Vital Times: The CSA Podcast

CSA Vital Times tracked down some of the chairs running some elite Anesthesiology Departments - they just happen to be in California! They have survived and thrived the seismic changes occurring across all academic medical institutions, ie the increase in clinical need, with huge growths in anesthetic opportunities (and locations - see #NORA), the competition with community hospitals, and resulting impact on their staff. Dr. Michael Gropper (UCSF), Dr. Ron Pearl (recently retired Stanford chair), and Dr. Richard Applegate (UC Davis and now Loma Linda) get together with Dr. Ludwig Lin for an eye-opening and thought-provoking chat. 

Dr. Rita Agarwal continues the conversation about sexual and gender harassment with fellow Drs. Christine Doyle, Sydney Thomson, and Alyssa Burgart.  Gender and sexual harassment can be harmful in many ways and not just to the person/people being harassed. It can occur to all genders and is often associated with increased costs to the institution, intention to leave and job/career dissatisfaction. I discuss the problems and possible solutions with leaders from the California Society of Anesthesiologists and the American Society of Anesthesiologist, focusing on what is being done and what still needs to be done.

To amplify the message of Black History Month, CSA Vital Times Podcast series revisits the talented Ashley Oliver, MD. We spoke with her in February 2022 when she was a cardiothoracic anesthesia fellow at UCLA, after having been a resident and Chief Resident at UCSF. Dr. Oliver is now a first-year faculty at UCLA’s cardiothoracic section, and we have a no-holds barred discussion about being a starting faculty, being a minority, building allies, representation, and the importance of building engagement via societies like CSA and ASA!

A recent study from the Association of Academic Medical Colleges reported tht sexual harassment is common in the medical profession and that anesthesiologist (both men and women) reported the highest incidence of harassment. Harassment led to decreased morale, decreased engagement and a higher intention to leave. Join me for a fascinating and engaging conversation with Diana Lautenberger the author of the AAMC article for suggestion on how to prevent harassment.

The utilization of physician extenders in the UK healthcare system has been quite controversial recently, with topics like training and validation requirements, impact on training and staffing, all bubbling to the surface. In addition, the lack of funding for physicians and residency slots has contrasted with the increasing spending on physician assistants. Dr. Ramey Assaf, resident and leader within Anesthetists United and Dr. Richard Marks, former Vice President for the Royal College of Anesthetists speak with Dr. Ludwig Lin on this topic.  

US and Californian Maternal morbidity is alarmingly high, especially in Black and Hispanic women. How did this happen, and how do we become active change agents in reversing the trend?Leaders in healthcare equity - Drs. Amanda Williams (OB), Jennifer Lucero (OB Anesthesia), and Mofya Diallo (Pedi Anesthesia) join host Dr. Ludwig Lin for this important podcast episode. 

Dr. Rita Agarwal interviews Drs. Jay Brodsky and John Brock Utne, the authors of a new book on the history of anesthesia at Stanford during the Larson Years. They share funny and moving anecdotes about the people, the department, and the events that shaped one of the top anesthesia programs in the country. 

October 1 was Latino Physician Day. For anyone interested in the health of Californians, this is important, because a large portion of our population is Latin-X, and the physicians who care for them should reflect that demographic. We at CSA are excited to bring together a panel of Latinx anesthesiologist at different stages and areas of their professional careers to speak on their journeys to Anesthesiology. This conversation is inspiring - for everyone - and is a call to action.

Those few precious minutes in the Preoperative area spent speaking with a patient and their significant others are essential to the initiation of a successful anesthetic, as is the “vibe” generated during the entire time until the induction agent for General Anesthesia goes in.  What are the keys to success? We speak with Dr. Phil Jones, a cardiac anesthesiologist now in Toronto, Canada, who nearly trained as an actor in Britain before enrolling in Medicine studies at Cambridge. He was a consultant in Anesthesia and Critical Care Medicine at the prestigious St. Bart’s Hospital in London. He is passionate about this topic, and about the importance of communication to improve the patient’s perioperative experience. Follow Dr. Jones (@philjones6) and Dr. Lin (@LudwigLin) on Twitter.   

