Working in a rural environment may require a little more reflection on what are the essential equipment needs and what is the essential information you need from others to accomplish your case. You also have to think more about the post-surgical care that will be needed since not all of the special care options are available in-house. The patient having a serious complication or need of extensive care may mean a helicopter ride or a several hour road trip for the patient. The question of should vs. could is a common topic.
What I feel is different is the attitude towards physicians in general. Whether or not the patient wants to seek care for a problem, there is a healthy deference towards the opinion of the physician regardless of their specialty. The patient expects you to be the expert in your phase of care and to do your job well. They also do not enjoy expansive detailed explanations of all the risks. Another peculiarity is that if they have come seeking care, it’s not going to be a simple or early presentation. With two crossing interstates, we get a multitude of travelers, over-the-road truckers especially, with acute health problems that we treat also. There have been many times that the dial-up translation service or (though I personally have never used it for patient care) Google Translate has been an immense help.
For the most part, working in a smaller community means you interact more with your patients and staff outside of work more than at a larger facility. And you could be easily related or become related to the staff and patients.
In 2018 you traveled to Guinea as part of a medical mission trip organized by Mercy Ships. What was your experience, and would you recommend it to others? Any advice for those who are thinking of embarking on a similar mission?
Participating in the Mercy Ships Mission has been a life changing event for me. The donation of my time and skills rather than just my treasure was a great renewal for my appreciation of my love of anesthesia. Since the entire mission is based in a country for longer than two weeks or a month, longer care plans and activities can be accomplished. In addition, there is a heavy focus to train local health care providers to serve their populations better.
I served for two weeks with a multinational anesthesia team, and I participated in operations for conditions that I only read about before. But the patients had been medically optimized prior to presentation to the operation theater. They are functioning as a Perioperative Surgical Home for multiple surgical specialties. The patients are immensely grateful for the care they are given, and they show it at all times.
I would highly recommend it to anyone, especially to those who are beginning to wonder if what they do matters. Especially now that the new vessel is online, I would love to get back. The biggest advice I would give to someone planning to go would be to ensure that you allow a readjustment time on your return.
You’re a member of the Society for Technology in Anesthesia (STA). What do you think is the role of technology and innovation in the specialty, especially given the COVID-19 pandemic?
Technology and innovation are the driving force behind the safety of anesthesia care today. I genuinely enjoy being a member because of the exchange of ideas that occur at the meetings. I also have relationships with leaders in academic and research that I would not have in a small practice setting. Seeing the development of products both hardware and software that expand patient safety and better applications of the data available in our information streams and challenging the developers to make their useful product practical and available to small practices is exciting to me.
Anesthesia rarely gets product development as a solo specialty, but we are quite affected by the novel medications and surgical techniques and we must evolve around these scenarios. A particular evolving problem for me is that the newer focus is on big data and its impact on anesthesia. While I understand the concepts, I get lost in the minutia, but I can see the impact it will have on my practice and want to make it practical to all small practices.
During the height of the pandemic, the STA members had an open exchange of information on how to repurpose anesthesia machines as long-term ventilators, how to share one machine between two patients, evaluation of novel devices for patient and staff safety, and how 3D printing could be used to overcome specific problems. I’m sure that the big data people are currently working on articles and research on the impacts of COVID-19 to the anesthesia world.
You’re also active in your state component, the Illinois Society of Anesthesiologists. How did you first get involved, what’s your current role, and how do you think your participation helps make you a better physician and/or moves the specialty forward?
I became involved in the state society shortly after starting practice in Effingham. I went to the meeting looking to earn some CME’s and was intrigued by the following. The president of the society was from Peoria, IL and talked about the challenges facing the downstate practice. Also, I was asked my opinion by several ISA Board and other members about these challenges and their impact. I have remained involved since.
Currently, I am a section chair in the 4th district of Illinois. District 4 covers more than 80% of the landmass of Illinois and my section covers basically from I-70 south to the state lines. I remain active on several committees and participate regularly in the Board meetings.
Participation in our legislative days and events has helped me advocated to the advantages of physician led, team anesthesia care. Also, interaction with members that are at the residency programs keeps me abreast of changes in our specialty.
Is there anything you’d like to talk about that we haven’t discussed?
I would encourage our society to promote more interaction between residents and small rural practices. Life in a small community has its unique challenges, but the rewards can be enormous. I realize that the economic difficulties generated by the lack of passthrough to physicians can be a factor in practice management, but the patients in rural areas need, nay deserve, the expertise and care that our members can provide.
John C. Sudkamp, MD, lives in Sigel, IL, with his wife of 30 years, Hope Knauer, MD. They have three adult children and are currently fostering four teenage children. He works at HSHS St. Anthony’s Memorial Hospital in Effingham, IL, where he has served as Director of Anesthesia Services since 2011. He is currently active in the ASA, Illinois Society of Anesthesiologist, Society for Technology in Anesthesia and the Effingham County Medical Society. Dr. Sudkamp is a member of St. Michael the Archangel Catholic Church and the Sigel Knights of Columbus.