Nashville, Tenn.-based Envision Physician Services Regional Medical Director and National Education Director Adam Blomberg, MD, spoke to Becker's ASC Review about the current anesthesiologist practice environment and offered leadership advice for young anesthesiologists.
Note: Responses have been edited for style and clarity.
Question: What are some of the current challenges facing anesthesiologists?
Adam Blomberg: All physicians are faced with a challenging and constantly evolving healthcare landscape. However, those who practice within the realms of anesthesia and pain have to be especially diligent and adaptable in their delivery of patient care. What we see today will not be the same in five years, and therefore anesthesiologists need to be willing to adapt.
In particular, the intricacies of pain management foster a very demanding work environment that is only intensifying with the focus on opioid reduction. Anesthesiologists are key players in developing narcotic-sparing, multimodal pain management care plans to reduce the use of opioids in surgery and mitigate the risk of opioids. As regional nerve blocks and preoperative pharmacogenetic testing continue to gain prominence, anesthesiologists must pursue education on these new techniques and processes to ensure they’re used effectively and safely.
Q: When it comes to supporting new anesthesiologists what are some implementable strategies for physician leaders to use?
AB: To successfully navigate today’s challenging landscape anesthesiologists must be adaptable. Adjusting to new conditions becomes easier with experience, and it is physician leaders’ responsibility to handle the changing healthcare environment so young anesthesiologists can focus on providing the best possible clinical care during this critical learning period.
Young anesthesiologists may need help identifying relevant continuing medical education opportunities and the latest evidence-based best practices so they can deliver the highest quality care. Physician leaders can ensure less experienced anesthesiologists have access to these resources, as well as a dedicated support structure, by securing a seat at the table with hospital or health system C-suite administrators and decision-makers. Having this visibility and influence at an organizational level enables physician leaders to effectively advocate for anesthesiologists to ensure they have the tools they need to handle the demands of the job.
Q: How does value-based care impact anesthesiologists, especially in the anesthesia group setting?
AB: In a value-based healthcare system, clinicians are asked to provide detailed data on all patient encounters to meet new quality reporting requirements while continuing to maintain a standard of excellence for quality care and patient safety. These new reporting requirements are designed to drive quality improvement and efficiencies, but they put an added administrative burden on clinicians. The smaller the practice, the greater the burden of compliance. Practicing in a larger provider group setting can offer anesthesiologists administrative support to help them navigate new value-based care models and focus on what’s most important, patients.
One metric determining reimbursement for providers in value-based settings is patient satisfaction. This is an area where anesthesiologists can play a key role as they coordinate with other clinicians to set the standard for care delivery and optimize patient flow throughout the perioperative process. For example, Envision Physician Services uses TEMPO, transition and action, evaluation and significant history, medications, procedure and condition and overall plan, to help anesthesia clinicians collaborate with hospitalists, surgeons and primary care physicians to provide the best possible postoperative outcome for patients.
Q: How can young anesthesiologists develop leadership skills in group settings?
AB: First, young anesthesiologists must build a foundation in clinical care before they can become effective leaders. Enrolling in courses, serving on committees and staying up to date on clinical literature will reinforce the knowledge gained in medical school and residency. As young anesthesiologists build upon the foundation of their clinical knowledge, they can start to develop their leadership skills by focusing on breaking down clinical silos and collaborating more effectively across functions. Doing so will help them develop the communication and teamwork skills they’ll need to improve care coordination and demonstrate their effectiveness as leaders.
Q: Could you elaborate on a leadership process you've had great success with that other groups can copy and learn from?
AB: Personally, I have found success in implementing principled feedback. When I was just starting out, the vice chief of my department at the hospital where I worked took me under his wing. He connected me with subject matter experts, provided me with books on leadership and encouraged me to participate in cross-functional committees. This not only developed my clinical skills but strengthened my ability to lead. I’ve followed his leadership model by making a point of listening and offering constructive insight to members of my team in the initial stages of their careers. Implementing this approach created an open dialogue and resulted in improved practices, an eagerness for knowledge and a shared commitment to patient care.