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Episode 53: Why We Need More Anesthesiologists Involved In Policy And Leadership w. Dr. Vanila Singh

Jun 29, 2020

This Episode

Interview W/ Dr. Vanila Singh

You Will Learn

– Dr. Singh’s experience with being the “spokesperson” for the shareholders of her task force. 
– Dr. Singh shares some of her favorite leaders from history who have impacted her life the most
– Dr. Signh shares some of her favorite ways to unwind when she is able to find the time to do so

Resources & Links

This week, I talk to Dr. Vanila Singh about her experience in organizational and policy leadership. We talk about what it takes to stay strong when you get involved in politics and the ways that Dr. Singh’s career in anesthesia has uniquely shaped her to become an incredible leader. We also discuss why we need more physicians involved in all sorts of institutional decision-making in both government and healthcare organizations.

Justin (00:24)
This week, I’m talking to Dr. Vanila Singh about her experience in organizational and policy leadership. We talk about what it takes to keep an even keel when you get involved in politics and why anesthesia is a specialty that uniquely lends itself to leadership because of the perpetual managing of different stakeholders expectations. While at all times maintaining the primacy of patient wellbeing. Finally, we talk about why we need more physicians involved in all sorts of institutional. Decision-Making both in government and other health care organizations in order to continue to emphasize a patient centric mindset. I really enjoyed this conversation with Dr. Sing, and I hope that you enjoy today’s interview.
Justin (01:03)
Hello, and welcome to episode 53 of the anesthesia success podcast. I’m really excited to have a special guest with us today. Dr. Vanila Singh, Dr. Singh is the immediate past chief medical officer for the office of the assistant secretary for health at the us department of health and human services, which you may have heard of. She’s also a pain physician and an associate professor of anesthesiology at Stanford university. I’m really excited to have her here today to talk about her extensive experience as an anesthesiologist in public policy and leadership, public health. Dr. Sank. Thank you very much for being with us today.
Dr. Vanila Singh (01:36)
Great. Thank you for having me Justin
Justin (01:39)
To start off. I, so I recently learned literally right before this interview that the department of health and human services is a one point 3 trillion with a T dollar budget organization. So what is it like being the chief medical officer with such a huge behemoth?
Dr. Vanila Singh (01:57)
Yeah, so, I mean, when I first saw that it was amazing, right? So first of all, it’s so nice to be able to speak to everybody and share the experiences and really what that whole entity is like on that side of the world, in the federal world, and then large, large U S government with such enormous budgets that it’s humbling. And you think about how we may like hope for a little grant of $10,000 or something. And, you know, you’re talking about a large, large budget. Most of which, when you think about it really goes to CMS, the Medicaid, Medicare realm with lots of payments in that way. But also FDA C SAMHSA their CDC, which we know in, in today’s world, just how vital what their work is in terms of disease prevention from infectious disease to really, they got into the opioid and pain space. And, and so many of the other key agencies, NIH, which it’s huge budget for research. So yes, it is huge. It was unfathomable. And then you acclimate ultimately, you know, people are people and people are the ones that make organizations. They’re the ones that make their household. It’s just our folks. It’s people that we’ve seen in some form or fashion throughout our lives.
Justin (03:12)
So I was giving myself a little civics lesson, as I was trying to understand sort of where on the government org chart, the CMO of the department of health and human services sits and what I sort of discovered or correct me if I’m wrong was that it was basically like right next to the UTR, the surgeon general, as far as the, sort of the strata of our physicians in chief, is that fair to say,
Dr. Vanila Singh (03:34)
Yeah, it is, it is fair to say I, me and surgeon general, of course we all know Dr. Adams is there. He, they have a very, you know, important, specific purpose with public service announcements, et cetera. My office was very much in the weeds on all these documents that would come from across agency on a variety of different topics. I had the real privilege to update and brief our leaders in HHS. So HHS is the parent agency and Oh, Ash, the office of assistant secretary is within that one. And there wasn’t, there’s a CMO and HHS. So I was considered the COO at HHS in that parent agency realm. So I got to brief them on really important topics and got to take part in key meetings. It’s very humbling. There are a lot of people who are unsung heroes, so who work all the time and really make things happen.
