Interview with a Leader in the Field

Interview With a Regional Anesthesiologist in Private Practice in the United States: Maggie Holtz, MD

Apr 30, 2019, 12:11 PM by Lisa Klesius, MD

Maggie Holtz, MD

I had the pleasure and honor of interviewing Maggie Holtz, a private practice physician anesthesiologist for Georgia Anesthesiologists. In addition to being a phenomenal physician anesthesiologist and mother of two children, Maggie is the chief of regional and orthopedic anesthesia at WellStar Kennestone Regional Medical Center in Marietta, Georgia, a position she has held for the past 5 years. She has been instrumental in enhancing the role and prominence of regional anesthesia at her practice by expanding the size of the team, implementing enhanced recovery protocols, and introducing new and advanced regional techniques.

Maggie is also passionate about teaching. She has been involved in several national and international workshops to promote education and knowledge of new regional anesthesia techniques with the ultimate goal of improving postsurgical outcomes and patient satisfaction. Maggie’s story is truly inspirational and shows how hard work, passion, and dedication to the field of anesthesiology can lead to a rewarding and successful career, no matter one’s background or gender.

Lisa: Can you describe the leadership roles that you have been in or are currently involved in? How did you attain those roles?

Maggie: I’ve worked for Georgia Anesthesiologists, PC, a private practice group in suburban Atlanta, for 7 years and have served as the chief of regional and orthopedic anesthesia at WellStar Kennestone Regional Medical Center for the past 5 years. I have to give a lot of credit to my amazing group for believing in me and never treating me like I was any less of a contributor simply because I was a woman, or—gasp—worked part-time. I spent a couple years on faculty: first at Emory, then at Yale, and when I took my job at Georgia Anesthesiologists, I had two kids under the age of 2. So I made the decision to put my career on hold and work part-time. My group was extremely male dominated, but once I—once anyone new—proved competence, gender became irrelevant.

After 2 years at my practice, I was offered the position to run the regional service, and I of course jumped at the opportunity. I am proud of what we have achieved: Our block service is a critical player in enhanced recovery protocols, and we have grown to where we now have 6 dedicated block bays, 10 anesthesiologists skilled in regional anesthesia, and 4 dedicated block nurses. We perform approximately 700 blocks per month, embrace the most progressive and advanced techniques, and are truly making a difference in the recovery of our surgical patients.

Lisa: What strategies helped you achieve success in becoming a leader in the field of regional anesthesia, particularly as a woman in a male-dominated field?

Maggie: I am true to myself. Always. And unapologetically. I have never understood female physicians who abandon their true selves in an effort to be “accepted” by the boys’ club. Quite the contrary: I think there is so much power in being a woman. And at the end of the day, what matters in medicine is not what chromosomes one was born with, but rather one’s competence, passion for the work, ability to work as a team, and empathy for patients. I believe self-righteousness and hierarchy should be checked at the operating room door, because they don’t belong there. We all have the same goal and are on the same team.

In regional anesthesia specifically, I am forever grateful for the network of incredible regional anesthesiologists I have met at ASRA meetings and through consulting. Through a series of chance meetings, I have had the incredible opportunity to get involved in teaching at various national workshops and one international regional anesthesia workshop, including state anesthesiology society meetings as well as the New York School of Regional Anesthesia. I am honored to work side by side with some of the giants—both male and female—in our field, and even though I am there to teach, I also continually pick up pearls just by being in the presence of those minds. I also speak throughout the country on opioid minimization, optimization of perioperative pain control, and migration to same-day total joint replacement. To me, it’s of ultimate importance to never be satisfied but rather to always be hungry for more knowledge, more progress.

Lisa: What differences or challenges have you experienced becoming recognized as a female leader working in the private sector compared to those working in an academic institution?

