Ellen Lockhart, MD profiled as one of STL Magazine's 'In-the-know Doctors'

Aug 13, 2014

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The article below was originally published in STL Magazine. You can read ‘In-the-know Doctors’ by clicking here.

Ellen Lockhart, MD
Barnes-Jewish Hospital

As a mother and an expert in obstetric anesthesia, Lockhart knows her patients are dealing with more than health-related matters: “As I drive in to work, I am thinking about my caseload, in addition to what my children are doing after school and what I am going to cook for dinner. Honestly, as soon as I see the hospital from Highway 40, my thoughts immediately turn to my patients. Some are having major procedures, some are dealing with a new cancer diagnosis, some are having babies, and all of them deserve my best. Many have a story beyond what you read in the medical record. The healthy patient having a very minor procedure may be dealing with a loved one in hospice. These realizations are humbling, make me very grateful for my family and friends, and remind on a daily basis why I chose a career in medicine: the patients.”

What is the most pressing issue in medical ethics today, and why?

I think that one of the most pressing ethical issues is examining how we address medical care at the end of life. This is an important issue because of the tremendous economic implications. A significant amount of healthcare dollars are spent on intensive measures at the end of life. There are important questions to answer: Will these interventions provide meaningful benefit? What are the patient’s wishes and expectations about their quality of life? What type of data-driven evidence can we provide to patients about potential outcomes? Deciding which therapies are beneficial is not always straight-forward, and it involves difficult conversation between patients, families and medical care teams. These topics are also challenging because they are interwoven with cultural, social, religious, and certainly political threads. Regardless of the difficulty, this is an important ethical issue for us to tackle. It is more than an economic concern: It will benefit our patients.

What’s the most fascinating case you’ve handled in recent years?

While I don’t want to get into specifics of a particular case, for me, the most fascinating cases are those involving high-risk pregnancies, which is my area of expertise and interest. This could be a woman with severe heart or lung disease, cancer, or even major trauma during her pregnancy. Not only are we caring for the mother, but we also need to consider the effects of our anesthetic management on the baby. These cases are intellectually and medically very challenging, and I enjoy the interdisciplinary collaboration that is involved. While you have to remain focused on delivering the best possible care to these patients, you also have to respect the emotional toll that these situations are taking on patients and their families.

What recent finding or trend do you believe will significantly shape your field in the years to come?

As anesthesiologists, we have a presence not only in the operating room, but are involved in preoperative assessment and planning, in the critical-care arena, and in treating acute and chronic pain. This breadth of experience provides us with a tremendous opportunity to better understand our patients, how to better assess their risk, and how our intraoperative management affects their short- and long-term outcomes and quality of life. Our department is actively engaged in using informatics and research to discover and implement solutions aimed at improving the outcomes of surgical, critically ill, and chronic pain patients. An important challenge facing anesthesiologists and other acute care physicians will be to use emerging evidence to mitigate perioperative risks and to optimize postoperative outcomes.

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Tags: ClinicalObstetrics