Dr. Vanila Singh (04:27)
And then of course before you knew it, the Kara legislation of the best practices in our agency taskforce, which was mandated by Congress to have HHS set this task force up with the department of defense and the veterans affairs and the office of national drug control policy, the white house, all of a sudden I was given this huge task from really its beginnings. I sort of dusted off the paper and learned incredible federal processes. And then that actually really took a lot of my time and attention for good reason because it had everything to do with anesthesiology, acute pain, chronic pain, really things that we as anesthesiologist are very much familiar with and an opportunity to really begin laying down that foundation in a very formalized manner with so many other specialties and experts and especially patients. And so that ends up taking up a ton of time. Plus all the other things, it was like drinking water from a fire hose. There was no doubt about that.
Justin (05:34)
Can you can you describe the mandate of the task force?
Dr. Vanila Singh (05:36)
Absolutely. So the mandate was really two fold. One is it was established by Congress with very prescriptive folks that they wanted on there. So we had, we had to meet the criteria that was so specific in that, and it was to identify gaps and inconsistencies that exist in acute and chronic management. And remember the context of all this of course, was the opiod crisis. And the second thing was to lay out best practices. So really recommendations for those gaps and inconsistencies. So what we really did initially was first do kind of a, a national environmental scan of the status. So we gather to the best of our abilities cause they wanted us to Emily do this nationally, but we went to County guidelines, organizational guidelines. You think about as, or ACEP or what a County somewhere has. You know, people have guidelines about different parts of this and it’s enormous.
Dr. Vanila Singh (06:38)
And so taking that going through it because being not only the lead on it, but the subject matter expert on it really put a lot on my shoulders. And I was thinking, geez, my colleagues are going to be like, well, how did this get in? So we had to sift through that kind of make it containable addressable, knowing that we had a deadline, we knew the taskforce was gonna send set. And so I put all that together while also in parallel, we were having folks apply and then it goes through the whole process. It was, you know, we were so by the book, I had excellent people who have great integrity and there was no bias or judgment. I know so many great people who applied, who didn’t get on and people may not know that it wasn’t, that they didn’t, they didn’t have much to contribute.
Dr. Vanila Singh (07:32)
So many people would have, but we had criteria specifically laid out by Congress that we had to meet. And that included geographic representation. It included minority health representation. It included veterans service organizations. They wanted people with expertise in mental health addiction, and a variety of other different aspects and facets of acute and chronic pain. So it was a vital. So, you know, what we expected would be the anesthesiologist trained board certified pain management doctor, which I had an amazing number of applicants from, but that hat had been met very easily and early and with the best of the best, but we were really trying to meet the other criteria, including hospital organizations professional medical organizations. We didn’t want it to just be pain medicine organizations that had to be representing all our colleagues from rheumatologists. Say as an example, we didn’t have a specific one, but I had a hematologist who’s familiar with sickle cell to our surgeons, to our colleagues. And perhaps, you know, we had a patient advocate. I had brought on even some expertise to present to us who weren’t on our task force, like the Indian health services or CMS. And we got all stakeholders in this huge project. So how many of the task force
Justin (08:56)
Were there?
Dr. Vanila Singh (08:57)
29 total members at the end of the day, which literally in the beginning it looked like we would have 50 and unwieldy, unlikely to make any dent in any issue. So we’re very proud of the fact that there were 29 members in the best capacity with what we were given. Meaning there were folks who applied and then we were able to, sometimes someone could have two or three hats that we were able to checklist, you know, that they represented not only a certain part, but they also had expertise say in minority health, things like that, that really mattered. We were considering women’s health. We’re thinking about a multitude of things. You know, someone who has a familiarity with some of the challenges in terms of stigma, mental health. We had a pain psychologist from Texas a and M. We had two pharmacists, one from East Tennessee.
