Anesthesiology News presents The Etherist

Whitney Fallahian, MD, an assistant professor of anesthesiology at the University of Wisconsin, in Madison, shares her thoughts on several important topics for fledgling anesthesiologists, such as fellowship options, work-life balance and salary expectations.

The American healthcare system is experiencing a growing crisis: How do we adequately staff our operating rooms, hospitals, clinics and offices with healthcare professionals? The lack of staff crosses all professional lines, from physicians to nurses to lab technologists—all levels of staff are in short supply. To deal with this challenge, health administrators have resorted to using temporary contract workers known as locums. These temporary, stop-gap employees are usually paid multiple times more than permanent staff. This practice not only undervalues full-time employees, but also exacerbates the crisis because it robs staff from other facilities to staff another. Finally, the increase in locums, and its associated costs, has undeniably harmed the bottom line with many services and facilities closing down, further decreasing access to healthcare for the public. We as health professionals need to address this crisis. To do so, the causes must be analyzed and solutions developed. Some issues, such as salary lines and child care, can easily be addressed. Others, such as professional burnout due to electronic medical record systems, which have taken professionals away from patient care—essentially making them data entry clerks—should be addressed, and jointly with technology companies. The bottom line is that all of us must focus on this crisis or it will lead to a marked decline of the American healthcare delivery system.

At the 2023 spring meeting of the American Society of Regional Anesthesia and Pain Medicine, Rajnish Gupta, MD, a professor of anesthesiology at Vanderbilt University Medical Center, in Nashville, Tenn., discusses how podcasting can be a way for anesthesiologists to highlight their academic work and communicate with other like-minded professionals in the specialty. “The beauty of podcasting is that it allows the speaker to talk on a specific topic to a narrow audience. That way you can expand on a topic that may not be appropriate for a large population of people, but in that small niche, there is a lot of enthusiasm.” 

Barbara Orlando, MD, PhD, an associate professor of anesthesiology and the division chief of obstetric anesthesiology at McGovern Medical School at the University of Texas Health Science Center, in Houston, discusses several ways to reduce morbidity and mortality in pregnant patients. She also addresses high-risk pregnant patients with various comorbidities, such as obesity and those with a lack of prenatal care.“This podcast is about my personal journey as an anesthesiologist in gaining understanding and being more involved with societies and committees in charge of maternal mortality and morbidity. My interest was sparked by my passion for obstetric anesthesia, and my new role as a division chief of OB anesthesia at UT Houston. Reviewing bad outcomes and thinking of ways of reducing such events was very eye-opening to me, and I hope to inspire others as well.”

Obstructive sleep apnea (OSA) affects 20% of U.S. adults, of whom about 90% are undiagnosed. The major risk factors for OSA include obesity, male sex and a family history of OSA. There is a large body of literature showing that OSA is an independent risk factor for hypertension, heart disease, type 2 diabetes and stroke.  This case illustrates how a patient presented for elective admission for surgery and suffered a stroke.  A 55-year-old man with obesity presented for elective surgery for a chronic nonhealing ankle fracture. The patient reported a long history of loud snoring and type 2 diabetes. He was administered a general anesthetic and had no issues during the case. The patient recovered and was admitted to the hospital overnight, and it was noted that he had marked bouts of hypertension overnight while sleeping; the patient had no past history of hypertension. The staff also noted evidence of sleep apnea patterns of sleep and snoring. The patient was then discharged home. Three weeks later, the patient presented with a large embolic stroke and was admitted to the neuro-ICU. He was discharged to a rehabilitation facility with marked cognitive issues.  This case illustrates how important it is for anesthesia providers to screen patients for OSA and educate patients about the major risks of OSA. There were also some key incidents during this admission that support the need for staff education. The episodes of hypertension during sleep and not while awake are a key sign of the cyclic sympathetic outflow that occurs during OSA. This also supports cyclic release of mediators that occurs during severe OSA that can affect the endothelium and cause activation of coagulation cascade. The snoring can also cause direct vibratory trauma to the carotid blood vessels, and also cause endothelium damage on the interior of those vessels that can generate a clot.  We as anesthesia providers should be at the forefront of identification of OSA and have a protocol to educate patients and refer them to sleep specialists for testing and proper treatment. This can be a major public health contribution of our specialty.  

Cancer is a major global public health concern that affects all citizens and communities around the world. Globally, the incidence of cancer is predicted to increase by 50% by the year 2030; and during the same period, cancer-related mortality is projected to increase by 60% to 13.1 million deaths worldwide. This increasing trend in cancer-related mortality exists despite a slow but steady decline in cancer-related death rates since the early 1990s in the United States and the Western world.Citizens 65 years of age or older have a cancer incidence rate that is 10 times higher than among younger people, while the mortality rate among older cancer patients is 16 times greater than among younger patients. However, cancer is no longer considered a terminal disease. With the implementation of effective cancer prevention education programs, widely available screening programs leading to early diagnosis, and the advent of effective biologic and immunotherapeutic modalities, the profile of cancer is changing to a chronic medical condition.There are more than 20 million cancer survivors currently living in the United States alone. Of the nearly 20 million new cancer cases worldwide in 2021, more than 80% of cases will need surgery, some several times as curative resection is essential for global cancer control, particularly for patients with solid tumors. It is estimated that by 2030, over 45 million surgical procedures will be needed globally for cancer control. Furthermore, both patients with cancer and cancer survivors will continue to need the services of our specialty in the perioperative setting well beyond their primary cancer care.  As most of the diagnostic and interventional procedural care for patients with cancer is provided in the community setting around the world, this textbook, “Perioperative Care of the Cancer Patient,” will serve the educational needs of anesthesia providers in all settings globally. Each of the chapters is authored by international experts in the field and discusses the current understanding and practices, current controversies and unanswered questions, and the direction for future studies.  I believe this is an exciting time for anesthesiology and perioperative medicine as we continue to partner with oncology and other specialties to break down silos and work together to improve postoperative outcomes and increase disease-free survival.   

