EA21 Newsletter: Honorary Member Profile – Stefan De Hert

One of our most well-known delegates and indeed the immediate past ESAIC President (2018-19), Stefan De Hert is one of this year’s nominated Honorary Members. Stefan has served ESAIC and its predecessor ESA in multiple committees and positions over the past two decades, while continuing his work as an anaesthesiologist at University Hospital Ghent, Belgium.

Q: Congratulations on your award Stef. How does it feel to be recognised by your peers in this way?

A: No doubt, it is really a big honour to be recognized by my peers with such a title. I thank everyone for this nomination and I’m grateful for the opportunities the profession of anaesthesiologist and the societal support has given me. I’m confident that thanks to the effort of every single anesthesiologist, together we can make a difference and strive for the ultimate goal of providing accessible and safe anaesthesia to patients all over the world.

Q: Take us back in time a few (!) years – what was it that attracted you to the speciality of anaesthesiology, and was it a speciality in its own right in Belgium back then

A: Indeed, it is more than a “few” years. I started my traineeship in 1986 and I can still remember these days. Long working hours, on duties, starting Saturday morning until Monday morning or afternoon, depending on how long the shortest program was. But the most important difference compared to these days certainly is the introduction of tools for adequate monitoring. In those times, the only monitoring we applied in general surgery was a 1-lead ECG, body temperature and manual cuff blood pressure measurements applied “at the discretion of the attending anaesthesiologist”. We had no pulse oximeter, no automatic NIBP, no end-tidal CO₂, no BIS or more advanced monitors of the depth of anaesthesia. Echocardiography, which is now a standard tool in our job, was virtually unknown to the anaesthesiologist, except for those involved in cardiac anaesthesia and the concept of remote monitoring was still only a science fiction item!

Another important development is that anaesthesiology is increasingly claiming its position in perioperative medicine including intensive care, which has become evident with the COVID pandemic where anaesthesiologists stood in the frontline. This role in perioperative care makes us anaesthesiologists the primary workers responsible for perioperative patient safety and prompts all of us to further advance the already high standards in anaesthesiologic practice.

Q: Have you always worked in the Belgian system, or did your training and other positions take you elsewhere?

A: I have worked a few years in the Netherlands, which was an enriching experience, to work in a quite different health system compared to the Belgian one. As an example, they have a well-established system of working with dedicated anaesthesia technicians, working under the direct supervision of the anaesthesiologist. I was impressed by their professionalism, their practical knowledge as well as their theoretical skills.

Q: How did you first become involved with ESA, the predecessor organisation of ESAIC? And from there, how did you become more and more involved?

A: This goes back a long time. From the early 1990’s I was already regularly present at Euroanaesthesia first presenting results of my early studies in the abstract sessions. Later on, I became involved as a regular lecturer and starting from 2004 I became really involved in the society, first as a member and later as chair of the Scientific Subcommittee on Clinical and Experimental Circulation. I have been a member of the Research Committee and chair of the task force for the ESA guidelines on preoperative evaluation of adults, undergoing noncardiac surgery. Then in 2012, I became chair of the society’s Scientific Committee and joined the board of Directors. In 2016 I was elected President of the ESA, now ESAIC, for the period 2018 – 2019. Currently, I’m chair of the ESAIC Education and Training Committee.

You see, I have quite a history with the society and had the chance to see it grow to the largest international society of anaesthesiologists in Europe.

Q: Did you ever envisage you would lead the organisation one day – tell us how it felt to find out you would be President?

A: I still remember my first steps within the society, I think in 1992, at the first or second congress of the ESA, still before the amalgamation in 2005. It was in Brussels, Belgium, at the Square where I presented one of my first abstracts. The society was still very young so there were far fewer attendees than we have now but still, it was impressive to meet international colleagues and to see the leadership of the European and international anaesthesiology community. At that time, I had no idea I would in the future be in such a leadership position.

When I was elected in 2016 as incoming president of such a prestigious society as ESA, now ESAIC, I considered this to be a very great honour and I was thankful for the trust and the appreciation my peers demonstrated in nominating me. Representing a society that is one of the leading scientific medical societies all over the world is challenging but also very rewarding. Thanks to the dedication and commitment of everyone involved in the various committees and in the ESAIC headquarters we continue to grow and get better in the service towards our members. I’m proud that despite these difficult times the society continues to develop its educational and scientific activities and promote patient safety.

Q: You have previously mentioned some achievements of which you are proud of during your time as President. We won’t go through them all here, but one of them was about promoting gender balance within the society, especially in leadership positions. Our Executive Director Cathy Weynants and our Scientific Chair Prof Idit Matot are leading the way here. How do you feel this initiative is going more generally?

A: Yes indeed Cathy and Idit are in the picture as role models. However, they are not the only ones. Actually, women are more visibly present in the leadership of the society. For instance, in my current committee, the education and training committee, all committees and entities involved in education and training are represented by their chair and I can tell you that 6 out of 9 chairs are women. Overall, women are chairs in 50% of the ESAIC committees, they also constitute about 50% of the council members. In our different committees, women now makeup to 40% and finally in our HQ staff 70% are women. Only the board of directors could do better with only a one-third representation of women. So this is a warm call for our female colleagues to also apply for these positions.

What particularly pleases me, is that gender equity now is finally accepted as “normal”. We want to achieve and promote gender equity in all educational and scientific activities not only for our activities but also for the external events that request ESAIC endorsement.

So yes, I’m very happy that the ESAIC community has embraced the gender equity project and has an active policy in making sure it happens.

Q: You also spoke of the importance of recognition of the Second Victim phenomenon and how more research and resources must be dedicated to this. For those delegates that don’t know, what exactly is ‘the Second Victim’ and what can we do to help him or her?

A: Second victims are health care providers who are involved in an unanticipated adverse patient injury, with or without personal medical error involved, and become traumatized by the event because they feel personally responsible for the event and the patient outcome.

The term is under discussion as both the use of the word “second” and the word “victim” are challenged but regardless of this discussion, we have to acknowledge that the phenomenon exists and that every person involved in healthcare will one day or another face a situation where a patient suffers harm while being under his/her care.

The problem has long been ignored, as people were told that this was part of the job and that one just had to deal with it. Obviously this was not the right attitude as this only leads to frustration, not being able to deal with the problem, feelings of guilt and uncertainty, potentially leading to burnout. No need to say that such feelings are not only bad for the person involved but may also seriously jeopardise one’s professional attitudes and skills, even with danger for patient safety. Therefore it is essential that the problem is recognised and dealt with in an adequate way. The ESAIC can act as a forum where the problem can be discussed and provide a framework to create an environment where national and departmental initiatives can be taken.

Q: Sadly we will not see you in person this year Stef as the congress is again fully online. In some ways, this is better because it gives you more time to catch up on sessions. Are there any particular areas that interest you in the program for this year’s Euroanaesthesia?

A: Well, my field of interest has always been cardiothoracic and vascular anaesthesia so I will certainly follow these sessions. And of course, related to my position of chair of the Education and Training committee I will follow all sessions of learning track 16, Leadership, Self-Development and Education, together with the different ESAIC sessions.

Thanks Stef, and congratulations on your honorary membership.

Read More of our special newsletter covering our virtual congress