“Communication, empathy and creating that rapport between patients and physicians is so incredibly essential to a safe and comfortable surgical experience.”
Meet ABA Director Tin-Na Kan, M.D.
Dr. Kan has worked as a clinical anesthesiologist and senior partner at The Permanente Medical Group (TPMG) in Northern California for the past 16 years. Dr. Kan serves on the Equity, Inclusion and Diversity Council at South San Francisco Kaiser Hospital and as the founder and director of a newly established TPMG Perioperative Simulation Program. Read her full bio here.
Why are you passionate about anesthesiology?
I honestly didn’t know much about anesthesiology when I started medical school. It wasn’t until my third year during my internal medicine clerkship that I started learning more. Late one night, while admitting patients “on call,” my PGY1 resident mentor asked me what specialty I was interested in, and I replied that I had no idea. I truly loved different aspects of all the rotations and specialties I had already experienced.
She said that I should consider anesthesiology with all the reasons she loved it. It turns out that those things became my reasons as well, including helping a variety of different patients, kids and adults, in all sorts of different types of surgery, working in real-time in the fast-paced environment of the operating room, and having the perfect mix of procedural and cerebral – we do a little bit of both, and oftentimes very much together, like combining physiology and pharmacology together with airway techniques and nerve blocks to create the perfect anesthesia plan.
There’s also a lot of heart in anesthesia, taking care of patients during one of the most critical periods of their lives and potentially saving their lives, although that part isn’t the draw for me. It is an important part of why I feel like anesthesiology is the right field for me and why I’m so passionate about it.
What is the biggest misconception surrounding anesthesiology?
The biggest misconception among patients regarding anesthesiology is that we are not actively taking care of them during the anesthetic. It starts out, “How do you know how much to give?” Underlying this question is the sense that we talk to them, make a decision about the medicine amount, give it, and then say, “Good luck.” Turns out, we are titrating medications to effect and monitoring the patient throughout the surgery. Sometimes you need a little more, sometimes you need a little less, and sometimes you need a different set of medications altogether.
Most importantly, we are there the whole time to make sure they are okay through the whole experience, and I think that’s both very comforting but also a little bit surprising for many patients.
There is another misconception that because the time that we spend with a patient while they are fully awake and can still remember what you’re telling them is so short, it’s somehow not as important. But those moments are even more significant because it’s such a critical period during which patients are often in pain, nervous and worried about the outcome. Surgeries are a big deal. This is a very critical period where communication, empathy and creating that rapport between patients is so incredibly essential to a safe and comfortable surgical experience.
How does that relate to the unique role anesthesiologists play in encouraging or owning patient safety?
I always think of anesthesiologists as the lifeguards in the operating room, and because we are there monitoring patients and making sure that they’re tolerating surgery well, focusing on patient safety is naturally a crucial part of what we do.
I think the field has done more than any other specialty to study and understand what puts patients at risk during surgery and when they’re critically ill. That’s made a huge difference for patients getting through surgery successfully.
What is the value of board certification, and what qualities set apart board-certified anesthesiologists?
Board certification is important because it means that the specialty has created a high standard that goes across all training programs and practices. We hold ourselves accountable to ensuring that anesthesia is safer for our patients.
Having continuing certification means that we aren’t just satisfied with what we learned in the training program 5, 10 years ago, or longer. It shows the public and our patients how important it is that we continue learning throughout our careers. And that makes a difference in patient care, because the field is changing at a very rapid pace with continual advancements in patient safety.
How has the field of anesthesiology evolved since you began practicing?
The main way the field of anesthesiology has evolved is through our leveraging of new technologies.
I think one of the examples that’s most near and dear to my heart is the use of ultrasound. When the technology was not as advanced, it was only useful for some invasive line procedures. When the technology improved to be able to see much smaller structures like nerves, this allowed us to vastly improve regional anesthesia techniques or nerve blocks. Now, we have advanced to using ultrasound to improve our diagnostic capabilities that help us figure out what’s going on in a critically ill patient.
Why did you want to become a member of the ABA Board of Directors?
Becoming an ABA Board Director was not on my career bucket list, not that it wouldn’t be a fulfilling, extraordinary opportunity to give back to a specialty that has given me so much and to have a chance to make a difference more broadly in medicine, but because I really wasn’t able to see myself in that position when looking at all the incredibly accomplished, primarily academic physicians that have come before me. And so, I’m hoping that I’ve already broken some barriers by just being here, and hopefully also breaking some more barriers by what I’m able to do.
What value has volunteering for the ABA brought you?
I’ve learned so much in my time volunteering for the ABA. I started several years ago as a Standardized Oral Exam (SOE) examiner and later also as an Objective Structured Clinical Exam (OSCE) examiner, and it’s been very fulfilling.
What keeps me coming back year after year is the people. It’s hard to find a group of people who are also enthusiastic about serving others and doing their part for the specialty through high-stakes assessments. The community is so unique and has been so important to me, both personally and professionally.
What do you enjoy doing when you’re not practicing anesthesiology?
I met my husband rock climbing, so that’s been a big part of our lives. Over the years, we have traveled to many different destinations to camp, hike and climb. Now, my daughter has pulled me into the horse world as an avid horse lover and English equestrian eventer. I’ve started riding and taking lessons myself, although at a much lower level than my 13-year-old. Ultimately, my family is a very important part of everything, and I’m trying to enjoy spending as much time as I can with them.