Neil Ratner, MD, has played remarkably divergent roles in his life, initially as a rock-and-roll drummer and staging entrepreneur, working with the likes of Edgar Winter and Emerson, Lake & Palmer. But he always had an interest in medicine, so eventually he ditched his successful rock career and went to medical school, later becoming an anesthesiologist who embraced the then-novel concept of delivering non-OR anesthesia, which he helped pioneer.  It was through his work as an anesthesiologist for a plastic surgeon that he ended up meeting Michael Jackson, of all people, who immediately liked Dr. Ratner and his rock-and-roll roots.  His rock music and medicine careers enjoyed some precipitous highs but also significant lows, all of which he candidly details in his book “Rock Doc.”Perhaps surprisingly, however, our interview with Dr. Ratner is mostly not about his rock-and-roll past or his work doing non-OR anesthesiology, but instead about what he is up to today: serving as a kind of public health announcer for a radio station in, fittingly, Woodstock, N.Y. His work interpreting medical news—particularly as it relates to COVID-19—for the station (WDST; 100.1 MHz) has made a difference in the public's understanding of the complicated issues brought about by the pandemic. 

The Drug Enforcement Administration Washington Division is warning local residents of a dangerous new drug emerging in the D.C. area that is as deadly as fentanyl. We as neurocritical care practitioners may therefore soon find ourselves caring for patients that have overdosed on this drug and may be suffering from severe hypoxic injury and coma. In the fall of 2019, a new synthetic opioid named isotonitazene made its debut in the U.S. and Canada. The drug, which is not a derivative of fentanyl but is equally as potent, is legal to export from China and was not initially banned in North America or Europe despite not being an approved pharmaceutical product anywhere in the world. However, the DEA has now issued an emergency temporary order placing isotonitazene as a Schedule I drug. Isotonitazene is a derivative of benzimidazole, an opioid analgesic. It is 500 times more potent than morphine and has slightly more potency than fentanyl with respect to causing relaxation, euphoria and respiratory depression. In March 2020, isotonitazene was found in counterfeit hydromorphone tablets sold on the streets of the United States and Canada. There are also reports that this is being mixed with other street drugs such as cocaine. Isotonitazene is a growing public health risk and a real danger to those who misuse drugs, especially users of heroin and cocaine. Street names of this drug including nitazene or ISO may be volunteered by patients and other involved parties. Another major issue for us in the ER and neuro ICU may be that normal toxicology screens do not identify this drug. Luckily, however, the drug is responsive to naloxone. It may be important for us to collect blood samples from patients responsive to naloxone but who tested negative for narcotics in our facilities and send it for analysis to help government agencies track the distribution of this drug. I also suggest that blood samples be sent for patients who present with hypoxic brain injury with unclear causes, especially individuals at risk.

Over the past two years, Saddleback Hospital, in Laguna Hills, Calif., has implemented a robust ERAC (early recovery after cesarean) protocol that includes a transversus abdominis plane block with liposomal bupivacaine for post-op cesarean delivery pain. Results have shown that the protocol has reduced the use of narcotics for the post-op period by 80%, and has improved the overall satisfaction with the post-op period considerably by reducing nausea and vomiting, itching, and constipation. In addition, hospital length of stay has been reduced by one day. According to Steve Garber, MD, a practicing obstetric anesthesiologist for more than 30 years, moms are eating earlier, up and around quicker, and ready and willing to go home earlier. The patient in this case study, who had a myomectomy 20 months earlier, essentially had a very similar surgery to a cesarean delivery. The incision was the same, the uterus was operated upon and the patient remained in the hospital. Her post-op course, as related to Garber and her husband, was vastly different in regard to her narcotic usage and how she felt. She was “out of it” for two to three days, and these were days she was home already. She felt dizzy, wasn't able to concentrate and was in moderate pain, which is to be expected for the extent of her procedure. So now, we get to compare the experience for the same patient, having essentially a very similar surgery, with a different post-op pain protocol: the ERAC protocol. Of note is the extent of the hemorrhage that occurred, the overnight stay in the ICU, Bakri balloon intervention and the patient didn't require any narcotics for pain throughout her stay. The patient was amazed how well she felt post-op day 1, back in her private room with her newborn. “Cesarean delivery is the most commonly performed major surgery in the world, with 1.3 million performed in 2019,” Garber said. “Unfortunately, every year 26,000 women become persistent opioid users after cesarean delivery. With a robust ERAC protocol, the reduction of opioid use is quite significant. “If you look at our patient, if no ERAC protocol was used, she would have felt the same, or probably worse, than after her first surgery. Lethargic, out of it, dizzy, and would have been expected to bond with and take care of a newborn. The first hours and days with a newborn are so precious, and I believe all the moms should have the ability and opportunity to experience it with little to no narcotic use.” 

