Who's Behind the Mask? Turns Out, You Can Choose Your Own Anesthesiologist

A new trend in surgery: More patients are powering up and insisting on pain management by a pre-selected anesthesiologist.

By: Sheila Mickool

Last year, at age 50, Grace* was diagnosed with breast cancer for the second time in three years. She was scheduled for a double mastectomy with immediate reconstruction, and would likely be in surgery for about 13 hours. “It was scary,” Grace says. “Especially the anesthesia consult several weeks prior, where they tell you that there is always a chance, with a long, complicated surgery, that you won’t wake up. At that point, I was more worried about [not waking up from] the surgery than the cancer.” Grace is not alone in her concerns. Dr. Shelley Agricola, a cardiac anesthesiologist at Overlake Hospital Medical Center, says it’s common for patients to be more fearful of the anesthesia than the surgery.

Until recently, most patients didn’t ask many questions about who would be doing their anesthesia. “Patients are more savvy now,” says Agricola, “and their level of concern is often driven by the news cycle.” The death of Michael Jackson from propofol in 2009 elevated the public’s concern about the risks of anesthesia, Agricola says. Patients started asking questions: What exactly does an anesthesiologist do? Is mine competent? Can I ask for a specific doctor?

In basic terms, anesthesiologists specialize in using drugs to control pain. They are essential members of the operating room’s patient-care team, whose purpose is to provide a safe and comfortable environment, according to James Stangl, M.D., president of the Washington State Society of Anesthesiologists (WSSA) and an anesthesiologist at MultiCare’s Tacoma General Hospital and Mary Bridge Children’s Hospital. They care for patients before, during and after surgery. In most cases, patients are not invited to choose a specific anesthesiologist—but that needn’t deter you.

In many cases, anesthesiology departments try to honor patients’ requests, barring emergencies and schedule conflicts. “We try,” says Dr. Max Lucero, an anesthesiologist at Swedish Medical Center who sees both adult and pediatric patients, “but if a little baby needs my attention, that takes priority over a patient request, because I have expertise in pediatric anesthesiology and most of my colleagues do not.”

Scheduling generally takes place the day prior to surgery, according to Dr. James Burkman, president of Physicians Anesthesia Service at Swedish. He says assignments are based primarily on the skill required for procedures, but patient requests are also considered.

Given her concerns, Grace did request a specific anesthesiologist. “I wanted a superexperienced, educated [physician] who would make me feel comfortable and whom I could trust,” she says. “Someone with a great bedside manner, because not only was I scared about not waking up from surgery, I’m also needle-phobic.” She asked for Dr. Lorri Lee at the University of Washington Medical Center, and Lee was assigned to the surgery.

Lucero suggests that when requesting an anesthesiologist, you ask for your first-choice anesthesiologist—and one or two backups. He advises patients to tell surgeons their preferences for an anesthesiologist, and to call the hospital’s anesthesiology department directly to make sure their requests are on record.

To find an anesthesiologist—or check on the qualifications of one—Sean Kincaid, M.D., of Matrix Anesthesia (and WSSA’s vice president) suggests checking with the Washington State Department of Health (doh.wa.gov; search by provider’s name) to verify that the doctor is licensed and in good standing, confirming board certification with the American Board of Anesthesiology (theaba.org), and looking at hospital and anesthesiology group websites. (Note that anesthesiologists are not included in Seattle magazine’s Top Doctors listing; this is because Castle Connolly, our research partner, does not consider them to be specialists whom patients can generally choose. The same is true for emergency room physicians.)

While you can request a specific anesthesiologist, you probably don’t need to, unless your condition is complex or you have particular concerns, says Agricola. “You really are in good hands, because, behind the scenes, anesthesiologists collaborate for the best possible patient outcomes.”

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