Vital Times 2019 - 79

for simultaneous patient interaction and medical record
documentation would increase patient alienation and thus
dissatisfaction, and also physician burnout.

Harrison Chow, MD, A Hospital Too Far,
Part III

Is there an answer? Perhaps. What Drs. Sibert and
Verghese offer is a call to arms - to return to a time of
deliberate and respectful interactions with each patient, to
set aside technology for physical examination, observation,
and human touch. It's certainly runs counter to the
production pressures of modern medicine, and challenged
me to think about my priorities and goals in my work as a
healer.

A big area of anxiety and uncertainty for anesthesiologists
in California is the flux of practice opportunities, and Dr.
Chow's three-part series about the whiplash-inducing
changes that set upon his anesthesia department in the
San Jose area of northern California was riveting for a
lot of us. Based in the Bay Area myself and having been
a part of multiple academic and community hospital
anesthesia departments in the area, I have friends in many
practice settings in the region. Discussions resulting
from the events that he described were dramatic to
witness. To have an opportunity to hear from Dr. Chow
in a first-person account was deeply affecting. For
anesthesiologists everywhere, these articles point out
the twists and decisions that may confront them during
the evolution of their career. There was a time when the
"business" of medical practice was more straight forward
and less anxiety-provoking; with changing economic
times and ever-increasing factors influencing the daily
workflows as well as long-term directions of healthcare,
reading Dr. Chow's accounts can only help one be more
knowledgeable and ready, if and when those changes come.

Rita Agarwal, MD, FAAP, FASA, February
4, 2019. Pediatric Dental Anesthesia
and Sedation: Where Are We Now?
In this blog post, Dr. Agarwal gives a thorough
chronological account of the efforts in California to
increase the accountability and standardize the anesthetic
care provided to children undergoing outpatient
dental procedures. It's certainly an area with multiple
perspectives - the advocates for patient safety are
countered by arguments regarding accessibility to any
dental care at all by less privileged patient populations.
There are various provider groups as well as regulatory
bodies involved, and change is occurring, albeit slowly.

You can find the CSA Online First Blog by visiting
http://csahq.org/news/blog.

Again, to continue the theme of the earlier articles
mentioned here, I think that it is a thought-provoking
piece about the need for developing rigorous standards
of anesthetic care, yet we do also need to be mindful
of how that impacts access to those more vulnerable
to the increased economic costs. How do we as a state,
and as a community, provide maximal access that is also
uncompromisingly safe?

Annual Publication 2019 | 79
http://csahq.org/news/blog
Vital Times 2019

Table of Contents for the Digital Edition of Vital Times 2019
