February 1997
Volume 61 |
Number 2
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"A Day in
the Life of an Anesthesiologist" -Developing a Mini-internship
in Anesthesiology
Part 1 |
Margaret G. Pratila, M.D, Chair
Committee on Communications
(This is the first article in a two-part series that will
explain the mechanics and the benefits of hosting a mini-internship
at your institution for a community leader, legislator or media
person. The information provided in the two-part article is based
on the experiences of the New York State Society of Anesthesiologists
(NYSSA) and its Public Education and Information Committee. Another
good source of information is the section on mini-internships
provided by ASA in the State Government Affairs Handbook. Contact
ASA for more information.)
Mini-internships are not new. The American Medical Association
and many state and county medical societies have run excellent
programs. What has been different about NYSSA's program is that
it is short and focused. It typically takes three to four hours
instead of one or two days, and it is geared to show exclusively
anesthesiology and the anesthesiologist; hence, the program's
title "A Day in the Life of an Anesthesiologist."
Its aim has been to educate legislators, the media and special
interest groups on the work of anesthesiologists and how they
function as a part of today's medical team. It was because legislators
and the media have time constraints that the program was developed
to last no more than four hours.
Our goals have been to educate legislators on the safety of modern
anesthesia, the role of the anesthesiologist as a perioperative
physician and the necessity of medical direction of nurse anesthetists
to ensure patient safety and care. The presence of the media has
two benefits. It encourages participation by the legislators and
it gives positive exposure of anesthesiology to the public.
In the future, we will have to attempt to educate CEOs of the
big health care management firms in the same way, although, realistically,
they will be a harder sell. Their bottom line is hard cash. No
matter if the pessimists among us believe that legislators are
no different, I think that they do want what is best for their
constituents, and also a little media coverage in a caring situation
does them no harm.
Although I have written this article somewhat lightly and tongue-in-cheek,
I do not view the mini-internship as being "light" in
any way. I believe we have made allies by educating those on whom
we have concentrated, namely the legislators, and as a result,
the mini-internship is one of the most important parts of our
public education activities.
I have divided the article into two sections:-
1. "How to"
2. A sample mini-internship kit
You are of course free to use these and/or modify them to suit
your own needs.
Who Are the Players?
- The Patient (who needs to agree in writing to participate)
- The Legislator +/- his or her Aide
- The Host Anesthesiologist
- The Surgeon (need his or her help to enroll patients)
- The Public Relations Representative of the hospital
- The TV Reporter +/- Cameraman
- The Print Reporter +/- Cameraman +/- The Radio Reporter
- You and one other PR person from your state component society
The host anesthesiologist is either the chair of the department
of anesthesiology at the participating hospital or a senior member
of the anesthesiology staff. They work with the public relations
department of the hospital to choose suitable patients and sites
to visit. They also choose and enroll the anesthesiologists who
will be giving the anesthesia or doing the procedure during the
mini-internship. They act as the spokesperson on the day of the
mini-internship. They are most often chosen by the television
reporter to speak on the topic of your agenda (local TV stations
want local doctors) or to answer questions, so choose your host
wisely and arm them with facts, figures, support material, etc.
The public relations personnel from the hospital are invaluable
in obtaining patient releases or other clearances and, in general,
handling the logistics of the visit. They have smoothed the path
on our mini-internships tremendously. This is not true altruism;
positive press for us is also positive press for the hospital.
Two persons from the public relations committee of your
state component society serve as the coordinators, "go-fors,"
trouble-shooters, etc. One accompanies the host to the TV interview,
and the other accompanies the legislator during this period, describes
the procedures and answers questions. If there is a large group
of people, the group may be divided into two or more smaller groups
during visits to the operating room and, here again, a public
relations committee person should accompany each group.
The TV reporter may bring a camera and sound crew or may
even do their own videotaping. I was impressed with the professionalism
of Debbie Feyerick of New York "One News." She toted
this heavy camera, probably half her weight, all morning. At the
end of the videotaping, she placed the camera on a tripod, put
on makeup, combed her hair (without a mirror), then looked into
the camera and gave her introduction. She looked and sounded just
wonderful on TV that evening. I wish I could do that after a day
in the O.R.
