Anesthesiology News Presents

The season premiere of Anesthesiology News presents The Etherist featured Dr. Amy Vinson, the chair of the American Society of Anesthesiologists Committee on Physician Well-Being. Among many other things, she explained why physician well-being needs to be addressed at an institutional and systemwide level. In this episode, we delve deeper into working during the COVID-19 pandemic, the unexpected toll burnout can leave behind and why being mindful of it is paramount. Join us as we talk with several anesthesiologists who’ve taken a hard look at the problem.  

Additionally, stay tuned for episode 3 of Anesthesiology News presents The Etherist where various other experts discuss issues in the well-being realm, including managing stress and dealing with the cognitive workload as a resident. We also hear from a European anesthesiologist about cultural differences in the specialty.

In the wake of the COVID-19 pandemic, anesthesiologists are being asked to do more than ever with less. Staffing shortages, supply chain issues, administrative burdens, regulatory compliance and unpredictable work hours continue to plague the field and contribute to burnout. This is a universal problem, and these are symptoms of a work environment that’s not conducive to sustainability.

Although “burnout” has historically been defined in several different ways, the term is generally characterized by three distinct components: emotional exhaustion (feelings of being overextended and depleted), depersonalization (having cynical and detached attitudes toward one’s work), and reduced feelings of personal accomplishment (involving a negative self-evaluation of one’s own effectiveness and worth).

So, what are the main causes of burnout and how can physicians foster a greater sense of well-being? Unfortunately, like any complex problem, there is no single solution. It’s a multifactorial condition that’s rooted in everything from schedules to culture. Anesthesiologists are often treated more like cogs in a wheel than professionals on which the system depends. And that’s what it’s mostly about, right? Simply wanting to feel valued, to be acknowledged as essential rather than expendable.

Nevertheless, there’s no scarcity of areas that require change. Do you curse the existence of the electronic health record? If you do, you are not alone. What is basically a billing system (one not designed by physicians) was forced on physicians, with virtually no input from physicians. It changed the way anesthesiologists worked; it changed how they thought; and it changed how they interacted with patients.

Additionally, in the push for volume-based care over value-based care, anesthesiologists are often asked to manage not one, not two, but three and even four ORs simultaneously. The expectation to simply get everything done, and as fast as possible, further cultivates this sense of depersonalization. It’s no longer Mr. Pizzi undergoing a total knee replacement; it's just another knee replacement. There’s an undeniable yet indefinable loss of personal achievement without that vital patient connection. Deprived of actually getting to know your patients, a profession that you once loved and maybe even felt a calling to, can slowly erode to feeling like a series of tedious tasks.

And without any say in what time a surgery begins or how long it goes on, the inability to dependably plan one’s personal time and achieve a sustainable work‒life balance only further highlights two recurring stresses: lack of control and a feeling of being marginalized.  

From institutional to legislative reform, there are countless opinions on how to stabilize the specialty’s turmoil. Yet the one prevailing sentiment is that if there isn’t significant change in healthcare, as well as the way anesthesiologists are viewed and treated, then the mass exodus will not only continue but even accelerate.

So, what can you personally do? Is the touted yoga and meditation combo the true salvation? For those listening to this right now, from medical school onward, did anyone actually teach you how to take care of yourself—walk you through the key elements for self-care and self-preservation? The focus is solely on taking care of patients, which obviously is critical, but as a former AMA president once said, "The most important patient we really have to take care of is the one in the mirror."

Join us as we speak with leaders in the physician well-being movement, and learn from their unique perspectives on achieving work‒life balance and personal fulfillment. In this first episode, we feature a true rock star: Amy Vinson, who among many other things is the chair of the American Society of Anesthesiologists Committee on Physician Well-Being.

This is episode 1 of season 4 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on November 3, 2022. It will delve deeper into defining just what burnout is, how quickly it can creep up, the unexpected toll it can leave behind, and why being mindful of it and your well-being are paramount.

Sponsored by Masimo.

In this new season of “Anesthesiology News presents The Etherist,” we’re going to examine a topic that’s both spoken about not enough and too much — physician well-being. In the wake of the COVID-19 pandemic, anesthesiologists are being asked to do more than ever with less. Staffing shortages, supply chain issues, administrative burdens, regulatory compliance and unpredictable work hours continue to plague the field and contribute to burnout. This is a universal problem, and these are symptoms of a work environment that’s not conducive to sustainability.

Join us on this journey as we speak with several leaders in the well-being field. And since we know that many of you are frankly burned-out from talking about burnout, please skip your mindfulness seminar and tune in, and maybe even find your happy place in the process.

This new season of The Etherist will be available on Thursday, October 20. The first episode will feature a true rock star: Amy Vinson, MD, who among many other things is the chair of the American Society of Anesthesiologists Committee on Physician Well-Being.

Sponsored by Masimo.

In this episode of “Ask the Experts,” Rita Agarwal, MD, joins the show to discuss the efforts in California to pass legislation to change anesthesia delivery in pediatric dental anesthesia cases. Agrawal has played an important role in advising and promoting the need for improved practices in the state, especially when it comes to the sole-operator model of anesthesia delivery.

