EmCare Anesthesia CEO: The Future of Perioperative Medicine

Posted on Thu, Dec 27, 2012

Dr. Michael Hicks’ Predictions on the Changes Coming for Anesthesiologists

By Jennifer Whitus, EmCare Marketing Communications Manager

rnf3537-hicks-,-michael-ray-231485-resized-600.jpgDr. Michael HicksDr. Michael Hicks, C.E.O. of EmCare Anesthesia Services, is helping to educate future doctors. Hicks, along with several co-authors, wrote the textbook Operating Room Leadership and Management. The book is published by Cambridge University Press and available November 30.

“The editors approached me directly,” Hicks says of the assignment. “Some of them had heard me speak about the future of anesthesiology at meetings. Dr. [Charles] Fox [one of the book’s editors] asked me if I would be willing to put my thoughts on paper and out in public for discussion. It took several months of work to get the chapter together.”

For his part, Hicks tackled a broad topic - The Future of Perioperative Medicine – which covers a wider scope than his own specialty of anesthesia.

“I think that’s an important distinction,” he says, “because, most of the time when people discuss the future of anesthesia, the mere fact of that title itself puts restrictions on how they view the possibilities. Most people, when they talk about anesthesia, talk about what goes on in the four walls of an operating room and maybe for 15 or 20 minutes before the operating room experience and 15 or 20 minutes or an hour afterwards in the recovery room.”

In the future, Hicks believes anesthesiologists and surgeons will work more closely together for longer periods to ensure better patient outcomes.

“I actually envision a world of perioperative medicine, and that’s gotten a lot of tractionHicksBookCover.jpg with the National Anesthesia Society and others. And I think it’s important - our society cannot continue to try to integrate things like surgical experience by looking at it as one-off, piecework-type encounters. And if you take the standard approach now to a patient having surgery, they’re typically referred by a primary care physician to a surgeon who will consult an anesthesiologist. The surgeon then will attempt to the care. A lot of times the surgeons don’t know what the anesthesia providers are going to need in terms of laboratory or imaging exams. So it’s not always ideal for patient preparation.

“In a more fully-integrated model, we as anesthesiologists and as CRNAs are going to have to
move further up the chain of patient preparation. And I envision a day where the anesthesia professionals will actually be consulted almost at the time, if not right at the time the decision’s actually made to have surgery. So it would be a week or two out from the surgery when the patient starts to interact with the anesthesia team. Likewise, with our ability now to render patients relatively pain-free post-operative care using a variety of or combination of nerve blocks and other pain adjuvants, I can see easily the care of the patient by anesthesia professionals extending well out after the procedure itself.”

The Future of Perioperative Medicine section was co-authored by Laurie Saletnik, the assistant director of surgical nursing at Johns Hopkins Hospital in Baltimore.

“It was interesting to co-author the chapter as we have never met. We exchanged our work via email,” Hicks says. “The chapter was edited so as to not duplicate sections contained in other sections of the book. That’s one of the ‘risks’ of several contributions for an edited text.”

Their contribution covers topics such as “The Perioperative System,” “Current System,” “System Theory Research,” “Blurring Specialty Lines,” “Technology,” “Telemedicine,” “Implications of Payment,” and “Reform.”

In the introduction, Hicks and Saletnik write:

Historically, the surgical patient has received care as if moving down a conveyor belt, much like a manufactured product in a quasi made-to-order industrial factory. Initial referrals by primary care providers to surgeons, decisions for referrals for imaging, labs, medical screening and preparation, scheduling and facility registration, the procedure itself, and postoperative pain management and rehabilitation are all essentially treated as separate stations along the surgical assembly line. This segmentation, while meeting the needs of the staff of each station, produces an overall experience that is inadequate for its intended purpose, wasteful of resources, and confusing to patients and their family members. Modern management science that has addressed these issues in other industries has been slow to be embraced by the health care system. Fortunately, increasing numbers of clinicians and administrators are adding management expertise and experience to their clinical abilities. Clinicians are in an ideal position to best understand the clinical and financial needs of direct care provision and must have a voice in the decision-making process.

Topics covered include O.R. metrics, scheduling, human resource management, leadership, economics, I.T. management and quality assurance. It’s an evidence-based text written by “leaders in the field of O.R. management and is relevant to medical directors, administrators and managing physicians,” according to the publisher. “Operating Room Leadership and Management enables all O.R. managers to improve the efficiency and performance of their operating rooms.”

The November publication of this text caps off an especially busy year for Hicks: the company for which he serves as C.E.O., EmCare Anesthesia Services, underwent a re-name and re-branding campaign over the summer, changing from its previous corporate moniker, AnesthesiaCare. In the spring, Dr. Hicks completed his Master of Science degree in Health Policy and Management from the Harvard School of Public Health.

“2012 was an eventful, busy, but highly rewarding year for me,” says Hicks. “My time at Harvard was one of the high points of my professional and educational life. I learned a lot about health policy and management theory but even more about myself. The year was a blur as I was always busy with work, school, writing and family and I won’t be signing up for all of that again for a while. However, I am glad I did it - even more now than when I started. I am already working on more writing projects and am focusing on leadership functions among the various constituents in health care with several of my former classmates at Harvard.”

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