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Excelling where men once reigned

Medicine@Yale, 2017 - Apr May


Longtime chair expands her department’s breadth and inspires more women to lead

Roberta L. Hines, M.D., chair and Nicholas M. Greene Professor of Anesthesiology, wants people to know that anesthesiologists do far more than sit behind the operating-room curtain. Rather, anesthesia is a multidisciplinary and often longitudinal discipline.

“The OR is always going to be our home, but we continue to expand our expertise outside this traditional clinical venue,” she says. “Our current focus is directed toward identifying ways to positively impact patient outcome across the entire clinical spectrum.”

Since taking over as chair of the Department of Anesthesiology in 1994, Hines has overseen a dramatic expansion in its clinical reach, pushing the specialty to realize more of its potential. Under her guidance, the department has set up a pre-screening clinic for surgical patients (it helps them get healthier for surgery); expanded its research to include tissue engineering and the study of postoperative cognitive impairment; and partnered with Smilow Cancer Center to provide specialized cancer-pain services.

The department also has grown in size and prominence. It cares for 55,000 children and adults each year, more than double what it did before Hines’ leadership. Most of its 120 faculty have advanced fellowship training. Spanning four medical campuses, it trains 76 residents, 12 clinical fellows, and three physician-scientists annually. Its graduates include eight department chairs, something Hines is especially proud of. They, in turn, are impressed with the evolution of the place where they trained. “Many of the residents who have come back after having left five or 10 years ago are in awe of the change in the department,” Hines says.

Hines says her proudest personal accomplishments are her 25 years’ service as an examiner for the American Board of Anesthesiology; editing the major textbook Stoelting’s Anesthesia and Co-Existing Disease, whose seventh edition was published in April; and serving as president of the Association of University Anesthesiologists and the Association of Academic Anesthesiology Chairs.

In the latter organization, Hines is a rarity. Of 131 such chairs nationwide, she is one of just nine women—though she expects to see that change.

“We are seeing a growing number of women entering anesthesia,” she says. “Two of my vice-chairs are female, many of my division and associate chiefs are female, and that really [speaks to] the fact that we’re now training more women [for leadership]. Having more diverse chairs will be a positive thing at every level.”

To that end, Hines makes mentorship a priority. “The lack of female mentors has been and will continue to be the biggest impediment to having women in leadership in medicine,” she says.

Hines grew up in the rural hamlet of Canaan, New Hampshire—the daughter of a nurse and a construction worker—and recalls being surrounded by supportive adults. She became the first in her family to attend college and one of just six from her 67-person high school class, graduating from the University of New Hampshire and Dartmouth Medical School. She maintains active ties to the region by organizing elder care, working to reduce rural hunger and poverty, and administering scholarships for area students.

“I wouldn’t be where I am today were it not for that very small regional high school, and I want to make sure that the students coming behind me have the same opportunities I did,” Hines says.

Hines began a surgical residency at Yale New Haven Hospital before deciding to train in cardiac anesthesiology and critical care instead. Soon after joining the Yale faculty in 1984, she saw to it that a cardiothoracic intensive care unit opened at the hospital, making Yale’s one of the first anesthesiology departments in the country to assume responsibility for post-cardiac surgery patient care.

That focus on what happens before and after surgery, not just during, will shape anesthesia’s future, Hines believes. “There are many things that we need to focus on to ensure that our patients are getting the best possible care across their entire spectrum,” she says. “That’s where I would like to continue to drive the department and our specialty.”