This is Part 2 of Debriefing on the Kindness and Empathy Deficit in the Medical Profession featuring Professor Doug Hollan of UCLA Anthropology, Dr. Wes Ely of Vanderbilt University Medical Center, and Dr. David Elkin of UCSF. 

Anthropologist, Intensivist, Anesthesiologist, and Psychiatrist, convene to talk about the anthropological concept of empathy, why it’s missing in modern-day medicine, and how to go about reclaiming it. Professor Doug Hollan of UCLA Anthropology, Dr. Wes Ely of Vanderbilt University Medical Center, and Dr. David Elkin of UCSF.  

In Part 2 of Dr. Lin's interview with Dr. Conte, they discuss how you can get involved in CSA advocacy and what led Dr. Conte to becoming President of the society.  Dr. Conte also discusses his diverse upbringing, what led him to becoming an anesthesiologist, and his love for competitive figure skating.  

This episode of the CSA Vital Times Podcast is with Antonio Hernandez Conte, MD, MBA, FASA, President-Elect and one of the current member advocates for the CSA in the State Capitol.  Dr. Hernandez Conte, along with CSA's legislative advocate, make our voices heard on decisions about the way medicine is practiced and reimbursed in California. All of us benefit from advocacy that helps us to care for our patients. Dr. Hernandez Conte tells us how he came to be a leader in this space and discusses the easy ways each one of us can contribute to this advocacy effort.  

Recently CSA Vital Times published a poignant first-person account by Dr. Zeest Khan, cardiac anesthesiologist, of her struggles with #LongCOVID. This is a follow-up, with Drs. Khan and Wes Ely, MD, a prominent critical care medicine specialist at Vanderbilt University and leader in ICU delirium management, who is now directing efforts in Long COVID. They sit down to discuss the therapeutic approaches. Follow Dr. Wes Ely on Twitter @WesElyMD and Dr. Zeeest Khan at @doctor_zeest. 

Hosted by Dr. Ludwig Lin, listen to Part 2 of this fascinating discussion panel featuring: Alyssa Burgart, MD, MA, FAAPElizabeth Duggan, MDJina Sinskey, MD, FASAAmy Vinson, MD, FAAP It’s no secret that being a healthcare professional in the United States right now, even more so within Anesthesiology, is stressful. The attrition rate is high. One of the factors that impact us daily is the high level of tension in the Perioperative setting in which anesthesiologists are required to practice. It’s a given that we provide superior and professional clinical care; however, we are doing this while dealing oftentimes with a non-collaborative environment.This multi-episode podcast arc gets together experts in the areas of well-being, organizational behavior, and ethics, and challenges them to help think of proactive ways that each anesthesiologist can take ACTION to improve their work life. Wellness isn’t only self-care; it needs to be a proactive, call-to-arm to our healthcare organizations to create better work environments. Our experts rise to the occasion, and not only discuss the factors resulting in our broken work space, but the language and asks that we can take to our administrations to demand improvement.Part 2 brings the panelists’ list of action steps for us to take back to our own institutions to initiate change. Additional Links:Washington Post Nov 14 – Opinion: How the pandemic ended America’s bad romance with workNEJM Humanism before HeroismASA Statement on Creating a Culture of Well-Being for Health Care Workers (October 2021)

In support of Black History Month, California Society of Anesthesiologists is proud to present a podcast conversation with Dr. Ashley Oliver, currently a cardiac anesthesiology fellow at UCLA. Dr. Oliver is a former PhD candidate in film studies, having received a Masters in it. However, she had an epiphany while working abroad, and pivoted to medicine. She has had a star-studded career ever since, including being Chief Resident at UCSF’s anesthesia residency. Dr. Ludwig Lin and Dr. Oliver have a wide ranging conversation about black identity, representing that identify, the importance of diversity in medicine, bringing equity to healthcare, and being well-rounded and merging one’s various life passions into one’s life work.

