By the CSA Women in Anesthesia Committee
In recognition of the many major accomplishments by women in anesthesia, CSA will be highlighting a variety of women leaders who practice throughout the state, bringing their diverse backgrounds and life perspectives into their work, taking purposeful steps to create pathways for mentorship and sponsorship, and helping support the clinical and research work that is being driven by an increasingly diverse field of anesthesiologists.
Below are two profiles on women making great things happen in anesthesia:
Shalini Shah, MD
- Associate Clinical Professor, Vice Chair, Department of Anesthesiology, UC Irvine
- Director, UC Irvine Health Pain Services
- Founding Chair, Committee on Pain Medicine- CSA
- Board of Directors, California Society of Anesthesiologists
- President, California Society of Interventional Pain Physicians (CALSIPP)
What do you like most about your work as a physician?
I have a background in the foreign service and was initially headed on a career path toward diplomacy and international relations, however decided to pursue a career in medicine where there are so many touchpoints to add value. The economics of healthcare is a large part of my focus as a physician– especially how we manage and distribute health and healthcare in the US. One of the biggest determinants of my personal satisfaction is the feeling that we are connected to a bigger mission for our specialty and for patients—beyond just an individual hospital or health system. And I love pain medicine, where we don’t have strict algorithms or easy answers. Pain medicine requires creativity coupled with patient involvement and motivation. I think this is one of the few fields that requires deep engagement by the patient and the physician in order to make progress in improved health outcomes. I also find it exciting to see the high level of innovation in this field, with lots of new devices and treatment options that open more doors for non-pharmacological approaches. We are doing radio frequency ablation, spinal cord stimulation, peripheral nerve stimulation and other treatments that allow us to give patients sustained relief without them having to take medication every day.
What do you enjoy about being in an academic setting?
Working in an academic program keeps your feet to the fire – the residents and fellows push faculty to stay engaged with new research and innovation so we’re always interested and exploring new things. Being challenged to research and to collaborate across institutions also helps broaden your network and provide new insights. Working with peers at other universities and hospitals helps us do pain medicine better everywhere. The world is feeling smaller and more accessible, especially with the rapid adoption of telemedicine during COVID and the virtual conferences – so you don’t need to travel to make connections. I’m leading a task force for ASRA on perioperative guidelines for chronic cannabis users – typically this type of collaboration would have occurred at a physician meeting or conference but now we are doing more of these collaborative endeavors just through virtual connection.
How has your MBA education changed how you view healthcare?
We’ve been looking into the importance of culture in a healthcare setting and how this matters so much, particularly as we see increasing consolidation with mergers and acquisitions. Typically after a merger there is a honeymoon phase for a few years, but then things can fall apart when there isn’t cultural alignment in the organizations. We have been looking into what are the determinants for a good fit, and what good culture looks like. For physicians who are in a practice that is going through a merger, I encourage them to do their homework. You need to understand the health of your practice and your performance compared to peer groups, and use information on trends and best practices to benchmark or improve your group. Using data and knowing where you stand is a valuable tool not just for financial reasons but also for providing good patient care.
Roya Saffary, MD
- Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital and Clinics
- Co-Director of OR Fellowship
- Clerkship Director for Residency Program
How did you find the right focus area for your career?
I was born in Afghanistan, grew up in Poland and Germany and immigrated to the U.S. for college. The right focus and fit came over time as a result of my interests, my training and also opportunities that I was given along the way. I completed my residency in anesthesiology at Boston University Medical Center. Toward the end of that program, I became increasingly interested in the management and administrative aspects of anesthesiology and I applied for the Stanford fellowship in operating room management. After the fellowship I stayed on at Stanford where I can now use those skills in addition to being able to teach medical students, residents and fellows. I spend most of my non-clinical time on administrative work for the anesthesia department and the OR management fellowship. I find the administrative work that includes staffing, scheduling and workflows very fulfilling and rewarding since it provides me with a different perspective of anesthesia care, including the collaboration between the various treatment teams. I also teach a medical school class on the physiological changes during the perioperative period and manage a rotation for residents on scheduling in the operating room. The three aspects of my work – clinical care, teaching and administrative work in OR management – allow me to have a very challenging but fulfilling career that continues to keep me engaged and excited. Given my unique background, I hope to bring more diversity and a new perspective to the medical school and healthcare system.
What opportunities do you see for the future of the specialty?
Anesthesiologists have the unique training that allows them to manage patients throughout the entire perioperative period. I think we still have the opportunity to expand on our involvement outside of the OR. That includes optimization of patients with poorly-controlled comorbidities such as hypertension, diabetes and anemia prior to the day of surgery to ensure better surgical outcomes and post-surgical recovery. Although this approach is already used in some institutions, a wider application would improve patient care overall. Along the same lines, as we are faced with an aging population undergoing surgeries, we also have to consider potential long-term effects of anesthesia and develop approaches that are tailored to older and more fragile patients. This may also include being involved in the decision-making process as part of a multi-disciplinary team to determine whether the surgery and possible outcomes align with the patient’s goals.
Another area with a lot of opportunity, not only for our specialty but also for medicine overall, is to keep up with the ever-accelerating technological advances. As technology and algorithms such as artificial intelligence and machine learning become more and more sophisticated, we have to learn how to use them effectively and safely to improve patient care. There are numerous areas in our field where these technologies can be used; however, the challenge will be to ensure that it is implemented in a safe manner that does not compromise the care standards we provide. Again, being the experts in the field of perioperative medicine, it is our responsibility to explore and evaluate these opportunities.
Last but certainly not least, diversification remains an important goal for our specialty and medicine in general. This will require more targeted mentorship and sponsorship of women and underrepresented minorities to create a leadership team that is representative of the membership at large.