Why Physician-Led Ketamine Therapy Matters: The Case for Choosing a Board-Certified Anesthesiologist

Choosing a Ketamine Provider in the Bay Area

As IV ketamine therapy has become more widely available across the Bay Area, patients may encounter meaningful differences in the clinical environments offering it. The qualifications of the clinician responsible for screening, administering, and monitoring treatment are important considerations.

For people in Silicon Valley considering ketamine therapy for depression, PTSD, or anxiety, it is reasonable to ask who will conduct the medical evaluation, monitor the infusion, and respond if a patient needs additional support during treatment.

At Soft Reboot Wellness in Menlo Park, care is physician-led. Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist who has guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy.

What Anesthesiology Training Brings to Ketamine Care

Anesthesiologists are physicians whose specialty training centers on anesthesia, medication effects, patient physiology, monitoring, and responding to complications during procedures. That background is relevant to ketamine treatment because ketamine can affect perception, consciousness, blood pressure, heart rate, and other physiological functions.

Guidelines for moderate procedural sedation emphasize appropriate patient assessment, monitoring, and the ability to recognize and respond when sedation becomes deeper than intended (American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, 2018).

At Soft Reboot Wellness, Dr. Herman’s clinical background informs the practice’s physician-led care model, including individualized screening, treatment planning, and monitoring throughout the infusion experience.

Ketamine Safety Requires Individual Assessment

Ketamine’s clinical risks are real, even though serious adverse events have been uncommon in published studies of low-dose IV ketamine for treatment-resistant depression. Common acute effects can include dissociation, perceptual changes, nausea, dizziness, and temporary increases in blood pressure or heart rate (Wan et al., 2015).

The American Psychiatric Association’s consensus statement on ketamine for mood disorders emphasizes careful assessment of medical and psychiatric history, informed consent, monitoring, and clinician readiness to address adverse effects (Sanacora et al., 2017).

At Soft Reboot Wellness, treatment planning begins with a thorough review of medical history, psychiatric history, current medications, cardiovascular considerations, and treatment goals. This is more than a questionnaire. It is an individualized medical evaluation designed to help determine whether ketamine therapy is appropriate.

For a closer look at the treatment process itself, read what ketamine therapy actually does.

Monitoring During an IV Ketamine Infusion

During IV ketamine treatment, patients may experience a dreamlike or dissociative state. They may also notice altered perception of time, visual changes, or temporary emotional intensity. These experiences can be expected effects of ketamine, but each patient’s experience is different.

Soft Reboot Wellness describes its infusion model as physician-supervised and monitored, with Dr. Herman personally involved in clinical administration and monitoring. Vital signs are tracked during treatment, and patients remain in the office until they are ready for discharge.

Patients can learn more about the practical details of a session in our guide to what to expect during ketamine therapy.

Physician Oversight and Treatment Decisions

Physician-led care is not only about what happens during an infusion. It also involves decisions before and after treatment.

Ketamine may not be appropriate for everyone. Medical conditions, psychiatric history, medication interactions, substance-use history, cardiovascular factors, and other individual considerations can affect candidacy. These decisions should be made through a careful medical and psychiatric review rather than a standardized protocol alone.

No clinician or setting can guarantee a particular treatment outcome. However, patients should understand who is responsible for clinical decision-making, how the practice approaches monitoring, and how concerns are addressed throughout treatment.

Understanding Fees and What Care Includes

Physician-led care may involve a different fee structure than other treatment models because clinical evaluation, ongoing monitoring, and individualized treatment planning take time and expertise.

Patients should feel comfortable asking what a treatment fee includes, who will be present during the infusion, how medical concerns are handled, and what follow-up is available. Soft Reboot Wellness discusses pricing during consultation so patients can make informed decisions without relying only on line-item comparisons.

Results vary by individual. The goal of careful oversight is not to promise a specific outcome, but to support appropriate selection, monitoring, and treatment adjustments when clinically indicated.

Ketamine Therapy and Stellate Ganglion Block

Soft Reboot Wellness also offers Stellate Ganglion Block treatments. SGB is a separate interventional procedure that uses local anesthetic near a group of sympathetic nerves in the neck.

The practice performs SGB with real-time ultrasound guidance. Dr. Herman’s anesthesiology background includes patient monitoring, airway management, and ultrasound-guided procedural experience relevant to this type of care.

Ketamine therapy and SGB are distinct interventions with different procedures, evidence bases, and candidacy considerations. Some patients may be appropriate candidates for one option and not the other. The right approach depends on an individual clinical evaluation.

Questions to Ask When Comparing Ketamine Providers

If you are evaluating ketamine providers in Menlo Park, Palo Alto, Redwood City, or elsewhere on the Peninsula, consider asking:

• Who will conduct my medical and psychiatric evaluation?
• Who will administer and monitor my infusion?
• What vital signs or other clinical measures are monitored during treatment?
• How does the practice screen for medical or psychiatric contraindications?
• What happens if I experience distress, nausea, elevated blood pressure, or another unexpected effect?
• How will treatment decisions be adjusted if my response differs from expectations?
• How does the practice coordinate with my existing psychiatrist, therapist, or primary care provider?

