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Dr. Neil Macdonald discusses the reach of his specialty, the honor of being named a Top Doc and why Roanoke still feels like home.
Courtesy of Carilion
Dr. Neil MacDonald
For Dr. Neil A. Macdonald, anesthesiology is about far more than putting patients to sleep. As Chair of the Department of Anesthesiology at Carilion Clinic, he leads a team that plays a critical role across nearly every corner of patient care.
“The broad scope of our practice remains one of its greatest strengths,” he says. “We care for patients across the entire lifespan — from neonates to the elderly — and are actively involved in everything from perioperative medicine and pain management to obstetrics and ICU care.”
He’s especially drawn to the mix of autonomy and collaboration. “We enjoy a strong sense of autonomy in the OR while working closely with surgeons, nurses, anesthesia techs and others. It’s a highly rewarding team-based environment.”
Being named a Top Doctor by his peers is a meaningful milestone. “It’s a significant professional honor,” he says, and a reflection of a group of Carilion physicians who combine “clinical excellence, system leadership, professionalism and team-based communication.” On a personal level, it underscores the values he’s carried throughout his career, including “the ability to remain calm under pressure, to lead with fairness and to act with integrity.”
Though often viewed as a behind-the-scenes specialty, anesthesiology is essential in life’s most vulnerable moments. “We are the front-line patient advocate when they are most vulnerable,” Macdonald explains. “Often unconscious and unable to speak for themselves, patients rely on us to make them feel safe. Other professions say that the majority of our time is ‘boring’ — we take pride in keeping it that way.”
Looking ahead, he’s energized by new developments in the field. “Artificial intelligence and machine learning are beginning to play a bigger role in real-time medical decision-making,” he says. “These tools can help doctors better understand a patient’s surgical risks and tailor anesthesia plans to each individual. We’re also exploring how a person’s genetics may one day help us predict things like how they process pain medication, their sensitivity to pain and how well certain treatments might work for them. While this is still in the early stages, it holds real promise for more personalized and effective care.”
Macdonald and his wife, Patricia, have called Roanoke home since 1994. “It’s been a wonderful place to raise our three children — one of whom still calls the area home,” he says. “We enjoy hiking along the Appalachian Trail, participating in local races and cheering on regional sports teams. There’s something special about the sense of community and natural beauty that keeps us connected to this place.”
The story above is from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!