ANESTHESIOLOGY NEWSLETTER

WEST VIRGINIA UNIVERSITY

March 29, 2004

Excellence through Teams of One

 

  1. Congratulations to Muhammad Abou-Samra, MD. He will serve as our Clinical Director. He will ensure the safe and efficient functioning of our clinical operations, and represent the department on various institutional committees. Abou-Samra is a very competent cardiac anesthesiologist with a quiet get-it-done style. He replaces Dr. Tom Walker who is leaving WVU. Dr. David McFadden, Surgeon-in-Chief, and Dottie Oakes, Vice President of WVUH, praised the choice of Abou-Samra.


 


Dr. Muhammad Abou-Samra and Dottie

          Oakes in the Anesthesia Suite.

 

 

  1. Congratulations to Mehmood Durrani, MD. He will serve as our Director of Cardiac Anesthesia. Durrani will review our cardiac services and lead our resident educational program in cardiac anesthesia. Durrani has completed both cardiac anesthesia and critical care fellowships.

 

  1. Walter Kielkowski, CRNA is visiting Morgantown this week to find a house. He plans to visit the department too. He will start work in the department on May 28.

 

  1. Congratulations to Dr. Kathy Rosen. The ASA accepted her Problem-Based Learning Discussion for the Annual Meeting in October. The PBLD is titled, “A whole new office-based world,” and addresses the establishment and standards for an office-based anesthesia practice in reproductive medicine.

 

  1. Thanks to Dr. Kathy Rosen. The Occupational Safety and Health Administration requires each institution to have a plan for fit-testing of N95 masks on employees and clinicians who may come into contact with TB patients. 3M corporation representatives will teach Rosen how to fit-test these masks, and then she will teach us.

 

  1. Per Se Technologies will visit UHA and our department April 14-16. Per Se is the largest anesthesia billing and consulting group in the country, currently billing for 3200 clinicians. Dr. Johnstone recommended that Per Se review our billing and compliance programs, and UHA has contracted with them to do this.

 

  1. Julie McWhorter, a MS4 student at CAMC and former anesthesia extern, will enter the anesthesiology residency at the University of Kentucky after doing a preliminary year in medicine at CAMC. They were her first choices and Dr. K. Rosen and Johnstone helped her get them.

 

  1. Congratulations to Dr. Chris Kwasny. He saved a life. While waiting for a flight in the Miami airport he heard a woman cry for help as her husband slumped in a concourse waiting area. Kwasny gave mouth-to-mouth ventilations, chest compressions, and then a defibrillatory shock. He used an AED defibrillator, and with one shock the victim turned from blue to pink.

 

  1. Department Grand Rounds. Wednesdays 7AM.

This week.  Making your block work.  Drs. T. Shackleford, L.Broadman

Next week.  Horizon Medical Records.  M. Martin

 

For the past two weeks we have held our Grand Rounds in the Hostler Auditorium from 6:45 – 7:45 AM instead of the Trauma Conference Room starting at 7 AM. The auditorium has adequate room and better audiovisual equipment, but lies further from the operating rooms. We’d like to settle on one location for our Grand Rounds. Please share any pertinent observations with Dr. K. Rosen who coordinates our Grand Rounds schedule.

 

  1. Signs of progress

A.     Cheat Lake Physicians is moving today into a new facility, which is twice the size of its old one. CLP will open tomorrow, continuing to provide pediatrics, family medicine, obstetrics and gynecology, breast and cosmetic surgery, while planning to add other services.

B.     The WVU Health Sciences Center will celebrate 100 years of Health Professions Education this weekend. Major events:

Friday 12:30. Pylons entrance. Governor Bob Wise will cut a birthday cake.  Saturday 1PM. Pylons entrance. Time capsule preparation. Bob     

D’Allesandri and Bernie Westfall will recount events and personalities from the past 100 years.  Saturday 7PM. Lakeview resort.  Black-tie gala.

Drs. Richard Eller and Robert Johnstone will represent the department. Others are invited to attend this kick-off of the second century of health             professions education at WVU.

