Category Archives: Leadership

American Society of Anesthesiologists, Anesthesiology, California Society of Anesthesiologists, Healthcare, Leadership

The Next Chapter

Video October 24, 2026 ermariano

ANESTHESIOLOGY 2026 (#ANES26), the annual meeting of the American Society of Anesthesiologists (ASA), has ended, but now the new work begins!

The 2026 annual meeting was very different for me than in previous years because I ran for ASA office in a contested election. I am so grateful to Team Mariano for supporting me through the past 10 weeks leading up to ANESTHESIOLOGY 2026 as well as the 29 state meetings, regional caucuses and networking events that I attended in 3 days at the conference. I also want to thank all of you from around the world who have been cheering me on!

This week, I started my term as Assistant Treasurer and member of the ASA Administrative Council. It’s time to move anesthesiology forward!

American Society of Anesthesiologists, Anesthesiology, Leadership

Why I Want to Be Your ASA Assistant Treasurer

August 3, 2026 ermariano

No matter how great a job we do at clinical care, research, and education, anesthesiology as a profession cannot survive without fair valuation and compensation for our work. In the same way, the American Society of Anesthesiologists (ASA) cannot survive without fiscal stability, a solid growth plan, and a value proposition that resonates with today’s anesthesiologists. My career centers on these realities – how to face them, analyze them, and chart a sound course into the future.

I know the importance of financial stewardship. As President of the California Society of Anesthesiologists in 2022-23, I led the effort to restore our in-person meetings and put our budget back in order after the havoc of COVID. At Stanford, I have managed a budget even larger than ASA’s, with responsibility for operations, personnel management, compensation, and incentives.

Nothing is less glamorous or exciting than Current Procedural Terminology (CPT) codes, yet without them we don’t get paid. Realizing that we didn’t have CPT codes for new fascial plane blocks, I worked to propose six new codes and shepherd them through the tortuous, three-year approval and valuation process. Just last January, we succeeded in getting two new codes for interventional pain procedures. It’s tedious, time-consuming, and anonymous work, but critical to anesthesiology’s financial future.

As Section Chair for Education and Research, I have directly overseen the editorial boards that produce valuable ASA educational products. As part of the team that updates the ASA Crosswalk and Relative Value Guide every year, I know how essential these coding and billing products are for anesthesiology practices and healthcare systems all over the country. These products need active promotion so our customers know that they cannot live and work without them, and we must keep working to develop new ones.

Difficult decisions lie ahead. Our debates at the ASA Board level can become tense as we try to trim expenses without sacrificing programs and activities that may be critical to ASA’s long-term success. As the chair of multiple scientific conferences, I know firsthand about the rising costs of hosting live meetings. We need creative ideas, and we need growth. I will bring my experience and perspective to future initiatives focused on new sources of non-dues revenue for ASA, the promotion of the ASA brand, and the active recruitment of new members who will come to recognize the value and community provided by ASA.

As a researcher, I understand the need for innovation to advance science and clinical care, and the critical need to support advocacy efforts so that grant sources don’t continue to dry up. I have represented ASA and our members in many governmental and regulatory settings where I have been your voice, and I want to continue speaking and acting on your behalf.

I ask for the honor of your support and your vote as ASA’s next Assistant Treasurer.

Anesthesiology, California Society of Anesthesiologists, Healthcare, Leadership, Pain Medicine, Patient Safety

My Last Update as CSA President

May 29, 2023 ermariano

It is hard to believe, but this is my last report as CSA President!

We recently held our CSA annual meeting in San Diego which was organized by annual meeting Chair Dr. Christina Menor. This meeting had a theme of “CSA Connect” and was designed to promote more interactive discussion within committees, opportunities to network and catch up with friends and colleagues, meet new people, and enjoy some time to relax. I think this meeting achieved all of these objectives! I have listed a few of my personal highlights and takeaways below.

Annual meeting Vice-Chair Dr. Engy Said put together a fantastic point-of-care ultrasound and regional anesthesia workshop on Thursday. We held very active committee meetings from noon until almost 10 pm (for those on the GASPAC Board), and it was great to see so many members participating in person and virtually thanks to the two new Owl Labs meeting cameras that we recently purchased for CSA. We had a number of special guests in attendance at the annual meeting including past CSA Presidents, one of whom is also our current ASA President Dr. Michael Champeau! We also had the President of the New York State Society of Anesthesiologists, Dr. Jason Lok, and Dr. John Fiadjoe, Executive Vice Chair of Anesthesia at Boston Children’s Hospital and Director of the American Board of Anesthesiology, joining us at the conference.