Dr. Vanila Singh (09:49)
The other one who works at the VA and we then also had federal members. I was a federal member, but there was also NIH, SAMHSA, FDA CDC. We had a representative from the department of defense, as well as the V the office of national drug control policy from the white house. And, and mind you, people came in with their own perspectives, their own experience and sometimes their own agenda. And to herd the cats really ended up taking a lot of time with a big public eye. We had three big public meetings that have a set agenda that have to be posted and ahead of time. And then people asked to speak. They flew in from all over the world or sorry, it really the country. And then we had organizations like the human rights organization that was super supportive of our work as, and that was a surprise how much they actually were following the issue, as well as the professional organizations from around the country. Some that are of course physicians, specialty like neurosurgery, ortho, palliative, and hospice medicine, of course the AMA, but we also had acupuncture, social workers. We had payers, we had the insurer group, you know, trying to ensure that they don’t end up having to cover everything, which we think they did. We need a full toolbox, you know? But we were very patient centered. Individualized care is what our real overall theme was.
Justin (11:13)
Did you ever have those 29 people all in the same room at the same time?
Dr. Vanila Singh (11:16)
Absolutely. Yep.
Justin (11:17)
And so I’d be interested to know, you know, take me to one of those moments when you’re maybe sitting, I’m envisioning just a huge boardroom with all these different stakeholders from all these different places. And probably like one of them is looking at that other one, cause they’re like, they, they represent these perennially at odds groups. Were there any like awkward dynamics or exchanges or somebody said something and then somebody else jumped in. I was like, Oh, of course, you know, the insurance, guy’s going to say that. And I was like, Oh, of course that specialist is going to be doing this. Were there any of those types of like tales from the trenches that you might share with us?
Dr. Vanila Singh (11:48)
The insinuations were made. I sometimes felt so we had three submissions. I had devised that we into three committees, sub committees where we worked behind the scenes, 75 subcommittee meetings which I was at all of them and led, most of them devise the PowerPoint agendas for them and named one person to head it. But everybody has a job, you know, so I knew that you can’t just leave it on their shoulders, but you sort of had to help them. And and each of the subcommittees had folks on it who had expertise that complimented what we broke out into the topics. So for example, one sub committee would be education access to care. And I believe they also, we threw in the complimentary integrative health section to even out the other subcommittee had medications, huge topic, right. Interventions, huge topic, and a, and one other, I believe it was restorative therapies.
Dr. Vanila Singh (12:47)
And then, and then the other one had the re I mean, it was, it was a breakout divvying up, but not too many. And so the thing is you, you identify very rapidly who has an issue with who, and I would say to the points of leadership as one is how do you command respect in this huge national effort, which it’s not an effort that can in my view, could not be lost, could not have I could not punch it. I didn’t want to lose that. Right. I don’t want to fumble this opportunity for our, our patients really as, as an in our profession to showcase it. So you have to command that respect. I think that becomes known when you’re respectful of everyone. I lived and breathed. I did calls that we, I had, sometimes our subcommittee chairs meet with me till four in the morning, East coast time.
Dr. Vanila Singh (13:39)
I’m not kidding. I wanted to get the work done, the work done. And if I was willing to do it, they were willing to do it. I picked people who saw the entire amazing purpose, really hard working. I had a great staff, great staff who were willing to work, like not, not normal federal. I brought that private sector mentality and they were, they were great because, and probably hugely annoyed too, because it voice not, not nine to five, it would, you know, on a dime something’s due. And they do actually have that experience because sometimes things come in for deadlines. Like we have to review it and get it done, put in our comments. In fact, that happens all the time. And my staff being in the office of the chief medical officer, we’re definitely, you know, all over it. And these are veterans of HHS.
Dr. Vanila Singh (14:30)
You know, one of my key people had been there for 30 years and circle the wagons and was, these are the key, you know, success people. So I always say, you have to have those folks recognize them. You know, there’s when you’re close encounters, it’s gonna, of course caused some annoyance of what I’m demanding and, and, and what was bringing to the table was an understanding of the trenches of how things really practically play out. But to your point about, you know, some tensions, of course there were tensions. I mean, sometimes I felt like I was having to break up a clearly brewing issue, which didn’t necessarily go away, but certainly in front of me, they couldn’t do it. And and even sometimes you yourself get pulled into the issue. When I felt like I had to say, you know, w we have to be patient centered.
