Tag Archives: anesthesiologist

My Reasons to Visit San Francisco for #ANES18

This year’s American Society of Anesthesiologists meeting (#ANES18) happens to be in my “neck of the woods”—one of the greatest cities in the world—San Francisco, California. Here are a few things you may or may not have known about San Francisco.

San Francisco is the biggest little city. At just under 47 square miles and with more than 800,000 inhabitants, San Francisco is second only to New York City in terms of population density. Despite its relatively small size, “the City” (as we suburbanites refer to it) consists of many small neighborhoods, each with its own charm and character: Union Square, the Financial District, Pacific Heights, the Marina, Haight-Ashbury, Chinatown, Little Italy, Nob Hill, Russian Hill, SoMa (South of Market), the Fillmore, Japantown, Mission District, Noe Valley, Twin Peaks, Castro, Sunset, Tenderloin, and others. This is probably why die-hard New Yorkers love it so much.

In the summer especially, San Francisco weather is somewhat unpredictable even when going from one side of the city to the other (part of the unique experience of visiting the city). “The coldest winter I ever spent was a summer in San Francisco,” a quote often mistakenly attributed to Mark Twain (no one really knows who actually said it), is nevertheless often true. Here in the San Francisco Bay Area, our local meteorologists provide daily forecasts for each of the region’s microclimates. The western side of the City along California’s coast is regularly plagued with fog while the eastern side of the City tends to be sunny most days of the year. It’s always a good idea to check the microclimate forecast before heading over to see the Golden Gate Bridge just in case it happens to be shrouded in fog. Average July temperatures in the City range in the 50s-60s Fahrenheit (no different than average November temperatures), so summer tourists often contribute to the local economy by buying “SF” logo sweatshirts for their walk across the City’s most famous bridge. Fortunately, #ANES18 is in the fall, and the weather near Moscone Center and the popular shopping area Union Square tends to stay reliably nice most of the year.

San Francisco is very family-friendly. If you’re debating whether or not to make a family trip out of #ANES18, my advice is to do it. Right around the convention center there are a number of attractions and events worth checking out. I highly recommend visiting the farmers market at the Ferry Building. While there, you can also take a ferry ride to a number of other destinations in the Bay Area (try Sausalito, a short trip that takes you past Alcatraz). For kids, there are parks within walking distance as well as the Children’s Creativity Museum, the San Francisco Railway Museum, Exploratorium, and the cable car turnabout at Powell and Market Street. Trips to Fisherman’s Wharf, Ghiradelli Square, or the aquarium are a short taxi or cable car ride away. In addition, runners will love running up and down the Embarcadero which gives you a view of the Bay Bridge and takes you past the City’s many piers. Shoppers will be in heaven, and foodies will have to make the impossible decision of choosing where to eat for every meal.

But don’t take my word for it—come to #ANES18 and see for yourself!

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To the Next Generation of Physician Leaders

I was recently invited to visit an academic anesthesiology department to speak to the residents about becoming a leader (see SlideShare). In addition to recognizing the honor and privilege of addressing this important topic with the next generation of physician anesthesiologists, I had two other initial thoughts: 1) I must be getting old; and 2) This isn’t going to be easy.

Balloon FiestaI came up with a short list of lessons that I’ve learned over the years. While some examples I included are anesthesiology-specific, the lessons themselves are not. Please feel free to edit, adapt, and add to this list; then disseminate it to the future physician leaders who will one day take our places.

  1. First and foremost, be a good doctor. Always remember that we as physicians take an oath. In the modern version of the Hippocratic Oath commonly recited at medical school graduations today, we say, “May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.” As a physician anesthesiologist, we care for the most vulnerable of patients—those who under anesthesia cannot care for themselves. Examples of anesthesiologists who do not honor their calling exist in the news and even scientific journals, but we cannot follow this path. 

     

  2. Define your identity. We live in the era of the “provider,” and this sometimes causes role confusion from the perspective of our patients. Team PhotoWe also don’t tend to do ourselves any favors. How many times have you heard someone say, “Hi I’m [first name only] with anesthesia”? According to the American Society of Anesthesiologists newsletter, approximately 60% of the public may not know that physician anesthesiologists go to medical school. While every member of the anesthesia care team plays a crucial role, the next level of non-physician provider in this model has one-tenth the amount of clinical training when compared to a physician anesthesiologist at graduation. I’ve written before about what I love about being an anesthesiologist, and being the physician whom patients trust to keep them safe during surgery is a privilege which comes with a great deal of responsibility.
  3. Consider the “big picture.” The health care enterprise is constantly evolving. Today, the emphasis is on value and not volume. Value takes into account quality and cost with the highest quality care at the lowest cost being the ultimate goal. The private practice model of anesthesiology has changed dramatically in the last few years with the growth of “mega-groups” created by vertical and horizontal integration of smaller practices and sometimes purchased by private investors. In this environment, physician anesthesiologists and anesthesiology groups will have to consider ways they can add value, improve the patient experience, and reduce costs of care in order to stay relevant and competitive.
  4. Promote positive change. Observe, ask questions, hypothesize solutions, collect data, evaluate results, draw conclusions, and form new hypotheses—these are all elements of the scientific method and clinical medicine. These steps are also common to process improvement, making physicians perfectly capable of system redesign. The key is establishing your team’s mission and vision, strategic planning and goal-setting, and regularly evaluating progress. Books have been written on these subjects, so I can’t do these topics justice here. In my opinion, physicians offer an important and necessary perspective that cannot be lost as healthcare becomes more and more business-like.
  5. Be open to opportunities. Thomas Edison said, “Opportunity is missed by most people because it is dressed in overalls and looks like work.” I have written previously about the merits of saying yes. As a resident or new staff physician, it often seems impossible to get involved. However, most hospital committee meetings are open to guests. Consider going to one that covers a topic of interest and volunteer for a task if the opportunity presents itself. In addition, many professional societies invite members to self-nominate for committees or submit proposals for educational activities at their annual meetings.
  6. IMG_7673Thank your team. Taking the first steps on the path to leadership is not going to be easy. There will be many obstacles, not the least of which is time management. A high-functioning healthcare team of diverse backgrounds, skills, and abilities will accomplish much more than what an individual can do alone. Celebrate team wins. Respect each team member’s opinion even when it differs from yours.

A good leader should earn the trust of his or her team every day.

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