On Friday, Dr. Cesar Padilla from Stanford gave a compelling presentation on his project to develop and promote Spanish language patient educational video content through a joint venture between Stanford and YouTube. He then introduced our keynote speaker, California Surgeon General Dr. Diana Ramos, who discussed the work being done in California to decrease maternal morbidity and mortality and how we as anesthesiologists can be leaders in this domain. We had so many talented speakers from multiple institutions throughout the state who presented on various topics relevant to anesthesiology, critical care and perioperative medicine, and pain management. After the end of the day’s programming, we had a fantastic networking reception, which Dr. Ron Pearl kicked off as the first of our 75^th Anniversary events.

I gave out the first annual CSA President’s Impact Awards to recognize CSA members for the amazing work they are doing. Here are the winners!

Educator of the Year: Dr. Sophia Poorsattar, UCLA
Physician Advocate of the Year: Dr. Todd Primack, Vituity
Clinical Innovator of the Year: Dr. Arash Motamed, USC
Rising Star: Dr. John Patton, UCLA
In-Training Physician of the Year: Dr. Abbey Smith, UC Davis

CSA President-Elect Dr. Tony Hernandez Conte led off the Saturday session with an overview of advocacy efforts by CSA and current legislative issues affecting anesthesiology and pain medicine. Then I had the privilege of introducing our honorary CSA Leffingwell Lecturer, Dr. Linda Mason, who has been one of my most influential mentors and sponsors. She is a true icon in our specialty and a role model. Her advice about a career not being a straight line, “There are squiggly lines too,” resonated with so many attendees. She even provided her own assessment of the top 10 challenges facing women in leadership and gave some advice about how to be successful. For anyone interested in hearing more from Dr. Mason as well as some other inspirational anesthesiologists, see these video interviews posted by Dr. Allison Fernandez for the Women of Impact in Anesthesiology project.

Attendees for the annual meeting even stayed until the end on Sunday! We had great talks on patient safety and communications, diversity and inclusion, pain management, and regional anesthesia. Then those of us on the Board of Directors closed out the meeting weekend with a very productive session with a fair amount of debate and discussion that will result in some action items for this June House of Delegates.

What else has CSA been up to in recent months?

The CSA website task force has been working closely with website and brand marketing experts to completely redesign the CSA website to make it faster, reflective of the society, and responsive to member needs. The task force is on track to launch the new website by June.

The CSA Communications Committee, chaired by Dr. Emily Methangkool and in partnership with KP Public Affairs, has increased its production of high quality content in a variety of formats, from social media to print media, to promote the value of anesthesiologists’ work and the profession of anesthesiology. Check out recent CSA Vital Times podcast episodes on perioperative work culture and a special interview with Dr. Sharon Ashley in honor of Black History Month in February. The CSA Online First blog posts new content every week! Recent posts have featured CSA members’ activities in research, clinical informatics and global health and member profiles of CSA’s women leaders during the Women’s History Month Spotlight series in March. The CSA Vital Times magazine under the editorship of Dr. Rita Agarwal has produced another fantastic issue that is full of society updates, highlights from each anesthesiology residency program in California, and special articles by CSA members on artificial intelligence, global engagement, Project Lead the Way and other community outreach programs, and the history of anesthesiology in recognition of the contributions of California’s anesthesiologists during this Diamond Jubilee 75th anniversary year.

The week of January 29 through February 4 was designated Physician Anesthesiologists Week in California by an unanimous vote in the Assembly. Assemblymember Matt Haney presented Assembly Concurrent Resolution 3 from the floor, stating that “Anesthesiologists are guardians of patient safety in the operating room, in the delivery room, in the intensive care unit, in pain management clinics, and on the frontlines of the COVID-19 pandemic. They are an essential profession in the healthcare industry. For their dedication to their patients, it is our honor to recognize them for the work they do to care for us.”

So what’s to come between now and the end of my term as President? We continue to work our legislative contacts to advance our advocacy efforts. We are developing more digital image and video content to highlight the importance of anesthesiologists in improving patient experience and outcomes over the course of history and in the present. We are promoting the next CSA annual meeting to be held at the Disneyland Hotel next April 4-7, 2024. We are preparing for the end of the academic year and are promoting the early career membership program for CSA and ASA to keep our soon-to-be graduates engaged in organized medicine.

