Jeffrey Glaser, MD, wants to change the world. The Encino anesthesiologist is an enthusiastic proponent of organized medicine's ability to create change for the better. And now he's got the political bug as well, offering him a vast stage from which to promote the kind of improvements in the health system he wants to see. And speaking of stages ...

"I'm not a professional actor, but I've done productions with the Malibu-based Southern California Children's Theatre," Dr. Glaser says. When his 8-year-old daughter, Sara, wanted to join the cast of "Annie," he went along for the ride. "I got hooked, and now I've also done 'Peter Pan,' 'Oliver!,' 'Cinderella' and 'Charlie and the Chocolate Factory' with her. It's a tremendous thrill to work with her in that capacity, and it's a really nice bonding experience," he says.

A sideline on the boards is not exactly uncommon for physicians. "For me, participating in theatre is a creative outlet and tension release," Dr. Glaser explains. "It's also really a continuum of what I do on a day-to-day basis. I like to think that every day I'm providing my best performance. I want to be flawless on stage in the operating theatre as well as the musical theatre."

Anesthesiology provides a means to satisfy Dr. Glaser's need for immediate gratification and his love of physiology. "You get to focus on one patient at a time, and you get to influence and watch the physiological changes take place as you have a positive impact on a patient's surgical experience," he says.

Dr. Glaser has honed his specialty further to focus on interventional pain medicine, a young, technology-driven field. "I've always been good with my hands and enjoy figuring out mechanisms of spine-mediated pain," he says. "So it was a natural development for me."

Pain medicine allows him a different kind of relationship with patients. "I see pain patients for long periods of time," Dr. Glaser says. "It's very gratifying when I can improve someone's quality of life. The new technologies being developed every day have really enabled interventional pain doctors to do things they couldn't do a few years ago."

In the past, a patient with an acutely herniated disc of the lumbar spine, for example, might have faced surgery as the only option. Now, with interventional pain management's minimally invasive procedures, physicians are often able to treat that same patient more conservatively.

Despite the exciting advances, Dr. Glaser is acutely aware of medicine's sober side. "A physician's ability to make medical decisions is constantly being challenged--and taken away--by third parties whose interest is in their own financial well-being," he says. "Frequently, the medical decision-making process is being dictated by people who haven't even gone to medical school and who certainly are not licensed to practice medicine. It's disheartening when you have good doctors, but interference from third-party payers makes it difficult for them to provide care their patients need."

One example: "Colonoscopy is the most cost-effective, lifesaving exam we do on a preventive basis, and it's usually performed by a gastroenterologist," Dr. Glaser says. "Many now request the services of an anesthesiologist to provide sedation, as they believe that by consulting a physician who specializes in anesthesiology, the patient will have a safer and more comfortable experience. Additionally, having an anesthesiologist responsible for the patient's comfort and safety enables the gastroenterologist to focus 100 percent on the procedure."

In addition, there's a backlog of patients needing screening colonoscopies. But by having an anesthesiologist on hand, a gastroenterologist could do more exams in the same amount of time. However, in late 2005, Blue Cross of California said it would no longer cover the routine services of an anesthesiologist for endoscopy or colonoscopy. "Patients are paying higher and higher premiums and insurance companies are more and more profitable--and yet benefits are being cut," Dr. Glaser says.

The whole situation is why Dr. Glaser wants to take his nascent interest in advocacy to a higher level. "In the future, I definitely see an expansion of my administrative involvement in medicine. I see so many flaws in our broken system, so my political involvement is important," he says.

He has been active in the Los Angeles County Medical Association and the California Medical Association for a little over a year and is increasingly committed to "global participation, representing all physicians." And he says he's not ruling out politics--kind of like a politician. "Healthcare is like the Titanic," he says. "We are heading straight for an iceberg. And not unlike the Titanic, healthcare does not turn on a dime. I hope we are wise enough to recognize the icebergs in our path early enough and turn our ship in the right direction."