Legacy Emanuel and Randall Children’s Hospital (LEH) provides a full range of services, including conventional surgery, heart treatment, critical care, neurology/stroke care/brain surgery, and care for high-risk pregnancies.

This means that we do just about every kind of surgical case including: General surgery, orthopedics, urology, gynecology, robotic surgery, neurosurgery, vascular surgery, ENT, OMFS, ophthalmology, burn surgery, cardiac surgery, thoracic surgery, pediatrics (including general, ENT, urology, orthopedics, dental, and cardiac). We also provide anesthetics in these procedure areas: MRI/CT, endoscopy unit, EP lab, Cath lab, and interventional radiology suite.

"Working at Emanuel is very rewarding because we get to practice the full spectrum of Anesthesiology, from obstetric and pediatric to geriatric patients and everything in between. The variety and complexity of cases can be a challenge, but our partners are always available to help, and they're amazingly supportive and flexible. Partners help each other, not just in the OR, but also to make our schedules and lives work because the group understands we should all be here for the marathon and not a sprint. Emanuel is a great fit for me, and I can't imagine working anywhere else in Portland. " - Justin Ramos, MD

We employ over 40 anesthesiologists at our Legacy Emanuel location. We have a variety of partners with fellowship training who work within sub groups, including pediatrics, cardiac and obstetric anesthesia. Individuals in the pediatric subgroup care for children under two years of age and critically ill children. The cardiac subgroup does a variety of on pump and minimally invasive cardiac procedures and the pediatric cardiac subgroup takes care of children with congenital cardiac anomalies. Our non-fellowship trained partner’s days consist of neuro, ortho, ENT, thoracic, gyn, urology and others.

"Legacy Emanuel and Randall Children's Hospital is truly a unique place to work. Our patients range from all ages and backgrounds. We regularly take care of both healthy outpatients and patients who have come to us as a last resort. Often our patients and their families have been coming to Emanuel for generations, and our patients see us as an anchor in the communities we serve.” - Amy Greene, MD LEH Department of Anesthesia Chairperson

Our group at Emanuel has come up with a room pick system that is fair and equitable. We have found that this system greatly enhances the frequency that we are assigned to a room that we enjoy working in.

Basically, every anesthesiologist on the schedule is assigned a "pick" number between 1-19 for each weekday they are scheduled to work. Pick numbers are distributed each trimester. Our schedulers are meticulous at making sure the numbers are allocated in a fair manner. If your pick number is “1”, you get first choice of the room you want the next day. Pick #2 gets second choice, and so on, until all rooms are assigned. Our Anesthesiologist-in-Charge (AIC) calls every person starting at 2:00 pm to make their pick.

You are expected to complete all cases that are scheduled in your room for the day. If your room is running late with scheduled cases and/or your surgeon adds an add-on case that is likely to go past 5:00 pm, the Call Team can work with you to arrange coverage.

Our staffing model includes an AIC (Anesthesiologist-In-Charge). The AIC works closely with the OR Charge RN to facilitate the smooth flow of the OR, complete the schedule for the next day, and generally troubleshoot all OR related issues. Anesthesiologists can go to the AIC with questions and requests during their workday.

We provide three in-house call positions every day (trauma, general operating room, obstetrics), and two home call positions. All positions are 24-hours, although if desired the in-house calls can be split into two 12-hour shifts, staffing permitting.

Post-call days off are mandatory for in-house call positions in order to allow our partners to rest and recuperate. If there are any days off on the schedule they are preferentially given to post-home-call staff.

Call assignments are meticulously tracked to ensure we all are assigned the same amount of call as determined by your FTE.

Generally, you will be assigned one call day for every five days you work. After call shifts have been assigned, members are able to swap or give away call shifts.

Vacation is scheduled on a first-come, first-served basis, with three weeks off every trimester for a full time position.

Holidays and certain desirable weeks off are picked once each year by means of a rotating list (after picking this year, the top partners move to the bottom for next year). There is no hierarchy for vacation picking and new partners may have off all holidays while established partners may end up with two holiday calls.

