August 28, 2024

Daniel I. McIsaac, MD, MPH, FRCPC

Daniel McIsaac, MD, MPH, FRCPC sees opportunities to improve care and outcomes for patients requiring anesthesia care everywhere. For Dr. McIsaac, research, including the key role that the International Anesthesia Research Society (IARS) plays in supporting and disseminating anesthesia research, is the key to unlocking these improvements. “There are way more exciting questions than there are researchers or research time to answer. The really exciting thing is that anesthesia research continues to play an important part of how we provide better, safer, optimized care, from the moment a patient is considering surgery, through the operating room, all the way to when a patient is home and recovering.”

As the newest member of the IARS Board of Trustees, both the organization’s mission, and the tangible impact that the IARS has had on his career and the specialty at large, motivated him to accept his invitation to join the Board. “Having an international society focused on what I’m passionate about, which is anesthesia research, is crucial to our specialty and crucial to our patients continuing to get better care,” Dr. McIsaac expressed. “Having an opportunity to be in a leadership position within the International Anesthesia Research Society is something that I really value, seeing the quality of people who are on the board, and the impact that they’ve made, both in their own careers and as part of the Society.” Now a professor in the Department of Anesthesiology & Pain Medicine and the School of Epidemiology & Public Health, and the Chair in Innovative Perioperative Care at University of Ottawa, Dr. McIsaac is sure to contribute unique perspectives and skills to the Board and further enhance the IARS’s mission and vision — advancing the science and practice of medicine worldwide. “It’s important for us to continue to strive to have an internationally oriented board and make positive, measurable impacts on anesthesia research and practice,” he emphasized.

The IARS has been a part of Dr. McIsaac’s anesthesia research journey since the beginning of his training in anesthesiology. He attended IARS Annual Meetings as a resident and later as junior faculty, read its journal, Anesthesia & Analgesia, and recognized the organization’s vital role in communicating, disseminating and funding high-quality science. However, it wasn’t until he applied for and received the IARS Mentored Research Award (IMRA) in 2016 for his randomized clinical trial evaluating prehabilitation in older surgical patients with frailty that IARS made an indelible mark on his career. As a newly funded researcher, he began to understand the pivotal role the organization plays for the specialty of anesthesiology. From that experience, and the mentorship he received in conjunction with that award, Dr. McIsaac was able to elevate his career and research to an international level. His work has had a major impact on patient care, which he remains fully dedicated to today. This early pivotal experience, and his deep desire to meaningfully improve the patient experience throughout perioperative period, underlie his drive to support the IARS’s mission.

With 10 years as a faculty member at University of Ottawa, his personal research journey from early-career to established investigator, and a track record of advancing anesthesia research, Dr. McIsaac will contribute substantially to the IARS aim to grow and support scientists globally. Without a doubt, these contributions will be informed by his experience leading a multidisciplinary, patient-partnered research group, the Aging Innovations in Perioperative Medicine and Surgery (AIMS) team. With his AIMS team and collaborators, Dr. McIsaac is tackling some of the most important questions facing anesthesiology today and expanding the specialty’s impact out into the perioperative setting. Their investigations focus on three major areas: 1) how to optimize the care of older surgical patients, especially those older surgical patients who are vulnerable and living with frailty; 2) how to prepare patients to be healthier before surgery so they have a better recovery after surgery, especially through prehabilitation, and 3) how to design and optimize the healthcare system so that it is best prepared to handle complex patients with complex perioperative needs. Dr. McIsaac and his team are also passionate about training the next generation of researchers focused on anesthesia and perioperative care, supporting over a dozen student, resident and graduate trainees at all times.

“If we want to help patients have better outcomes after surgery, which is the fundamental driver of being an anesthesia researcher, then we need to be involved in both caring for and researching the processes that we use to care for patients. This has to start from the moment that they get a diagnosis, or they decide that they’re going to go ahead and have surgery, all the way through to when they’re back home and ideally, doing well,” Dr. McIsaac articulated. He recognizes great opportunity leveraging patient’s motivations, clinician’s priorities and the health system’s interests. “When we think about a truly perioperative intervention like prehabilitation, better outcomes don’t just emerge from getting people to exercise, eat better and manage their stress,” he said, “but also from how we tap into patient’s motivations to improve their participation levels, how we leverage clinician’s beliefs in prehabilitation to get them to actively send their patients to our programs, and how we get the system leaders and administrators to lean in by proving, through robust clinical research, that outcomes will be better, length of stay will be shorter, and costs won’t be higher.”

For Dr. McIsaac, this approach is grounded in his own experiences providing clinical care, engaging in multi-methods research (both quantitative and qualitative), and partnering with patients, clinicians, scientists, and health system leaders in his research. “Research should be clinically grounded. Being in the operating room every week and working overnight and doing challenging cases, it gives you a good sense of what questions are really important,” Dr. McIsaac conveyed. He spends two days a week in the OR, building the clinical knowledge for his research. The other three days a week, he runs his research program, utilizing that clinical experience to advance patient outcomes. As a clinically-oriented researcher with a passion for randomized clinical trials, understanding what patients are going through helps guide Dr. McIsaac to identify the most impactful questions to address in his investigations.

While these clinical and research perspectives complement each other, the roles and the demands that accompany them can often be in conflict. With the increase in patient numbers and the types of care that require anesthesia service, anesthesiologists are in even higher demand inside and outside of the operating room than in the past. Often, the demand for anesthesia service doesn’t line up with the workforce resources. “This means that we need to make sure that we continue to be willing to protect anesthesiologists to perform research, which often means that they’re not in the operating room on a given day,” Dr. McIsaac observed. Allowing this crucial time to research important questions is the only way to enhance the specialty and understand how to best provide anesthesia care to all the patients who require it. Finding the ideal balance between focusing on research and providing clinical care is a constant challenge during these underresourced times, but one he tackles willingly and with optimism daily. “If we don’t continue to maintain a focus on research and supporting people to put their main focus on producing high-quality research, then the clinical care that patients require isn’t going to advance,” he conveyed.

Dr. McIsaac finds that the reward of finishing a clinical trial and discovering an answer to a question after investment of substantial time, effort and resources, is incredibly rewarding. Then, to be able to implement that new knowledge to improve the anesthesia care, amplifies that progress to a new level. “Going to the operating room or clinic, or going to the ward, caring for patients, helping them to get through a really challenging period of their life safely and on track to have a good recovery, that’s obviously a foundationally enjoyable part of this job,” Dr. McIsaac expressed. “The support and creation of important new knowledge plays a crucial role in how we communicate research findings to providers across the globe and it increasingly is playing a role in how we unite the international anesthesia community together to provide better patient care.”

In his new role as an IARS Trustee, he plans to convey how crucial it is to support international anesthesia research, uniting the global community on a shared mission, while providing valuable opportunities for support and mentorship for the next generation of scientists, just like he received from his IMRA early on. Dr. McIsaac recognizes that progress in patient care can’t occur without high-quality research, and especially clinical trials being done within the specialty. He hopes to further IARS’s mission to support them. “The IARS plays a crucial role within our international community because of its focus on science,” Dr. McIsaac expressed. “Thinking about international anesthesia research, if we can advance multicenter international trials and how they can be optimally conducted, that’s really how we’re going to make the biggest impacts on improving patient care every day.”