When Arnold Schwarzenegger was governor, he decided that you and I don’t need to have physicians in charge of our anesthesia care, and he signed a letter exempting California from that federal requirement. Luckily most California hospitals didn’t agree, and they ignored his decision. When he needed open-heart surgery to replace a failing heart valve, though, Governor Schwarzenegger saw things differently. He chose Steven Haddy, MD, the chief of cardiovascular anesthesiology ...

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A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009. For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling ...

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Nothing brings out the mama lioness in me more than seeing one of my cubs not being treated as well as I think it should be. Recently I had the unusual experience of accompanying my oldest daughter into an unfamiliar hospital for a minor surgical procedure. Now, this daughter isn’t exactly a cub; she’s a full-fledged adult, with a master’s degree in health care administration, a husband, and two small boys of ...

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The numbers haven’t changed significantly in several years -- only five percent of the U.S. population consumes a full 50 percent of annual health care spending, and just one percent is responsible for nearly 23 percent of spending. Within the top 10 percent of high spenders, most (nearly 80 percent) are age 45 or older. About 42 percent are persistent high consumers year after year, while the majority requires high spending ...

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Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology. Why would I do that? There are many positive reasons. I believe in the teaching mission of academic medicine:  to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years ...

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“For some must watch, while some must sleep.” – William Shakespeare, Hamlet I admit, I was taken aback at the headline that ran in the Houston Press today: "Going under:  What can happen if your anesthesiologist leaves the room during an operation." It’s bound to make the curious reader wonder why the anesthesiologist would leave the operating room in the first place. Of course, reporter Dianna Wray explains that in many hospitals, one ...

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It’s amazing how quickly my role changed from physician to patient, thanks to a silent assailant: osteoporosis. I went to the gym in the morning before work 12 days ago, as I often do now that my children are all grown up and out of the house. First, a couple of light sets of leg exercises served as a warm-up, and then I started a set with a barbell on my ...

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Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”? Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white? Every day, I go to work and see the example of the ...

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shutterstock_265206557 In case you were wondering -- robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans. I’ve been practicing anesthesiology for 30 years now, in the ...

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shutterstock_138554978 Dr. Margaret Wood, who chairs the Department of Anesthesiology at Columbia University Medical Center, has published a wonderful article titled "Women in Medicine:  Then and Now," in the journal Anesthesia and Analgesia. I think I speak for many of us in admitting that Anesthesia and Analgesia doesn’t occupy a prominent place on my bedside table. Many readers may have missed Dr. Wood’s article. ...

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