I cannot be more excited for the upcoming governance year as Dr. Tony Hernandez Conte takes over as President. He has been a fantastic partner this year, and I have learned so much from him. As I wrap up, I will conclude by saying again how proud I am of all the work we have accomplished in advancing the mission of the society this past year. We have stayed true to our identity as an organization representing the great specialty of anesthesiology, anesthesiologists in California, and our patients. I wish to thank to all of our CSA physician volunteers, association management staff members (especially Dave Butler, Megan MacNee, Rachel Hickerson, Dena Silva, Evan Wise, Denise King, Kate Peyser, and Jonathan Flom who got frequent messages from me all year), Alison MacLeod at KP Public Affairs and Bryce Docherty at TDG Strategies on behalf of CSA for the tremendous amount of personal effort and dedication that it takes to keep this organization mission-focused and moving forward.

Anesthesiology, California Society of Anesthesiologists, Leadership, Medical Education, Research

First Annual CSA President’s Impact Awards

February 2, 2023 ermariano

2023 is the 75^th anniversary of the California Society of Anesthesiologists (CSA)! In addition to celebratory events, CSA is also introducing the 1^st annual CSA President’s Impact Awards. This is an important new initiative developed by the CSA Membership Committee and other CSA leaders, and I am thrilled to provide a little more detail about these awards, which be presented at the CSA annual meeting in San Diego this April.

It will come as no surprise that I love being an anesthesiologist – a blog post of mine about this from a few years ago is probably the only thing I have written that people may have actually read! One unique aspect about our work as anesthesiologists is that it often takes place in the background. The important decisions we make, and the planning and anticipation involved, may make the difference between life and death for our patients, but they often go unnoticed. As I wrote in the KevinMD blog, “No one claps when the plane lands, just as no one expects any less than a perfect uncomplicated anesthetic every time.”

Doing our jobs without the need for attention or validation is one of the attributes about anesthesiologists that I love the most. We practice our specialized form of personalized medicine every day, drawing our own satisfaction from the positive outcomes of our patients, whether or not we get the credit. However, what we do makes a profound difference in the lives of our patients and their families, our health systems, and our communities.

We see you!

During this Diamond Jubilee 75^th Anniversary year, we are starting a new annual tradition of recognizing the incredible work performed by CSA members through the new CSA President’s Impact Awards, and you can help!

Using this form, nominate your colleagues and/or trainees in the following categories:

Educator of the Year – for excellence in educating colleagues, trainees, other healthcare professionals, patients, or the community
Physician Advocate of the Year – for outstanding leadership in legislative advocacy or practice management
Clinical Innovator of the Year – for creative innovation that has led to improvements in clinical care, patient safety, healthcare processes, patient experience, or outcomes
Rising Star – for an early career member (less than 3 years from completion of training) who has already demonstrated excellence and tremendous future career potential in one or more of the above categories: educator; physician advocate; or clinical innovation
Resident/Fellow of the Year – for a current resident or fellow who has demonstrated excellence in one or more of the above categories: educator; physician advocate; or clinical innovation

Nominees must be CSA members, and nominations must be submitted using this form. Nominate your colleagues and trainees for the CSA President’s Impact Awards today!

The deadline for nominations is Monday, February 6th.

Anesthesiology, California Society of Anesthesiologists, Healthcare, Leadership, News

My First Report as CSA President

September 3, 2022 ermariano

At the first in-person House of Delegates (HOD) session since 2019, I became President of the California Society of Anesthesiologists (CSA), the first Filipino-American to do so. This could have only happened because of the incredible mentors and sponsors that I have been fortunate enough to have in my life.

Over the course of the HOD weekend in June, we held a fundraising luncheon for the CSA Foundation, listened to project presentations from the first cohort of our CSA-UC Irvine Leadership in Healthcare Management Program launched by Drs. Phillip Richardson and Ron Pearl, were treated to a special guest lecture by Sasha Strauss on how to communicate as leaders and demonstrate value, and I provided an educational session on using social media for advocacy. We hosted Dr. Robert Wailes, President of the California Medical Association (CMA), for an update on the Medical Injury Compensation Reform Act (MICRA) since passage of AB 35 (MICRA Modernization). For more information, see Dr. Wailes’ summary.

