Speaker 1 (00:05):Welcome to Hospitals in Focus from the Federation of American Hospitals. Here’s your host Chip Kahn.

Chip Kahn (00:14):Dr. Ana Pineda joins me today on Making the Rounds. Ana is the Associate Medical Director of Emergency Rooms at HCA Florida, Kendall Hospital, as well as HCA freestanding emergency rooms, Doral and South Kendall. Ana started with HCA Kendall Hospital as a resident, and is now leading some of the busiest ERs in south Florida. Needless to say she has her hands full. So I really appreciate her taking time to talk with me. Ana, thanks for being with me today.

Ana Pineda (00:46): Thank you for having me.

Chip Kahn (00:48):Ana, to get started, can you tell us a bit about why you became a doctor?

Ana Pineda (00:52): Sure. So I’ve actually worked with doctors since I was in my mid teens, around 15, 16 years old. I took a small part-time job after high school, and I worked at an ENT office. It was a very nice community, basically the community that I work in right now. And I saw the interaction that these doctors had with their patients aside from treating their diseases. They built these very meaningful relationships where people would keep coming back. And they were coming back not only to get their ears checked out or their throat checked out, but sometimes just to talk to the doctor. So I really appreciated that relationship that they built, the bonding that they had with the community. And that kind of triggered the whole go out there and pursue medicine concept that I went on and it was really nice. It was kind of like your way to give back to the community and connect with them.

Chip Kahn (01:45): So once you decided on going into medicine, what led you to emergency medicine particularly?

Ana Pineda (01:51): So once I decided that I wanted to do medicine, I began also working as a scribe in the emergency department. I’m not sure if you’re familiar with what scribes do. They’re basically like assistants to the doctors. They help do their medical records. They help them in their patient encounters. And I was in the emergency department and I was with this amazing group of people, actually in the emergency department that I work in right now. And I worked with the doctors that I work with right now. So they really inspired me.

I would see them have different interactions with patients. Some of them were very positive. You’re telling first time mom that she’s having a baby and everything was going great. And sometimes they were not so positive. You were telling someone that they lost a loved one. And there was so much variability in that. And I really love that about emergency medicine. Sometimes it’s super hard. You’re having to tell people the worst news they’re going to ever hear, but other times it’s inspiring. And emergency medicine is one of the only fields where you’re basically touching every aspect of the human body. You’re seeing adults. You’re seeing pediatrics. You’re seeing pregnant women. And it’s this organized chaos. And I was really attracted to that.

Chip Kahn (03:06):Well I can see what keeps you inspired, but what was the most unexpected part of your job that you love doing?

Ana Pineda (03:14): So what I love about my job aside from the variability, which I never thought I was going to love this aspect, by the way, is the behind the scenes. Everything that it takes to run emergency department. Everything that it takes to get the patient in through one door and out the other. And I really enjoy that. In my position in leadership, we create protocols. We design different parts of the ER and that’s not something you learn in medical school. And that really attracted me to staying in leadership, pursuing more careers in this area. And it’s something that I didn’t think I was going to like. You never think you’re going to love designing a protocol as much as we do.

Chip Kahn (03:54): I can hear how much you love your job. And I’m sure you like getting up every day to go into work, but the pandemic, it really set a different tone. In my discussions with people in various hospitals and other parts of the healthcare system across the country, I just get back that it’s been very wearing. Now we’re getting into our third year. How do you stay motivated in this COVID environment which is a little different than all your previous experience, I’m sure?

Ana Pineda (04:25): Yeah, COVID changed everything for us, especially in emergency medicine. We were the front line. We were having to deal with something that nobody knew what it was. Nobody knew what was going to happen. So we were starting from scratch. We were building these protocols from nothing. And that was very humbling. And the most inspiring part of COVID, even though there’s been a lot of challenges, is the team aspect, how everybody came together. I’m not speaking just about the physicians. The nurses came together, the respiratory therapists, the environmental were a huge contribution. And we all came together. We stayed motivated as a team. We looked out for each other. We were super supported by our facility, by HCA Florida, Kendall. We had the resources that we needed.

And that was very humbling because we were watching what was happening around the world. People were running out of oxygen, running out of ventilators, running out of beds. And thankfully we didn’t have those issues down in south Florida. And we were hit pretty hard. I think our hospital was one of the hardest hit sites in Florida. And we saw immense amount of patients. And the team motivated us to stay together. The hospital gave us what we needed and that motivated us to keep going to work. And think that it takes a village, but we got through it and we’re still getting through it. And thankfully with the advances of medicine, there is a light at the end of the tunnel.

Chip Kahn (05:52): So clearly from what you described, you grew up into medicine at the hospital where you’re practicing now, but now in some ways the tables have turned and you’re in charge and you’re training the next generation of physicians. Can you tell me a little bit about that and what you do in terms of being a role model?

Ana Pineda (06:12): Yes. So I train the residents just how I was trained at my exact same site. We were super supported by our facility, HCA Florida, Kendall Hospital. It’s an HCA Healthcare facility and we have a lot of amazing GME opportunities for our residents. And my site specifically, I think it’s over 150. HCA in general, I think it’s over 5,000 residents every year. And we work with them one on one, in patient encounters. They’re highly supervised. We go, we see a patient together. We talk about it. And then once they’re done with all of those encounters, they also have to have conferences. COVID really put a dent on that because we had to have a lot of things happen virtually, but luckily we had all the resources that we needed.

And then we also do simulation training. So what they couldn’t practice on a real patient, we were practicing on SIM patients, which is basically mannequins that were provided to us by our facility. And it’s basically training the next generation. These residents are going to be treating my family members, my kids, my grand kids. So we’re highly invested in their education.

Chip Kahn (07:21): What do you value most about working for a large health system, a national health system actually like HCA Healthcare?

Ana Pineda (07:30): So what I like about HCA, the reason why I’ve pursued HCA, stayed with HCA, and plan to stay with HCA is that they have a large investment in education and in training, not only doctors, but also nurses, respiratory therapists, all these other caveats of medicine. And when you come from such a large corporation like this, we have a large database. So we can access a lot of information about patients. And this helps us create protocols, design patient centered, and evidence based medicine protocols, which are super important to us in our hospital.

I work in leadership and I’ve seen everything that our hospital has done to make sure that our patients get everything that they need, that we get everything that we need so we can provide the best care. And that’s super inspiring. And I don’t see that in other facilities, because I have worked at other facilities. So that kind of has what’s kept me here, kept me centered.

Chip Kahn (08:24): So to conclude, what do you say to young people out there that are considering a career in healthcare or want to become physicians?

Ana Pineda (08:33): Healthcare is very fulfilling. It has its challenges, but it’s inspiring and it’s humbling. And I know that COVID has changed a lot of people’s perspective about whether they want to really get into this. It almost feels like it’s dangerous. A lot of people during COVID felt that they were putting their life at risk and at some way shape or form they were. But I feel like what you gain out of it is so much more and you connect with people and you become part of the solution, not part of the problem. And I want to tell people out there, don’t be afraid to pursue a career in medicine because I don’t think you’re going to regret it. I think that you’re going to feel fulfilled and accomplished at the end of your life.

Chip Kahn (09:15): Ana, thank you for being with us today and thank you so much for your service.

Ana Pineda (09:19): Thank you for having me.

Speaker 1 (09:25): Thanks for listening to Hospitals in Focus from the Federation of American Hospitals. Learn more at faah.org. Follow the Federation on social media at FAAH Hospitals and follow Chip at Chip Kahn. Please rate, review and subscribe to Hospitals in Focus. Join us next time for more in depth conversations with healthcare leaders.

Dr. Ana Pineda