Let's Be Louder: Why Increasing Anesthesiologists' Visibility Is Essential With Dr Dolores McKeen
Interview conducted by Calvin Barr, Public Relations & Marketing Coordinator, CAS.
Calvin: Tell me about your job and the areas of work involved in your practice.
Dr. McKeen: I spend roughly 30% of an average week providing clinical care. My clinical practice includes General Anesthesia for adults undergoing many different types of surgery, as well as Obstetric Anesthesia for patients giving birth. For me, balancing multiple roles over the past 30 years has been necessary for advancing the specialty in all the ways I want to. Clinical anesthesia research, for example, has always been one of my priorities, because it’s so central to giving patients the best evidence-informed care.
Another vital part of my practice is making sure that I provide culturally competent care that fully involves my patients in decisions. Anesthesia is often thought of as a complex and technical process with little room for patients’ priorities. However, it’s both essential and relatively easy to understand what matters to people and allows them to make anesthesia care choices that make them feel safer and more confident.
Calvin: What made you decide to pursue Anesthesiology as a specialty?
Dr. McKeen: I started my postgraduate training in Internal Medicine, which helped me to develop a strong appreciation for the integration of medicine and anesthesia in perioperative and critical care. After a few years, it became clear that Anesthesiology was a better fit, since it allowed me to merge my foundational Internal Medicine training with my desire to use more hands-on technical skills in high-pressure inpatient environments, like hospitals. You could say that the specialty felt like a perfect marriage between those two priorities.
Calvin: And what inspired you to make Obstetrics your subspecialty?
Dr. McKeen: Maternal Medicine and Obstetric Anesthesia subspecialty training focuses on expertise in managing high-risk deliveries and providing fetal anesthesia care for prenatal procedures, along with multidisciplinary collaboration and research. Pursuing this subspecialty allowed me to incorporate my passions for both medicine and research into my career—on top of the clinical care and technical skills and responsibilities that come with being an anesthesiologist.
Calvin: What do you enjoy most about your job?
Dr. McKeen: For me, one of the most rewarding aspects of Anesthesiology is the level of intensity and trust involved in my relatively brief relationships with patients. I often meet them just 15 to 20 minutes before surgery and it’s my role to get a comprehensive understanding of their medical history and emotional state within that time. Before we go into the OR, I am asking my patients to put their life in my hands, as they undergo one of the most vulnerable events a person can experience. The result is a very powerful connection. It’s both an immense responsibility and incredibly humbling to be given that level of trust.
From a broader perspective, modern anesthesia has transformed previously very painful and often traumatic medical experiences, such as surgery and childbirth, into far safer and less stressful events. Supporting patients through these moments is one of the most fulfilling aspects of my profession.
Calvin: Absolutely. And on the flip side, what do you find most difficult about it?
Dr. McKeen: Depending on where you work in Canada, Health Human Resource allocation and OR cancellations and scheduling problems can present major issues for anesthesiology departments. Sometimes, health authorities don’t sufficiently involve anesthesiologists in leadership decisions. This can lead to overextended workdays and reduced flexibility that decreases autonomy and overall workplace satisfaction for staff.
When anesthesiologists are meaningfully integrated into an organization’s governance and decision-making processes, strong interdepartmental collaboration that supports excellent patient care and sustainable work-life balance generally follows. For patients, the result is access to better-quality anesthesia care and potentially shorter surgical wait times.
Calvin: It sounds like you’re describing how we tend to look at perioperative care as a collaborative, team-oriented approach, but in practice, that’s not always the case.
Dr. McKeen: That's exactly right. Changing the way that anesthesiologists are often viewed as “OR technicians” instead of Perioperative Medicine physicians is vital to improving perioperative team functionality. This doesn’t just boost team morale—it has a direct impact on reducing risk to our patients.
It’s also been a long-term struggle for anesthesiologists to be seen at the leadership table. Rather than cultivating our roles in healthcare leadership, we’ve had to make providing clinical care our priority, due to the ongoing health human resource shortage. That’s especially true of women anesthesiologists, who are only now starting to fill more leadership, medical education, and administration roles.
Calvin: I’m curious about the patient care experience. What do you consider most important for patients or their loved ones to know before they go into surgery?