The newspaper and/or radio reporters are looking for "sound-bites."
Everyone involved should say only what they are willing to have
quoted. Keep in mind that videotape footage can be cut or edited
as can the sound track. Newspaper reporters can have a field day
by taking your remarks out of context. This is not common; however,
you learn to be careful with these people on any second occasion.
Only rarely is it worth taking them to task.
Watch out for our surgical colleagues! Some of them are
great hams! Everyone is there to learn about anesthesiology and
not the virtuosity of the surgeon. Many surgeons also love to
teach. However, joking aside, they have been, virtually without
exception, very helpful in persuading their patients to be a part
of our program.
How Do You Get the Media to Come?
The simple answer is, find a story they can use. Unfortunately,
this is not so simple to do. Some successful topics have been:
- Patient safety
- New anesthetic techniques
- The anesthesiologist as a perioperative physician
- Pain clinics
- How the lack of funding for postgraduate education would impact
inner-city medical care
- Medical direction of the nurse anesthetist.
- How the anesthesia care team works.
Develop a working relationship with your local media. If you
have given them good story ideas in the past, they are more likely
to come to your mini-internship.
Know which reporters cover which topics in your area. Most of
the time, our stories are geared toward newspaper health editors,
but a story that concerns Medicare funding might be of interest
to the political or financial editors, and a mini-internship based
on advances in obstetric anesthesia may be more suitable for a
news editor - on a quiet day. You will always be pre-empted by
the O. J. Simpsons of this world or other major news events. Roll
with the punches! There is always another day.
It will be easier to obtain media coverage for the first mini-internship.
Hospitals, particularly the operating room, are good settings
for visuals for the TV reporter. After the first time, though,
they will want to know, "What is your new story?"
How Do You Get Legislators to Come?
- Issue an individual invitation to your state senator or assemblyperson
when you visit them on Legislative Day. Follow up with telephone
calls and a letter.
- Seek input from your government and legal affairs chair and/or
your Society's lobbyist about whom to invite. Then contact the
legislators by telephone through their aides. Follow up with
a letter.
- Visit your legislators at their local offices; speak with
their aides and invite the legislators and their aides to participate
in a mini-internship. Follow up the same way as above. (I have
used "follow up" many times deliberately. These are
busy people with many items on their calendar. We do not want
to get lost in the shuffle.)
- Zero in on those legislators who are important for your agenda.
In New York at the moment, one of our priorities is maintaining
medical direction of nurse anesthetists, since we believe this
provides safety in patient care. Those legislators who are on
the health committee and higher education committee have two
bills to discuss. One would give prescriptive authority to nurse
anesthetists and remove the necessity of medical direction;
the other codifies nurse anesthesia practice and maintains the
medical direction, which is presently a part of the New York
State Health Code.
- Send a mini-internship kit with a cover letter to the legislator.
- Follow up with telephone calls and, if necessary, with alternative
dates. You may ask which hospital they would like to visit.
They almost invariably choose one in their own district. This
makes a lot of sense since it also gives them an opportunity
to let their constituents know that their legislator cares about
medical care in their community.
Read Part 2 of
"A Day in the Life of an Anesthesiologist-Developing a Mini-internship
in Anesthesiology".
Click
here to download the complete Mini-internship kit. This file
is in pdf format. You must have the free utility, Adobe Acrobat
Reader, in order to read or print the application. The utility is
available for Macintosh, Windows, Sun SPARC, HP/US, Silicon Graphics,
and IBM AIX platforms.
Click
here to download a free copy of Acrobat Reader.
Acrobat and the Acrobat logo are trademarks of
Adobe Systems Incorporated
Margaret G. Pratila, M.D., is Associate
Professor of Clinical Anesthesiology, Cornell University Medical
Center, and Associate Attending Anesthesiologist, Memorial Sloan-Kettering
Cancer Center, New York, New York.
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