Aiding in the advancement of a new program in Houston is a big task. Aiding in the growth and development of a profession is an even bigger one. Thankfully Sam Gumbert M.D. is up to both challenges. He currently serves as Medical Director of the Master of Science in Anesthesia Program at Case Western Reserve University - Houston location. In this role he helps advocate for the Certified Anesthesiologist Assistant profession in Texas.
In talking to Dr. Gumbert, it is clear that he is passionate about what he does. He genuinely enjoys his work, and enjoys education itself. Dr. Gumbert feels privileged to be able to help others, and he is a strong proponent of the MSA Program. As he has observed, the Texas Medical Center benefited greatly from the introduction of CAAs. Read on for more of his story.
Have you always been interested in anesthesiology?
No, actually. This is a third career for me. I originally received my Master’s in Audiology. I studied ears, speech and language pathology as an undergraduate, and afterwards as a graduate student for my master’s degree at The University of Texas at Austin. Then I went into medical school thinking I would specialize in otorhinolaryngology and become an ear, nose and throat (ENT) doctor. I matched into ENT after my first year of medical school. After my internship I changed to anesthesiology. It was kind of a blind leap of faith. A former chairman of the anesthesiology department called me up and basically said that he thought I was a nice kid and wanted to offer me a job, so I took the leap. Thankfully it worked out very well.
The cultures between ENT and anesthesiology are very similar. It was helpful that there’s a lot of overlap between the two programs. The two specialties coupled much of the same anatomy, physiology and complex air management. Also I felt privileged to be surrounded by exceptionally wonderful people.
How did your involvement with Case Western Reserve University's MSA Program begin?
I started as assistant residency director in the department of anesthesiology. In my first year I lead the internship training program and changed many components of it. Basically I overhauled the program in order to modernize things in line with the ASA perioperative model that was being introduced at the time.
In my third year out as a faculty member, my colleague and her husband received new jobs and moved to Utah, which opened up the Medical Director position at the MSA program. My chairman at the time asked me, in light of the success I had while serving as internship director, if I would take on the position. There had been a fairly rapid turnover of two prior medical directors with the CWRU Houston program in successive years prior to my coming in. I think they wanted someone familiar who had an interest in CAA training as well as a broader education to get involved in the program. I believe they also wanted to try and find a measure of stability. It fit like a glove, and I really enjoy educating our graduate students.
When the program came to the Texas Medical Center there were no mid-level providers at all at the hospital. How many are there today?
We are currently at 37 anesthetists within the system at the primary teaching hospital. But we are looking to hire an additional 5 anesthetists this fall. There is potential growth of about 10 to 15 providers within the next three years. We’re building a whole new trauma institute. That will increase the operating size by about 20%.
Can you describe that transition?
It was a unique experience. We had been an all MD practice for 50 years and we have a large residency program. It raised some questions. How do you fit in trainees as it relates to our CWRU graduate students with residents? How do you prepare and nurture both groups? We faced also the cultural change of implementing a care team model.
It took time and we ran into lumps and bumps along the way, like any family or large employer/employee relationship. But it worked out for the best in the end. Good communication and commitment by the leadership on both sides has really fostered an incredible relationship. Mutual respect promotes growth throughout our system, the city of Houston, and the state of Texas. When we look back over the past six years, every metric that the hospital values has improved: utilization, efficiency, cost, quality, and care. There has also been a significant, positive reception of the CAAs from the University and hospital administrations and the community at large. These partners and their commitment have been instrumental to the success and maturation of the CWRU program in Texas.
Looking at the CAA model within our system, we went from improving our quality metrics as a hospital to becoming the busiest trauma center in the United States! We were recently rated in the top 10 for hospital quality metrics and outcomes.
Why are you a proponent of the CAA profession?
I initially dipped my toe in because I love education. For me it was the somewhat self-serving fulfillment of educating future CAA practitioners. That role has evolved over time into greater leadership roles that has let me see and experience more of the program. From serving on the national accreditation board for CAA programs, and moving up to resident director to vice chair within my department, I’ve seen the outcomes of a strong care team on patient outcomes.
The team atmosphere, communication, and outcomes really do speak for themselves. It’s a group of eager 20-somethings who are really excited and passionate about medicine. Their drive comes from all of the right reasons: a love for what they do and a desire to help people.
What advice would you give to someone who is thinking about joining the CAA program?
I’m someone who always believed in helping your fellow man and training the future of healthcare. My advice would be to do it for the right reasons. This isn’t an easy path. Students study and work very hard, but they get so much fulfillment from the work they do. They get to be a small part of their patients’ lives. CAAs are able to hold someone’s hand and shepherd them through some of their worst moments. I would advise someone to keep sight of why we work so hard to be successful.