In the previous chapters of “Anesthesiology News Presents The Etherist,” we defined just what physician well-being is, when it came to light and why the concept needs to be addressed at institutional and systemwide levels. We also explored managing the cognitive workload during residency, the stress of working during the COVID-19 pandemic, and the unexpected toll that burnout can leave behind. And now, for the final episode of the series, various experts share their thoughts on how to best recognize and manage burnout, as well as how to strive for an optimal work‒life balance. These aren't instant fixes, but rather takeaways for anyone, regardless of whether they are struggling or not. There has been no shortage of thought-provoking quotes throughout this investigative series, but the one that has most resonated with us is one that we hope you also hold onto: “When I think about wellness, the first thing that comes to mind is the old cliché of being on the airplane and being told, ‘Put on your own oxygen mask before you help those around you.' So certainly, in the long run, one cannot be an effective doctor, caring for one's patients, if one does not also care for oneself. However, it's equally as important that physicians work in environments that support their ability to do that.” Translation: Management can't simply prescribe yoga when the reason for burnout is staffing shortages. Researchers recently found that 62.8% of physicians had at least one manifestation of burnout in 2021; and while the pandemic's peak is over, supply chain issues and staffing shortages still continue. Substance use disorder does affect anesthesiologists, as we know. This might be due to the ease of access to intravenous opioids, propofol and other anesthetic drugs. More sobering is the fact that every year in the U.S., roughly 300 to 400 physicians die by suicide. The ASA has a comprehensive webpage highlighting various help resources, including suicide and physician support lines, well-being apps, a burnout calculator and guides for doctors facing adverse outcomes and malpractice litigation. However, the most important thing to know is that you are not alone. Despite what you may think, many of your colleagues have previously gone through or are even currently experiencing many of the same feelings of burnout. So create a buddy system and know that there's nothing wrong with confiding in a peer, friend or even a trained professional. While your focus is predominantly and perpetually on taking care of patients, it's okay to think about yourself for a change. Because as a former AMA president once said, "The most important patient we really have to take care of is the one in the mirror."

In the second episode of Anesthesiology News presents The Etherist, we discussed some of the main causes and signs of burnout. We also explored what it was like to work during the onset of the COVID-19 pandemic. In this installment, we first examine well-being during residency. Managing the cognitive workload and production pressure can be incredibly demanding, even for seasoned doctors. So, without proper guidance and a strong foundation, the acute setting can easily lead to burnout for residents. We then speak with a European anesthesiologist about cultural differences in the specialty. Just how much better might your life be if you didn't have to worry about electronic records and patient billing?   Stay tuned for the final episode of Anesthesiology News presents The Etherist, where a variety of experts share their thoughts on how to make the situation better, both at an institutional and an individual level. We hope that their experiences can inspire you. 

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 Agrawal, 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.Agrawal 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.Links Mentioned:Caleb's LawDisagreements Persist Over Safety of Dental Anesthesia - Anesthesiology NewsLink to Interview with Peggy Seidman, MD, a SmileMD anesthesiologistTake Our Listener Survey!Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

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.Links Mentioned:Link to OFFOR HealthLink to Interview with Peggy Seidman, MD, a SmileMD anesthesiologistLink to the ASA's Difficult Airway GuidelinesTake Our Listener Survey!Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

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.Links Mentioned:Link to The Frost SeriesLink to Submit Your Own Case ReportLink to listener surveyFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

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.Links Mentioned:Sign up for Going ROAG seminarRevised Difficult Airway Guidelines Broaden Scope – Anesthesiology NewsASA Updates Difficult Airway Guidelines - Anesthesiology NewsLink to the ASA's Difficult Airway GuidelinesLink to presentation by Tim Cook on “no trace, wrong place”Send us an email submit a case for The Frost SeriesTake Our Listener Survey!Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

“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 listener survey!Other Links Mentioned:Link to Case ReportLink to Submit Your Own Case ReportFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

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. Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

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.Suggested ReadingBrown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. _N Engl J Med_. 2010;363:2638-2650. İnce R, Adanir SS, Sevmez F. The inventor of electroencephalography (EEG): Hans Berger (1873–1941). Childs Nerv Syst. 2021;37:2723–2724. https://doi.org/10.1007/s00381-020-04564-z Gibbs FA, Gibbs LE, Lennox WG. Effects on the electroencephalogram of certain drugs which influence nervous activity. Arch Intern Med. 1937;60:154-166. Glorfeld J. Hans Berger has a real brainstorm: accident inspires a career and the invention of EEG. Cosmos. November 20, 2020. Accessed November 16, 2021. https://cosmosmagazine.com/health/hans-berger-has-a-real-brainstorm/ Mets B. Waking Up Safer? An Anesthesiologist's Record. SilverWood Books; 2018. Purdon PL, Sampson A, Pavone KJ. Clinical electroencephalography for anesthesiologists part I: background and basic signatures. Anesthesiology. 2015;123(4):937-960. doi:10.1097/ALN.0000000000000841 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-eegFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In the previous episodes, we relived the incredible achievements of the discoverers of anesthesia in Davy, Morton, Simpson and Long. But another individual may be just as important to the progress of the specialty as those who discovered it.John Snow was a doctor and scientist in London when he first witnessed a demonstration of ether anesthesia. Even though he was not credited with the discovery of ether or chloroform, he became a leader in the advancement of modern medicine in England.In fact, it was Snow's forward-thinking mentality that laid the foundation for the spirit of the specialty of anesthesiology: the idea that there is always a better answer to the problem than the one we have now. To do that, Snow developed the first ever anesthesia practice standards to guide his colleagues in the use of anesthesia.In this episode, we turn our attention to our future, and explore how understanding Snow's original ether anesthesia practice standards was just the first chapter in a 175-year story of anesthesia innovation. We will also discuss the current outlook of our modern research into the development of more targeted anesthesia drugs and more.This is episode 3 of season 3 of “Anesthesiology News presents The Etherist.” The fourth and final episode of the season will be available on Nov. 23, 2021.Sponsored by Masimo and Medtronic.Suggested ReadingFenster JM. _Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253. Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021. Mets B. Waking Up Safer?: An Anesthesiologist's Record. SilverWood Books; 2018. Richardson BW. Memoir of the Author: John Snow, Chloroform and Other Anaesthetics. London: John Chruchill; 1858. Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008. Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

