I’m going to take a stand on something that really gets my blood boiling… health insurance companies. People want to blame physicians for bad outcomes (I’m looking at you NRA supporters that are claiming we, as physicians, need to fix our own lane first). They want to blame hospitals for long wait times, they want […]
via The Bad Guys in Healthcare Aren’t Who You Think They Are — Doctor Enough
To promote the series #asawoman started by @nataliecrawfordmd (from Instagram)
.
.
Throughout medical school, residency, fellowship, even now in private practice… patients have often judged a book by its cover. They’ve thought I was their nurse, volunteer, high school student or college student shadowing, almost everything but the person who will lead their anesthetic care. While this can seem deflating given all the extra work and studies one puts in to become a physician, I’ve changed my mindset re: my patients’ initial thoughts on me.
.
.
First of all, thank goodness they think I’m super young! I have my mom’s genes and beautiful skin to thank!! At this rate, I hope I start to look 30 when I hit 50. When patients ask my age, I happily oblige them with a bold 39. Then I see a look of relief over their faces. I, of course, ask them how old they think I am….and I get the range of: just graduated college to mid-20s. Awesome!! I use it as a bonding moment and icebreaker with my patients. Sometimes with the right patient, I joke with them that it’s my first day… it usually entertains a good laugh. Then, I go into an overly technical schpeel on risks/benefits of anesthesia, expectations, PACU recovery. This typically solidifies to the patient that it’s not my first day on the job. Additionally, many patients tell me in the PACU that they feel better than their prior experience or better than their expectation and are quite grateful for my care.
.
.
There are a lot of men in my anesthesia group. Sometimes, after I introduce myself to the patient, they’re shocked that a woman anesthesiologist would be delivering their care. In this day and age, I’m shocked that a lot of patients still assume that a male physician will oversee their care. When caring for female patients with this mentality, I purposefully address a gentle and vigilant anesthetic plan. With my male patients with this mentality, often times they’re happy to talk about the “happy juice” cocktail they’ll get and some much deserved relaxation knowing that I will carry a watchful eye over their surgery and anesthetic.
.
.
Lastly, since becoming pregnant with my first and currently pregnant with my second… I feel I have a better understanding of the worried/concerned parents who are at the bedside to be with their child about to enter surgery. Oftentimes, the parents think I’m young and want to know where I trained and when I graduated. I offer them this info, and continue speaking to the patient (their child) about their concerns or questions. I make sure the parents know everything that will go on re: anesthetic plan, how the patient will feel in recovery and risks/benefits of anesthesia options. I TAKE MY TIME with the parents and the patient. While my age and gender often work against me (even though it shouldn’t!), I make sure the controllable worries by the parents are addressed. I speak to the parents after the surgery. They go into the recovery room and see their child (older than 13 at our hospital) comfortable and recovering. While I can’t change my appearance (nor would I want to…), I can change perceptions of women physicians. We are every bit as capable of everything our male colleagues can do. In addition, we tackle pregnancy, motherhood, businesses, and everything in between. #asawoman As A Woman, I feel more empowered now than ever before.
American Medical Women’s Association
American College of Physicians: Women in Medicine
Bias, Bravery, and Burnout: The Journey of Women in Medicine
A friend of mine’s son is just about to graduate from high school. He’s interested in medical school, and his mom asked me what advice I would give to help him pick a college knowing that he has an interest in medicine.
Keep in mind: I am not a counselor or an advisor. I am a physician, and this is what worked for me.
My advice:
If you’re in high school and interested in medicine:
If you’re in college and interested in medicine:
. If I had that available to me, I would’ve read that in high school… re-read it in college… read it again in medical school… and read it again throughout life. Yes, I’m constantly revisiting this book because it is that good.AAMC fact sheet for medical schools
My Training:
My Job:
A piece I’d like to submit for: CNN Money 24 hours With….an anesthesiologist
About Kris:
I grew up in a small west Texas town called Abilene, TX. My mom was a standard tiger mom in that she encouraged me to pursue multiple activities while nudging me to do my best. After drama lessons, tennis lessons, basketball, volleyball, piano, violin, band, taekwondo, pageants, and just life, I left Abilene and pursued a biomedical science degree at Texas A&M University. My earliest memory of wanting to be a doctor started when I was in the third grade. I hadn’t been feeling well and was diagnosed with pneumonia — I had been reading a book called This is the Child. My family practice physician Dr. Lawson was about to prescribe me prednisone and I immediately got worried because that was the same medication used to help with the child’s leukemia. Dr. Lawson picked up on my early curiosity and invited me to hang out with him in his medical office observing patients. After college, med school proved to be a great experience at University of Texas Medical Branch in Galveston and felt like learning on steroids (as compared to college). My clinical rotations led me to the path of choosing anesthesiology as a career. Anesthesia is the perfect combination of anatomy, physiology, pharmacology, psychology, and sociology. I matched into a terrific internship in Austin, TX and continued my anesthesia training at the prestigious Massachussetts General Hospital. Following 4 grueling years of training, late nights, memorable cases, and lifelong friendships, I chose to pursue a cardiac anesthesia fellowship at University of California San Diego — a world renowned institution for the treatment of right heart failure following pulmonary thrombosis. 14 years after graduating high school, I have the job of my dreams. Here’s a sample of my day…
My Day:
Today I’m #2 in our call lineup, which means it will be a pretty busy day. Typically, we have 15 call spots in our main operating room (OR) numbered #1 to #15. #1 position gets the first pick of cases. #2 gets the next pick and so on.