“The scheduling flexibility is fantastic at Emanuel. There's often the chance to pick up more work if I need to pay for a remodel at home. Conversely, by scheduling post-call days or arranging a swap with a colleague in advance, I can almost always make it to my kid's soccer games. We work hard in the hospital, but we also value our lives outside of work.” - Kate Ropp, MD

Our Anesthesiologist group is supported by a Certified Anesthesia Specialists (CAS) team who assist with lines, blocks and run blood gases for us. They also run the cell saver machines and assist with all outlying cases. There is also an Anesthesia Aide team who does all turnovers within the operating room and can bring you equipment when needed.

We communicate via a Vocera, which we all wear during the day. In all trauma cases, and any case involving a massive transfusion, we have specially trained Trauma Resource Nurses who specialize in transfusions and trauma cases. They are an invaluable resource for establishing IV access and transfusing patients.

Our new ORs are currently under construction and should be finished by 2024.

Who practices critical care at OAG?
The Critical Care Division of Oregon Anesthesiology Group consists of a cohort of Board Certified Intensivists practicing Critical Care Medicine at hospitals throughout the Portland metro area.

Practice sites include:

• Legacy Emanuel,
• Legacy Meridian Park,
• Legacy Good Samaritan,
• Providence St Vincent.

How will I divide my time between anesthesiology and critical care?
The typical scenario is to block out weeks for Critical Care Medicine (CCM) and weeks for Anesthesiology. Most partners work at a ratio of 25:75 CCM:Anesthesiology though a few work a greater percentage of CCM.

At what types of ICUs are OAG physicians working?
Medical, Surgical, Neurosurgical, Cardiac. Some practice locations include V-V and V-A ECMO management.

What is the call schedule?
The call schedule varies by location. The majority of call is taken from home but a few sites necessitate in-house night-time coverage. Call burden also varies per site is anywhere from Q3 to Q7 days.

Will I be working at night?
Yes you will be working at night, either in-house or from home.

We hope you are interested in joining our dynamic group to practice Critical Care medicine with OAG!

“Emanuel is a special place for a number of reasons. There are very few practices around that have the case diversity and lifestyle flexibility that we enjoy. During my relative short tenure here I have been able to join Doctors Without Borders on six different missions ranging from six weeks to three months in duration. Not only have my partners been willing and able to give me the time off, my familiarity and comfort in pediatrics, trauma, OB and burns on missions directly relates to having seen those cases at Emanuel. Additionally, I routinely consult my partners and Emanuel's specialists with questions about complicated patients in the field. I quite frankly cannot imagine working anywhere else.” - Matt Hotchkiss, MD

“My work family makes this my dream job: from the respectful surgeons to the helpful nurses to the call for help from my anesthesia colleagues that never goes unanswered. The trauma system lends a true "team" mentality, and I feel a great sense of support and belonging whenever I'm at work.” - Kate Ropp, MD

“The foundation of our group is based on collaboration. We work with each other, rely on each other and lean on each other. We are a work family in the truest sense of the word. We have a strong mentoring program, Anesthesia-In-Charge program and a Social Director who organizes happy hours and events. We also place a strong emphasis on work-life balance, ensuring that no one is feeling like they are sacrificing one for the other. If you have a special event, we bend over backwards to make sure you can attend it. No one should miss a wedding or reunion or girls trip because they couldn't get the time off from work.

We look forward to meeting and talking with you! Even if we do not fit what you are looking for in a practice, we hope that by showing you around Emanuel we can start to develop OAG friendships that will last for years." - Amy Greene, MD LEH Department of Anesthesia Chairperson

What if I am a generalist who hasn't managed pediatric patients in a while? Support is available for helping you transition back into young patients again. At first, you’ll be able to pick rooms with patients over the age of 12, who will come with an IV in place. You can then gradually pick rooms with younger kids, as you are more comfortable. We have call people and the AIC available at all times to help you until you are comfortable on your own. Also, the RNs are experienced with placing IVs in children and place almost all IVs while we manage the airway. There is always a pediatric fellowship trained person on call to manage pediatric cases during the night.

What is it like to be the new person on the team? You will absolutely be 100% supported at LEMC. We encourage you to ask for help early and often. Our motto is “Asking for help is a sign of good judgement and not a sign of weakness." LEMC's staffing model places multiple colleagues outside the OR (C1, AIC, OB) who are always willing to help any partner with a challenging situation. We also believe strongly in the OAG mentoring program, where a partner will be assigned to be your go-to resource person for anything you need. (Examples: How does this surgeon like to do this surgery? Do we need an A-line in that surgeon’s cases? Where should I park? Who has the best sushi in town? You get the idea!)

