A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
Behind every denial letter, there’s a story. A cancer patient forced to delay life-saving treatment, a parent battling red tape to secure the recommended …
5 game-changing New Year’s Resolutions the insurance industry should adopt
Maternal mortality crisis in the U.S.
The U.S. faces a significant maternal health crisis, with alarmingly high maternal mortality rates compared to other developed nations. As of 2022, the overall maternal mortality rate was 22.3 deaths per 100,000 live births, with a disproportionately high rate of 49.5 deaths per 100,000 live births among Black women. These figures starkly contrast with much lower rates in countries like Germany, Australia, Japan, and Sweden.
Maternal …
Critical care in critical moments: Anesthesiologists play a vital role in maternal health
Agatha Christie was onto something when she stated, “The truth, however ugly in itself, is always curious and beautiful to seekers after it.” Brian Thompson, the 50-year-old CEO of the United Health Care insurance company, was shot and killed in Midtown Manhattan on December 4th in broad daylight. His assailant, Luigi Mangione, has become a media-fueled darling, with multiple documentary projects already underway to explore the complexities of his crime. …
Murder of an insurance titan: the case for health care reform
The question is whether practicing medicine is like or unlike practicing law. Only those in distress come in search of physicians and lawyers. Thus, their clients need healing as well as protection from the ills in their innate systems or in the systems surrounding them. The absolute dependence or even surrender of those in need during times of need provides their physicians as well as their lawyers the moral high …
Why practicing medicine is both like and unlike practicing law
The box office hit Wicked is a modern retelling of the classic Wizard of Oz, where the Wizard labels Elphaba as “wicked” in his pursuit of control and greed. Much like the Wizard, who manipulates society by changing Elphaba’s name and orchestrating a movement to bring about her downfall, today’s health care insurance industry uses similar tactics to portray physicians—particularly anesthesiologists—as the villains. A recent article from Vox echoes …
Health care’s modern-day Wicked: How insurers label doctors as the villains
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We sit down with anesthesiologist Kolleen Dougherty as she reflects on her experience of career burnout after two decades at a Level 1 hospital. Kolleen shares the internal struggles that kept her in …
Is staying worth it? How one physician broke free from the “sunk cost fallacy” [PODCAST]
My work was draining. The joy was no longer there. Sure, I loved caring for patients, but the schedules, the call, and missing my children’s life events were all catching up to me. It all was too much. After two decades at a Level 1 hospital, I was the epitome of a “burned-out” physician. My mind would harken back to the Clash’s famous song from the 1980s—”Should I stay or …
Why this doctor stayed stuck in a job for years and how she finally broke free
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We sit down with Alopi Patel, an anesthesiologist and interventional pain physician, to explore the gender-based inequities women face in their careers. Inspired by the metaphor of flamingos losing their pink during times …
From career to motherhood: Navigating gender inequity [PODCAST]
Continuous quality improvement undoubtedly contributes to the ongoing honing of best practices in medicine. This health care-specific parallel of total quality management programs in business helps us daily inch closer to the ultimate goal of eradicating patient harm. Health care professionals familiar with these variation-reducing processes are likely well-versed in the popular Ishikawa fishbone diagram. While the focus is intended to be spread across materials, processes, equipment, and …
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We explore the evolving dynamics of health care teams with guests Matthew Sherrer, an anesthesiologist, and Brooke Vining, a nurse anesthetist. We discuss the shift from traditional team structures to a “teaming” mindset, …
Teaming in health care: Why the future of patient care depends on collaboration [PODCAST]
The term “organ harvesting,” once a misnomer for organ procurement after organ donation, echoes in the phrase “procedure harvesting,” which could be an inadvertent misnomer for procedure procurement following procedure donation. Who knows if some may even suggest preemptive extracorporeal membrane oxygenation when cardiac arrest seems imminent during an elective non-cardiac procedure? Regardless, while pre-procedure optimization is always a goal for elective procedure procurement—and may even be achievable in emergent …
How pre-procedure optimization could save your life—and the economy
When one envisions a team, sports teams likely come to mind. Musical groups represent another common example, as both musical groups and sports teams consist of bounded and static collections of individuals working toward a common goal. These individuals are physically located in the same place when they practice and perform together. As such, members of teams, in this sense, learn how to interact with one another, generally understanding each …
Care teaming: a new paradigm for anesthesia care teams and beyond
“Adapt or perish, now as ever, is nature’s inexorable imperative.”
– H. G. Wells, 1945
Many anesthesia professionals will likely recall the rise and fall of the Sedasys platform. Touted as a revolutionary advancement that would one day put anesthesiologists and nurse anesthetists “out of work,” the Sedasys computerized propofol-infusion platform predictably generated a fierce response from anesthesia professional societies who deemed it dangerous, off-label, and fraught with medicolegal liability. Sedasys …
How AI is reshaping the anesthesia workforce
Privacy protection does not cease to exist at death, as privacy laws protect information until 50 years post-mortem. So, why does the protected information of public figures often find its way into the public domain long before this embargoed period elapses, sometimes almost immediately after death?
Firstly, the primary question is: What defines a public figure? Some individuals are public figures long before their deaths, while others become public figures at …
Privacy protection after death: an ongoing dilemma
One of the best safety strategies in anesthesia is the anticipation and prevention of complications and errors at every step of preparation. An intact intravenous drug delivery system is essential for almost every anesthetic plan. In this article, we will specifically discuss the intravenous drug delivery system, focusing on its vulnerabilities, strategies for preparation against potential complications, and error prevention. We visualize this concept as an educational endeavor and as …
Essential safety strategies in anesthesia: anticipation and prevention of complication
When we call out to deem a patient difficult regarding access-airway-anesthesia, we do not consider the procedure, provider, proceduralist, place, phase, payer, or player as difficult. Does this mean that only patient conditions make it difficult, with conditions surrounding the procedure, provider, proceduralist, place, phase, payer, or player never coming into play? Aren’t we putting the onus solely on the patient when we document all such experiences of difficulty only …
How mislabeling patients affects health care outcomes
Just like distracted driving, there can be a term called distracted detecting; however, when one delves further, one realizes that distracted driving itself is one form of distracted detecting. Distracted detecting can be understood through the prey-predator analogy within the animal kingdom, with particular relevance during vulnerable adolescence. This concept is detailed in books co-authored by Barbara Natterson-Horowitz and Kathryn Bowers, titled Zoobiquity: The Astonishing Connection Between Human and …
Why distracted detecting is the hidden threat to your health and safety
Charm and competence among providers should ideally be concordant, but they can sometimes be discordant, which should be evaluated and corrected if possible. This discordance isn’t limited to health care; it can also be observed in politics, during litigation, and within families. Charming politicians can sway followers, charming litigators can sway juries, and charming family members can influence their families. Whether or not their competence, or lack thereof, gets overlooked …
Why charm and competence are essential for career survival
It was something out of an Indian Bollywood movie. My best friend, Raj, found a girl he liked and was completely captivated by her. We had never seen Raj with such a glow – but for our group of friends, we knew something was different with Raj, and I dare say he was in “love.” For reference, he is the kind of man who is honest, loyal, trustworthy, and …
A doctor’s broken heart: lessons learned from a failed relationship
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
We always hear about the art and science of medicine, but with our busy practices, the science stays at the forefront, while the art can get lost. Personal experiences or a special patient can help open our eyes. The …
Stop and listen: How listening to patients and families is ever important for optimal care
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