UPDATE: Interview with Anesthesiologist, Alddo MolinarJanuary 6, 2020
Since the release of this interview, we’ve received plenty of interest about the views of Dr. Alddo Molinar with respect to technological advances in the field of medicine. As detailed below, the doctor has long been a proponent of spreading the use of technology in his work as an anesthesiologist and in the hospitals at which he practices medicine. An example of this in the past has been his efforts to further the integration of digital medical records so that medical facilities could access these records in a timely and efficient manner.
Another aspect of technology that is making big news in the doctor’s field is the use of enhanced monitoring equipment for anesthesiologists. These physicians are often tasked with keeping close watch of a patient’s vital signs as they undergo a surgical procedure. Should these vital signs deviate from a normal range, it’s up to the doctor to work with the rest of the surgical team to take appropriate actions.
New technological advancements are helping to streamline this work and make anesthesiologists more effective within their field. Perhaps one of the clearest examples of this has been advancements in integrated monitoring devices which present the ability to monitor multiple vital signs in a single device. Not only does this help make more efficient use of a doctor’s attention, it also opens the ability for these devices to utilize advanced algorithms to provide recommendations that can help inform the actions of physicians.
In this way, the doctor’s field is continuing to progress towards more advanced usage of technology in order to provide increasingly higher levels of care.
Alddo Molinar is an attending anesthesiologist at both Ohio Valley Medical Center and East Ohio Regional Hospital. As a first-generation U.S. citizen born to Mexican parents, expectations were high for him during his childhood growing up in Texas. However, it was clear from an early age that he had a natural aptitude that would allow him to not only meet but also exceed those expectations.
This fact was most apparent when examining his lifelong interest in medicine. Feeling drawn to a career in which could help others and relieve suffering, a career as a medical professional was an early goal in Molinar’s life. This desire would only intensify as he saw family members fall ill to cancer.
In the pursuit of his goals, Alddo Molinar attended Trinity University where he earned a BS in Biology. Following his undergraduate work, he attended medical school at The University of Texas Southwestern at Dallas where he was awarded the Bryan Williams Scholarship and became a member of the United Latin American Medical Students association.
The doctor’s residency was completed at the world-renowned Cleveland Clinic, where he not only trained at the medical center’s Anesthesiology Institute, but also participated in additional training in the field of critical care medicine. This work would continue with a fellowship at the same medical center during which he served as Chief Fellow and trained in numerous other subspecialties including neurological and cardiovascular intensive care.
Alddo, tell us a little 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 or major illnesses. 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. People often 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 you wake up in the least amount of pain possible. I also have obtained extra training in Critical Care Medicine, which allows me to take care of the sickest of the sick in the intensive care unit. The sicker you are, the more likely you will need a physician like me.
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 needed to know the results of a test done at the Cleveland Clinic. It would make a difference in taking the best care of this patient; the only catch was I needed to know soon – this patient required an urgent operation. When I asked the nurse how they usually got the result of this study, she rolled her eyes and said it wouldn’t be here in time because we had to fill out a form on paper, send it via fax, wait for someone at the Cleveland Clinic to review the fax, find the record and fax it back. The process would take hours in the best-case scenario and days in the more likely scenario. The process was incredibly inefficient, and it left the sickest and most vulnerable patients at the most significant disadvantage.
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 results of a test the patient had already undergone and paid for to take the best care of a patient today?
I initiated a process that ultimately led to a strengthened effort to link the two electronic medical records so they could communicate directly to avoid the inefficient middle steps, which still involves a fax machine. This process is now called CareEverywhere, and the software or operating system that made it possible is called EPIC. Thankfully, many non-medical, highly skilled software engineers listened to clinicians like me to help make a positive difference in the lives of millions of patients. Together, we make a tremendous difference! For this, I was named a physician champion, an award I cherish to this day. More importantly, the process I helped strengthen continues to exist and will exist for years to come.
What’s your favorite thing about your past job?
In my past job, I had the opportunity to be a department chairman, one of the lead physicians in a hospital. I had a chance to shape a world-class team towards the best practices and impact the care of tens of thousands of patients. I am most proud of how we integrated our workflows with the use of technology and an electronic medical record. I am also proud of our effort to move an entire obstetrics service, with about 3,000 deliveries per year, to our hospital. There is a tremendous amount of preparation that must happen before a new service starts in a hospital. Also, the first case has to do well. I did the first operating room delivery in our hospital in a theme that has persisted in my career. When someone needs to do well, as someone who works well under pressure, I am usually involved in their care.
What are your keys to making yourself productive?
I stay organized, and I surround myself with people that hold me accountable. I carry a composition book in my messenger bag as a journal. I keep track of everything from meetings to projects (large and small), including the steps needed to complete these projects. I also like to have multiple projects simultaneously, which allows me to move them along daily in various ways. Often I am inspired during relatively mundane activities like driving home or waiting for my kids to fall asleep. I usually take a quick moment to jot down notes and refer to these notes for further brainstorming, planning, and ultimately to see them through thorough completion. The importance of who you surround yourself with cannot be underscored enough. I believe we all have different strengths, and if you can line up these strengths well, you can form a Superbowl winning play. Sometimes patients need Superbowl winning plays and a Superbowl winning team to get them through a hospital stay and home to their loved ones. They simply deserve nothing less, whether in a big city like Cleveland or visiting family in an underserved part of Appalachia.