The discovery of chloroform was closely intertwined with ether anesthesia because of the relative closeness of their discoveries, but it did not take long for the early pioneers of anesthesia use to understand the enormous difference between the two anesthetic agents. From October 1846 to November 1847, anesthesia providers used ether to ease pain in surgery and it might have seemed as if a golden age in medicine was just beginning, but tragedy would eventually strike the growing specialty of anesthesiology. Hannah Greener's experience with the use of chloroform anesthesia as a patient would mark a major crisis point for the early advocates of anesthesia.This season of the series is about revisiting the history of anesthesiology while also reimagining those events based on what we know today. But that story can't be told without also diving into the dangers of the use of anesthesia. It is perhaps the most important piece of knowledge that we possess now, that those early anesthesiologists were not sufficiently aware of at the time.This is episode 2 of season 3 of “Anesthesiology News presents The Etherist.” Episode 3 will be available on Nov. 2, 2021.Sponsored by Masimo and Medtronic.Suggested ReadingFenster JM. _Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253. Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021. Mets B. Waking Up Safer?: An Anesthesiologist's Record. SilverWood Books; 2018. Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008. Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

On Friday, Oct. 16, 1846, William Thomas Green Morton changed the world of medicine with his demonstration of vaporized ether anesthesia at Massachusetts General Hospital, in Boston.The discovery and public demonstration of ether anesthesia was not a sudden achievement, though. In fact, it was the results of incremental scientific gains by dozens of scientists from Raymond Lully, the Spanish alchemist who first distilled sulfuric ether in 1275, to Joseph Priestly, the English researcher who developed nitrous oxide in 1774, and finally to Morton.But there is more to the story than those early pioneers could have known. This season we will be retelling and reimagining the story about the dawn of anesthesia use with a slight twist. We will also dive into the latest research into the mechanisms of anesthesia's effects on the brain—knowledge the early innovators in anesthesia could not have realized in their time.This is episode 1 of season 3 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on Oct. 26, 2021.Sponsored by Masimo and Medtronic.Suggested ReadingFenster JM. Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.Mets B. Waking Up Safer?: An Anesthesiologist's Record. SilverWood Books; 2018.Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

