James Cain, MD, MBA, FASA, FAAP, is more than a physician. He is a husband, father of three, anesthesiologist, intensivist, mentor, educator, researcher and a patient and physician advocate.
He is also passionate about improving health care. Cain recently joined the University of Florida College of Medicine – Jacksonville in June 2023 as professor and chair of the department of anesthesiology. He earned a bachelor's degree at the University of Scranton, where he also lettered in wrestling, a doctorate in medicine and a master’s in business administration from the University of Pittsburgh. He completed an internship at Yale University and an anesthesiology residency and advanced training in critical care medicine and adult and pediatric cardiac anesthesiology at Harvard University’s Massachusetts General Hospital and Boston Children’s Hospital. He is triply board-certified in anesthesiology, pediatric anesthesiology and critical care medicine. He has exemplified excellence in medicine and scholarship throughout his career. Now his focus is on enhancing anesthesiology at the UF College of Medicine – Jacksonville and UF Health Jacksonville.
“I want to be where great health care is delivered,” Cain said. “The University of Florida College of Medicine – Jacksonville, certainly delivers. The clinical care, along with our educational mission, are exceptional and well established — our team does great work. I am looking forward to sharing our mission and vision as we together build a destination academic anesthesiology department.”
Prior to coming to UF COMJ, Cain served as chief of pediatric anesthesiology, Department Quality Officer, professor and senior vice chair of anesthesiology at the West Virginia University. Preceding that, he served as an associate professor at the University of Pittsburgh, as well as perioperative medical director and director of solid organ transplant at the Children’s Hospital of Pittsburgh. Previously, he served as director of pediatric cardiac anesthesiology at the Massachusetts General Hospital and instructor at Harvard University School of Medicine.
Why health care?
While Cain’s parents both had careers in health care — his mother a critical care nurse and father a child psychologist — his drive to be a physician was driven by the loss of those he only knew from family stories.
“I lost both of my grandfathers to sudden cardiac disease before I was born,” Cain said. “I felt sadness for them missing out on having more time with their families. I also always felt a void, an empty chair at the table, if you will. These feelings inspired me to pursue medicine to help people, patients and those that love them.
“Further, I’ve always cared for the sickest of patients and am continuously humbled and honored by their trust. Additionally, the opportunities in academic medicine to pay it forward in areas other than direct patient care, such as educating our next generation, pursuing scholarly activities and advocacy, are particularly rewarding.”
Trauma anesthesiology
Early in his medical career, Cain also became passionate about trauma care. As president of the Trauma Anesthesiology Society and the past president of the International Trauma and Critical Care Society, he has worked to expand the expertise of traumatologists and care of trauma patients nationally and globally. Trauma anesthesiologists and anesthesiology intensivists play a vital role in providing comprehensive care for trauma patients. Their expertise is crucial in ensuring the successful management and treatment of patients who have experienced significant injuries. Trauma anesthesiologists work in a team-based model, collaborating with various medical specialties to address the needs of complex trauma patients.
“Historically, trauma is the leading cause of death and disability for those aged 1 to 40,” Cain said. “While we see trauma around us daily, from the news to the car accidents on our commutes, it often seems we are inured to it. We don’t think about the devastating effect upon us and our communities, and we have fewer than half a dozen trauma anesthesiology specialty training programs in the country.
“The University of Florida College of Medicine – Jacksonville has a rich history of trauma care as Florida’s first accredited trauma program, and the only adult and pediatric Level I trauma program for Northeast Florida and Southeast Georgia. Among my goals is to start a trauma anesthesiology fellowship, positioning us at the forefront of this specialty and preparing tomorrow’s trauma care clinicians and leaders.”
Value-based care
His strategy to develop a recognized anesthesia department incorporates a value-based health care model. This approach is patient centered and focuses on holistic care with anesthesiology well positioned to bolster collaboration across nearly all specialties.
“Optimized anesthesiology requires consideration of the significant multidisciplinary nature that defines our specialty,” Cain said. “Anesthesiology must strive to add value to everyone we interact with: patients, surgeons, proceduralists, perioperative nursing, perioperative administration, colleagues and trainees. Further, as chair, it is my aim to pay particular attention to adding value to all those in our department.”
Problem-solving research
The answers are not always clear when caring for patients. Cain has been active in research and research supporting activities throughout his career, including serving as editor-in-chief of the journal Trauma Care. Early on, he concluded the research he would conduct would be more clinical than in the lab, particularly looking at questions that impact patients’ quality of care and quality of life.
“I enjoy problem solving, which in essence defines research,” he said. “It’s trying to figure out what gap in knowledge is keeping us from providing the best patient care and how do we provide a solution.”
While in medical school, Cain had the opportunity to work under the direction and mentorship of Peter Safar, MD, the “father of CPR” and three-time Nobel Peace Prize nominee for medicine.
“Peter Safer suffered a terrible tragedy when his young daughter died after a severe asthma attack. This spurred him to devote his life to resuscitation research, resulting in saving innumerous lives and earning the title of father of CPR,” he said. “His example was my formative influence in research. Under his leadership and guidance, I learned the process of clinical research from conception to completion.”
One of Cain’s impactful examples of solution-based research occurred not long after he completed anesthesiology training.
“Colleagues were discussing a challenge they were facing,” Cain said. “Electroconvulsive therapy is frequently successful in treating patients with severe, debilitating depression who have been unable to gain relief from other modalities. Unfortunately, inducing a therapeutic seizure under anesthesia can be difficult in some patients, as most anesthetics make a seizure less likely. While ECT was not then an area of my specific interest, I was interested in alleviating suffering. I had been using a new anesthetic when caring for my patients with cardiac disease and had been talking about it with a friend researching the same medication. We put our experience together and created a novel anesthesia protocol for these patients, which has since become an accepted practice that nearly ensures effective ECT for these patients.”
Cain’s current research interests include trauma and psychological safety and its impact upon patient safety.
Education
Long committed to global health improvement, Cain continues to see that the most immediate and long-lasting impact is through education. He has taught at all levels of medical education from local to international, developing and implementing curricula, supporting scholarly activities and critically evaluating professionalism and competency from trainees through faculty. He has been consistently ranked among the top speakers at meetings and top faculty educators by residents, fellows and allied health professionals.
“Among my most rewarding endeavors was chairing the University of Pittsburgh Anesthesiology Department’s Evaluation and Competency Committee and inaugural Milestones Committee,” Cain said. “We developed de novo the department Milestones process as one of a handful of ACGME beta test sites, including educating the department on the Milestones evaluation concept and then enmeshing our electronic medical education evaluation system within the Milestones process to continuously evaluate our program’s educational mission. It is exceptionally satisfying to see our students, residents and fellows graduate and go on to accomplished careers.”
Cain at the core
When he is not practicing medicine, Cain enjoys spending time with his family — his wife of 31 years, Roberta, and children Jamie, Francesca and Noelle — engaging in the arts and cheering on his favorite teams. He dabbles on the drums and occasionally the guitar. Among his favorite activities is taking in all that nature offers, especially running, hiking, biking and swimming. He and his family are looking forward to exploring all that Jacksonville has to offer.
Featured Faculty
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James G. Cain, MD, MBA, FASA, FAAP, D.ABA
Professor
Chair, Department of Anesthesiology