Greg Janelle was appointed interim chair for the Department of Anesthesiology in January, but his time with the University of Florida goes much further back. We sat down with Greg to discuss his past, present and future with the department.
Q: What was your time at UF as a resident and fellow like?
A: I came here on an interview to spend a weekend with my brother, who was in a PhD program at the University of Florida. I never intended to go anyplace for training south of the Mason-Dixon line, so I didn’t interview at any other place in the south. I then wound up comparing every other place to UF. The culture was obviously different here, and at the same time, despite being a tiny little college town, we had a dense concentration of really high-acuity cases, and that’s exactly what I was looking for in my training.
During my residency, the program was a little bit different than today. There were 27 people in my class, but only three of us had four-year spots in Gainesville. For my internship year, I did six months of internal medicine and then started anesthesia training in January. During my first six months, I was on the same ward at the VA, so I really got to know people very well over there, but I was also integrated into the internal medicine intern class where I met my wife. I still have a lot of friends from that intern class, including some physicians who are still here today.
We didn’t have any in-house moonlighting. I had to go to UF Jacksonville to do any anesthesia moonlighting. I did that for 48-hour consecutive shifts at least one weekend per month just to make minimum payments on my loans. By the time I had finished residency, I’d done eight months of critical care, including five or six months as an acting fellow in the units. In my CA3 year I did a six-month subspecialty track in cardiac anesthesia. I was pretty heavily embedded into the cardiac and critical care training pathways and then I decided to stay here and do a fellowship in cardiac anesthesiology.
Q: What made you choose anesthesiology as your specialty?
A: I did a surgery rotation early on and the mystique behind the curtain always intrigued me. I think a lot of us in anesthesia are motivated in part by immediate gratification. The tangible wins for my wife as an ID doc, like the long-term viral load suppression in an HIV patient, are extremely gratifying to her; however, to me personally, injecting something into an intravenous line and monitoring the immediate effects, being able to take control over somebody’s physiology while still guiding them safely through a procedure, and emerging them comfortably is a really incredible gift that we get to experience on a daily basis.
Q: How have you seen things change over the years at UF Health and in the Department of Anesthesiology?
A: When I got here there were 23 operating rooms and four outpatient ORs, and that was it aside from the VA. Now we have three towers with over 1,100 beds, 300 ICU beds and 75+ anesthetizing locations daily. We have five ambulatory surgery centers, including two adult sites, one for pediatrics, an outpatient interventional chronic pain location where we perform state-of-the-art surgical interventions, and an endoscopy center. We’re also doing off-site ECTs and oocyte retrievals at separate locations. That doesn’t even include our Regional Provider Network facilities! The growth has just been incredible, and it really seems like it has been accelerated in the last 15 years, especially starting with the opening of the south tower.
The culture has changed a lot, too. I think this place has always had an incredible working relationship between anesthesiologists and surgeons/proceduralists. It’s one of the things that drew me here, and one of the things that kept me here and in academic medicine. Yet even more so, I think the old-school mentality in the perioperative environment, where an element of hostility was expected, is simply not tolerated anymore. I think we’ve been change leaders here at creating a safe working environment over the decades, while the culture shift across the country has lagged.
Q: What was it like being on the NASA Medical Support Team?
A: The hospital had a contract with NASA that stemmed in part from the fact that we had a multi-place hyperbaric chamber that was on permanent loan here, and so this was one of the triage areas for NASA for any decompression illnesses. I did additional hyperbaric medicine training, and I’ve been a diver for a long time. The physiology of extreme environments has always fascinated me. When I was a chief resident and the opportunity came to go and do the training at Kennedy Space Center and be part of the medical support team, I jumped at the chance. Any time there was a launch or landing that allowed me to participate, I would go.
It was a blast and part of the process included massive simulations. They had eight different launch or landing mode contingencies, and after some of the actual missions they would declare a mock emergency. But it was a full-scale mock emergency. They would sometimes have a model of an orbiter thrown in the middle of the swamp and there’d be astronauts in full gear, and they’d deploy the amphibious bear cats and have KSC, military, and even adjacent hospital search and rescue choppers airborne. We would provide mock treatment of their injuries and sometimes we’d actually take the victims and load them up in one of the local support helicopters and fly them to one of the hospitals. I flew once to the Halifax helipad with an actual astronaut serving as a victim who pulled out a card in midflight that said “I’m now having a seizure”. It was a very unique experience!
Q: What are your priorities as you start your time as interim chair?
A: I’ve been in the department for a long time and have a pretty good understanding of the clinical operations, budgeting and Education Office. One of my priorities is making sure that I have a comprehensive view of the department and the other aspects with which I have not necessarily been fully integrated over the years.
I think there is always a little bit of uncertainty and trepidation with any leadership change, and so I want to keep us going on the trajectory that we’re on. We still have growth plans and keeping our employees happy and working in an environment where they are appreciated is imperative for us to be able to accomplish our goals while sustaining expansion.
We’re uniquely poised at a time when we have so many anesthesiologists in leadership positions in the College of Medicine and in UF Health. There’s a lot of positive energy and support with senior leadership here. I still need to make sure that our compensation plan gets fully vetted and integrated and still need to be focused on growth and recruitment and not lose sight of the fact that there are a lot of people doing important jobs who need our attention as well.
Q: You’ve been in the position about a month now, how has your daily life changed?
A: Well, my calendar tends to be very full of meetings these days. I’ve been peripherally involved in budgeting before and now it’s a primary role and responsibility, and the season just started so I’m on a crash course for revenue cycle, finance and administration.
The main thing is just the volume of things that I have to learn to effectively do this job on behalf of the faculty and employees. I have learned more about the incredible support that this department has. It’s been really refreshing to know that the people in our amazing support staff can patiently walk me through the myriad things I don’t know. I have the wisdom of three previous chairs who are still part of our department to help guide me through some of the stickier situations. That’s pretty atypical, but serves as a tremendous advantage for me in this position.
Q: Where do you see the Department of Anesthesiology moving forward?
A: We’re going to be at the forefront for the Artificial Intelligence initiative for the college and university. There’s been a lot of energy towards AI initiatives in the institution and it’s going to be really exciting to see how some of those projects come to fruition and how those will potentially be integrated into the clinical and research world. I think the ability to integrate big data from some of the systems that we have, but we haven’t necessarily been able to access to their fullest potential, will be a good opportunity for us to learn more about how to perform our roles better and more safely. I think the world of research here in our department is going to continue to grow. We’ve got some really amazing, energetic and innovative researchers here.
The department’s mission in the college is clear and sound and I think the role that we play as consultants to so many different proceduralists and the critical care organization is firmly established, but will to continue to evolve as well.
I think we have great leadership with our RPN affiliates in Deltona and Halifax and look forward to our potential for expanded presence in other communities as well.
Q: What do you do outside of work for fun and relaxation?
A: Fishing, tennis, walking, jogging, diving, skiing, hunting alligators, spending time at the beach and finding any opportunity I can to spend time with my family. In September of last year, we became empty-nesters when our high schooler graduated and started college, and our UF Gator undergrad son commenced grad school. Traveling is also a passion, and this year we are lucky to have a couple of adults-only trips planned!
My brother, who originally drew me to Florida, is still a Gator as well as a Professor and Associate Dean for Academic and Student Affairs in the College of Health and Human Performance. We try to get together as frequently as possible!
Thanks to Greg for taking the time out of his busy schedule to sit down with us. As we move into the 2023-24 academic year, we look forward to the many opportunities, innovations and amazing experiences sure to come.