Navigating the Clinical Component
Patient Population
Level II Trauma Center with cardiac capabilities
- High-acuity patients requiring full spectrum of anesthesia skills
- Urban, suburban, and rural patients from across Northwest Ohio
- Regional referral center for complex cases community hospitals cannot support
- Diverse socioeconomic backgrounds and health conditions
Operating Room Environment
Current State & Growth Plan
- 12 contracted OR rooms expanding to 14 rooms
- 6.6 FTE physicians taking call adding faculty to reduce burden
- 14.2 CRNAs supporting care team model
- CAAs on team within medical direction structure
Surgical Services & Case Volume
Vascular Surgery
- 4 surgeons (3 hired recently)
- Open and endovascular procedures
- High-acuity cases requiring hemodynamic expertise
Orthopedics
- High volume across trauma, joint replacement, sports medicine
- Regional anesthesia opportunities
- Bread-and-butter cases keeping ORs productive
Surgical Oncology
- Breast surgery
- Urologic oncology
- Range from straightforward to complex multi-hour resections
Endoscopy
- 70% volume growth in past year
- Efficient sedation services required
- High throughput demands
Transplant
- Regular kidney transplants
- Select liver and pancreas cases
- Complex anesthetic management
Cardiac Surgery
- Stable volume (surgeon certification maintenance)
- Not high-volume program
- Cases available for cardiac-trained anesthesiologists
Additional Services
- Plastics (recruiting, will add microsurgical cases)
- General surgery
- Urology
- GYN
Teaching & Resident Supervision
Residency Program Structure:
- 12 residents total (3 per year)
- Only anesthesia residency in Northwest Ohio
- 2:1 supervision ratio standard
- 1:1 supervision for high-acuity cases (cardiac, complex trauma)
Teaching Integrated Into Clinical Work:
- No separate classroom time required
- Real-time teaching during cases
- Residents rotate through your ORs
- Educational relationships vs. stretched coverage models
Program Leadership:
- Associate Program Director has 0.8 FTE (protected admin time)
- Accreditation requirements managed by program leadership
- Faculty focus on clinical teaching excellence
Call Coverage Structure
In-House First Call (24/7):
- Currently 7-8 calls per month per physician
- Department acknowledges this as unsustainable
- Your recruitment specifically aims to reduce this burden
Call Support:
- 1 resident in-house overnight
- Backup resident available for multiple simultaneous cases
- Second-call attending for surge support
- Typical overnight volume: 1-2 ORs maximum
No OB Coverage:
- No labor epidurals or emergency C-sections at night
- Focus on trauma, emergency general surgery, urgent cases
Call Requirement:
- Must reside within ~30 minutes for response time
- Shared burden across all faculty (no exemptions)
- Additional compensation for extra call beyond standard expectations
Technology & Systems
Epic EMR:
- Standard anesthesia documentation platform
- Integrated with hospital systems
- Epic Good Install award recognition
Care Team Model:
- 14.2 FTE CRNAs under medical direction
- CAAs providing additional support
- Experienced support staff (OR nurses, surgical techs, recovery)
- Low turnover creates institutional knowledge
Clinical Practice Environment
Case Mix:
- Full spectrum: general, regional, cardiac, trauma, transplant
- Prevents monotony of repetitive private practice work
- Maintains skills across subspecialties
- Intellectually engaging variety
Departmental Support:
- Collaborative culture (crisis support vs. isolation)
- Colleagues respond to help during difficult cases
- Academic environment values teaching and mutual support
- Stable faculty (many 20-30+ years tenure)
Work Structure:
- Academic salary (not productivity-based)
- Clinical judgment drives scheduling (not revenue pressure)
- Sustainable workload vs. maximizing case volume
- Protected time considerations built into schedules
Pain Management Division
- Separate division led by Dr. Alexander Escobar
- Fellowship-trained pain director
- General anesthesia faculty focus on perioperative care only
- No pressure to maintain pain clinic responsibilities
- Clear subspecialty boundaries
Key Clinical Advantages
- Level II Trauma maintains acute care skills
- 2:1 resident supervision better than many academic programs
- Manageable call with backup systems
- Full case variety prevents skill atrophy
- Academic structure removes productivity pressure
- Collaborative faculty culture during crises