Prakash Chandran
(Host): Intensive care doctors specialize in saving the lives of seriously
injured or critically ill patients. In an intensive care unit, it's the medical
director's job to coordinate these physician services and make sure patients
are getting the best care possible. Here with us to discuss is Dr. Michael
Patz, a critical care medicine specialist, anesthesiologist and ICU medical
director with San Juan Regional Medical Center.

Host: This is Celebrate Health, a podcast by San Juan
Regional Medical Center. I'm your host, Prash Chen. So Dr. Patz, thank you so
much for joining us today. I truly appreciate your time. I'd love to get
started by you sharing a little bit more about your medical background and how
you specifically got into this area of medicine.

Dr. Michael Patz: Of course. So, I grew up around the
Four Corners area in Grand Junction, Colorado. I went to the University of
Colorado in Boulder for college. And then following that, I moved to Boston,
where I went to Harvard Medical School and then did my anesthesiology residency
in Seattle, University of Washington. And then following that, I came back to
Colorado for a critical care medicine fellowship. That was at the University of
Colorado in Denver.

Host: And Dr.Patz, you always know that you wanted to go
into critical care. I'm curious as to what drove you into that specific focus
area.

Dr. Michael Patz: That's a good question. Actually, I
tried not to go into critical care, but I think it might be in my genes a
little bit. My dad, he's a pulmonologist and also practiced critical care in
Grand Junction. And my grandfather on my mom's side was an anesthesiologist and
an intensivist also. So, I knew it was a lot of work. And for that reason,
initially tried not to go into medicine and then, certainly, I was not looking to
go into critical care just based on that alone. But once I got into learning
about all the different fields in medical school, I think it was just so
satisfying to take care of patients that so obviously were in need. We take
care of some of the sickest patients in the hospital and to be able to really
rapidly turn some patients around and save their lives is extremely satisfying.

Host: Yeah, absolutely. So, I know that you are the ICU
medical director. What exactly does that role entail?

Dr. Michael Patz: Well, that's a good question. I think
it encompasses a lot of things. But mainly, I get to work with an incredible
group that's really a multidisciplinary team, that's some other physicians, the
ICU nurses, our pharmacists, our respiratory therapists, our dietician, our
physical therapist, our chaplain, our social worker and we work together on a
variety of things to improve the quality and the value of the care that we
provide. And I think my role as a leader of that team is to really help set
some strategic priorities, focusing on big picture goals really to ensure that
our ICU is providing the state-of-the-art care and also cater that care to our
unique local environment that we serve. And so, that's one component.

I mean, I think the other component that really I think the
most exciting for me and for the hospital at this time is serving as sort of
founder intensivist or leader for this new intensivist physician group that's
going to be providing onsite physician staffing with critical care expertise every
day of the year. So, I think that's the most exciting thing for the hospital
generally. Because even while prior to this, the hospitalist and the nurses,
the respiratory therapists were all delivering excellent care, the hospital
still realized that with how many sick patients we serve in our ICU, there is a
need for that extra level of expertise. And that's something that unfortunately
hasn't become a standard, especially in rural ICUs. But it has been shown to
dramatically improve patient outcomes. For example, in a lot of studies
comparing hospitals where intensivists do staff the ICUs onsite every day,
there's 40% reduction in ICU mortality. So, I think seeing the take the
initiative to bring us in and for me to be able to take that role is really exciting.

Host: Yeah, absolutely. So, there's a couple things that
I want to highlight there. The first is that, in the ICU, there really does
seem like this big multidisciplinary team of people. You mentioned ICU nurses,
pharmacists, chaplains, there's so many different people and you like basically
orchestrate or coordinate them to provide the best care to the patient.

And the second thing, and I imagine this is another boon to San
Juan Regional Medical Center, is really being that founding leader for this
intensivist group, right? Like someone that focuses on critical care for
patients that can produce better outcomes because of that critical care
knowledge and the multidisciplinary team. Is that correct?

Dr. Michael Patz: Yeah, that's spot on. That's exactly
right. And then, we also provide an additional level of support for all non-ICU
services. Just having us there for if a patient does become a acutely ill, I
think, can be supportive to them. And then for other services, we can really
serve as a backbone where patients may more routinely go to the ICU like after
surgery for major neurosurgeries, trauma or cardiothoracic surgery or major
vascular surgery. So, we help create the infrastructure for that.

Host: Yeah. Given your experience in this critical care
setting, I imagine that you have a lot of experience, working not only with
patients but with families as well, what advice might you give to our listeners
around just what they should know about the critical care setting?

Dr. Michael Patz: Yeah. So, I think the first thing to
realize is that any ICU admission, it's extremely rare that any ICU admission
is a planned thing. So, they're almost exclusively unplanned. And as with any
hospital admission really, you don't know when you're going to get sick, you
don't know when you're going to get in a car accident. And a large percentage
of patients once they reach the ICU, it's impossible to comprehend the
situation you're in and oftentimes you need someone else to make medical
decisions for you.

So, it's our goal always to understand your wishes as a patient
and to honor those and to care for you in the best way that we can. And for
that reason, it's really important for anyone in the community, whether you're
a healthy person in your 20s or 30s or in your 80s with multiple medical
conditions, you want to think about, when you come to the hospital, if you're
sick and you're not able to make decisions for yourself, who do you want to
decide, who should make those decisions for you? And talk with that person or those
people and start to think about the kind of care that you want and what your
sort of goals would be if you're so sick that you need to be in the ICU. I
don't want to go in too much detail about what to think of in terms of the
goals of care. But perhaps that could be another cast for the hospital.

In terms of what family should think about anytime close family
or a loved friend is in the ICU or just in the hospital or very sick, it's a
tremendous value just your presence in the hospital being with your loved one
or your family member. It's actually been shown in clinical trials to have a
very significant clinical effect in terms of outcomes. And it's also important
to be able to communicate on the patient's behalf and really communicate what
their values were, and how they would want to be cared for.

And one more thing to note there. So, we have multidisciplinary
rounds in the icu every day at 9:30 in the morning. We always invite family and
patients that they're able to be present for those multidisciplinary rounds
where we get together with the various physicians, our pharmacists and our
nurses, our respiratory therapists, physical therapists, and we all come
together and think about the patient together and think about what our goals
are for the patient that day. So, we always welcome family presence for those
rounds.

Host: Yeah. That is just so good to know because it's
obviously a difficult time. And just having some answers and being able to talk
to people that know what's going on, different perspectives, I think all of
that really helps. So, Dr. Patz, thank you so much for your time today. I
really appreciate it.

Dr. Michael Patz: you're welcome. My pleasure. Thanks so
much for having me on.

Host: That was Dr. Michael Patz, a critical care medicine
specialist, anesthesiologist and ICU Medical director with San Juan Regional
Medical Center. Thanks for listening to this episode of Celebrate Health, a
podcast by San Juan Regional Medical Center. For more information about San
Juan Regional Medical Center, you can visit us online at sanjuanregional.com.

If you found this podcast to be helpful, please share it on
your social channels and be sure to check out the entire podcast library for
topics of interest to you. My name's Prakash Chandran. Thanks again for
listening. Be well.