made clear to him he didn’t want to go that route.

“I worked on the weekends counting tablets in the pharmacy and I used to see all of these prescriptions written by doctors, and I developed an interest in medicine very early,” Sandler says. “I knew I was going to be a doctor from when I was 8 or 9 years old. I never really swayed from that. The only question was what type of doctor … and I knew I didn’t want to count tablets my whole life. I’d done enough of that.”

His career pursuit sent him on a collegiate path that started in Johannesburg. He earned a Bachelor of Medicine and Surgery Degree. Then, an elective at the Department of Pediatric Neurology and Cardiology in London, England; an internship at a hospital in Johannesburg and a surgery internship; followed by the aforementioned compulsory military service where he served as lieutenant. He continued studying medicine in South Africa until 1987, when he moved to North America.

He did some post-graduate training at Albert Einstein Medical Center in Philadelphia, followed by cardiology training at Washington University School of Medicine in St. Louis.

In 1994, he moved to Gwinnett County, taking a post with Gwinnett Consultants in Cardiology, where he stayed until 1998 when he started with Cardiovascular Group, P.C., where he remains to this day.

The differences in the private practices that he worked at in Gwinnett County and the medical facilities he worked in while in South Africa are vast. That’s partly to do with the fact that it was in the 80s when he practiced there – but Sandler says it’s also due to the fact that the countries are very different.

There were only two medical schools where he trained in South Africa.

“Fortunately, I managed to get into the one I applied for,” Sandler says, adding that he owes his decision to stay in the field to two talented professors of cardiology who greatly inspired him.

“Different professors give you clinical training, teaching, etc.,” he says. “There were two professors both leaders in South African cardiology who solidified my decision to pursue a career in Cardiology… They were both behemoths in the South African medical field. They were brilliant, and they were excellent teachers.”

In South Africa, he also learned from the greatest teacher – real world experience. 

“While I was over there, things may be different now, but the technology wasn’t what it is here,” he says. “You had to use your brain and your stethoscope to make life saving clinical decisions. He learnt early on that listening to the patient is absolutely vital to making a diagnosis. This together with a thorough examination as well as basic testing allowed me to appropriately diagnose and treat patients without ordering every test known to man or womankind. It taught me to become the physician I am today.”

‘I started asking some uncomfortable questions’

To this day, Sandler is averse to what he refers to as “overtesting.” He likes to use his brain, doing examinations and speaking to and listening to the patient’s story. Often, their diagnosis can be made before even laying a hand on them, he says. 

His medical colleagues in Gwinnett County have enormous respect for Sandler’s expertise as a cardiologist.

“He’s the consummate physician gentleman – always has been,” says Dr. James Smith, medical director for the emergency department at Northside Hospital Gwinnett. “(Sandler) has the ability to make everyone he interacts with feel like the most important person in the room.”

Dr. Martin Siegfried says Sandler “has relentless integrity. When he does it, he does it right. He treats staff, employees and patients like they are the most important person he knows. I think that’s how he really sees them too. He respects everyone.”

Being a good listener, Sandler says, is one of the best traits a cardiologist can possess – as well as compassion and a patient-focused outlook.

“You’ve got to give them the attention they deserve. They’re there to see you,” he says. “They want advice from you, so you have to be attentive to what their concerns are.”

It’s an approach that has served him well as a cardiologist in Gwinnett County, where he’s garnered many accolades (including the Gwinnett Chamber of Commerce Citizen of the Year in 2010 ) as both a physician and as a citizen who has worked to improve the county. He has been voted one the best cardiologists in Atlanta every year by his colleagues as published in Atlanta Magazine and US News and World Report.

His most notable achievement includes efforts to establish a first-rate cardiac facility in Gwinnett County.

When Sandler arrived in Gwinnett County in 1994, the county was well populated “but very underserved from a cardiology point of view,” he says, adding that their capabilities were limited because they weren’t allowed to perform procedures like stents, balloon angioplasty or open heart surgery. This was during a time when Gwinnett’s population was around 750,000, making it one of the largest counties in the state.

“And yet, we were having to put patients in an ambulance and transfer them to another county for cardiac care,” Sandler says. “This is around the time I started developing an interest in the political side of things, because I wanted to know why we couldn’t do all of this at (what was then called) Gwinnett Medical Center. So, I started asking some uncomfortable questions of the people in government.”

He learned of a law called Certificate of Need, which is Georgia’s and certain other states program for evaluating the need for new hospitals or services in designated regions of the State. Without a Certificate of Need, hospitals cannot open or expand either their bed capacity or new services. This was the roadblock that the administration of then Gwinnett Medical Center faced when trying to become an Open Heart full service cardiac facility. The hospital had attempted to get the CON once before and failed. 

Sandler became vocal with hospital administration as well as educating leaders of the county. He also spoke with an attorney, Gerald Davidson, who pointed him in the right direction.

He arranged a meeting with the community leaders, most notably: Wayne Mason, Bartow Morgan, John D. Stephens, Richard Tucker, Rudy Bowen, Clyde Strickland and Bill Russell. 

“I explained this healthcare need to them, and they unanimously agreed to support the effort.

‘I still get choked up’

It became a mission for Sandler to see this through. He joined the hospital board, became more involved with the Gwinnett Chamber of Commerce and, together with the hospital’s then CEO Philip Wolfe applied to the Department of Community Health to prove the need for this service in Gwinnett County.

“In our case, we were transferring patients to St. Joseph’s Hospital (for cardiac procedures) … we were literally driving behind ambulances with our patients under some circumstances to Atlanta to treat the patients we had just examined in our hospital,” Sandler says. “It was crazy.”

They were transferring as many as 1,500 patients out of the county per year.

The hospital hired attorneys. Sandler served as lead physician in the case. Together with the hospital’s CEO, they traveled the county educating and rallying as many people in the community as they could.

“We were like a dog and pony show,” he says. “We spoke to rotary clubs, churches, community centers and just broadcast to anybody who would listen why we needed this service in Gwinnett.”

The initial filing for the Certificate of Need was denied – opposed by Emory and Piedmont hospitals. After weeks in court in which Sandler served as lead witness, the judge ruled against approving the Certificate of Need.

They appealed this ruling and won. It had taken over five years from start to finish, but they had finally been victorious. Gwinnett County would have an all-inclusive heart center to serve the needs of its residents.

The next obstacle would be the cost. For this, Sandler teamed up with the group of people he’d met with prior to discuss the need for the center itself.

He became the Chairman of the Hospital Foundation and together with the  foundation staff embarked on the most ambitious campaign to raise as much funding toward the estimated $32 million dollar cost Sandler recalls. The financial support received from the citizens of Gwinnett County was overwhelming. Clyde Strickland was the lead donor. Sandler approached his doctor colleagues within Gwinnett County to understand and support the need and they followed suit by donating funds on an annual basis.

The group raised over $11 million. The medical facility was christened the Strickland Heart Center in 2011.

Today, the new, dynamic and ambitious leadership of Northside Hospital Gwinnett continues to expand the heart program adding state-of-the-art services, developing the newly named Northside Heart Institute into a powerhouse program that offers Cardiovascular treatment to the residents of expanding Gwinnett and surrounding counties. Heart disease remains the number one cause of death in the country. 

While not looking exactly like 23-year-old Lieutenant Sandler’s rough sketch of a cardiac center, the man, now 63, says it does bear many similarities.

“I still get choked up about the heart center,” Sandler says. “People come up to me and say, ‘do you realize what happened here? Do you understand the gratitude people have towards you being instrumental in bringing this to fruition?’ I was just glad to be able to be here at the right time and help make it happen.”