Leadership Experience

Listen to Dr. Mariano discuss the impact of power and influence in physician leadership on Stanford Medcast.

Healthcare Transformation

Founded and developed the regional anesthesiology and acute pain medicine program at the University of California, San Diego (UCSD), which included educational programs for trainees and physicians in practice, clinical services at 3 adult and pediatric hospitals, and a clinical research program
Chaired the Perioperative Care Center Redesign Subcommittee at UCSD which resulted in a new process for preparing patients scheduled for elective surgery including a new staffing model, workflow, physical clinic plan, and technology support
Established the first Perioperative Surgical Home (PSH) program within the Veterans Affairs (VA) health care system at VA Palo Alto in 2010 including a new 24/7 acute pain service and providing anesthesiology-led care coordination for surgical patients
Appointed as the first Associate Chief of Staff for Inpatient Surgical Services at VA Palo Alto Health Care System employing the PSH model to facilitate ongoing evidence-based change implementation in anesthesia and perioperative medicine clinical practices
Received the Veterans Health Administration’s John D. Chase Award for Physician Executives Excellence
Achieved Lean Six Sigma Black Belt certification
Selected to serve on key national healthcare initiatives: The Joint Commission standards review panel on pain assessment and management in the acute care setting, Centers for Medicare and Medicaid Services MACRA Episode-Based Cost Measures Clinical Subcommittee (Musculoskeletal Disease, Non-Spine), FDA public workshop on regional anesthesia, ASA-ASRA Technical Expert Panel on the Development of Quality Measures related to Pain Medicine, Veterans Affairs National Acute Pain Medicine Committee, and the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic
Chaired the first-ever multi-organizational Pain Summit, a two-year process involving 14 medical societies that culminated in the establishment of 7 guiding principles of acute perioperative pain management which were published in Regional Anesthesia and Pain Medicine in 2021 and will inform the development of future clinical practice recommendations as well as legislative and regulatory initiatives
Appointed as the first Senior Vice Chair for Clinical Operations and Value for the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford with responsibilities including budget, operations, compensation and incentives, allocation of nonclinical time, and personnel management
Received Distinguished Service Awards from ASRA Pain Medicine and ESRA Spain.
As Current Procedural Terminology (CPT) Advisor for the American Society of Anesthesiologists, successfully prepared and submitted the application for: 6 new fascial plane block CPT codes that were accepted, published and incorporated into the Medicare physician fee schedule starting in 2025; and 2 new CPT codes for interventional pain released in 2026.

Medical Education

Founded the first Regional Anesthesiology and Acute Pain Medicine (RAAPM) Fellowship program in California (at UCSD) recognized by the national RAAPM fellowship directors group
Co-founded the UCSD-NMCSD Intensive Regional Anesthesia Course in 2005, the first ACCME-accredited regional anesthesia course in California
Led the task force to establish RAAPM as a new ACGME-accredited fellowship and subspecialty of anesthesiology from 2013 to 2016 which successfully achieved accreditation status in 2016
Became the program director for the RAAPM fellowship at Stanford in 2016 and established Stanford as one of the first 9 ACGME-accredited RAAPM fellowship programs in the country
Selected to serve as Chair of the committee charged with developing competency-based Milestones for ACGME-accredited RAAPM Fellowships
Chaired over 30 regional and national conferences and workshops offering continuing medical education
Received the Distinguished Educator in Anesthesiology Award from the American Society of Anesthesiologists and Society for Education in Anesthesia

Professional Societies

American Society of Anesthesiologists: Past Chair of the Committee on Regional Anesthesia and Acute Pain Medicine; ASA representative to Centers for Medicare and Medicaid Services cost measure development, National Academy of Medicine action collaborative addressing opioid and substance use disorders, intersociety pain management guidelines, and American Board of Anesthesiology nominations committee and continuing certification committee; ASA Delegate to the American Medical Association House of Delegates and World Federation of Societies of Anaesthesiologists General Assembly; Section Chair for Education and Research overseeing the ASA Editorial Boards and their work products; Committee on Economics and ASA Crosswalk editorial team; Center for Anesthesia and Perioperative Economics (CAPE) Steering Committee; Current Procedural Terminology (CPT) Advisor
California Society of Anesthesiologists: District Delegate; District Director; Chair and member of multiple committees including Bylaws, Educational Programs Division, and Finance and Administration; Vice Speaker and Speaker of the House of Delegates; President 2022-23; Delegate to the ASA House of Delegates
Association of Anesthesiology Subspecialty Program Directors: First Council Member representing the regional anesthesiology and acute pain medicine fellowship directors from 2017 to 2022
American Society of Regional Anesthesia and Pain Medicine: Director from 2015 to 2020; served as Chair of Communications which included website, social media, newsletter, and public relations; developed a social media strategy for the Society which included outreach through multiple social media platforms, starting the ASRA Blog, and supporting the launch of the ASRA RAPP podcast; converted the print newsletter to an electronic format, streamlined email communications with the ASRA Digest, and launched the expansion of patient education resources about surgical pain management options and opioid safety

Global Health and Global Surgery

Dr. Mariano has been worked with the EQuIS Research Group and Ariadne Labs on updates to the World Health Organization Surgical Safety Checklist: modification, implementation, training, and evaluation.

Dr. Mariano has had an interest in global health and global surgery throughout his career. Since 2004, Dr. Mariano has worked with the Philippine American Group of Educators and Surgeons (PAGES) as a senior volunteer anesthesiologist.

Founded in 1981, PAGES is a non-profit volunteer organization that conducts its annual Operation HOPE mission for the underprivileged children of the Philippines who are afflicted with craniofacial birth defects and deformities related to burn injuries.

Dr. Mariano has volunteered his pediatric anesthesiology and acute pain medicine skills on multiple medical missions to the rural provinces of the Philippines and usually brings residents and fellows with him to expand their training with exposure to global health. So far he has completed mission trips with PAGES to Cavite City (Cavite), Bay City (Laguna), Trece Martires City (Cavite), Alaminos City (Pangasinan), Quezon City (Metro Manila), inner city Manila, Morong (Rizal), and Cabanatuan City (Nueva Ecija), with multiple trips to many of these locations. Unlike many medical mission groups, PAGES provides continuity of care and long-term follow-up for patients through collaborations with local health officials and our PAGES Philippines colleagues.

In 2006, Dr. Mariano was recruited by Project Perfect World (PPW) to participate in pediatric orthopedic surgery missions to Guayaquil, Ecuador. PPW is a humanitarian effort sponsored by the Association for Healthcare Resource & Materials Management that provides needed medical and surgical care that is otherwise unavailable to the children of low and middle income countries. PPW conducts regular missions to Ecuador to care for impoverished children who are afflicted with limb deformities.

Dr. Mariano has brought a regional anesthesiology and acute pain medicine fellow with him on each of these missions along with ultrasound and perineural catheter equipment in order to provide the highest quality pain control to these deserving patients.