Tuesday, November 3, 2009

Featured Doctor: Aalok Agarwala

Aalok Agarwala, MD
Aalok Agarwala, MD

Aalok Agarwala, MD, was not prepared for the cold when he moved from Southern California to the East Coast.

After completing his internship at New York University Medical Center, he had a "little taste" of what East Coast weather was like, he said. But Boston was a different story.

"When winter started, I went kind of crazy buying coats and boots," he said. "Then I'd look out the window and see that it was clear and sunny. That first winter, I kept making the mistake of looking outside, seeing that it was clear, and going outside in a light jacket. When you look out the window and see that it's clear in Los Angeles, it's probably 70 degrees — not quite the same in Boston."

Now, however, he's used to it.

"It's hard for people from Southern California to get acclimated to Boston in the beginning. But you buy a good coat and some boots and it's all okay," he said.

Dr. Agarwala joined Mass General after completing undergraduate and graduate degrees, including an MBA at the University of California, Los Angeles. Although he planned on going into medicine, anesthesia wasn't his first choice.

"I was planning on going into emergency medicine, actually, and was moving in that direction," he said. "Then I did an anesthesia rotation to get more experience doing procedures, and realized that everyone I met was really happy doing anesthesia."

Anesthesia offers a "wonderful blend" of knowledge, application, physiology and pharmacology, he said.

Dr. Agarwala said what he enjoys most is clinical care, as well as working with Mass General's "smart, dedicated, hard-working" residents.

"I do a lot of vascular anesthesia, and the most exciting part of my job is getting to do what we call the big cases: sick patients who have lots of physiologic changes during the operation," he said.

Dr. Agarwala is also interested in the intersection of business and medicine, including cost, quality and OR efficiency. He became interested in health policy and economics at UCLA, where one of his projects involved reorganizing a comprehensive spine center practice.

"While awareness of the economic impact of clinical decisions is essential to making medical care possible for the greatest number of patients, it's best when the 'business of medicine' is behind the scenes," he said. "In an ideal world, the physician shouldn't have to think about the business side of things when they're involved in clinical care, but in today's healthcare environment, that's not always possible. At the end of the day we have to balance the books, but it shouldn't be the driving force."

The work is challenging, he said, because "there's a limited number of resources, there's a lot of work to be done, and we have to use the resources we have efficiently."

Dr. Agarwala's current projects include working on reorganizing the staff call system, as well as participating in the Finance and Compensation Committees.

"I've spent a lot of time recently working on trying to come up with a system that allows our physicians more flexibility" in scheduling, he said. He also recently had a medically challenging case submission accepted for presentation at the American Society of Anesthesiologists (ASA) conference in October.

"I think that's one of the great things about this place. The cases that are newsworthy at the ASA are routine cases for us here," he said.



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