Before the discovery of ether anesthesia, surgery was an excruciating experience for patients, their loved ones and even the surgeons who performed the operations.In the 1840s, an important scientific breakthrough changed the course of medical history—the discovery of anesthesia. However, over several decades leading up to that historic discovery, the potential for less painful surgery existed without anyone managing to connect the dots between a series of scientific developments with nitrous oxide and the need for anesthesia in surgery. Those decades presented a stark missed opportunity for all surgery patients of the time, and a true conundrum affectionately known as “laughing gas.”In the prologue for season 3 of “Anesthesiology News presents The Etherist,” we delve into the decades-long conundrum of the coexistence of anesthesia—in the form of nitrous oxide and ether—and the continuation of painful surgery during the early 19th century.Episode 1 of The Etherist will be available on Oct. 16, 2021—175 years after the original demonstration of ether anesthesia, now known as Ether Day.Sponsored by Masimo and Medtronic.Suggested ReadingFenster JM. Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.Mets B. Waking Up Safer?: An Anesthesiologist's Record. SilverWood Books; 2018.Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this new season of “Anesthesiology News presents The Etherist,” we celebrate the 175th anniversary of the original Ether Day by looking back at the origin of anesthesiology as a modern medical specialty.We will revisit those early days of discovery and innovation and the people who made it all possible, but we won't stop with the history of anesthesia. This season we will also dive into the emergence of new research that has revealed the basic effects of how anesthetic drugs work in the first place.Join us on this journey into the past as we uncover what those early pioneers of anesthesia knew and didn't know as they made one of the most significant medical discoveries in history.This new season of The Etherist will be available on Oct. 16, the 175th anniversary of Ether Day.Sponsored by Masimo and Medtronic.Suggested ReadingFenster JM. Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.Mets B. Waking Up Safer?: An Anesthesiologist's Record. SilverWood Books; 2018.Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this exclusive feature of “Anesthesiology News Presents,” Jodi Kuhlman, MD, comes forward to share her story of fentanyl addiction and drug diversion for the very first time. Kuhlman's story was first published anonymously in a feature in the women's magazine Marie Claire, in 2019. She recently decided to come forward to share her story directly to bring more awareness about the dangers of drug abuse and addiction for anesthesiologists.Kuhlman is an anesthesiologist in Calhoun, Ga. She has also partnered with IntelliGuard in a joint effort to advocate for better drug diversion practices and awareness in hospitals around the United States.“Anesthesiology News Presents” is the podcast network for Anesthesiology News including “On the Case,” a behind-the-scenes look into the popular case reports published in the news magazine; “Ask the Experts,” an up-close and personal conversation series with some of the leading experts in the field; and “The Etherist,” the flagship series that delves into the key stories shaping the specialty in the past, present and future.Links Mentioned:Link to article in Marie ClaireLink to panel discussion with IntelliguardSend us an email submit a case for The Frost SeriesFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this episode of “Ask the Experts,” Sonia Vaida, MD, comes on the show to explain her process for editing new reviews and case reports for “The Frost Series” every month in Anesthesiology News. She also shares her best advice on how to write reports to get them published for the first time. Vaida is the clinical editor of “The Frost Series” for Anesthesiology News. She is also a professor of anesthesiology and obstetrics and gynecology, the vice chair for research, and the director of obstetric anesthesia in the Department of Anesthesiology and Perioperative Medicine at Penn State Health Milton S. Hershey Medical Center. “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.Links Mentioned:Link to The Frost SeriesLink to IMDB page for Zorba the GreekLink to Zorba the Greek, in paperbackSend us an email submit a case for The Frost SeriesFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this episode of “On the Case,” Peter J. Papadakos, MD, discusses a case report he wrote in the Journal of the American Academy of PAs (2021;34[4]:33-36) about a 54-year-old man who was transferred with a large right frontal intracerebral hemorrhage after ingesting kratom.Papadakos is a professor of anesthesiology, surgery, neurology and neurosurgery, and the director of critical care medicine at the University of Rochester, in New York. He is also a member of the Anesthesiology News editorial advisory board.“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.Links Mentioned:Link to Case ReportLink to Kratom Commentary in Anesthesiology NewsLink to Submit Your Own Case ReportTell us what you thought of the first season of “On the Case”Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this episode of “Ask the Experts,” Peggy Seidman, MD, joins us to discuss dental anesthesia and the need for more qualified anesthesia providers for routine office-based dental procedures, especially in pediatric cases. She also shares her favorite section of The New York Times and one thing that has inspired her throughout her career.Seidman is a board-certified pediatric anesthesiologist, practicing in Cleveland. She partners with SmileMD, a mobile anesthesia services company founded by anesthesiologists, to provide anesthesia services for local dental procedures.“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.Links Mentioned:Link to Dr. Seidman's commentaryLink to resources on anesthesia for children's dental workLink to SmileMDSend us an email to submit questions for future guestsFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this episode of “On the Case,” Matthew Shachner, DO, discusses his case report about a 2-year-old girl who developed malignant hyperthermia during a routine dental cleaning under general anesthesia. The patient had presented to the hospital for the procedure due to poor dentition, and it was her first time undergoing general anesthesia.Shachner is an anesthesiologist in the Department of Anesthesiology at the Anesthesiology Consultants Exchange, P.C., in Cleveland, Tenn.“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.Links Mentioned:Link to Case ReportLink to The Malignant Hyperthermia Association of the United States (MHAUS)Link to Submit Your Own Case ReportFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

Show Notes:In this episode of “Ask the Experts,” Cheryl Gooden, MD, joins us to discuss some of the challenges that she encounters with pediatric airway management. She also talks about her work in medical mission work around the world from India to Peru.“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.Links Mentioned:Link to Plasticos FoundationLink to The Orbis Flying Eye HospitalLink to Maya Angelou QuoteSend us an email to submit questions for future guestsFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

Show Notes:In this episode of “On the Case,” Steve Garber, MD, discusses his case report on a 39-year-old woman (gravida 5, para 4), at 36 weeks’ gestation, who was diagnosed with COVID-19 pneumonia after presenting to the emergency department with shortness of breath, cough and myalgias three days after her COVID-19 diagnosis.Dr. Garber in an anesthesiologist at Saddleback Medical Center, in Laguna Hills, Calif.“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 what it was like to experience those clinical situations and why they decided to write about them afterward.Links Mentioned:Link to Dr. Garber's Case ReportSubmit Your Case Report for Consideration!Follow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

Show Notes:In this episode of “Ask the Experts,” Karen Sibert, MD, joins us to discuss the future of anesthesiology and the evolving role of anesthesiologists in modern health care. She also explains her reason for giving up on Twitter as a way of communicating her ideas and opinions about the specialty.“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.Links Mentioned:Link to article comment for question 1Link to tweet for question 2Link to interview with Karen Sibert, MD, in “The Etherist” Season 2Send us an email to submit questions for future guestsFollow Us:Our WebsiteApple PodcastsSpotifyGoogle PodcastFind Us on Social:TwitterFacebookLinkedInInstagram

In this episode of “On the Case,” J. Eric Greensmith, MD, PhD, joins us to discuss his case report about the history of chloroprocaine and the benefits of using it in ambulatory surgery today.Greensmith is an associate professor of anesthesia and critical care in the Department of Anesthesiology and Perioperative Medicine at Penn State Health Milton S. Hershey Medical Center, In Hershey.“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 what it was like to experience those clinical situations and why they decided to write about them afterward. Links from the episodeLink to case report: The Rise, Fall and Rise Again: Navigating the History of Chloroprocaine In Ambulatory SurgeryLink to other reports from The Frost Series. Link to submit a case report: AnesthesiologyNews.com/CaseSubmission Link to study on isobaric spinal mepivacaine.Link to study comparing spinal 2-chloroprocaine and lidocaine.Link to study on spinal chloroprocaine solutions.Link to study on mepivacaine and transient neurologic symptoms.

