Spotlight on: The Department of Anesthesiology

The Department of Anesthesiology has been part of SEAMO since its inception and is made collage of photos of Anesthesiology doctorsup of 35 FTEs. We interviewed Department Head Dr. Ramiro Arellano about what the Department does and the work they have currently been up to.

Dr. Arellano said the most basic work of the Department is in providing general anesthesia in operating rooms in KGH and Hotel Dieu, but that’s not all. “We call ourselves the Department of Anesthesiology and Perioperative Medicine because we provide care outside of operating rooms by staffing an acute pain service where we take care of patients who have pain issues after surgery and we provide specialized care to that group of patients, which includes the provision of local anesthetic-based regional anesthesia.” The Department also had anesthesiologists who work in a pre-operative consult clinic where patients are assessed for their suitability for surgery and where they are optimized for surgery. Dr. Arellano said: “We also have anesthesiologists who work in other domains such as critical care medicine, chronic pain medicine, and the cardiac sciences unit. We also provide anesthesia services outside of the operating room environment in the Cancer Centre, in the Diagnostic Radiology Department and in the Electrophysiology suite.”

Outside of clinical operations, the Department of Anesthesiology also plays a role in research and academic pursuits. “We co-administrate with the School of Nursing Health Quality program, which offers a Master of Science and a Doctorate of Philosophy in Health Quality. We also contribute to undergraduate medical education through direct teaching and administrative roles,” Dr. Arellano said. “Our research activities are by and large clinically-oriented with strengths in pain, cardiac anesthesia and perioperative anesthesia. We also have a basic sciences researcher who supports our pain research.”

One thing is for sure: physician wellness is top of mind for Dr. Arellano, especially since anesthesiologists are one of the few groups that are in the hospital 24/7 providing emergency care (along with obstetricians and emergency room doctors). “We have a very flexible workflow that allows people at different stages in life to accommodate our practice and at the same time deal with issues of wellness. We’re a Department that takes the position that high stress is associated with our work, but we’ve come up with innovative ways to deal with physician wellness. For example, we allow people to work as a partial FTE so they work, let’s say, four days a week that allows them to deal with other professional aspirations and matters of wellness.”

When asked what he is most excited about in terms of the Department’s work, Dr. Arellano said he is pleased with the way the physicians have been able to cope with changes due to COVID-19. “With the current stressors or changes that COVID has brought to medicine, we’re excited to be looking at ways that anesthesiologists can enhance patients’ recovery following surgical procedures through e-health. We are planning follow up with them in their homes by using eVisits and monitoring vitals at home in high risk patient groups.”

Speaking of the COVID crisis, Dr. Arellano said the Department has had to cope with fewer operating rooms and increasing training and availability to assist with intubations in the setting of the pandemic. “We’ve improved our processes for AGMPs (aerosol-generating medical procedures) so we have better ways of protecting health care workers while performing those procedures,” he said. “We’re also part of the hospital’s response to transfer surgical care from KGH to a new ward that’s opening up at Hotel Dieu hospital.”