• Our case volume is heavy in bread and butter cases, but still includes some thoracic, complex vascular, and neurosurgical.
• Optimal location of hospital provides superior payor mix.
• Heavy regional anesthetic program.
• Very busy joint replacement site. All of these patients get at least single shot blocks.
• All general surgery and nearly all gynecological patients get regional.
• We have an active Acute Pain Service for management of nerve catheters. Opportunity to become involved in Acute Pain Service for medical management as well.
• True pediatrics and trauma are rare. No open hearts.

• Collegial site with 16 Anesthesiologists (4 of them part time).
• New partner mentorship program - we want to see new partners succeed!
• Opportunity to be involved in hospital leadership

You pick your own room assignment in order of your call assignment. 1st call picks first.

Low call burden. First call usually ends at a decent hour (ie 7- 9 pm) and call backs at night are rare. OB call is supported by the hospital and may be taken from home (provided no running epidural).

Vacation is picked 1 week at a time in rounds. No maximum or minimum.

• 5 Ultrasounds dedicated to anesthesia.
• Recently upgraded anesthesia machines.
• We use Epic for all of our documentation.

Who practices critical care at OAG?
The Critical Care Division of Oregon Anesthesiology Group consists of a cohort of Board Certified Intensivists practicing Critical Care Medicine at hospitals throughout the Portland metro area.

Practice sites include:

• Legacy Emanuel,
• Legacy Meridian Park,
• Legacy Good Samaritan,
• Providence St Vincent.

How will I divide my time between anesthesiology and critical care?
The typical scenario is to block out weeks for Critical Care Medicine (CCM) and weeks for Anesthesiology. Most partners work at a ratio of 25:75 CCM:Anesthesiology though a few work a greater percentage of CCM.

At what types of ICUs are OAG physicians working?
Medical, Surgical, Neurosurgical, Cardiac. Some practice locations include V-V and V-A ECMO management.

What is the call schedule?
The call schedule varies by location. The majority of call is taken from home but a few sites necessitate in-house night-time coverage. Call burden also varies per site is anywhere from Q3 to Q7 days.

Will I be working at night?
Yes you will be working at night, either in-house or from home.

We hope you are interested in joining our dynamic group to practice Critical Care medicine with OAG!

General surgery, endoscopy, orthopedics, gynecology, urology, podiatry, and otolaryngology.

One of us has ICU fellowship training and splits working between the Mt Hood OR, ICUs and ECMO service. The rest of us are general anesthesiologists.

We all place high value on a collegial work environment and an excellent work life balance. Many of us job share to allow more time for family and all that the Pacific Northwest has to offer.

The work environment is professional, collegial, and fun. The surgeons and proceduralists are talented and pleasant to work with. The nursing staff is excellent.

We range in age from mid 30s to early 60s. Several of us have families with children (ranging from newborn to college age). Most of us live in Portland and find it is an easy reverse commute to Gresham. One of us lives in Hood River.

We currently cover 5-6 rooms a day designating call positions 1-6. Cases are assigned the day before based on scheduled length of day (C1 gets the longest room and so on). This allows for an even distribution of case types among everyone as we rotate through call positions week to week.

C2 and C3 typically finish between 5-7 pm, but sometimes earlier. C4 and 5 may work until 5p but often finish earlier. C6 (pre-call position) goes home first, often working a half day. Post call day is off.

The C3 position covers a full day of endoscopy each weekday. These are pleasant, fast-paced days.

We meet yearly to review vacation requests. We do our best to accommodate each individual’s vacation requests while making sure we provide the hospital with appropriate staffing levels.

High demand weeks such as school spring breaks, winter holidays are rotated annually. Vacation weeks are typically distributed on a first-come first served system for specific week requests, and are otherwise randomly distributed.

Vacation is typically scheduled a week at a time, though it is possible to work out a partial week-off situation.

Job-sharers divide up their schedules independently and do not draw from the vacation pool of full timers.

Call is allocated evenly among the group (pro-rated for part time positions). It is often possible to trade for more or less call based on interest.