Dr. Vanila Singh (15:24)
This is, these are patient comments and the thousands coming, we have to recognize it. This is what’s going on for these patients who are invested enough to give us these comments of their brave stories are very personal stories are putting it out for the public to see it doesn’t matter how it doesn’t work, or that we may not be appreciated. We have to address this. And so sometimes it may seem like, Oh, holier than though it wasn’t. I just felt like I was speaking to myself as well as them, that this something. So, you know, you, there were a lot of, lot of moments there.
Justin (15:57)
I’m sure that was nerve wracking walking into that first meeting, that first time and looking around and seeing 28 of your very, you know, intelligent, esteemed colleagues from all over the place who all have opinions and all have, you know, they think they probably have a desired outcome in mind. And they’re probably a lot of disparate opinions. And they’re looking to you to be the one to make their collective efforts productive. That sounds like it’s a lot of pressure.
Dr. Vanila Singh (16:20)
Well, preparation, I tell you. So the first real meeting we had prepared everything. We had folks from Cleveland clinic from Mayo university of Michigan, like excellent institutions. We had people from the front lines who are dealing in rural America with very little resources. We had folks who like the president of the Texas medical board was on the task force. And, and you know, the editor in chief of one of the big journals and, you know, people who are in their own, right. So well established have contributed so much. And then you can’t be the, you know, no, it also, I did always want to acknowledge that amazing experience and harness it and utilize it in a way that propelled us forward. And so it was hopefully never a, you know, someone who is more right than others or something like, or William like that, it was rather, you know, here’s our goals. Here’s what we need to do. Then we break it down and we created this huge document. That first meeting was all preparation, you know, ensuring and acknowledging who they were and their accomplishments and leaving no one out. So even when it seemed like somebody who may not have those accolades, cause they’re not in academia, but you know, it’s a frontline, a doctor who’s primary care who actually understands and deals with it day in and day out. And ultimately it’s about her, how you say those things really matters. Yeah.
Justin (17:50)
So it sounds like this, I’m sure this was a very you grew a lot in having to walk through this as a leader. I’m curious. Tell me about a leader or an experience of you experiencing someone else’s leadership that made an impact on you and has helped in some way inform or shape your own perspectives on what it means to be a leader.
Dr. Vanila Singh (18:09)
Yeah, absolutely. Yeah. You know what? I think of a lot of people, I mean, I think of historical figures I mean from, you know, someone like Gandhi to Winston Churchill, to maybe Abraham Lincoln and the aspirational terms of you think and stuff, but how challenging their situation was. And it’s not about that. We were at that level. Although I think for the pain community, it probably felt like that, but it was that, how do you take challenging circumstances nothing’s being handed? This is not a checklist thing. You’re not just getting adorned with the title and then you get to leave. That happens a lot. I think it makes people cynical. This was really challenging. And we were doing it with an honesty and an integrity, and it seemed overwhelming at times, you know, there, and there are people with different agendas, some darker forces than we even expected who are don’t care if there’s a callousness to it.
Dr. Vanila Singh (19:03)
But by far, the vast majority of people want to get the right thing done. What was really nice is that even our emergency medicine docs on our task force with one who was with the American association of poison control centers, who really appreciated the issues from a different perspective, but remain so compassionate and willing to work that we like we’re closing the circle really in terms of all the different dynamics that go into number one, pain care, but understanding where the intersection may be for people who are concerned about the risk of dependence and worse yet addiction and even worse yet overdose deaths. So that was really cool to think about those folks so that you always felt humbled. And then of course, like it was really in everybody that I’ve seen. I mean, I even think about, Oh, how does our chair handle, like all these different personalities and all of their different interests in needs and stuff.
Dr. Vanila Singh (19:57)
We only see ourselves in that one moment, but they’re doing it every day and you have to keep the balance. And you’re also not there to be loved your own, I mean, want to be loved, but you’re there to give a respectable conclusion to it. And I, once the committee got that, you know, that they knew that were willing to work hard. I would call everybody have personal relationships. I think then you start to see that you can move that tide. So yeah. You know, I also like sometimes it’s not until you’re in a certain circumstance, I say this to your audience that you learn of what you’re really made at. You don’t know where we’ve only really know what we can do based on our training, but who you actually are comes out in those sometimes not so comfortable situations for me. This was definitely one.