 

 

 


 


                                                                                 New operating rooms March 26, 2004

 

             C.   Steel girders are visible both in front and behind WVU hospital

 

  1. Let there be light. Researchers previously showed that patients awaken from anesthesia more quickly if someone shines a light in their eyes. Now researchers have found that postoperative patients in bright hospital rooms require 21 percent less pain medicine than those in dark rooms. Patients in light rooms also report less stress and better moods.

                                

  1. Signs-of-the-times

A.     Last month we turned down an anesthesiologist in another country for residency training at WVU. So he applied for faculty positions and has three offers. Apparently he’s taking one at the University of Washington. See depts.Washington.edu/anesth/employment/faculty/positions/generalnoticexternal for information on skipping US residencies.

B.     Nellcor, a division of Tyco, sent letters to anesthesiologists promoting its pulse oximeters. Excerpts:

 

Dear Valued Customer:

         You may have heard that Nellcor has been involved in patent litigation with one of our pulse oximetry competitors, Masimo Corporation. On March 15, 2004, a Los Angeles jury found that Nellcor infringed certain patents held by Masimo, covering their SET signal processing technology. We are greatly disappointed with the jury finding and fervently maintain our position that the motion-tolerant software we designed is unique and different from anything Masimo claims to have invented….

         Trial decisions are only one step in a long process. The Company plans to immediately ask the District Court to overturn the jury finding and rule in favor of Nellcor, or to order a new trial. If those requests are denied and judgment is entered, Nellcor will file an appeal with the Court of Appeals for the Federal Circuit….

         Our top priority is to ensure our customers have uninterrupted access to the Nellcor technology they know and trust. Be assured we are continuing to ship and service products as usual. Also, bear in mind that Nellcor’s standard sales terms include a patent infringement indemnity clause – a standard type of clause in product sales contracts to protect our customers against patent infringement claims.

 

  1. Dr. Sujatha Nigam visited the department last Friday. While feeding Jeevan she discussed parenting with Dr. Julie Cherolis. Both agreed we have a family-friendly department, and Elizabeth Conrad burped Jeevan to confirm it.


 


Dr. Sujatha Nigam and son

 

 

 

  1. We have received copies of the 2004 Booklet of Information from the American Board of Anesthesiology. This new booklet informs those interested about the policies, procedures, regulations, and requirements governing its certification programs. Changes in the 2004 booklet include new test dates and fees, and regulations for training away from a resident’s accredited programs. Drs. K. Rosen and R. Johnstone, as well as Drew Gross, Residency Coordinator, have copies of the 2004 booklet. Some excerpts from it:

A.     Applicants and candidates for ABA examinations have the ultimate responsibility to know and comply with the Board’s policies, procedures, requirements and deadlines regarding admission to and opportunities for examination.

B.     In 1995, the ABA approved a policy of time-limited certification, so that all certificates issued by the ABA on or after January 1, 2000, will be valid for a period of ten (10 ) years after the year the candidate passed the certifying examination.

C.     A Board certified anesthesiologist is a physician who provides medical management and consultation during the perioperative period, in pain medicine and in critical care medicine. A diplomate of the Board must possess knowledge, judgment, adaptability, clinical skills, technical facility and personal characteristics sufficient to carry out the entire scope of anesthesiology practice. An ABA diplomate must logically organize and effectively present rational diagnoses and appropriate treatment protocols to peers, patients, their families and others involved in the medical community. A diplomate of the Board can serve as an expert in matters related to anesthesiology, deliberate with others, and provide advice and defend opinions in all aspects of the specialty of anesthesiology. A Board certified anesthesiologist is able to function as the leader of the anesthesiology care team.

D.     The total of any and all absences during Clinical Anesthesia training may not exceed the equivalent of 20 working days per year….

Absences in excess of those specified will require lengthening of the total training time to the extent of the additional absence.

E.      A $550.00 non-refundable administrative services fee and a $400.00 written examination fee must accompany  the application for primary certification in anesthesiology…

A $1,725.00 oral examination fee is assessed when candidates are notified of their successful completion of the written examination requirement.