C1 is typically scheduled until 5pm, does any add-on cases and then is 24-hour home call. Overnight call burden is typically light.

There is one person on 24-hour (7a-7a) home call Saturdays and Sundays. Each Full Time Equivalent takes 45 calls per year. 7 Saturday calls and 7 Sunday calls are included in the 45 total calls. Weekend days, particularly Saturdays, can be busy, but evening call-ins are usually light. We stipend weekend positions—some people prefer to take more weekend call and make more money, some people prefer less weekend call.

The C1 position is also responsible for assisting/supervising our excellent group of CRNAs who cover the obstetric service on an as-needed basis for complex cases (this is rare). Some of us elect to pick up shifts in OB (this is optional).

“Mount Hood Medical Center’s OR is a relaxed, collaborative and friendly work environment. Our surgeons are pleasant and easy to work with, and our case mix is bread and butter. Our call burden is below average and very tolerable. This is a job that allows me to stay busy in a fun Anesthesiology practice part time while also having plenty of energy to pursue other interests.“ - Luke Parr, MD

“What I appreciate about this practice is the great camaraderie we have as an anesthesia group. We work with a group of generally excellent surgeons and nurses, and it feels like being part of a small, happy family at Mt. Hood. There's a high respect for work-life balance amongst the anesthesiologists, and with several part time docs, people have made a real commitment to their lifestyle. And while I greatly respect the clinical skills and judgement of everyone in our department, what I really love about the culture here is we're not caught up in the ego of being "doctors" but rather trusted colleagues who work well together and really respect and enjoy each other. What a pleasure it is to practice here!” - Andrew Smith, MD

General Practice Information

• Primarily doing your own cases
• Occasional AIC days with medical direction not to exceed 4:1 ratio
• Occasional pediatrics experience with healthy basic bread and butter cases
• Call obligation split equally but will likely be tradable
• Nocturnist positions (2 currently) covering evening OB call most every evening covering approximately 50% of call.

Service Lines

• General Surgery
• Orthopedic
• Neurosurgery (Spine and some Craniotomies)
• Urology
• OB/GYN
• Gynecology/Oncology
• ENT
• Vascular
• Plastic Surgery
• Podiatry
• Pediatrics (ENT/Dental)
• Robotic (General/Urology/Gynecology)
• Interventional Cardiology
• Endoscopy
• Pulmonology
• Imaging

Hospital Information

• 220 Inpatient beds
• 32 Bed Closed Medical/Surgical ICU
• 34 Bed Family Birth Center
• 285-300 Monthly Deliveries
• C-section rate 27.7%
• Two Physician/Provider Lounges with coffee and food
• Cafeteria
• Starbucks Cafe

Regional Experience

• Interscalene
• Supraclavicular
• Femoral
• Adductor Canal
• TAP for ERAS and OB
• Spinal
• Epidural

Hospital is located in Felida, Washington at the North end of Vancouver

• Population 9500
• Great payor mix
• Suburban area with close freeway access
• 15 miles (25 minutes) from downtown Portland
• 7 miles (15 minutes) from downtown Vancouver
• 15 miles (18 minutes) from Portland International Airport
• 60 miles (1.5 hrs) from skiing Government Camp, Timberline, Meadows)
• Great food, entertainment, nightlife in Vancouver
• Fantastic mountain biking, hiking, boating nearby

Scheduling will be handled centrally with AIC assisting with auditing assignments and optimizing resources.

Extra services

• Occasionally called to assist with airway management in the ER/ICU
• Occasionally called to assist with CVCs/Arterial Lines in the ICU
• OB may be called to help with Femoral Blocks for all hip fractures
• OB may be called to help with Epidural Blood Patches and LPs

• 2 Sonosite Ultrasounds
• Multiple Glidecopes
• Difficult Airway Carts
• Single shot block supplies, catheters available with surgeon request early

Leadership

• Jon Hersen (President)
• Greg Saunders (CMO)
• Vicki Eastridge (Director of Surgical Intervention Services)
• Jen Walling (OR Manager)
• Megan Parsons (OR Assistant Manager)
• Jen Eland (Physician Engagement)

Evening Call Obligations

• 7 days OB Coverage
  • Dual coverage at night
• One backup call position each evening