Dr. David Smith feels very strongly about motivating people to stop heart disease before it starts-so strongly that the cardiologist has spoken about healthy lifestyles at local middle schools, using a cow's heart to illustrate his points.

"With the cow's heart, I can show them what a heart looks like, how the arteries feed the heart and where blockages occur," he says. "The kids love it. I believe prevention offers the greatest amount of good for the greatest number of patients, and this is especially important in light of the obesity epidemic."

Dr. Smith attended MIT and then graduated from the University of Pennsylvania Medical School. He completed his residency at the Hospital of the University of Pennsylvania, followed by a cardiology fellowship at Thomas Jefferson University in Philadelphia. He has been in practice with Central Bucks Specialists in Doylestown since 1990 and can be reached at 215-345-6050.

Why did you choose cardiology as your specialty?

"I made the decision to go into cardiology in the mid-1980s. It was the technical and procedural parts of the job that I enjoyed the most, such as cardiac catheterization, inserting pacemakers, and the various studies such as stress tests and ultrasounds. I still enjoy the technical and procedural parts of cardiology, but my greatest interest now is seeing patients in the office. I like getting to know my patients and following them over the years."

What is your most serious challenge when treating patients?

"Getting patients to alter their lifestyle is a big challenge. The targets are simple-weight loss, moderate exercise, smoking cessation, and optimal blood pressure and cholesterol, but getting there can be tough. You have to understand the obstacles in a patient's life and then make sure the patient understands why the goals are important. "Empathy and encouragement can be the best tools in the doctor's bag. Sometimes you have to set modest goals, and the patient has to believe that you are on their side. If you take your time, it's amazing how many patients will listen to you and try their best."

What is your philosophy about practicing medicine?

"I think physicians have to set very high standards for themselves in terms of clinical excellence, and they have to be excited about learning ways to improve care. Physicians also need to have a genuine affection for patients. "

What exciting advances in technology are you using?

"The evolution of angioplasty and stents has been one of the most exciting stories in cardiology. In my father's time, a heart attack meant six weeks in the hospital and a high chance of death. When I started, a heart attack meant seven to 10 days in the hospital and transfer to Philadelphia for a bypass or angioplasty, with a high risk of failure or recurrent blockage. Today, heart attack patients routinely have angioplasty within 90 minutes of arriving at the Doylestown Hospital and, if necessary, get a drug-coated stent. They are often discharged within 48 hours and have outcomes that are far superior to those of the 1990s."