ASA February 2003 Newsletter

To many of us, internship means training beyond medical school in order to gain a better understanding and application of the knowledge learned in clinical practice. However, in the context of this article, mini-internships deal with a grassroots program to educate legislators, members of the media, hospital CEO, health care managers, members of the entertainment industry and community leaders by inviting them to see firsthand the daily activities and responsibilities of anesthesiologists. The goal of this program is to pass on a clearer understanding of the realities and challenges of anesthesiology practice and to build strong working relationships. Emphasis on the role of the anesthesiologist as a perioperative physician and the importance of medical direction of nurse anesthetists to ensure patient safety also must be stressed.

During this time of increased scrutiny by governmental agencies over health care costs and still more cuts in anesthesia reimbursements, mini-internships are valuable programs in giving nonphysicians an opportunity to visit our institutions for a day or a half day to observe how we, as anesthesiologists, perform in our specialty. Those who have been involved with this type of program realize how important it is. The purpose of this article is to convey information to those unfamiliar with the mini-internship program.

Many formal mini-internship programs have been sponsored by the American Medical Association, the New York State Society of Anesthesiologists (NYSSA) and various county medical societies. The mini-internship program can be complex and involve considerable time in development, planning and implementation. However, it need not be a difficult undertaking if done on a smaller scale and on a one-to-one basis. It is interesting to note that many mini-internship programs sponsored by county medical societies have decreased in number or stopped entirely because of time constraints and increased costs. That is why smaller programs on an individual basis work best, as they allow us to promote the importance of our specialty.

It does not matter who the intern is because the program is basically the same for everyone. Due to time constraints by legislators, their legislative aides or members of the media, the program must be tailored to give the greatest amount of exposure in the shortest period of time.

An organized program planned by your component society can be important to that society’s success, and depending on the targeted area, the emphasis may vary. A more detailed booklet explaining the mechanics and benefits of mini-internships can be obtained from NYSSA by calling (212) 867-7140 and requesting “The Mini-Internship, A Day in the Life of an Anesthesiologist” or in the section on mini-internships provided by ASA in its “Handbook for State Government Affairs.”

Our medical practices are governed by both state and federal regulations. Therefore, when dealing with elected officials, priority should be directed to those legislators or key staff members who work on committees concerning health care issues. If a relationship has been established by either supporting a legislator with campaign contributions or by a visit on Legislative Day, it is easier to invite that individual or the health care aide to observe your practice. This invitation can be extended by mail or telephone. The ASA Office of Governmental Affairs at (202) 289-2222 or <mail@ASAwash.org> can be contacted for information about ASA legislative issues and can answer questions about designing a program or giving assistance in targeting interns for participation in the mini-internship program.

The media play an essential role in getting the word out concerning our specialty. In general, though, the media seems not to have an interest in anesthesiology unless there is a catastrophic event. Nevertheless, one should establish a relationship with the medical editor of your local media. If you do not have a contact, make the media outlet aware of your availability should a question or issue arise concerning anesthesiology. Invite them to participate in the mini-internship program. If you are using this program to target media representatives, additional information and guidance can be obtained from the staff of the ASA Communications Department at (847) 825-5586 or <communications@ASAhq.org>.

Prior to having the intern visit your institution, it is imperative to obtain the permission of the hospital’s CEO, the operating surgeon and the patients. It is also important to alert your hospital’s public relations office. On the day of the intern’s visit, he or she should follow the anesthesiologist through the conduct of anesthesia throughout the preoperative, intraoperative and postoperative periods. This should give that individual a feel for the important role that anesthesiologist’s play within the surgical team. Emphasize that we are not only involved in surgical anesthesia but also in other areas such as intensive care, emergency medicine, pain management and obstetrics. After the visit, send a letter thanking that individual for participating in the program, and let it be known that you would be delighted to answer any questions pertaining to anesthesiology that might arise. By establishing this relationship, you improve your chances to visit the intern and to discuss issues of interest concerning anesthesiology in the future.

Although they are not new and have been in existence for many years, mini-internships are invaluable and their importance cannot be overemphasized. It is important to become proactive and to get involved. The contacts made and the exposure experienced by the intern during this type of program can benefit the image and the future of anesthesiology for years to come.

Norman Levin, M.D., is Chief, Department of Anesthesiology, Century City Hospital, Los Angeles, California.

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