In this episode of “Ask the Experts,” Amy Pearson, MD, joins us to discuss her leadership role in Women in Anesthesiology, which is an organization that focuses on the professional and personal development of women anesthesiologists as well as promoting a culture of inclusivity and diversity.“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. This is the first episode of the series, and new episodes will be published every month. Links from episodeLink to tweet in question 1Link to tweet in question 2Link to tweet in question 3Resources from MythsMyth 1: “Anesthesiology should be popular among women medical students.”www.aamc.org/data-reports/workforce/interactive-data/acgme-residents-and-fellows-sex-and-specialty-2015Myth 2: “If women don’t choose our program or practice, we can’t help it.”pubmed.ncbi.nlm.nih.gov/31199206/www.ncbi.nlm.nih.gov/pmc/articles/PMC5131263/weli.pedsanesthesia.org/wp-content/uploads/2020/04/Motherhood-and-Anesthesiology.pdfMyth 3: “If residents were allowed to graduate by just achieving their milestones, maybe it would be easier for women to take maternity leave in residency without making up the time.”jamanetwork.com/journals/jamainternalmedicine/fullarticle/2607209jamanetwork.com/journals/jamanetworkopen/fullarticle/2768342Myth 4: “It’s a good thing harassment doesn’t happen in the hospital or OR anymore.”link.springer.com/article/10.1007/s12630-019-01333-8Myth 5: “We need to flatten the hierarchy and call women by their first names.”Myth 6: “The only reason there’s a pay gap is because women work less hours and don’t negotiate.”weli.pedsanesthesia.org/wp-content/uploads/2020/04/Closing-the-Gender-Wage-Gap-and-Achieving-Professional-Equity-in-Medicine.pdfpubs.asahq.org/anesthesiology/article/123/5/997/12599/Regional-and-Gender-Differences-and-Trends-in-theMyth 7: “It’s easy to have kids in medical school/residency/practice.”journals.lww.com/obstetricanesthesia/Abstract/2020/12000/Motherhood_and_Anesthesiology__A_Survey_of_the.33.aspxwww.ncbi.nlm.nih.gov/pmc/articles/PMC5818808/CBS News report on birth rate: www.cbsnews.com/news/birth-rate-declining-younger-generations-crisis/Myth 8: “Mothers going part time are the reason there’s a physician shortage.”www.aamc.org/download/498034/data/aamcstatementtothehousesmallbusinesscommitteeregardingmedicaled.pdfwww.aamc.org/download/484890/data/2017annualaddressofthephysicianworkforce.pdfMyth 9: “There’s a shortage of women leaders and professors because historically they were not as well represented in medicine.”www.aafp.org/news/blogs/leadervoices/entry/20200228lv-diversity.htmlwww.forbes.com/sites/lipiroy/2020/02/25/its-my-calling-to-change-the-statistics-why-we-need-more-black-female-physicians/#7f17e21a56a5www.bjanaesthesia.org.uk/article/S0007-0912(20)30010-6/abstractwww.scholars.northwestern.edu/en/publications/status-of-women-in-academic-anesthesiology-a-10-year-update-2www.aamc.org/data-reports/faculty-institutions/report/state-women-academic-medicinetwitter.com/JulieSilverMD/status/1176123023348383745/photo/1Myth 10: “Women have several deficiencies they need to fix in order to be successful.”Link to interview with Amy Pearson, MD, in “The Etherist” Season 2: www.anesthesiologynews.com/Multimedia/Article/10-20/The-Etherist-Podcast-Season-2-Episode-3-A-Perfect-Match/60710Reading Recommendations From Amy Pearson, MDOn Attrition www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/comment-page-3/On Life Coaching janetatansey.comthecareerlauncher.com/careerrx-certified-coaches/Brene Brown (Daring Greatly)  To submit questions for our next guest, Karen Sibert, MD, email us at ANPresents [at] mcmahonmed.com.

In this episode of “On the Case,” Carl (Yuan-Feng) Lo, MD, joins us to discuss his case report about using lung point-of-care ultrasound to diagnose and treat transfusion-associated circulatory overload in a toddler with upper gastrointestinal bleeding.Lo is a clinical assistant professor of anesthesiology in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital Los Angeles, and the Keck School of Medicine of USC, also in Los Angeles.“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 what it was like to experience those clinical situations and why they decided to write about them afterward. This is the first episode of the series, and new episodes will be published every month. Links from episodeLink to case report: https://www.anesthesiologynews.com/Clinical-Anesthesiology/Article/03-21/Pediatric-POCUS-to-Diagnose-Treat-TransfusionAssociated-Circulatory-Overload/62701Link to POCUS training: https://www.asra.com/events-education/event-item/2021/11/06/default-calendar/introduction-to-perioperative-point-of-care-ultrasound  

In this episode of “Ask the Experts,” William Rosenblatt, MD, joins us to discuss the “Airway on Demand” video series and answer a few questions about some unique airway management moments he has caught on camera.Rosenblatt is a professor of anesthesiology at Yale New Haven Hospital and the Yale School of Medicine, in Connecticut. He is the president of “Airway on Demand” and a past president of the Society for Airway Management.“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. This is the first episode of the series, and new episodes will be published every month.  Links from episodeLink to video in question 1: https://www.anesthesiologynews.com/Policy-and-Management/Article/09-20/Airway-on-Demand-Cricopharyngeus-Muscle-Contraction-During-Video-Laryngoscopy/59603Link to video in question 2: https://www.anesthesiologynews.com/Multimedia/Article/07-20/Airway-on-Demand-Oxygen-Insufflation/59061Link to video in question 3: https://www.anesthesiologynews.com/Multimedia/Article/02-20/Airway-on-Demand-Sleep-Apnea-and-a-Snoring-Airway/57338Link to video in question 4: https://www.anesthesiologynews.com/Multimedia/Article/01-21/Airway-on-Demand-Specialized-Intubation-Via-Supraglottic-Airways/62325Watch more “Airway on Demand” videos at https://www.anesthesiologynews.com/MultimediaLink to “Airway on Demand”: https://www.airwayondemand.com/Book recommendation from Dr. Rosenblatt: https://www.timothysnyder.org/books/our-maladyTwitter follow recommendation from Dr. Rosenblatt: https://twitter.com/JohnCSakles?s=20To submit questions for our next guest, Amy Pearson, MD, email us at ANPresents [at] mcmahonmed.com.

