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The Department of Anesthesia, Critical Care and Pain Medicine spotlights Jean Kwo, MD.

Featured Doctor: Jean Kwo

06/Feb/2009

Jean Kwo, MD

Jean Kwo, MD

Jean Kwo, MD, medical director of Mass General's Pre-Admission Testing Area (PATA), went from networking computers to networking people.

As a student at MIT, she majored in electrical engineering. After she graduated, she worked at Wang Laboratories, networking local computers. Two years later, she decided to attend medical school at the University of Massachusetts.

"I wanted to work more with people," she said.

After graduation, she finished three years of a residency in surgery at the University of Massachusetts Medical Center.

But Dr. Kwo's career took another turn when she discovered an affinity for the field of critical care, which she explored as a resident in the intensive care unit.

"I liked taking care of sick patients," she said. "And I didn't mind being up all night."

Dr. Kwo realized the best way to enter the field was to become an anesthesiologist. She went to St. Elizabeth's Medical Center in Boston for her anesthesia residency.

"My mentor said, 'If you want to go into critical care, the best place to go is Mass General,'" she said.

After completing her critical care fellowship, Dr. Kwo joined the staff at Mass General. She worked as the co-director of the Respiratory Acute Care Unit (RACU) for a year before Dr. Peter Dunn offered her the opportunity to lead PATA in 2004.

PATA's purpose is to evaluate, assess and prepare patients for surgery at Mass General, according to the clinic's website. Patients meet with PATA doctors 1-30 days before surgery.

According to Dr. Kwo, PATA's patients fall into two groups: relatively healthy patients with stable medical conditions, known diseases and documented clinical statuses, and patients with medical conditions that are not well-controlled. The second group of patients presents a more difficult challenge, she said.

"We have patients who discount their symptoms and don't discuss them with physicians" until they meet with PATA, she said. Another issue: Patients with medical conditions that remain undiagnosed until they come to PATA.

In every case, PATA physicians take the time to make sure patients get the best possible care.

"Our goal is to not only find out about the patient and make sure they're ready for surgery, but to allay their fears, so on the day of surgery they know what to expect," Dr. Kwo said.

The clinic sees about 60 patients a day, she said: "It's busy, but I like that we get to spend individual time with patients. They get the time that they need."

One of PATA's strengths is its team approach, Dr. Kwo said. The clinic works with all of the patient's caretakers to provide a comprehensive approach to treatment.

In one recent case, a patient needed surgery to remove a brain tumor, but had poor lung function. Radiation oncologists were reluctant to treat the patient with radiation because of the risk of swelling in his brainstem, and his physicians weren't sure if he would be able to undergo brain surgery because of his pulmonary problems. PATA coordinated a conversation among radiation therapists, brain surgeons and neuroanesthetists to determine the best treatment method.

After "five days of emails" among team members, she said, the team finally decided to go ahead with surgery.

Because of the well-coordinated care, the patient did very well, she said.

"He had the surgery on a Friday and was out of the hospital on Monday," she said.

A few years ago, Dr. Kwo herself underwent minor surgery. She said the experience affected her work at PATA and her interactions with patients in a positive way.

"I have a better understanding of how patients feel," she said. "Even if you do this every day, it's very different when you're the patient."

Anesthesiologists, she said, are uniquely able to understand all the possible medical and surgical complications of a procedure and coordinate the discussion among caregivers.

Dr. Kwo's latest project is working to optimize the process of meeting with patients at PATA and assessing how the clinic can help operating rooms to run more efficiently. The project is in its early stages, she said, and will involve evaluating and redesigning PATA's operations.

She praised the opportunities available at Mass General.

"I really like being here," she said. "It allows me to do a lot of different things I enjoy: staff the RACU, run PATA and take care of patients in the OR."

"I get to participate in the whole spectrum of patient care," she said. "No other place would let me do this."

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