Dr. Vanila Singh (20:48)
I kinda thought I had something within, I just didn’t know. I, I could do all this and flight weekly or across the country and go to different meetings to speak and try to remain steadfast and honest to my colleagues. Cause I, what would keep me up is if some anesthesiologists, you know Stanford like, Oh my God, she’s, she’s our colleague. And she said that it’s just stuff like that. That keeps you real honest because you care about that. I also was really humbled by our patients. A lot of people around the country are suffering so much worse than we could ever imagine you. And if you stop and think about it, they’re being stigmatized. If their pain patients are being assumed to be drug seekers, and if they’re addicts are already judged badly and you’re thinking, what are the options out there for them?
Dr. Vanila Singh (21:36)
And many of them were being driven to the illicit black market. Some people were on a fine regimen, never had any issues. Doc gets scared because of some DEA lit a letter shuts down. And guess what? Suddenly out of desperation, someone is finding themselves in the worst of circumstances and the worst outcome happens. How do we not have an overreacting pendulum? And I think that became a real central theme that I didn’t know I could crystallize. And maybe you look back in your history and you look at yourself and you go, maybe that’s what I think I’ve always wanted to say, is that being balanced? And to take that into anesthesiology, we’re very solutions oriented and, and we’re enablers. You know, I’ve always thought about this because when I went there and I said, I brought in the private sector stuff, hard work, does it worry me?
Dr. Vanila Singh (22:27)
I want a good outcome. And I want a solution. And in this I felt like here, you see the whole task force as a big Orr case. That’s super complex and I wanted to get through it and I wanted to do it well and bring in every expert that we may need, ask what folks need to, but get it done and do it right and safely. And I wanted the good outcome. Our outcomes are only acceptable to us if the patient is alive and does well. And I really think that that training is so unique. I don’t think our surgical colleagues know that we see so many things happening all the time, and we are just about how do we help you? How can we make it happen? And I think that’s such a huge characteristic in terms of leadership. And it’s not as surprised why we see a lot of our colleagues running a hospital, they’re in administration, they’re running organizations, you see them and there’s suddenly like CMOs somewhere and they are, I’m not referring to me by the way.
Dr. Vanila Singh (23:29)
I mean, I’m thinking about private companies too. And our, our anesthesiologists learn the art of really taking a, you know, potential problem and bringing it to solution with a good outcome. And we also do run into, depending on where you practice, if you’re private practice, you understand the inner financial challenges. You, you actually are exposed to what our colleagues and other surgeries or procedures that could be dermatologist. They could be GI docs to write cardiologists. We get exposed to a lot of the challenges that exist in healthcare, and yet we’re there to enable the best outcome.
Justin (24:13)
Yeah. I’m curious, take me back to the beginnings of your interest in public policy. How did that kind of begin to form for you and what did your early forays look like?
Dr. Vanila Singh (24:25)
You know, it’s funny, cause I have had to think about that because people have asked and I look back and I remember my father took me when I was a kid to the inauguration of California, governor Pete Wilson. And that was so back in the day and I have this like foggy memory of it. And I realized my parents were very they’re immigrants, right? I mean, you look at their stories. It was really amazing that my father came here and he got a scholarship. He was from a family that really went through a time of destitution and then brought them really by the bootstraps up. And and then when he comes here, he like thinks various which is where we are, is heaven. And then he begins to take part in it. He was planning commissioner of the city of Fremont.
Dr. Vanila Singh (25:14)
He was he’s still with like the red cross. And he does stuff with the Alameda County and he’s, you know, in his late seventies, but he’s, he’s very much a part of the community. And, and then my mother got into it too, and they did sister city stuff. So I think, I didn’t even realize it cause they’re professionals, but you know, that, that probably just made it normal. My brother was an intern in the white house under bill Clinton. I know in that time era, which I don’t know if the audience is even that you’re with, but he just did it out and hearing was medicine and he was doing accounting. And, you know, we all at our dinner table talk a lot about policies, but I will reiterate in today’s world in an even balanced fashion. That’s what we believe in because we think this country is really super and gives great economic opportunity, but we have to always consider where we’re at.