In this episode of “On the Case,” Richard Kim, MD, MSc, joins us to discuss his case report about a patient who experienced hemolacria, or blood in tears.Kim is a regional anesthesiology and acute pain medicine fellow at Stanford University School of Medicine, in California.“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 discuss with the authors of those case reports what it was like to experience those clinical situations and why they decided to write about them afterward. This is the first episode of the series, and new episodes will be published every month. Links from episodeLink to case report: Just in Time for Halloween: Hemolacria, or Blood in TearsSubmit your case report here: AnesthesiologyNews.com/CaseSubmission 

Introducing two new podcast series from the same team that brought you “Anesthesiology News presents The Etherist.” These new shows, called “On the Case” and “Ask the Experts,” will be premiering next week. “On the Case” is a behind-the-scenes look into the popular case reports published in the news magazine. We’ll be discussing what it was like to experience those clinical situations with the authors of some of the most popular cases. We will hear directly from them why they decided to write a case study about those experiences. The first episode features an interview with Richard K. Kim, MD, MSc, who co-wrote a case report about a patient who experienced hemolacria. “Ask the Experts” is an up-close and personal conversation series with some of the leading experts in the field of anesthesiology. We will be asking questions submitted by our readers and listeners to experts on topics such as the difficult airway and women in medicine. The first episode features an interview with William Rosenblatt, MD, who answers questions about some of his most popular Airway on Demand videos. These episodes will be published later this month. And new episodes from both of these new series will appear every month.

This story started with a number—a shortage of 139,000 physicians—and for anesthesiology that could mean a shortage of between 17,000 and 42,000 physician anesthesiologists. Throughout this season, it became clear that the exact number of physicians wasn’t the real story. All of the elements affecting the specialty, from changing practice models to the role of physician anesthesiologists to new business models, could leave anesthesia providers with either a better or more uncertain future. In this episode of Anesthesiology News presents The Etherist, we try to find where that balance between the very good and potentially very bad exists today and what it could mean for the future of the specialty. Sponsored by Masimo and Envision Physician Services 1. Association of American Medical Colleges. The complexities of physician supply and demand: projections from 2018 to 2033. June 2020. Accessed September 13, 2020. aamc.org/system/files/2020-06/stratcomm-aamc-physician-workforce-projections-june-2020.pdf 2. New York State Department of Finance. Out-of-network law (OON) guidance (part H of chapter 60 of the laws of 2014). September 16, 2015. Accessed October 5, 2020. dfs.ny.gov/insurance/health/OON_guidance.htm 3. New York State Health Foundation. Issue brief: new york’s efforts to reform surprise medical billing. February 2019. Accessed October 5, 2020. nyshealthfoundation.org/wp-content/uploads/2019/02/new-yorks-efforts-to-reform-surprise-medical-billing.pdf 4. Corlette S, Hoppe O. New York’s 2014 law to protect consumers from surprise out-of-network bills mostly working as intended: results of a case study. May 2019. Accessed October 5, 2020. georgetown.app.box.com/s/6onkj1jaiy3f1618iy7j0gpzdoew2zu9 5. American Society of Anesthesiologists. Surprise medical bills/out-of-network payment. Accessed October 5, 2020. asahq.org/advocacy-and-asapac/advocacy-topics/surprise-bills

Anesthesiology is a specialty experiencing unique changes. On the one hand, there is debate over practice models and supervision rules. On the other hand, there is rapid consolidation of anesthesia practices across the United States. These two issues are in addition to the potential crisis of a physician anesthesiologist shortage in the coming years. The question that we seek to answer in this episode of “Anesthesiology News presents The Etherist” is whether these issues will lead to positive or negative outcomes for the specialty, and more specifically for the role of physician anesthesiologists. In episode 2, we ask how these large specialty-specific trends could shape the future of anesthesia care and the pending physician anesthesiologist shortage. 1. Association of American Medical Colleges. The complexities of physician supply and demand: projections from 2018 to 2033. aamc.org/system/files/2020-06/stratcomm-aamc-physician-workforce-projections-june-2020.pdf. June 2020. Accessed September 13, 2020. 2. Daly K. Consolidation in the anesthesiology services market continues with new partnership options. Anesthesiology News. anesthesiologynews.com/PRN-/Article/05-16/Consolidation-in-the-Anesthesiology-Services-Market-Continues-with-New-Partnership-Options/56101. October 23, 2019. Accessed September 21, 2020. 3. Shekar AJ, M’Bodj A, Daly K. Consolidation in anesthesia. providenthp.com/wp-content/uploads/2020/03/Consolidation-in-Anesthesia-.pdf. March 2020. Accessed September 21, 2020. 4. American Association of Nurse Anesthetists. CRNAs: we are the answer. aana.com/docs/default-source/marketing-aana-com-web-documents-(all)/crnas-we-are-the-answer.pdf. Accessed September 21, 2020. 5. American Academy of Anesthesiologist Assistants. Anesthesiologist assistants work states. anesthetist.org/assets/AAAA%20Work%20States%20Map%20June%202019.pdf. June 2019. Accessed September 21, 2020. 6. American Society of Anesthesiologists. Statement on the anesthesia care team. asahq.org/standards-and-guidelines/statement-on-the-anesthesia-care-team. October 23, 2019. Accessed September 21, 2020. 7. American Society of Anesthesiologists. Anesthesiologist assistants. asahq.org/advocacy-and-asapac/advocacy-topics/anesthesiologist-assistants. Accessed September 21, 2020.