Tell us one long-term goal in your career.
I am at the point in my career where I understand my strengths and weaknesses and know I can make a difference one patient at a time. I also know that I can use the armamentarium I have developed over a lifetime to help strengthen the system that cares for patients by further applying technology. I think we need to be at the forefront of technological trends, including advanced monitoring and artificial intelligence to make the most meaningful impact on our patient population. For example, I can envision a future where we use artificial intelligence to flag something happening in one of our operating rooms as a critical event, which can bring more resources to help that patient and avoid the downward spiral of an adverse outcome.
What’s the most valuable lesson you’ve learned through the course of your career?
I think it is essential to be flexible and highly adaptable. I read a book by Joseph Campbell called The Hero with a Thousand Faces. He describes the hero as a very ordinary person who is called to adventure. The hero faces many battles along the way and gets “special powers” by overcoming battles, temptations, and failures. The hero gains allies and enemies and learns how to fight both conventionally and unconventionally. The hero seeks mentors along the way that provide advice about the path both far and close. The hero also experiences failures along the way. Every hero has at least one major fall in life. Campbell calls this the abyss or being in the belly of the whale. When the hero is in this phase, they undergoe tremendous growth. While not losing the fear of failure, the true hero gets back up with the same grit, determination, and aggressiveness that propelled them to succeed before. If you adapt and maintain your courage despite failure, you are very likely to succeed in life.
What advice would you give to others aspiring to succeed in your field?
Medicine is a fascinating field. In some ways, it doesn’t change much; in others, it is ever-changing. If you look at something like pneumonia, or an infection of the lungs, you would initially think it has been around forever. However, the causes of lung infection are varied, and the ways of treating this are many. The specific bacteria, virus, or fungus causing pneumonia makes a tremendous difference in how you manage this. You also have to support the body while giving it the best chances of succeeding in overcoming the infection. Things like the best type of programming for the ventilator, the best nutrition, the best sedation become essential. Medicine is also so vast that you have to stay on top of different studies that control for specific variables. All of these require a lifetime of learning and remaining connected to the respective sources of literature. The most important advice I can give anyone interested in pursuing medicine is to continue to learn. I strongly suggest one hour of professional learning each day. Sometimes you have to do more, but the emphasis is on small aliquots over long periods. It should be such that you have covered everything in your respective specialties’ textbook at least every few years. Conversely, you should not encounter anything in clinical practice that you haven’t reviewed in a structured formal manner within the past few years. Medicine is very much a journey.
What are your favorite things to do outside of work?
I am the sort of person who likes to tackle big projects at work and home. I enjoy the planning, budgeting, researching, and recruiting the best team. I also like dividing projects into different phases and developing metrics to track success at each stage. If you can string a series of successful steps together, you can achieve something worthwhile. Besides being intellectual, I am also fairly good with my hands, so I enjoy working on projects around the house with the same attention to detail as in my professional life. I am often found in the garage looking up the torque specs for a bolt or drawing a circuit diagram to understand the flow of electrons better. There are many parallels between medicine and the physical world around us. They both conform to the laws of physics, and understanding one often leads to a parallel solution in the other. My next project is the restoration of a 1975 C3 Corvette. When I want to get away truly, I enjoy playing golf. There is something incredibly relaxing about being out in nature with a bag of tools trying to find the best way to finesse a ball into a tiny hole battling the laws of physics. In golf as in life, even the small undulations on a green can affect a putt’s trajectory. Similarly, a well-executed series of plays leads to an equally gratifying clink sound of a ball in the cup as a clapping sound high five after a job well done in the operating room.
I also really enjoy music, especially playing the guitar. I grew up in Texas, so country music flows through my veins. I met the love of my life from the great state of Kentucky, so I have taken a liking to bluegrass. One of my favorite songs is playing the fingerpicking part of “Take me home, country roads” by John Denver. I have a variety of other interests, and I have found that I can draw from these life experiences to best communicate with patients. Speaking to patients and their families in a language they can understand is one of the most humanizing ways of caring for patients.
Name a few influential books you’ve read and/or websites you keep up with that you’d recommend to readers.
One of the best growth opportunities is related to failure. Although failure can be trying, it is often necessary for meaningful growth. I recently read a book by John Maxwell called Failing Forward. This is an excellent leadership book that suggests that unless you are failing with some frequency, you likely aren’t pushing ahead enough. Of course, you don’t want to fail too often, but if you’re going to have any chance of hitting a ball out of the ballpark, you have to swing big. The second book that I recently enjoyed reading was The Serving Leader: Five Powerful Actions That Will Transform Your Team, Your Business, and Your Community. The principal concept is that a good leader serves those in their organization. Remaining grounded and humble, you can get far more done in life. Thanks for the opportunity to contribute.
More about Alddo Molinar at https://about.me/alddo-molinar