Dr. Vanila Singh (26:12)
And it’s really just, I think an interest in maybe that goes from, you know, your ancestors and stuff, I mean, and what they used to contribute. And I think it really probably was just a natural and I didn’t even know that, you know, what I was doing was public policy until I formally started to do it. But I, I did take a lot of interests. I will say this one last thing and, and forgive me, cause I know I do run on, on things, but for the younger audience, I would say as doctors, we have to hold true to our oath to be balanced, to not advance any kind of political agenda because our patients can be of any right. We don’t discriminate. We don’t, we, we want anyone who comes to our care to feel like they’re getting the best care. It doesn’t matter.
Dr. Vanila Singh (27:01)
But policy and advocacy is only important in the sense that our voices are heard in our voices are important because they represent the voices of, of good, safe care for patients. And the idea that we are, we have at least in the past, been more quiet than I would have liked, I think has hurt our healthcare system and definitely has hurt our patients. And I would just say it’s really important to get out there and share to your patient number one, what you do when you have an opportunity to sign on to good things that will bring good care to do that, to be, even to know that other sides have their own constriction and when you’re really even, and your understanding of things, you can actually thread the needle and come to a solution that actually may go somewhere.
Justin (27:55)
Yeah, I think that’s a, that’s a great reminder. I’m curious, you know, as you transitioned from, I think being more as a, more of a physician in academic medicine and some policy involvement, but then becoming an important political figure, coordinating a policy effort that all of a sudden puts you in this category of you know, we mentioned a little bit before the call, people that don’t know you all of a sudden have really strong opinions about you and you become subject to greater scrutiny and probably like, you know, insult and you, you have to sort of change the way that you process these things that usually would be, I guess, hurtful or disorienting. You have to just kind of stay focused and shut all that out. I’m curious, how did that evolve for you? How did you grow into if you, if this is how it worked for you grow into an internal stability and you know, basically being able to put on your armor and say like, I’m going to go do it again today and I’m not going to let anybody stop me. Did you have that kind of evolution for yourself?
Dr. Vanila Singh (28:56)
I really like how you put that just in those really nicely I put on your armor every day. Yeah. That, that was the, you know, I ran for Congress. That was also a perfect storm, no plan to do that. And I’ve never had an aspiration to be a member of Congress or anything. It was a perfect storm, you know, sometimes things line up. And I think it was really what actually it’s clear that it led me to do this, which was something that was such an honor and a privilege, very humbling to be able to be there and do something in my own field at that right time. But that was a very eyeopening experience because of two things. One is you’re right. People criticize and they don’t, a lot of the criticism is a manufactured criticism from your opponent. You know, you’re like, that’s just a blatant all out.
Dr. Vanila Singh (29:51)
That’s not true at all. So when you learn that it hurts you less, but you do realize that it’s hard to correct things, right. That’s hard. And and I think that we took them off guard, but still I saw the willingness and the willingness to really go dirty. What was really the take home message though? Is that so many good people, so many good people of all party backgrounds of all geographic backgrounds, nationalities, ethnicities, especially the Bay area has that we’re so full, like, like just coming forward to help. And even though it was a really short run because it was so last minute, it was really only a few months, but I think we broke records, all kinds of records and got so much support that it did change me in the sense that I realized that if not you then who, and we should all ask ourselves that because we’re in a culture right now where people are screaming like, so and so should have done this and this should be done. That should be done. But there is no one else. What I’ve learned is you must do your part that, you know, we want to lead peaceful lives. I think sometimes I’m like, gosh, why, why did I get off on this road here? I mean, you know, I have two kids grade has been just vacation and why, and you know, like, like planner life, but it’s because you, you can actually make a difference and somehow balance it all.
Justin (31:23)
It’s clear that you could carve an easier path for yourself, but I, I really appreciate the fact that you think about impact and you think about the responsibility of the physician community and you take on that mantle and you’re, you’re you’re coming to play and, and you’re moving the ball down the field. And that’s really exciting to see, I’m curious in the context of taking on these huge challenges and being a public figure and also very busy, I’m sure as a, as a physician clinically, what do you do to deal with the stress on wine? Try to relax a little, how do you, how do you handle that?
