Olga Dobrenko: “An Anesthesiologist Accompanies the Patient Throughout the Entire Treatment Journey”

An anesthesiologist-intensivist from Germany discusses the importance of a multidisciplinary approach, advantages of German healthcare, and distinctive features of the younger generation of physicians

Anesthesiologists are among the key specialists in modern medicine. The very fact of survival for people in critical situations, as well as their subsequent quality of life, largely depends on anesthesiologists. Given the aging population, the growing number of complex surgeries, and the increasing proportion of patients with comorbid conditions, the importance of this profession will only continue to grow, believes Olga Dobrenko, an anesthesiologist at Klinikum Siegen. Olga Dobrenko began her medical career as a plastic surgeon in Russian clinics. After relocating to Germany, she worked in vascular surgery and ophthalmology, and now practices as an anesthesiologist-intensivist. Her successful practice across various fields earned Olga Dobrenko recognition and a position on the jury of the All-Russian National Award “Health and Medicine Trends,” which honors leading physicians from different countries. We asked Olga Dobrenko about why anesthesiologists today must be broad-spectrum specialists, what defines the key characteristics of the German healthcare system, and what trends in modern medicine she noticed while serving on the competition jury.

— The role of anesthesiologists is becoming increasingly significant. As a practicing specialist working as an anesthesiologist-intensivist, how do you explain this trend?

— Today, an anesthesiologist isn’t just a specialist who administers anesthesia. Our role is significantly broader and deeper because modern medicine has become more complex, and with it has grown the need for highly qualified physician oversight of the patient’s condition. Surgeries have become more labor-intensive, high-tech, and lengthy, and each requires precise real-time management of human physiology. Additionally, the patient profile itself is changing: the population is aging, and more and more people are coming to surgeons with multiple chronic conditions simultaneously. For such patients, the anesthesiologist essentially becomes a clinical strategist, a physician who assesses risks, selects anesthetic tactics, stabilizes the condition, and accompanies them throughout the entire treatment journey. In short, modern medicine requires not just mastery of anesthesia techniques, but a comprehensive approach to patient safety. And we are precisely those specialists who ensure this safety from the first minute of surgical preparation through complete emergence from anesthesia and stabilization in the postoperative period.

— You have several specializations. Before becoming an anesthesiologist, you practiced vascular and plastic surgery, and then ophthalmology, quite successfully: in 2023 you became a laureate of the “Health and Medicine Trends” award in the “Best International Surgeon and Ophthalmologist” category. How does this interdisciplinary practice help you make optimal decisions when working with patients in critical condition?

— Interdisciplinarity in clinical medicine isn’t just a variety of specialties, but an expansion of thinking models. In critical conditions, the integration of knowledge about microcirculation, neurophysiology, tissue metabolism, respiratory regulation, and systemic hemodynamics is especially important. My experience in surgical disciplines has shaped precisely this holistic concept. For example, vascular surgery provided a deep understanding of macro- and microcirculatory mechanisms. This directly influences tactics for managing hemodynamics in conditions of hypovolemia, shock, blood loss, or reperfusion injuries. Plastic surgery is, above all, work with tissue viability and regenerative potential. This knowledge is important when assessing critical conditions where oxygen delivery is impaired, acidosis develops, and metabolic shifts occur. Understanding the physiology of tissue nutrition helps more accurately choose ventilation strategies, fluid therapy, and vasoactive support. Ophthalmology, which may seem unexpected, provided competencies in neurophysiology and microanatomy. For intensive care, this is critical: pupillary response, ophthalmologic signs of intracranial hypertension, features of neuromuscular transmission – all are markers of central nervous system status and indications for certain types of anesthesia or intensive therapy. Anesthesiology unites all these directions within the framework of critical care physiology.

— You began your professional journey in Russian clinics, and today you are a recognized specialist in the German healthcare system. This international experience allows you to combine different medical schools in your practice. Which elements of the German healthcare system, in your opinion, deserve widespread adoption in other countries?

— I would highlight several things that really work in Germany and could benefit any healthcare system. First, clear standardization: there’s a comprehensible protocol for practically every clinical step, based on international recommendations. This approach makes medicine predictable, transparent, and most importantly, safe. Second, Germany has a strong culture of documentation – every stage, from patient consultation to dosage selection, is recorded. This isn’t bureaucracy, but an element of safety: any specialist joining the case understands the entire treatment history. The third point is preoperative preparation. Patients are prepared for surgery with maximum thoroughness: anemia is corrected, chronic conditions are stabilized, additional diagnostics are conducted so that the person approaches the intervention in the most stable condition possible. This reduces complications. And of course, multidisciplinarity: the anesthesiologist, surgeon, internist, rehabilitation specialist, and sometimes psychologist discuss the patient’s treatment together. This allows every nuance to be considered and truly optimal tactics to be chosen.

— You’re not only a practicing physician but also an expert involved in evaluating and training young specialists. Last year, you were invited to the jury of the “Health and Medicine Trends” competition, where you evaluated the achievements of doctors from different countries. What trends in modern medicine did you notice when reviewing participants’ projects?

— Participating on the jury allowed me to look at medicine through the eyes of a new generation of specialists and recognize several obvious trends. For example, young physicians are increasingly integrating digital technologies into clinical work, and this isn’t a fad but a new logic of medicine: decisions are made faster and more accurately thanks to data. I also saw a strong shift toward interdisciplinarity: talented specialists are combining knowledge from surgery, anesthesiology, IT, bioengineering, and genetics. An equally obvious trend is the emphasis on safety and prevention: the younger generation of physicians perceives safety as a core value, not a formality. I can also note a trend toward globality. Young specialists think in international terms: they compare data, adapt global experience, and propose models applicable in different clinical environments. This kind of thinking is a major step forward.

— Your career trajectory—relocating to a new country and confirming your qualifications—appears to be the result not only of professionalism but also of personal perseverance. What character traits do you think helped you successfully adapt and achieve recognition at the international level?

— Probably the main quality for me has always been the ability to not be afraid of difficult tasks. Moving to another country isn’t just a change of language and healthcare system; it’s a complete restructuring of life. But I perceived it as an opportunity to grow, not as an obstacle. The second quality is discipline. In Germany, the qualification confirmation process is quite rigorous and requires systematic preparation. So I built a clear schedule and adhered to it as strictly as professional protocols. Mental flexibility helped a lot. A physician who enters a new system must be able to adapt their knowledge, learn from colleagues, and simultaneously preserve their own professional foundation. Another key trait is stress resilience: the ability to maintain internal balance, focus on the goal, and not let difficulties consume you is very helpful. And, of course, a genuine interest in the work plays a major role. When you truly love your profession, every new stage is perceived as a natural path of development. It was precisely this professional motivation that gave me the strength to go all the way and achieve recognition.

— And what stage will be next in your professional development? In what direction do you intend to move in the near future?

— Right now I’m focused on advancing in the field of intensive care and anesthesiology, as well as participating in projects related to patient safety and improving perioperative care protocols. I’m interested in developing educational initiatives: training young specialists, sharing experience, and participating in expert discussions. I’m confident that medicine is moving toward greater technological sophistication and personalization, and my task is to keep pace with these changes, implement the best global practices, and continue to develop professionally. To put it simply: my plans are to become better as a specialist and bring more benefit to patients and the system.