June 20, 2024

Leading the Way

Meet ABA Secretary Alex Macario, M.D., MBA


“One of our most important contributions in the operating room is ensuring the environment is set up to provide safe patient care and a high-quality experience.”

Meet ABA Secretary Alex Macario, M.D., MBA

Dr. Macario is a professor of anesthesiology, perioperative and pain medicine, and, by courtesy, health research and policy at the Stanford University School of Medicine. His clinical practice focuses on adult patients in the general operating room. As hospital scheduler, Dr. Macario provides management and leadership in the medical center’s operating and procedure rooms, including interventional radiology and endoscopy. His research career has been dedicated to the economics of health care, in particular, costs, quality and outcomes for patients having surgery and anesthesia. Read his full bio here.



Why are you passionate about anesthesiology?

When an anesthesiologist approaches a patient in the operating room before they have surgery, it’s possibly the most impactful day of the year, if not their entire life. They’re at a vulnerable point, and I get to be a part of the care team that administers a procedure that could change the trajectory of their life. For example, I do a significant amount of anesthesia for joint replacements, which is a surgery that can drastically improve a patient’s quality of life.



What unique role do anesthesiologists play in encouraging or owning patient safety?

The anesthesiology specialty has long been a leader in patient safety. It comes naturally because one of our most important contributions in the operating room is ensuring the environment is set up to provide safe patient care and a high-quality experience.



Share a recent story about an impactful patient case.

What is so rewarding in the medical field is that every patient has a story about how they ended up in the hospital. I recently saw a patient who was 85, had never had surgery and was on no medications, which is pretty unusual. She had developed atrial fibrillation and needed to have cardioversion and a transesophageal echo. She was a gentle soul who was nervous about the outcome of the procedure and what her newly developed condition meant in terms of her longevity and quality of life. I was able to talk her through the procedure, reassuring her that we had the tools needed to administer anesthesia, help her recover and send her on her way home. It was ultimately a successful intervention!



How has the field of anesthesiology evolved since you began practicing, and what do you think the future of anesthesiology will look like?

I began practicing anesthesiology in 1991, and if I compare what’s available today versus then, I think about how the medications, devices, monitoring equipment and technology have improved dramatically. I’m amazed that despite how safe anesthesia already was, we’ve continued to make many improvements in the tools and medications we have to care for patients.

A lot is up in the air in terms of the future of the field and of medicine, but I know that anesthesiologists will be the leaders in determining how best to care for patients who require anesthesia and perioperative care.



How have your continuing certification activities translated to your practice?

I personally find value in MOCA Minute. I often get questions I’m not familiar with. This is because of the rapid changes in medicine. I reflect on the questions while I take care of patients who have some issue related to the question.

I give credit to the committee of board-certified anesthesiologist volunteers who write the MOCA Minute questions. They do a great job of developing questions and topics relevant to direct patient care.

The other piece of continuing certification that has translated to my practice is the requirement for continuing medical education. This encourages me to access various programs and lectures to learn about new developments in the specialty. Continuing medical education is a crucial part of our professional commitment.



What is the value of board certification, and what qualities set apart board-certified anesthesiologists?

Patients expect anesthesiologists to stay updated with changes in medicine and healthcare. The main value of board certification is that it signals to the hospital and the patients that the board-certified anesthesiologist is staying current with changes in knowledge and skills in the specialty. It’s a stamp of approval showing you’re maintaining knowledge in a competent way.



Who has impacted or influenced you in your career as a board-certified anesthesiologist?

There are many individuals who have impacted me directly, but as I reflect on my career, I think about all my peers and colleagues on faculty at Stanford. They are amazing physicians and incredible anesthesiologists taking care of very sick patients. To see them do that work is inspiring and has made me a better clinician. They each have unique skills and talents, and I’ve gotten the opportunity to learn from them.



Why did you want to become a member of the ABA Board of Directors?

At the Stanford University School of Medicine, we have a history and tradition of our faculty serving as volunteers for the ABA. In addition, I worked with two prior ABA directors when I first joined the faculty. As I worked with them and they mentored me, I saw how much they enjoyed their work with the ABA, which planted the seed for me to become involved in the organization in some capacity.



What value has volunteering for the ABA brought you both personally and professionally?

Volunteering for the ABA has been quite rewarding. For example, during the weeks we administer our APPLIED exams, I have the opportunity to connect with other anesthesiologists from across the country and hear what’s happening in their practices and institutions. ABA volunteers play a role in creating the future of the specialty by administering and developing the exams and our continuing certification program.



What ABA project or initiative are you most excited about?

The Board of Directors just finished our strategic planning process. We spent time discussing future scenarios and then, from there, created different potential strategic plans to address those various scenarios. After additional deliberation, a consensus about our priorities moving into the future was finalized. Every ABA director played a role in the process. I look forward to seeing the execution and implementation of the plan going forward.



What do you do when you aren’t practicing anesthesia?

I enjoy sports and getting exercise, so I spend my free time playing tennis and riding my bike around the Bay Area. My wife and I love traveling and hiking together. We also have two adult children—one in New York City and the other married with a baby girl!