Dr. Vanila Singh (31:56)
So some days are worse than others. I tell you, as I, as I write, like I did an op ed recently for our veterans and it was, you know, because I saw here’s a perfect storm, right? Our veterans are already subject to like a lot of challenges from their own past or Misty and have chronic pain issues. And then boom, you know, they’re, they’re like maybe a lot of them are vulnerable in the COVID era. And it was just really writing about like keeping sure about their mental health, et cetera. And I’m thinking to myself, I need to do all these things because I’m not doing that. And I think yeah, I, you have to, I’m not good at this. And I am trying though, to be better at it is to limit that, which you can do. So you do things well and you do it in a balanced way.
Dr. Vanila Singh (32:46)
It comes right back to that balance because then you have more to give and there’s super opportunities that come around. But I think just being even, and ensuring you have the help that you need and figuring that out, what, what helped you need. And I’m in that process right now to figure that out. But I love Netflix movies. I love great white sharks. I love Orca. I, you know, if I was, I’d probably be a Marine biologist, I love to dive. I love the ocean. So like, we’ll do a quick John to half moon Bay and like, just like the ocean. And those are for me, my Zen Zen moments, fresh air. I go on a walk, hiking call friends. I have a very, you know, I have a social side to me that loves like the music and stuff. And so as you’re getting in this, sometimes you catch yourself, you’re a little too serious.
Dr. Vanila Singh (33:35)
You got to not take yourself too seriously and make sure that you’re down to earth because I think that’s where you always are effective. Right. You have to be able to relate to people and be there to mentor them. Sometimes, you know, people will come to me and it’s a young person and can you write a letter of rec, can you support my effort and want to go get this degree or that, and those are priorities. And they make me feel good because that’s when you’re like, okay, I’m I’m me. And I like this. And I hope someone will do that for my kids in the right positions for it. Yeah. Have you had any mentors in your life or people that have helped to pave the way absolutely they’ve come in different shapes and forms at different stages? I would say you know, I trained the era that we trained in right before was really tough.
Dr. Vanila Singh (34:25)
Like we, my time of anesthesiology was like, we did not qualify for a grandfathering into the board, so I did subject to mocha. Right. But I also did. I missed the ADR rules. So I always say that we were, you know, right in that group. And it was, and I looked back, I realized it was folks who got me through those long, you know, really long hour weeks are our friends that I still maintain friendship with at Cornell and a C now. And then when they were happy to see me and, you know, like I was, I went around to like, I don’t know, 40 or 50 keynote talks, but when I went to Cornell to give grand rounds, that was a super moment, you know, this to be back. So because I get a chance to thank them and they were just, just being friends and, and kind was really important.
Dr. Vanila Singh (35:16)
UCLA, I was there for only one year in between graduating Cornell, my pain fellowship, and anesthesia residency at UCLA in just that year, I made lifelong friends who also were mentors because we were going through the same thing and watching how they were doing it. The chair of anesthesia at that time was super Patricia Cooper. And she probably doesn’t even know it still, but in that one year, she did so much. And of course, coming to Stanford and having the supportive of, of our current chair and others, it’s, it’s amazing because sometimes you wonder, what do they think that, you know, do they think this is, you know, good or smart and yet they’ll, you know, support me to do it. So I, I appreciate that. And very strong figures. There’s always someone out there who may not even know it was the phrase they said at a time, you really needed to hear it. Yeah. To me, that kind of mentorship, whether it’s long term or just a moment, I never forget. And, you know, hopefully we all stay helpful to them. That’s what I want to be to them and others who come my way, because it is life changing.
Justin (36:31)
We shared before the call a little bit talking about the importance of physicians in decision making roles, institutionally, organizationally, and also with policy. Maybe you could just take a minute and sort of share why you think that’s important if you think it is. And, and for the listeners of this podcast, a lot of anesthesia and pain physicians, themselves, many future leaders. Do you think that anesthesiology is a uniquely the way I think it is a uniquely composed specialty that I think is going to probably have more leaders per capita. And it’s funny, you know, right now I’m thinking about oil, we’ve got Dr. Adams and we’ve got you, the, our anesthesiologists and chief who are, I think, bearing that out. How do you, how do you think about that in the context of physicians in decision making roles?