During the HOD session, I outlined my leadership priorities for this year: expanding public-facing and internal member communications; continuing leadership development; planning the CSA’s 75^th anniversary (diamond jubilee); and promoting wellbeing and professional fulfillment within the CSA membership. I discussed the challenges facing anesthesiology and the importance of recruiting and retaining members. I summarized the value proposition as “Community, Solidarity, and Advocacy,” which also happen to have the acronym “C-S-A.”

Receiving the gavel from Dr. Ron Pearl, Immediate Past President of CSA and my biggest mentor and sponsor

We followed HOD with our first Board of Directors (BOD) meeting of the governance year. We welcomed new Directors, appointed the CSA delegations to the American Society of Anesthesiologists (ASA) and CMA, and approved committee appointments for this governance year including an expanded Committee on Professional and Public Communication (CPPC). This new CPPC chaired by Dr. Emily Methangkool and staffed by Kate Peyser, and in partnership with Alison MacLeod and Lisa Yarbrough at KP Public Affairs, will be interfacing will all major committees, divisions, and task forces as well as the CSA Foundation to actively promote the great work by CSA members and advance the recognition, social standing, and influence of anesthesiologists.

Over the summer, I was Visiting Professor at the University of Michigan, hosted by Dr. Chad Brummett, and then had the privilege of participating in the American Medical Association (AMA) annual meeting as an ASA delegate to the AMA HOD. In this role, I was able to cast my vote for Dr. Jesse Ehrenfeld and witness him become the first anesthesiologist President-Elect of the AMA!

With Drs. Chad Brummett and Mark Bicket at the University of Michigan stadium

My family and I visited Greece for the first time as I participated as a guest speaker at the European Society of Regional Anaesthesia and Pain Therapy (ESRA) congress in Thessaloniki, and I also welcomed attendees to my first CSA educational event as President: the 2022 CSA Summer Anesthesia Conference. This meeting was chaired by Dr. Brendan Carvalho and featured a superstar all-women expert panel of dynamic speakers: Drs. Dalia Banks , Sapna Kudchadkar, Alana Flexman, BobbieJean Sweitzer, Romy Yun, and Elizabeth Ozery. All week, attendees and speakers engaged in conversations related to the practice of anesthesiology, caught up with old friends, and made new connections within the meeting room and around the resort. It was an amazing week of learning and family time and reinforced the value of CSA and its educational events in fostering community.

With friends and fellow ESRA invited speakers (Drs. Amit Pawa, Steve Coppens, Lloyd Turbitt, and Clara Lobo)

Before leaving Hawaii, I participated in a face-to-face meeting of the Hawaii Safer Care initiative, part of the Improving Surgical Care and Recovery collaborative supported by the Agency for Healthcare Quality and Research, and led by Dr. Della Lin, Senior Fellow in Patient Safety Leadership with the Estes Park Institute and is an inaugural National Patient Safety Foundation/Health Forums Patient Safety Leadership Fellow. Dr. Lin invited me to participate as a virtual coach during the pandemic last year and work with improvement teams focused on implementing multimodal pain management for surgical patients, so this was my first time meeting the group in person. For this meeting, teams from three statewide health systems within Hawaii reported out the results of their projects. The leadership and collaboration among the multidisciplinary teams to implement change despite the challenges of variable resource availability, staffing, and inter-island coordination could serve as a model to inspire our statewide efforts within CSA.

What do we have on deck for CSA?

At the time of this report, we are receiving applications for the next CSA-UC Irvine Leadership in Healthcare Management Program cohort. Anyone interested can sign up here. We have appointed the task forces to work on revamping the CSA website and planning activities for the 75^th anniversary, including a family-friendly reception at the Annual Meeting in San Diego (April 27-30, 2023) that will be chaired by Dr. Christina Menor. Stay up to date with CSA events through our online calendar. Then in October, our CSA delegation heads to New Orleans for the ASA annual meeting, and CSA members will actively participate in educational programming, committee deliberations, and governance activities. CSA will host a member reception during the conference, and our delegates will stand proudly when CSA’s very own Dr. Michael Champeau takes over as President of the ASA at the conclusion of the Wednesday ASA HOD session!

Anesthesiology, California Society of Anesthesiologists, Healthcare, Leadership, Medical Education, News, Patient Safety, Research

You Are Not “Asleep” Under Anesthesia

September 23, 2021 ermariano

“You will be asleep for your surgery,” anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the operating room nurse saying, “Think of a nice dream as you go off to sleep.”

While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all.

That’s why you need medical doctors – anesthesiologists – to take care of you under anesthesia, and why you don’t need us when you’re sleeping comfortably in your own bed.