F.      The ABA shall confer Board eligible status only on physicians who are candidates in the ABA examination and certification system. The ABA dos not confer Board eligible status indefinitely.

 

  1. Thanks to Erin Shiel. She types our newsletter most weeks, and developed the new header. Please offer an opinion on it to her or Dr. Johnstone. Shiel has some other ideas for making our newsletter more spiffy.

 

16. Recruitments.

Deloitte and Touche consultants in Dec 2003 recommended adding 8.5 faculty and 3.8 nurse anesthetists for the current workload, and then more faculty and nurse anesthetists whenever the new OR’s opened. We’ve been recruiting.

 

What’s happened since December.

 

Faculty leaving/reducing time

            Jim Cain going to 0.05 FTE (March)

            Lisa Sinz leaving (April)

            Tom Walker leaving (April)

            Peggy Seidman going to 0.53 FTE (July)

 

Faculty arriving/ increasing time

            Matt Watkins to 1.0 FTE (March)

            Sujatha Nigam to 0.6 FTE (May)

            Bob Stough (June)

            Shanis Padgett (July)

            Brian Grose (July)

            Chad Davis (Nov)

            Jeff Kessel (Jan 05)

 

CRNA’s leaving

            None

 

CRNA’s arriving

            Donna Lyness (March)

            Walter Kielkowski (June)

            Amber Frazier (June)

 

Faculty call incentive renewed. CRNA extra shift incentive started in March 04.

 

 

 


            Drs. Nick Cottrell and Matt Watkins with  Barb Carson, CRNA

 


  1. Barb Carson, CRNA visited the department last week. Carson, one of the first nurse anesthetists to work at WVU, left a couple of years ago for the traveling locum tenens life. She worked in Seattle this winter, and will work in Boston this summer. She is moving her permanent house from Morgantown to an island off the west coast of California. Carson was in good spirits, reporting she liked the locums lifestyle.                                                   

 

 

  1. Thoughts

 

We celebrate Doctors Day on March 30.  Congress selected this date because it’s the anniversary of the first anesthetic, the greatest miracle of medical science.  Anesthesia is a discovery and development of United States doctors, as is so much of modern medicine.

 

162 years ago Dr Crawford Long of Madison County, Georgia used the gas diethyl ether to make a patient insensitive to pain while a surgeon removed a neck tumor.  Within a few years the use of anesthesia had spread throughout the world.  Doctors now administer more than 100 million anesthetics each year worldwide.

           

The discovery of anesthesia allowed the development of safe surgical operations, which can remove cancers, straighten broken bones, and replace worn-out organs.  For these operations anesthesiologists and other doctors developed blood banking, mechanical ventilation, critical care, and other technologies to keep patients alive during procedures that might otherwise kill them.  Our healthcare is very sophisticated and impressive.  People witnessing modern anesthesia and surgery often exclaim, “Wow”.

 

Anesthesiologists routinely do things that seem impossible.  They induce unconsciousness, block responses to pain, stop hearts, and then return normal thinking and functioning.

 

Anesthesiology is one medical specialty among many.  All doctors today use sophisticated techniques, mostly developed in the United States, that save, prolong, and improve lives.  They examine our insides with precision imaging devices to accurately diagnose anatomic irregularities. They prevent many infections with vaccinations, and cure the infections that do occur with antibiotics.  They promote standards so good that we can travel anywhere in the United States and find dependable doctors.  Our life expectancy has thus increased steadily for decades.

 

Doctors practice today in a complex world.  Medicare regulators, managed care administrators, pharmaceutical industry representatives, and malpractice attorneys are facts of life.  The proper focus though is on a healthcare system that is the envy of the world, and the doctors who deliver the care.  What they do routinely is reflected in the anesthesia origin of this day.  Doctors relieve pain, keep us going, and advance medical knowledge.

 

Doctors day is a good time to say thanks for the wows of today, and to encourage more tomorrow.*

 

                                                                        Robert E. Johnstone

           

*Dr Johnstone has submitted a version of this column for outside publication.