Dr. McKeen: It’s important to remember that care models vary nationally and internationally. If you look at the situation in the U.S., anesthesiologists are often running between three or four rooms at a time. My approach is to reassure my patients that they are receiving anesthesia care that is personalized to their medical and psychological needs and that I will be closely monitoring them through their entire surgery.
It’s imperative that I know how they’re feeling when I meet them, as well as anything I can do to make them feel more secure—whether physically or mentally. What I usually say to my patients is: “You are the most important person in this room right now. Is there anything you want me to know or that you need to make this day feel safer?”
Calvin: If someone's particularly nervous, do you have any go-to relaxation techniques that you recommend?
Dr. McKeen: There is no universal approach. Some patients find comfort in conversation, while others prefer quiet reassurance. I'm a chatty person, and for some people, just talking about their hobbies, travel plans, or their day goes a long way towards lowering their anxiety. But that’s not helpful to people who need more non-verbal support to feel comfortable. So, it really comes back to asking the patient what they need in that moment and interacting with them in a way that helps them relax. The key is to be responsive to what your patient needs in the moment and adapt your approach accordingly.
Calvin: We're delighted at CAS to see more medical students showing an interest in Anesthesia. What advice would you give to those considering the specialty as a career?
Dr. McKeen: During their training, medical learners—by which I mean undergraduates or medical students—may have relatively little exposure to anesthesia as a specialty. Some programs don’t have a mandatory anesthesia rotation, which is why I recommend that learners look for opportunities to better understand what’s involved with being an anesthesiologist.
I think it’s critical for members of our specialty to be more visible, not just through our clinical work, but also outside of the OR. This could include teaching medical learners clinical skills in their classrooms, as well as through high-fidelity simulations that show them what we do in a low-pressure environment. We also need to remember that learners may have misconceptions about anesthesiologists being perpetually overwhelmed and unhappy. It’s true that we do have a heavy workload—and will for the foreseeable future—however, strategies like opening more Anesthesia Assistant positions and implementing Anesthesia Care Teams are making a big difference. More importantly, we need to display our enthusiasm for the profession, as so much of what we do is immensely rewarding. We need to share that loudly.
Calvin: If you weren't an anesthesiologist, what do you think you'd be doing?
Dr. McKeen: You know what, I’d love to be a food critic going to Michelin-star restaurants and running a food blog! I love to travel and experience new things, so I think it would be amazing to do that for a living.
Calvin: Can you share your most positive memory with a patient?
Dr. McKeen: Years ago, I had a labouring patient who experienced an amniotic fluid embolus, which is a life-threatening obstetric event. She suffered cardiac arrest as well as disseminated intravascular coagulation (DIC)—a serious condition that causes excessive bleeding throughout the body. Over the course of seven hours in the OR, myself and the other members of a perioperative team were able to stabilize her through our collective expertise and training. It was one of the hardest cases I've ever managed—I was physically and mentally exhausted afterwards.
Two weeks later, when she was ready to be discharged, I accompanied that mother along with her newborn baby to the front door of the hospital. She didn't remember anything and probably had no idea why I was walking her out. But I felt so personally and professionally proud to have been instrumental in saving that woman's life, and to know that her baby would grow up knowing their mother. That patient stays with me and reminds me of why I have the specialized training that I have: For those once-in-a-career or lifetime saves.
Calvin: That’s incredible. One last question: What do you hope for the future of the specialty?
Dr. McKeen: I hope that we maintain our relevance and our ability to make a positive impact in a healthcare environment that’s critically short on Health Human Resources, including anesthesiologists. Anesthesia is a new specialty compared to surgery or internal medicine—we’re about 100 years old. But in that time, we have achieved some truly extraordinary medical advances, and we don’t always celebrate that enough.
As an anesthesiologist, sometimes you hear that if a patient doesn't remember you, it means you’ve done a great job. However, I hope that in the future, we as members of the specialty become more visible. It’s not boastful to be vocal about how proud we are of everything that we do. I believe that embracing wider recognition of how essential anesthesiologists are will only strengthen the specialty and lead to more innovation in anesthesia and perioperative care that ultimately saves more lives.