Differences between natural sleep and general anesthesia

Natural sleep represents an active though resting brain state. Every 90 minutes, the brain cycles between rapid eye movement or “REM” sleep and non-REM sleep. During each of these REM cycles, the brain is active, and dreams can take place. The rest and rejuvenation that result from getting a good night’s sleep are essential for overall health and wellbeing.

On the other hand, general anesthesia produces a brain wave pattern known as “burst-suppression,” where brief clusters of fast waves alternate with periods of minimal activity. In a recent article published in Frontiers in Psychology, Drs. Akshay Shanker and Emery Brown explain brain wave patterns found in patients under general anesthesia. They are similar to those of critically ill patients who fall into a coma, have a dangerously low body temperature, or suffer from other serious diseases. Under general anesthesia, patients do not dream.

Confusing general anesthesia and natural sleep seems innocent but can be dangerous. A person who falls into natural sleep doesn’t require constant monitoring or observation. A patient under anesthesia, like an intensive care unit patient in a coma, may appear peaceful and relaxed, but anesthetic drugs don’t produce natural sleep and may cause breathing to stop or have other serious side effects. Some may recall that Michael Jackson died at home while receiving the anesthetic drug propofol in his veins without an anesthesiologist nearby to protect him.

For patients with chronic health problems, having surgery and anesthesia can put significant stress on the body. Anesthesia gases and medications can temporarily decrease the heart’s pumping ability and affect blood flow to the liver and kidneys. Patients under general anesthesia often need a breathing tube and a ventilator to breathe for them and support their lungs with oxygen.

Respect anesthesia, but don’t fear it

While having anesthesia and surgery should never be taken lightly, anesthesia care today is very safe as long as it is directed by a physician specializing in anesthesiology: an anesthesiologist. Anesthesiology is a medical specialty just like cardiology, surgery, or pediatrics. Research by anesthesiologists has led to the development of better monitors, better training using simulation methods inspired by the aviation industry, and new medications and techniques to give safer pain relief.

As a medical specialty, anesthesiology focuses on improving patient safety, outcomes and experiences. Anesthesiologists work with surgeons and other healthcare professionals to get you or your family member ready for surgery, designing an anesthesia care and pain management plan specific to the type of operation you need. The anesthesia plan will guide your care during your procedure and throughout your recovery. While general anesthesia is far different from natural sleep, the job of the anesthesiologist is to make sure that you wake up just the same.

This post has also been featured on KevinMD.com.

Healthcare, Leadership

#HerTimeIsNow: Be an Ally!

September 30, 2020 ermariano

Today is the last day of #WIMMonth, but supporting #WomenInMedicine doesn’t stop today!

Everyone should sign this petition at Change.org.

Deans, Chairs, and other healthcare leaders can go even further by reading this pledge and signing on.

I have been promoting the #HerTimeIsNow campaign led by the inspirational Dr. Julie Silver throughout the month of September. This campaign represents a collaboration between the American Medical Women’s Association, She Leads Healthcare, and Executive Leadership in Academic Medicine (ELAM).

There is still so much work to be done to achieve gender equity in academic medicine, especially for underrepresented minorities.

Read the full #HerTimeIsNow report.

Men in medicine, particularly those in leadership positions in academic departments, editorial boards, and professional societies, have a huge role to play as allies. Here is my full quote from the report:

Anesthesiology, COVID-19, Healthcare, Leadership, Social Media

Being a Positive and Authentic Voice

June 5, 2020 ermariano

“The key is to not reflexively get defensive, but to treat people on social media as you would treat them in real life.”

Season 2 Episode 33: Being a Positive and Authentic Voice with Dr. Ed Mariano

Drs. Shillcutt and Mariano get real and talk:

Dealing with the COVID-19 pandemic information overload
Discussing hard topics on social media
Being a positive voice for marginalized groups
Being a “Chief Cheerleader”
The key to joy at work

In this episode of The Brave Enough Show, I had a chance to speak with host Dr. Sasha Shillcutt about a variety of topics including #HeforShe, leadership, and maintaining a positive voice on social media. Enjoy!

Anesthesiology, Healthcare, Leadership, News, Pain Medicine, Patient Safety, Regional Anesthesiology

My Trip to Washington: Speaking Out Against Drug Shortages

November 13, 2019 ermariano

UPDATE: The MEDS Act was incorporated into the Coronavirus Aid, Relief, and Economic Security (CARES) Act and passed into law on March 27, 2020. I commented on the COVID-19 pandemic’s exacerbation of ongoing drug shortages in this interview with CBS news.