“Anesthesiology News presents The Etherist” is back. In Season 2, we dive into the future of the specialty of anesthesiology and the looming physician shortage that could threaten the field as we know it. We start by looking into a recent report from the Association of American Medical Colleges (AAMC) and its projections of health care–wide physician shortages expected by 2033. In fact, the AAMC report projects that the United States will experience a shortage of 139,000 physicians, and that anesthesiology—along with specialties like pathology and emergency medicine—will have a shortage between 17,000 and 42,000 physicians. But what do all of these numbers mean for anesthesiologists in the field? Will the specialty actually experience a physician shortage? And what would that shortage look like, if it happens? We have dedicated a new season of The Etherist to answering these questions. 1. Association of American Medical Colleges. The complexities of physician supply and demand: projections from 2018 to 2033. aamc.org/system/files/2020-06/stratcomm-aamc-physician-workforce-projections-june-2020.pdf. June 2020. Accessed September 13, 2020. 2. Birk S. Looming anesthesiologist shortage fuels high market demand. Anesthesiology News. anesthesiologynews.com/PRN-/Article/08-19/Looming-Anesthesiologist-Shortage-Fuels-High-Market-Demand/55607. August 13, 2019. Accessed September 13, 2020.

Season 2 of Anesthesiology News presents The Etherist is almost here! In this brand-new season, we explore the truth and myths behind a looming physician anesthesiologist shortage, based on reports from the Association of American Medical Colleges. Those projections show a potential shortage of nearly 139,000 physicians in the United States, with anesthesiology being among the key specialties to suffer. But will anesthesiology really experience a physician shortage at all? And if so, how will we get to that point? We aimed to answer those questions, but along the way we discovered some unexpected trends that are already transforming anesthesia care into something profoundly different today. In Season 2, we explore a series of forces that are already shaping anesthesiology including advances in medical technology, changing practice models, evolving business trends, diversity, the COVID-19 pandemic, and federal laws that could considerably affect the future of the specialty. This is not a story about a simple statistical projection of a physician anesthesiologist shortage. It is a story about the future of a specialty…

The crisis of drug shortages, largely misrepresented by debates about a need for better policy, is fundamentally about the patient–provider relationship. This ongoing crisis continues to put providers in the uncomfortable position of whether to inform a patient of the problem. In addition to that predicament, companies and organizations continue to search for solutions to the shortages, with little progress so far. But a breakthrough may be close as emerging advanced technology and improved communication among industry, policymakers and providers are increasing the options available for alleviating this crisis. Those efforts could hold the potential to make these drug shortages and the ethical dilemma inherent in the patient–provider relationship obsolete.

From the shortages of quinine during the U.S. Civil War to the sudden lack of saline bags in the wake of Hurricane Maria, the pharmaceutical manufacturing industry has continued to struggle with health care demands. Those resulting shortages have led to unique and complicated situations across the country throughout modern medical history. But one organization has always had the power to create meaningful change in that overburdened industry: the federal government. Using regulatory agencies and legislative efforts, people within government could use that power to force shifts in manufacturing practices to improve outcomes and eliminate disruptions in the drug supply chain. And after all this time the question still remains: Where should they start? How can the very same regulators and legislators who watched these problems arise make the necessary changes to reverse the course in this drug shortage crisis? Join us as we explore the possibilities of government action to fix the drug manufacturing system.

Despite the focus on drug shortages, the nationwide decline in available saline bags was one of the most daunting shortages in recent years. It started in the aftermath of Hurricane Maria, which devastated many islands in the Caribbean in September 2017, including Puerto Rico, where nearly all of the U.S. supply of saline bags was manufactured. That disaster revealed health care’s fragile supply side in the United States, and how manufacturing consolidation can lead to major shortages for basic medical supplies. Understanding how health care manufacturing works—and how it doesn’t—could unlock the answers to preventing these shortages in the future.

In the early months of 2018, a shortage of hyperbaric bupivacaine swept across the country affecting providers and their normal ability to care for their patients. The world of anesthesiology was rattled, but through the efforts of several leaders in the field, the drug shortage didn’t become a debilitating crisis. This is the first episode of “Anesthesiology News presents The Etherist,” the new series that tells the story of ongoing anesthesia and analgesia drug shortages affecting patients and providers across the country.

This is the final teaser for Anesthesiology News presents The Etherist, the new podcast series that tells the story of ongoing anesthesia and analgesia drug shortages affecting patients and providers across the country. The first episode of The Etherist comes out next week.

This is the first teaser for the new series from Anesthesiology News. The Etherist tells the story of the ongoing anesthesia and analgesia drug shortages that have been affecting anesthesiology across the United States. The series examines the causes and major effects of the shortages, as well as the numerous proposed strategies to solve this problem for good.