Medical Staff Profile: Andrew Zadoff, M.D.

Q: You see patients when they are experiencing a difficult time medically – and emotionally, too. How do you approach this situation as a physician?

A: When patients first come to the ICU, my biggest concern is making sure I understand all the details of their health issues. So I do a complete medical history and physical exam to find out about any pre-existing conditions and any illnesses that occurred during their acute care hospital stay. Then I develop a framework of medical conditions that I need to address.There are some things I can fix quickly and others we address with a long-term plan. Their neurological status is addressed by the rehabilitation physician. If the patient is on a mechanical ventilator, I assess their current and potential respiratory function given their injury.Then I talk to the patient and their family about the problem with their lungs, how long it might last and what evaluations we can do to show progress in getting them off the ventilator eventually.

Q: Reviewing your 25-plus years of consulting at Shepherd Center, what would you cite as the most significant medical advances that have helped patients at the intensive care stage and in respiratory therapy?

A: We have found in the medical literature, as well as our own experience, some things that have improved our ability to get people better faster. These developments include better respiratory secretion control, more specific ventilator weaning criteria to give patients the best chance at success and, from our own experience, we’ve learned how to talk to patients to help them understand their time on the ventilator so we can all reach the same goal of weaning. Technologically, one of the biggest advances is the Neu RXTM Diaphragmatic Pacing System (DPS), which is an implanted device that helps ventilator-dependent patients wean off the ventilator. The vast majority of patients do not need this technology, but it is a significant development for the patients who do need it.

Q: What are a couple of the frequently asked questions you hear from ICU patients and their families, and how do you answer them?

A: Other questions relate to pre-existing conditions, such as diabetes, heart disease and emphysema. Patients want to know how to manage those conditions now that they have a spinal cord or brain injury. So I give them the framework of how we’re going to go forward with treatment. I try to be realistic and honest with patients about how we’re going to approach the problem.

Q: How do you work with your physician assistant and the Shepherd respiratory therapy staff to provide excellent care to ICU patients?

A: My physician assistant is Karen Kline, and she does an excellent job. We’ve worked together for almost 20 years. I trust her completely. She is basically my right arm. Karen acts as another set of eyes and ears and helps tremendously in balancing the volume of patients we care for. The Shepherd respiratory therapy staff is absolutely excellent. We are very lucky to have a number of staff members who are dedicated to caring for spinal cord and brain injury patients. They enjoy their jobs and are given independence under supervision in providing care.

Q: Why did you become a physician and choose pulmonology as your specialty?

A: I did not plan to be a physician. I wanted to be a research chemist. It was kind of a backwards way of getting into medicine. I was not interested in patient care, but the people who advised me in college suggested that I pursue an M.D./Ph.D. degree so I would have more jobs available to me. Then I got into medical school and, to my surprise, I enjoyed patient care so much that I never went back to research. I enjoy pulmonology because I like critical care medicine. The people who trained me trained me to understand the physiology of critical illness and to look at different avenues and keep an open mind in terms of treatment of patients to get the best possible care.

Interesting Facts:  Andrew Zadoff, M.D.

First Started Consulting at Shepherd Center: 1984

Random Facts:
• Dr. Zadoff enjoys playing golf and snow skiing, especially in Colorado.
• He grew up in Florida and never saw snow until he was in his thirties.
• Dr. Zadoff has been an avid bridge player for more than 40 years. He used to play in tournaments. Now, he plays with the same group of guys he’s played with since his school days. His regular bridge partner has been a friend since he was 10 years old.

Interviewed by Jane M. Sanders