Dr. Vanila Singh (37:19)
Absolutely. So you are so right. I think we will have more per capita leaders from anesthesia. And that really, again, goes to what I was stating earlier is our ability to be solutions oriented. We are uniquely in a different manner trained than others. We’re doing ICU care every day in the operating room, right? I mean, if a case is straightforward, it’s straightforward, but if it’s more complex, it’s really ICU care. We have skillsets physical skillsets and on the spot decision, making, being preemptive, thinking about a certain plan and we’re enabling things, we rarely have the opportunity to opt out, opt out of something. We’re all about patient safety. We created the field really. We created the field of critical care and, and, and really pain where it is. And that’s amazing. I think we’re going to continue to evolve and utilize this and move the field of medicine forward.
Dr. Vanila Singh (38:19)
I, I just think those skills are so amazing. Whenever something suddenly happens in an emergency type of situation, I really feel like I come into my own. It’s like grace under pressure. And I think that’s true for most anesthesiologists, we are trained those moments and that’s, those are like great abilities, crisis management, conflict management, all fancy terms about things that we do every day. So I’d like people to think about that because how you use those skills, just the key thing is this don’t, don’t sell your soul, don’t sell your principles even as you go up higher. And it’s an harder battle because you have other stakeholders, you have to remain true to that, which, you know, is there whenever that moment came and someone was saying, you know Oh, interventional procedures for pain are not, you know, they’re just over, you know, some sort of moment, you have to still stand up and say, listen, the vast majority, et cetera, dot, dot, dot, and follow through with what you want to say, what you believe. You can say it in a really smart, strategic way, but don’t just hold true to your principles. Yeah.
Justin (39:29)
I really appreciate your time today. Dr. Sing. I want to ask one last question, then we’ll wrap it up your, your career trajectory and the way which you’ve applied yourself. It’s, it’s obvious that you have, you’re immensely accomplished. And there’s a lot of things that I’m sure you could point to as things that you’re proud of moments when of professional or policy validation. I’d love to just close with a brief story of one of those moments where you, after a lot of effort and a lot of time, and a lot of mental, emotional energy, you had some breakthrough or some accomplishment where you, you thought, you know what, I’ve, I’ve given a lot and I’ve been through a lot, but in this moment I can experience the joy of the accomplishment and see the progress that’s being made.
Dr. Vanila Singh (40:15)
Oh, so the moment that I enjoyed at all, yeah. Oh, geez. I, you know, I’ve had a lot of reflection over these months because it was so fast paced. I felt like those years, it was like 10 years compressed and just a short time, maybe longer. I have so many memories and I reflect on it and I, you know, kept a lot of things and I look at it and I really thank God that I had, you know, or think the larger whatever universe, whatever people believe in the larger forces that I had, the right people at the right time. It w it, I always believe in that sort of maybe whether it’s destiny or whatnot, it was really amazing. And I really started to first understand it and appreciate it. I went to Japan with my kids and my husband right after, and that was such the perfect place to go do this.
Dr. Vanila Singh (41:08)
We were at temples and we were like in beautiful like scenes and the country, so great. And I was able to really stop and say, wow, this was really something that I could be proud of. And what’s great is I remained very close to my, the task force. And you know, it’s amazing that I can bring them for efforts still. And I think it’s because by some chance and luck in life and maybe coming into your own, you know, you earn the trust of great people and they bring out the best in you and, and hopefully the other way around too. Awesome.
Justin (41:51)
Well, thanks for sharing that story. And Dr. Sing, it’s been a pleasure having you today on the anesthesia success podcast.
Dr. Vanila Singh (41:58)
Thank you, Justin. It’s really, it was great. Fun. Appreciate it.
Justin (42:04)
If you liked what you heard this week, head on over to anesthesia success.com, where you can find more content and free resources to help you build a successful career in anesthesiology and pain management. If you want to leave a review in iTunes, I would also really appreciate it. Thanks for using some of your valuable time to join me today on the anesthesia success podcast.

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