Dr. Ludwig Lin hosts a discussion panel featuring: Alyssa Burgart, MD, MA, FAAPElizabeth Duggan, MDJina Sinskey, MD, FASAAmy Vinson, MD, FAAP It’s no secret that being a healthcare professional in the United States right now, even more so within Anesthesiology, is stressful. The attrition rate is high. One of the factors that impact us daily is the high level of tension in the Perioperative setting in which anesthesiologists are required to practice. It’s a given that we provide superior and professional clinical care; however, we are doing this while dealing oftentimes with a non-collaborative environment.This multi-episode podcast arc gets together experts in the areas of well-being, organizational behavior, and ethics, and challenges them to help think of proactive ways that each anesthesiologist can take ACTION to improve their work life. Wellness isn’t only self-care; it needs to be a proactive, call-to-arm to our healthcare organizations to create better work environments. Our experts rise to the occasion, and not only discuss the factors resulting in our broken work space, but the language and asks that we can take to our administrations to demand improvement.Additional Links:Washington Post Nov 14 – Opinion: How the pandemic ended America’s bad romance with workNEJM Humanism before HeroismASA Statement on Creating a Culture of Well-Being for Health Care Workers (October 2021)

Dr. Zeest Khan is a Stanford-trained cardiac anesthesiologist. Very early in 2020, she fell ill with COVID, but the worse was to come - she developed “Long COVID”. To be a physician used to crises, there can’t be a scenario worse than feeling disempowered and unable. To add to that, Dr. Khan encountered skepticism from the healthcare system she sought for care and treatment. As an articulate and driven healthcare professional, Dr. Khan’s personal account of her experience as a Long COVID survivor is a powerful testimonial. You can also access the article she wrote in 2022 for the CSA Online First Blog: https://bit.ly/3VXJm4h and follow her on Twitter @doctor_zeest. 

Welcome to the latest episode of the CSA Podcast, Vital Times. Dr. Ron George interviews his friend, mentor, fellow Obstetric Anesthesiologist, and a highly engaged member of the California Society of Anesthesiologists, Brendan Carvalho, MD, FRCA, from Stanford University. Dr. Carvalho is Professor and Chief of the Division of Obstetric Anesthesia and the Vice Chair for Faculty Development at Stanford University School of Medicine. He is a Past-President of SOAP, the Society for Obstetric Anesthesia and Perinatology and during his tenure on the executive he started the development of the foundation for the SOAP Centers of Excellence designation: https://soap.memberclicks.net/. This was created to recognize institutions that demonstrate excellence in obstetric anesthesia care and to set a benchmark of expected care to improve standards nationally and internationally. You can find Dr. Carvalho on Twitter @CarvalB. 

In honor of #CRPSAwarenessMonth, Dr. Lin interviews physician scientist Vivianne Tawfik, MD, PhD, who just won the ASA James Cottrell Presidential Scholar’s Award for her work with Complex Regional Pain Syndrome (CRPS). Dr. Tawfik has a successful lab studying causes such as glial function,  her clinical work with CRPS, as well as her work mentoring upcoming physicians and scientists. The topic is one that is intellectually challenging, with life-changing implications for people with CRPS, and one that the CSA Podcast is proud to call attention to.So many people with CRPS struggle to see the possibilities of living and thriving despite it - the podcast has pulled in an amazing advocate who managed to return to her international sports career after proper diagnosis and management - by Dr. Tawfik!This is the story of Coco Vandeweghe, an American professional tennis player. She achieved a career high world ranking of #9 in 2017, when she made the semifinals of two Grand Slam tournaments, the Australian Open and US Open. She was knocked out of her sport in early 2019 with mysterious symptoms which, after a lot of uncertain times, was diagnosed by Dr. Vivianne Tawflik at Stanford as CRPS, and she has beaten all odds to return to an elite level of professional tennis. This August, she won a professional tennis tournament in Concord, Massachusetts.