Q&A With Dr. Alddo Molinar, Critical Care Anesthesiologist

Tell us a bit about yourself.

I am a critical care anesthesiologist. I am the physician that takes care of you when you need to get through tough situations, like surgeries, often emergency surgeries. I work in concert with your surgeon to get you through in the best possible way. Usually I work with an excellent team of nurses and aides as part of what is called a care team. Oftentimes people forget about the importance of their anesthesiologist, because we are very much a “behind the scenes” doctor. Among other things, we are critical to making sure your brain continues to receive oxygen, your kidneys continue to purify your blood, and that you wake up in the least amount of pain. I also have extra training in Critical Care Medicine which allows me to take care of the sickest of the sick. The sicker you, or your loved ones are, the more likely you will need a physician like me.

Medicine has been a calling from a very young age for me and I find it very gratifying. It is a tremendous privilege to be able to care for patients and make their lives better.

At home, I am happily married, have a wonderful wife and three beautiful children. I remain grounded with my faith and support system.

On a personal note, I had a recent health scare, where I was diagnosed with a mental illness. I had never been a patient before and had to see medicine from the “other side”. Like many other patients I am thankful there are medications and treatments available, but the entire experience has been incredibly humbling. I can honestly say I relate to patients so much more, especially when it comes to mental illness. Also, I can see some of the risk factors that led to my mental illness in other colleagues and am passionate about helping not just my patients but also the people that take care of patients (other healthcare providers). I hope to write a book about the experience, and am trying to start a national organization for mental health [affected] professionals. Ten years from now I want to look back and say that I made a difference not only in the lives of my patients but also my colleagues.

What is a recent idea you had and how did you bring it to life?

I was recently taking care of a patient from a different hospital system, the Cleveland Clinic to be exact. I really needed to know the results of one of his studies that was done at the Cleveland Clinic. It would really make a difference in taking the best care of this patient, the only catch was that I needed to know soon – this patient needed an urgent operation. When I asked the nurse how they normally get the results of this study, she rolled her eyes and said it wouldn’t be here in time because we had to fill out a form (paper), fax a request (need a fax and a number), wait for someone at the Cleveland Clinic to review the fax (who knows how long this could be), find the record (is it readily available?) and fax it back (where would I be?). The entire process would take hours in the best case scenario and days in the likely scenario. The system was incredibly inefficient. This was a system and a process problem.

Thankfully, we had recently upgraded to a new electronic medical record called EPIC. EPIC was the same as the electronic medical record used at the Cleveland Clinic. The Cleveland Clinic is a great place, I know this because I trained there. How could I get the information that the patient wants me to have, I do need their permission afterall, from Cleveland to my fingertips so I can make a decision about the best way to care for them?

I initiated a process that ultimately led to a strengthened effort to link the two system wide electronic medical records so that they could communicate directly to avoid the middle inefficient steps (involving the fax). This process is now called CareEverywhere here and the operating system that makes it possible is called EPIC. Thankfully, there are a number of people, non-medical people, that listen to small clinicians like me to help make a positive difference in the lives of our patients. Together we can make a tremendous difference! For this I was named a physician champion of the electronic medical record, a title I cherish.

What’s your favorite thing about your past job?

In my past job, I had the opportunity to be a department chairman, which was the lead physician in a department. I had the opportunity to shape a department towards best practices, to motivate a world class team, to interact with thousands of patient directly or indirectly through policies and procedures. I am proud of how we integrated our workflows into the electronic medical record called EPIC (noted above). I am most proud of our effort to move our entire obstetrics practice, about 3,000 deliveries per year to our hospital – and the anesthesia was provided by my department. The first operating room delivery in our hospital was done by me. This is a great memory.

What are your keys to making yourself productive?

Stay centrally organized. I carry a composition book in my messenger bag to use as a journal. I keep track of everything from meetings to projects (large and small), including the steps needed to complete these projects. Life is all about timing and we can often shape the timing of projects to be most productive. I often do my best brainstorming in the evenings, after the kids are off to sleep, and it is not uncommon (you can ask my wife) for me to get up, go to my study and jot down thoughts on how to do/time something better.

Tell us one long-term goal in your career.

As I mentioned above, my long term goal is to not only make a difference in the life of each of my patients each and every day, but to care for other health professionals that often give too much of themselves. This can often lead to depression, anxiety, and other mental illnesses. I have been tremendously blessed to be able to care for patients but I also want to advocate for those that also take care of patients.

What’s the most valuable lesson you’ve learned through the course of your career?

Maintain a compass. Life often throws obstacles towards you, especially when you are not expecting them, or even when you are down. The trick is getting back up and following your compass. Be adaptable too, often arriving at the destination requires multiple attempts at different paths.

Persist.

Be adaptable.

Follow your compass.

What advice would you give to others aspiring to succeed in your field?

No matter your field, we all would benefit from reading an hour per day of something that makes us better at our profession. For me, medicine is always changing, and the more I know, the better I will be when those precious seconds count. We’ve all heard the adage that there is no need to re-invent the wheel. This is true, oftentimes someone has been in this situation before, and it’s an absolute must to know what works and what doesn’t work. That’s part of our training to be a special kind of doctor (like an anesthesiologist). But, one of the really exciting things in medicine is when you read to the point where noone knows the answer. To get to this point, you have to read the textbook(s), read the journal articles, listen to expert opinions and then you get to the point where you need a study that is designed just to answer this question. It’s very satisfying to get to this point, but you will never get to that point if you don’t read at least an hour per day.

What are your favorite things to do outside of work?

I really enjoy spending time with my family. I have a wonderful wife, two beautiful daughters, and a precious son. We enjoy spending time riding bikes, going on hikes, and my son has recently taking a liking to fishing.

Name a few influential books you’ve read and/or websites you keep up with that you’d recommend to readers.

The Cleveland Clinic Way, by Toby Cosgrove. 

CONNECT:

Website: www.dralddomolinar.com 

Twitter: @dralddomolinar

Doximity: www.doximity.com/pub/alddo-molinar-md