5:45a Early heart day wake up. Today, I will be providing anesthesia to a 70-something year old lady who needs a new heart valve. On heart days, I wake up at 5:45a to be at work by 6:30. And on regular main OR days, I wake up at 6:15a to be at work by 7:00. Ahhhh… To have more beauty sleep!
6:17a Breakfast in the car – it’s either green juice, Shakeology, or banana on the go!
6:31a I meet the patient and her family in the pre-operative area. We go over a detailed plan for her anesthesia as well as answer any questions. One of the best parts of my job is meeting all different types of people. It’s an amazing feeling to meet people at one of their most vulnerable moments in their lives and win over their trust and respect. It is my job to safely manage their physiologic processes. Oftentimes, patients tell me it is the anesthesiologist who is the most important part of a surgery — they understand how easy it is to bring them close to the brink of death and then revive them back to a wakeful state. It’s incredible the amount of trust patients place in your hands in such a short time after meeting them.
7:15am The patient is under anesthesia and all invasive monitoring lines (arterial, central venous pressure, cordis, pulmonary artery lines) have been placed. The transesophageal echocardiogram is performed and results are relayed to the cardiac surgeon.
7:45am Cardiac surgeon makes incision. The patient is monitored throughout the case. Multiple screens show all the physiologic monitoring results.
10:00a Bathroom break! Partners/colleagues break each other out so there is always an anesthesiologist monitoring the patient. It’s also a good time to grab a snack!
11:32a Drop first patient off in Cardiac Care Unit and grab some lunch. The doctor’s lounge keeps us fed with soup and salad. Today, I’m feeling the vegetable soup. Grab a quick bathroom break and then to interview the next patient.
11:45a Electrophysiology study for atrial fibrillation ablation. The view from this OR is such a delight!
The view from my little nook.
14:00 I get a call from our anesthesia czar, one of my partners who runs the schedule. He was wondering if I would make my 15:00 hip replacement. After a quick conversation, we decide that I would call him in 30 minutes for an update.
14:33 We are finishing up with the current case and I call the czar back to find out about my next case. I learned that there is an emergent heart that will be started by another colleague and that I will continue the lineup in EP (so my day went from a 16:30 finish on paper to roughly a 19:00 finish). Anytime I am in the top 5 call positions, I know not to make defined plans because you never know if there will be addons or changes to the schedule. This makes my social life a bit frustrating as my non-medical friends have a tough time understanding and adapting to this “you don’t get out of work at 5p?” concept.
15:20p Drop patient off in the Post Anesthesia Care Unit (PACU). Grab a quick snack and head back to EP for the next patient.
15:25p Speak to the next patient who has arrived for an afib ablation as well. Induce and get started with the case.
19:22 Drop last patient off in the PACU. As #2 on the call list, I look at my watch and realize that I am #2 at night. This means I will be the 2nd person they call tonight if extra rooms in the OR get booked (traumas, heart call, etc.). As much as I’d love to head home and grab a glass of wine and unwind, I meet up a friend for dinner to catch up and relax.
21:42 Head home. Shower. Brush my teeth and get into bed. There’s always a risk of being called into work. Tomorrow will be a shorter day. After the hectic day, I am still thankful for my wonderful job and colleagues. Looking back at my journey to get here, I smile because I couldn’t be happier.
I came across this very true article. How do I know it’s true? I’ve made the journey myself. I wish government would actually listen….
http://www.kevinmd.com/blog/2013/03/dear-lawmakers-doctor-today.html
This website defines the essence of physician care in the field of anesthesiology. Want to know what separates an anesthesiologist from an anesthetist? Check out the link. Plus, it lists tips on what to ask and what to bring for your upcoming surgery.
March 13, 2010
One of my least favorite patient populations: doctors.
This group knows just enough to be dangerous. They remember what they’ve learned in medical school, but they don’t know enough of the information that doesn’t encompass their specialty.
We had a patient who was a physician, and her husband was also a physician. When it came time for her epidural placement, she wanted an “attending only” placement (i.e. didn’t want a resident to place her epidural).
(Note: my hospital is a teaching hospital; there’s no question about it. Most large academic centers are run by residents.)
So, we go in to place her epidural and her husband refuses to leave the room.
(Note: it’s a policy at our hospital to have the husbands/significant others/partners, to leave the room and then come back when the epidural is placed — plenty of significant others have passed out…even when sitting in FRONT of the patient. Moral: don’t turn 1 patient into 2!).
He was interfering in every way possible. And because the staff know that this patient and her husband are physicians, they feel the need to change up their care by trying to do things different from routine. She got her epidural… by the staff. She’d been having late decels…so when she got the epidural, it was just a matter of time before going back for a cesarean section. The baby was known to have IUGR…it was delivered by C-section and went intubated to the NICU. The patient had various episodes of freakout (not uncommon on OB when you’re awake but being operated on) — as told to me by another resident who took care of her in the OR. The husband was walking around all over the place on the OB floor like he owned the place. Ugh, just b/c you’re a doctor doesn’t mean you get to prance around and receive “super special privileged” care over the normal population.
When it’s time for me to be the patient, you can bet that I won’t be anything like these people. Oh wait, I’ve already been the patient!
Sleepy Time 