On November 5, 2019, I had the opportunity to participate in a Congressional briefing related to drug shortages at the Capitol in Washington, DC. Senator Susan Collins (R-ME) opened the session and co-sponsored the Mitigating Emergency Drug Shortages (MEDS) Act with Senator Tina Smith (D-MN). I was one of only two physicians on the panel and tried to represent the voice of clinicians involved in perioperative care and the patients we care for (video). Below are the notes from my presentation.

As a physician specializing in anesthesiology, this ongoing crisis of drug shortages in the United States is frankly terrifying.

Continue reading →

Anesthesiology is a unique specialty within medicine. Our patients are the most vulnerable in the hospital. Patients under general anesthesia cannot advocate for themselves and trust us with their lives.

We do not know what the next drug shortage will be or how long it will last. This week it is prefilled syringes of lidocaine, a life-saving emergency medication we give in case of a dangerous heart rhythm. Two weeks ago it was phenylephrine, a routine medication we use to increase blood pressure when it goes down after inducing anesthesia.

Last year, we had complete shortages of common injectable opioids and local anesthetics used for numbing injections. This directly affected surgical patients in terms of anesthesia and pain management. For 3 months in 2018, we did not have the local anesthetic indicated for spinal anesthesia. We know this is the safest anesthetic for patients having certain surgeries. During this shortage, we used an alternative anesthetic in order to continue providing spinal anesthesia, but our patients experienced more side effects. The reasons for this shortage were complex and involved a limited number of manufacturers and quality issues.

Thankfully, the shortage of spinal local anesthetic ended. We do not know when or if the rest of our current drug shortages will end. All we know for sure is that there will be another one.

The predictably unpredictable cycle of drug shortages puts physicians in an impossible position. Medicine is a calling, and we physicians have sworn an oath to support the well-being of our community and humanity in general.

Not having access to the right drugs at the right time for every patient and being forced to use less acceptable alternatives, if any exist at all, represents a form of moral injury. Moral injury “is being unable to provide high-quality care and healing in the context of health care” and is now recognized as a contributor to the epidemic of physician burnout.

Listen to my interview with Paul Costello on SoundCloud.

From left to right: Daniel Teich (Fairview Pharmacy Services), Dr. Peter Adamson (Children’s Hospital of Philadelphia), Senator Susan Collins, me, and Brian Marden (MaineHealth Pharmacy)

Healthcare, Leadership, Outcomes Research, Patient Safety, Social Media

More Reasons for Doctors to Tweet

August 30, 2019 ermariano

This press release came out during the annual scientific meeting of the New Zealand Society of Anaesthetists based on my talk, “The Role of Social Media in Modern Medicine.” While in New Zealand, I was interviewed on Newstalk ZB by host Andrew Dickens and Afternoons with Jesse Mulligan.

Doctors need to be active on social media and other communication platforms to offset the noise of the anti-science movement according to a visiting professor of anaesthesiology, Dr. Ed Mariano from Stanford University in the US.

Continue reading →

Dr. Mariano is speaking at the New Zealand Anaesthesia Annual Scientific Meeting in Queenstown this week on the role of social media and medicine. He says, there has been a growing anti-science movement and physicians have a moral imperative to stand up for science and evidence-based treatments.

“Surveys show that physicians are one of the most trusted professions in the eyes of the public. Yet most people in the world today get their information, including health information, from the internet. We have to be there to offset the noise,” he says. “We can’t ignore where our patients get their information, and we can join the conversation.”

Dr. Mariano, who is one of the top 10 anaesthetists on Twitter, says social media also offers a way for doctors to keep up-to-date with the latest research and new treatments. For example he cites the exponential growth of regional anaesthesia. Regional anaesthesia allows procedures to be done without the patient being unconscious and can provide targeted pain relief.

“We have more tools at our disposal. New blocks are being performed and described every month and it’s hard to keep up with the literature. Social media allows you to be part of a learning community made up of people who have similar interests and it can curate information for you,” he says.

Dr. Mariano says it works the other way too. He says he’s created great collaborations through social media. “As well as learning things, I’ve had interesting conversations on Twitter that have developed into projects. As an academic physician, I’ve found the use of social media has been invaluable. Engaging in social media gives physicians a worldwide community of colleagues who can help curate the vast and ever-growing amount of information available today.”