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Member Spotlight: Dr. Michael Fabbro Effects Culture Change Through Leading by Example


For Michael Fabbro, DO, the “busyness” of a thriving cardiac surgery service served as inspiration to pursue a business degree. In this ASA Member Spotlight, he discusses how hard work, smart management, and a commitment to mentoring the next generation of leaders are the key ingredients to continuous quality improvement.

You serve as Site Chief of Cardiothoracic Anesthesia at the University of Miami Hospital and Clinics, one of the busiest cardiac surgery services in Florida. How do you stay on top of things?

The most crucial part of a busy surgical service line is the team. We have an incredible cardiac anesthesia group, including our tech Galen Smith and my closest colleague Pankaj Jain, MD, who have been instrumental in forming our process.  The remaining faculty is a diverse group from many of the major cardiac surgery services across the United States. Joseph Lamelas, MD, the surgeon, has also assembled an all-star nursing and surgical tech team. This has created an environment that remains efficient and delivers the highest quality care even when key members of the team are absent.


How does your work ethic inform your role as program director for a cardiothoracic anesthesia fellowship. What qualities do you like to see in the anesthesiologists you help train?

A major theme in any anesthesia career is support. Like many anesthesiologists, I use a hard work edict to support the clinical mission of our hospital, the academic mission our university and the education mission of our trainees. It is important that each stakeholder feels their needs are being supported. This lead-by-example approach is meant to mentor trainees into supporting the missions of whatever organizations they move onto with the same thoughtfulness.


You’re currently pursuing an MBA. What inspired you to add this credential to your CV, and how do you anticipate putting it to work?

As anesthesiologists we have the unique perspective of functioning within multiple teams in a single day. It is apparent that not all teams deliver the same level of quality and efficiency. I have always spent a lot of time thinking about how to take a microsphere of high quality, high efficiency and translate that into other microspheres within an organization. I feel much of this type of influence is cultural and comes from the “top.” In respect to this, I frequently consider my career path and my failures. This has led me to pursuing an MBA in effort to position myself where I can provide the most influence over this type of cultural change. The University of Miami also offers an Executive MBA with a health focus, which was a big part of this decision. Lastly, I couldn’t pursue any of these interests without the support of my Chairman.


You serve on the University of Miami’s perioperative leadership team, and you have a strong focus on efficiency and culture change. What do you think are the biggest barriers to culture change in surgery care, and how are you working to overcome those obstacles?

Every organization desires efficiency. Most traditional top-down management styles use key performance indicators as way to measure and drive these initiatives. This is not a bad practice per se, but if every problem area identified is not addressed this can appear punitive to many members of the team. Even more developed process change methods, like Six Sigma, can share this issue. In respect to this, buy-in is key. A true partnership between C-suite leadership and departmental leadership, with a clearly stated mission is essential. Defining roles, routine feedback, and incentives all aligned with this mission are the first steps to wide buy-in. Transparency in how these missions are being met is also an important element.


Is there anything you’d like to discuss that we haven’t yet touched on?

Mentorship. There are so many great people in the anesthesia space trying to find their way. In leadership positions it is imperative to think carefully about mentorship. Harnessing people’s strengths and demonstrating an interest in their successes is a great way to your own success. It goes without saying that when patients do not have the desired outcome, no one wins.  Careers are not that much different. Circling back to the previous question, leading and collaborating in a way that brings everyone up is also a great way to get buy-in and have the most impact on culture. Lastly, I would like to thank the ASA and @Carla Cordova, MD, an incredible anesthesiologist, for nominating me for this spotlight.

Michael Fabbro II, DO is the Site Chief of Cardiothoracic Anesthesia at the University of Miami Hospital. He also serves as the Medical Director of Perioperative Services and the Adult Cardiothoracic Anesthesia Fellowship Director. He is in the final stages of an Executive MBA at the University of Miami.


ASA Community Blog is published as a benefit for ASA members. The views expressed on this blog are those of the individual contributing writers only and do not necessarily represent the opinions of ASA.