Agarwal is a clinical professor of anesthesiology at Stanford University School of Medicine, in California. She is also the past president of the Society for Pediatric Pain Medicine. She has been working on the efforts to pass legislation on dental anesthesia delivery since 2015.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

• Caleb’s Law
• Disagreements Persist Over Safety of Dental Anesthesia - Anesthesiology News
• Link to Interview with Peggy Seidman, MD, a SmileMD anesthesiologist

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In this episode of “Ask the Experts,” we talk with Navin Goyal, MD, a co-founder of OFFOR Health, and Saket Agrawal, the CEO of OFFOR Health, about their company’s success in building a mobile anesthesia service aimed at providing office-based anesthesia for dental procedures.

Goyal is an anesthesiologist from Columbus, Ohio. He started OFFOR Health to address the problems with patient access to anesthesia care in his community. Agrawal, who is also a Columbus native, spent 10 years working in Silicon Valley gaining experience in building startup-style companies. Goyal and Agrawal now run OFFOR Health and SmileMD, which provide office-based anesthesia care in Ohio, Illinois, Kentucky and Tennessee.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

• Link to OFFOR Health
• Link to Interview with Peggy Seidman, MD, a SmileMD anesthesiologist
• Link to the ASA’s Difficult Airway Guidelines

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In this episode of “On the Case,” James Prudden interviews Elizabeth A.M. Frost, MD, about some of this most unique and memorable cases of her career.

Frost was the original clinical editor of The Frost Series, which bears her name in honor of her contributions to the art of the case study. And she will be the guest editor of the series again in the May and June issues.

In preparation for her return to editing the series, Prudden, our editorial director, caught up with Frost to discuss some of the highlights of her career in treating and writing about unusual cases.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

• Link to The Frost Series
• Link to Submit Your Own Case Report

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In this episode of “Ask the Experts,” William Rosenblatt, MD, comes back on the show to discuss his work on the American Society of Anesthesiologists (ASA) Difficult Airway Guidelines. He also explains how it took years to build the Airway on Demand video library and why he does it.

Rosenblatt is a professor of anesthesiology and otolaryngology at Yale School of Medicine, in New Haven, Conn. He developed the Airway on Demand program to provide educational resources on airway management. He was also a co-author of the ASA’s guidelines.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

• Sign up for Going ROAG seminar

• Revised Difficult Airway Guidelines Broaden Scope – Anesthesiology News

• ASA Updates Difficult Airway Guidelines - Anesthesiology News

• Link to the ASA’s Difficult Airway Guidelines

• Link to presentation by Tim Cook on “no trace, wrong place”

• Send us an email submit a case for The Frost Series

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“On the Case” is back for another season of in-depth interviews with the authors of the best case reports published in Anesthesiology News. The first episode of the year features L. Jane Stewart, MD, JD, MPH, who co-wrote the review titled “Comatose in the PACU? Remove the Scopolamine Patch” (Anesthesiology News Special Edition 2021;17:81-85).

Stewart comes on the podcast to discuss the details behind the case as well as how she and her team were able to determine the right diagnosis despite the uniqueness of the case.

Stewart is a senior instructor of anesthesiology at the Denver Health Medical Center, and the director of Diversity, Equity and Inclusion in the Department of Anesthesiology at the University of Colorado, Denver.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

• Link to Case Report
• Link to Submit Your Own Case Report

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Anesthesiology News will be publishing a new season of our popular podcast series, “On the Case” and “Ask the Experts.”

“On the Case” is a review series that features the authors of our popular case report series. We hear the behind-the-scenes story on the most unique clinical case studies published in the magazine directly from the professionals who managed them. The first episode of this new season features an interview with L. Jane Stewart, MD, JD, MPH, who co-wrote a case report about a patient who experienced a unique complication from a scopolamine patch.

“Ask the Experts” is an interview series that features leading anesthesia experts on topics ranging from airway management to medical mission work and the future of anesthesia practice models. The first episode of this new season will feature an interview with William Rosenblatt, MD, who was a co-author of the new American Society of Anesthesiologists difficult airway guidelines.

These episodes will be published later this month. And new episodes from both of these new series will appear every month.

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In this episode, we turn our focus to the present to see how recent research could be used to shape the future of anesthesiology.

In previous episodes, we reviewed how the pioneers of anesthesia were able to successfully use ether and chloroform without the full knowledge of those drugs that we have today. In that spirit, we explore whether there is untapped potential in our current scientific expertise that could help improve the delivery of modern-day anesthesia.

This season of the podcast began with the retelling of the origin story of anesthesia use. We revisited the classic tale of Ether Day with the benefit of hindsight and almost two centuries of clinical advances. But the stories about William T.G. Morton, Simpson Young and John Snow are also just chapters in a much larger story of medical progress. It is our story, too. While this season of The Etherist is ending, the story of anesthesia continues, as does the push for clinical progress. In this episode, we try to answer the question: What will be the next chapter in the story of anesthesiology?

This is the fourth and final episode of season 3 of “Anesthesiology News presents The Etherist.”

Sponsored by Masimo and Medtronic.

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• Science News. Electric currents picked up from head show brain action. Science News Letter. 1935;719(27):35. Accessed November 16. https://www.sciencenews.org/archive/electric-currents-picked-head-show-brain-action
• Sanders L. How Hans Berger’s quest for telepathy spurred modern brain science: instead of finding long-range signals, he invented EEG. Science News. July 6, 2021. Accessed November 16, 2021. https://www.sciencenews.org/article/hans-berger-telepathy-neuroscience-brain-eeg

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