Anesthesiologists are physicians (M.D. or D.O.) who have chosen to specialize in anesthesia, pain management and critical care medicine.  According to the American Society of Anesthesiologists (ASA), physician anesthesiologists provide or guide nearly 90 percent of the anesthetics used in the more than 100 million procedures performed every year in the United States.  With 12 to 14 years of education and 12,000 to 16,000 hours of clinical training, these physician specialists are experts in managing pain. Many times, the anesthesiologist is considered the “hidden physician,” however, they play a vital role in patient care.  Physician anesthesiologists have the education and training to evaluate, diagnose, treat and manage the entire spectrum of medical conditions and patients’ needs, including potentially life-threatening complications that can happen suddenly during surgery.

The Licking Memorial Hospital (LMH) Anesthesiology Department is comprised of 8 board-certified physicians and 10 Certified Registered Nurse Anesthetists (CRNA).  CRNAs are advanced registered nurses who specialize in anesthesia.  After completing extensive education and training, they are nationally certified.  The CRNAs provide anesthesia care under the medical direction of the anesthesiologist, who is present for key portions of anesthesia care, including induction, emergence and recovery.  

There are many types of anesthesia available to help patients feel comfortable during medical tests and procedures.  Sedation involves medication which relaxes the patient, sometimes making them fall asleep.  Monitored Anesthesia Care (MAC) typically is used for minor surgeries or shorter, less complicated procedures, such as biopsies, or the use of a scope to examine the stomach or colon, to diagnose or treat medical conditions.  Sedation medications usually are provided through an IV placed in a vein.  Depending on the procedure, the level of sedation may range from minimal — drowsy, but able to talk; to deep — patients typically will not remember the procedure.  

Local anesthesia involves one or more injections to numb a small area of the body.  Another type of anesthesia is regional, which numbs a larger part of the body.  During the use of regional anesthesia, often provided through an injection or a small tube called a catheter, patients are awake, but unable to feel the area that is numbed.  This method is often used for childbirth and for surgeries of the arm, leg or abdomen.  Local and regional anesthesia may be combined with IV sedation for pain relief.

General anesthesia is provided through an anesthesia mask or breathing tube and induces unconsciousness.  It is used for most operations, including abdominal and orthopedic surgeries.  The type of anesthesia received depends on a variety of factors, including the procedure, current patient health and in some cases, the patient’s preferences. 

Anesthesiologists provide a wide variety of medical care to patients, including preoperative evaluation, consultation with the surgical team, creation of a tailored plan for each patient, airway management, intraoperative life support and provision of pain control, intraoperative medical stabilization, and proper post-operative management of patients.  Outside the operating room, an anesthesiologist’s spectrum of action includes in-hospital and pre-hospital emergencies, intensive care units, acute pain units and chronic pain consultations.  

In addition to anesthesia care, LMH anesthesia providers offer the latest in pain care through medications, therapies and minimally invasive pain management procedures at the LMH Pain Clinic.  A board-certified physician in Pain Management performs more than twenty procedures on an average day, managing common ailments such as back, joint, shoulder, muscle and neck pain.

A typical day for an anesthesia provider could last from 8 to 24 hours, depending on the volume of surgeries and emergent cases.  As a whole, the LMH Anesthesiology Department could be involved in as many as one thousand cases each month.  “Utilizing a team approach and combining staff resources, helps us to provide a safe, high standard of care,” explained KW Tim Park, M.D., LMH Anesthesiology Medical Director and Department Chair.  “We have an excellent pool of talent and many of us have additional training in subspecialties,” added Ann Govier, M.D.  

As Medical Director and Department Chairman, Dr. Park has developed many of the Department policies.  He also affirms the maintenance of all required practice guidelines.  Monthly staff meetings include reviews of evidence-based medicine.  The valuable information learned then is adapted to LMH guidelines.  “Set guidelines and continual communication of such ensures staff awareness of expectations.  Additionally, guidelines enable us to maintain uniformity in management and patient care,” he explained.  Under the guidance of Dr. Park, LMH anesthesiologists and CRNAs are vigilant about fulfilling the requirements to maintain their skills and knowledge.  He coordinates the department’s Continuing Medical Education (CME) as well as monthly conferences which feature review of literature and cases of interest.  “We use this opportunity to further educate ourselves and I am proud to say that the lecture series and this style of education is an uncommon offering for a community hospital.  This practice truly enables us to provide a very high level of patient care,” Dr. Park remarked.  Dr. Govier added that all of the LMH providers are board certified.  “We are fortunate to have this group and their collective skills set.”

The anesthesia providers also are involved outside of the operating room by facilitating procedures in various other departments such as Endoscopy, Labor & Delivery and Psychiatry.  Endoscopy procedures performed under anesthesia-provided sedation are approaching 4,000 cases a year.  Of note, the Anesthesiology Department is collaborating with Psychiatry to provide novel therapeutic measures for depression and PTSD (post-traumatic stress disorder).  For major depression, modified electroconvulsive therapy under general anesthesia is being offered, as well as the use of certain euphorigenic anesthetics such as nitrous oxide and ketamine.  Recently, it has been found that a right-sided stellate ganglion block can be beneficial in PTSD and this modality has achieved some success.

The Anesthesiology Department maintains active participation in various Hospital committees, including the Medical Staff Executive Committee, Cardiac and Critical Care Committee, Medicine Quality Improvement Committee, Education Committee, Pharmacy and Therapeutics Committee, Transfusion Committee and Perinatal Committee.  The Department directs the Procedural Sedation Committee for non-anesthesia medical staff who administer conscious or deep procedural sedation, presenting guidelines, fielding questions and offering education.