Dr. Heike Knorpp on the importance of trust

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It goes without saying, but trust is a critical part of the healthcare experience. Patients trust that physicians and healthcare organizations have their wellbeing in focus and understands them as a person and not just a collection of ailments to be treated. Physicians, in turn, trust that healthcare organizations respect their autonomy and decision-making. Patients’ overall experience as well as the ownership they take of their health and the outcomes that flow from their behaviors and treatment hinge on trust.

Dr. Heike Knorpp is a board-certified anesthesiologist with Mobile Anesthesiologists in the Chicagoland area. In practice for over 20 years, she has also been an assistant professor in the medical school at the University of Illinois at Chicago. A dedicated patient advocate, Dr. Knorpp enjoys working with varied proceduralists and getting to fully understand her patients in order to provide tailored care that rises above mere anesthetic administration.

Recently we spoke with her about the role anesthesiologists play in developing trust with patients, how taking a holistic approach to patient care can pay dividends, and the value she sees – both to patients and providers – in performing procedures in appropriate settings.

Patients clearly have to trust their healthcare providers, but anesthesiology is a unique specialty. How is that need for trust reflected in the patient/anesthesia provider relationship?

When you go to a doctor, normally, you have an issue usually, and you want to get it addressed. You’re not feeling well, you’re sick or have problems. Anesthesiology, however, is the only specialty where we actually get a pretty much healthy patient and we take their protective reflexes away, we put their brain asleep, and they trust us enough to actually get them back the way they were before. We get them not functioning as a human, and they have the trust to bring them back the same way or even better afterwards. People can be even more incredulous that we do this safely, time and again, in offices.

You moved from practicing in hospitals to performing anesthesia in offices. What was the transition like?

When I quit my old job, I told them, “I’m doing office-based anesthesia, and I’m cardiac-trained.” [A colleague] was like, “Oh my god. First of all, you’ll be bored. Second of all, it’s not safe.” I said, “You know what? I wouldn’t do this unless I would think it’s safe to do.”

I think just with [Mobile Anesthesiologists] being the way it’s set up, it’s fantastic because I have the same crash cart I would have at the hospital. It’s everywhere I go, the exact same. I think that confidence that I know that I can provide a safe anesthetic in an office, I think carries over that we can tell patients, “No, you’re safe. It’s a good space to have a procedure.” I think patients just embrace that.

And what does the office space offer you from an intimacy and trust standpoint?

I love taking care of patients. I was always thinking, I’m cardiac-trained. I love doing ICU because I actually like taking care of the patient themselves. A lot of anesthesiologists go into anesthesiology so they don’t have to talk [to patients.] At least, that’s how it was when I trained. I don’t mind actually handling families, and talking to patients, and doing all that, and talking to other specialties. I think the office space gave that back to me because I sometimes get patients, and I do enjoy actually having these extra two or three minutes. When I see patients are still smoking, I actually do smoking cessation. Or, I see they have a lot of anxiety, but they are not on anxiety medications. I can bring that up to them and I ask whether they have done any yoga, or acupuncture, or what kind of approaches they have taken.

How does that translate into the patient experience?

Taking that extra minute to just show that you’re interested in the patient and you care about them, I think, gives them that extra trust, and trust into healthcare, too. It shows you care for the patient. You care for the whole system and not just one little thing, which is now [common] in medicine. You have a shoulder issue and you go there, but it might actually be from your hips because you’re standing crooked the whole time. Nobody pays attention to that anymore. I think having that extra little time that you can spend focused on the patient as a whole helps a lot.

When we discuss office-based procedures, often, in addition to trust, the ideas of convenience and comfort come into play. How does that reflect in the provider-patient relationship?

It gives back the respect and trust from the physician to the patient, to see them actually more as a team member because you’re respectful of their time. You’re respectful of their life too, so it’s not like you’re dictating to them and they just have to do whatever you want. It gives the physician the flexibility to really appreciate the patient as a person, and as a partner in their healthcare.

Finally, now that you’re performing ambulatory anesthesiology in the office setting, what is it that you love most about it?

From the anesthesiologist’s perspective, I think actually, just the flexibility. The awesome thing is with Mobile Anesthesiologists, I can work for the same company, but I can go to a different place every day. I work with different people every day. I do every specialty, multiple specialties per week. I just love that it keeps me on my toes, but I’m not sacrificing safety, and so I really enjoy that.

I’m also learning new things, learning new people. I like meeting new people, trying to figure out spaces, how it works better for me. How maybe it works even better for the proceduralist, and then when they maybe expand their places, they actually work with us to figure out their space because we have so much expertise, and we’ve seen so many different places.