Maggie: Having worked in an academic setting before I joined my practice, I can say that it just takes more self-directed learning. We don’t have grand rounds, visiting professors, or contributors to research. The literature and the newly described techniques aren’t in our faces every day. We feel the pressure of performance and efficiency rather than research and teaching. We don’t have the infrastructure to support carrying out big studies, and because publishing is so critical to being recognized as a leader in this field, we are at a disadvantage if you look at it that way. But what we do have is numbers. Lots of them. And so we become very skilled very quickly. Our recognition as private practice regional anesthesiologists isn’t ever going to be on the podium at national meetings or on the cover of Regional Anesthesia and Pain Medicine, and that’s okay with me. Rather, my fulfillment comes from our patients who are able to go home a couple hours after having a total joint replacement because of the blocks we perform, the multimodal regimen we initiate, and the protocols we have in place, and also their family and friends who subsequently come for the same surgery and ask for us by name to take care of them.

Lisa: Did you encounter any obstacles on your path to success? Did you feel that you had to work harder than your male colleagues to attain success?

Maggie: I do feel like I had to up my game when I first joined my practice—to prove my worth, if you will. But once I demonstrated my competence and my commitment, I have never since felt like my gender has had much to do with anything in my group. Sure, I get tired of everyone else—patients, staff, etc—assuming I am a nurse simply because I am a woman or address the male PA student as “Dr” and me as “Ms,” but that’s an exhausting, consuming, and losing battle to fight. So I prefer to just move on. I know who I am.

I have had obstacles, of course: not necessarily because I am a woman, but because I am progressive. When the goal is something new, something that challenges the status quo, it’s easier to stay the course. But we must develop a thick skin; not take failures, challengers, or challenges personally; and keep the end goal in mind. Very few things that are worthy are easy.

At the end of the day, what matters in medicine is not what chromosomes one was born with, but rather one’s competence, passion for the work, ability to work as a team, and empathy for patients.

Lisa: Do you feel that the barriers for women in anesthesia to attain success have decreased or changed now that more women are entering the field?

Maggie: I feel grateful to have so many positive female role models in the field. I hope they continue to inspire female medical students to enter anesthesiology and female anesthesiologists to learn more about regional anesthesia.

This may be an unpopular and divergent sentiment, but I must say I hope we don’t cause a greater gender divide by putting so much emphasis on “female” this and “male” that. Why must I have the qualifier as a female regional anesthesiologist? Why can’t I simply be a regional anesthesiologist? I much prefer the latter.

Lisa: What challenges still exist for women entering the field of anesthesia to become successful leaders?

Maggie: I think a lot of it depends on the standing leadership at the individual institutions. A gender-blind leader will promote based on merit, not because of, or in spite of, a specific gender. On the other hand, if the standing leadership has an inherent bias, I do believe that women have to work harder to surpass their male colleagues.

Lisa: Did you have any mentors who helped you in your path to success? Do you think it is important for women starting out in their careers to seek out a mentor?

Maggie: I have had a number of amazing mentors along the way, both male and female. It has always been more important to me to find someone, regardless of gender, who shares common ground and similar goals.

Lisa: What advice can you give women who are just beginning their careers in anesthesia?

Maggie: Stay true to yourself. Be a team player. Go out of your way to be inclusive: Everyone on the surgical team, from the person who cleans the floor to the attending surgeon, is important. Always, always maintain a hunger for learning new things. Push the envelope in the name of progress. Fail. Try again. Find joy in your job: It’s the best field in medicine.

Lisa: How do you maintain your work-life balance?

Maggie: Does anyone have the definitive answer to this? It’s just that: a balance. A very wise female surgeon once told me, many years ago, “you can have it all. You just can’t have it all at the same time.” For me, it’s about being present. When I’m at the hospital, I try my best to be present and fully focused on my patients and the work at hand. When I’m at home, I try to be fully present with my kids and not take too much work home. Of course it’s not always that perfectly compartmentalized, but it’s my consistent goal.

Lisa: Is there anything you wish you had known when you were at the beginning of your career?

Maggie: I wish I hadn’t looked so far ahead but rather appreciated where I was in the present. I love my job in private practice, but I genuinely miss academics. I was in too much of a hurry to get settled; I wish I would have known it’s okay to take a little more time, take a little detour, and accept that an initial career goal may not be the ultimate one.

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