At Soft Reboot Wellness, we welcome these questions. Patients can also review our ketamine therapy FAQ information before consultation.

FAQ

What does it mean that Dr. Herman is a Harvard-trained anesthesiologist?

Dr. Herman completed anesthesiology residency training at Harvard Medical School’s Brigham and Women’s Hospital and completed a cardiothoracic anesthesia fellowship at Columbia University Medical Center. Her training includes anesthesia, pharmacology, patient monitoring, and procedural care.

Is ketamine safer when administered by an anesthesiologist?

No clinician or treatment setting can guarantee safety. Ketamine can cause temporary changes in blood pressure, heart rate, perception, and consciousness, which makes appropriate screening and monitoring important (Wan et al., 2015). An anesthesiologist’s training is directly relevant to medication administration, physiological monitoring, airway management, and responding to changes during a procedure. Patients should ask any provider about their training, monitoring practices, and emergency-readiness protocols.

Does it matter what type of physician is overseeing my ketamine infusion?

It is reasonable to ask about a clinician’s training, experience with ketamine, approach to psychiatric and medical screening, and role during the infusion. Different physicians may bring different backgrounds to ketamine care. Patients should understand who is responsible for treatment decisions and monitoring before beginning a program.

How does physician oversight affect ketamine patient selection?

Patient selection involves reviewing medical history, psychiatric history, medications, cardiovascular considerations, prior treatment response, and individual goals. A physician-led evaluation can help identify factors that may affect candidacy, monitoring needs, or treatment planning.

Why does Soft Reboot Wellness also offer Stellate Ganglion Block?

SGB is an image-guided nerve block procedure that Soft Reboot Wellness performs with real-time ultrasound guidance. Dr. Herman’s anesthesiology background is relevant to the procedural assessment, technique, and monitoring involved in SGB care.

Key Takeaways

• Ketamine treatment requires individualized medical and psychiatric assessment, appropriate monitoring, and informed consent.
• Anesthesiology training is relevant to ketamine administration because it includes pharmacology, physiological monitoring, procedural care, and response to changes during treatment.
• Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist with experience guiding more than 10,000 patients through anesthesia, pain management, and ketamine therapy.
• Soft Reboot Wellness provides physician-led IV ketamine therapy and ultrasound-guided Stellate Ganglion Block in Menlo Park.
• Patients should ask clear questions about screening, monitoring, clinician credentials, costs, and coordination with existing providers before starting treatment.
• Results vary by individual, and no provider should guarantee a specific outcome.

Conclusion

Choosing a ketamine provider is an important part of deciding whether treatment is right for you. A thoughtful consultation should include discussion of your medical and psychiatric history, current medications, treatment goals, potential risks, and the clinical environment in which care is delivered.

At Soft Reboot Wellness in Menlo Park, Dr. Sara Herman provides physician-led evaluation and monitoring for patients considering IV ketamine therapy. To learn more or schedule a consultation, reach out to our team today.

References

American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, & Society of Interventional Radiology. (2018). Practice guidelines for moderate procedural sedation and analgesia 2018. Anesthesiology, 128(3), 437–479. https://doi.org/10.1097/ALN.0000000000002043

National Institute on Drug Abuse. (2024, April 9). Ketamine. https://nida.nih.gov/research-topics/ketamine

Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., Summergrad, P., Nemeroff, C. B., & American Psychiatric Association Council of Research Task Force on Novel Biomarkers and Treatments. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399–405.

Wan, L.-B., Levitch, C. F., Perez, A. M., Brallier, J. W., Iosifescu, D. V., Charney, D. S., Murrough, J. W., & Mathew, S. J. (2015). Ketamine safety and tolerability in clinical trials for treatment-resistant depression. The Journal of Clinical Psychiatry, 76(3), 247–252. https://doi.org/10.4088/JCP.13m08852

About Dr. Sara Herman

Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist and founder of Soft Reboot Wellness. She has guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy.

Her clinical background informs Soft Reboot Wellness’s approach to individualized assessment, ketamine administration, physiological monitoring, and ultrasound-guided Stellate Ganglion Block procedures.

Medical Disclaimer

The content provided on this page is for educational purposes only and does not constitute medical advice. IV ketamine therapy is used off-label for psychiatric indications and is not FDA-approved for the treatment of depression, PTSD, or anxiety disorders. Individual results vary, and not every patient is an appropriate candidate. This information should not replace a consultation with a qualified medical provider. Please discuss with your provider whether any treatment described here is appropriate for your specific health situation. Soft Reboot Wellness serves patients in Menlo Park, CA and the greater Bay Area.