Future of Anesthesiologists

[Consigliere]

I think a great academic job will soon be the white whale everyone wants.


--
Il Destriero

Not me. I'd rather not work.

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[Carbocation1]

Securing a fellowship is easy, if you don't care which fellowship. I think for the last few years there have been more fellowship spots in nephrology than applicants. Endo and ID are also quite easy to get fellowship spots in as well.

Unfortunately, fellowships in the desirable IM subspecialties (like GI) are less easy to come by, and even if you do get a fellowship, that's a total of 6 years of training, or even 7 years if you choose to do a chief year before fellowship. And even GI has its own share of problems. Reimbursements for colonoscopies (the bread & butter of GI) have dropped significantly in recent years and are slated to receive more cuts in 2016.

I remember speaking with an endocrinologist last year who said that his outpatient work week was M-F from 8-5, with an additional 4 hours of working at home every day to finish up notes/answer messages/process paperwork/review the next day's patients. That adds up to a 65-hour work week. When you do the math, that's significantly less pay per hour than most CRNAs.

The grass is not always greener on the other side.

Bingo

 

[bronx43]

Lol.
Also, literally your post just prior to this one stated how the vast majority of people end up losing interest and passion in their field. You shoulda gone into politics

You should go back to grade school. I said very few people have passion to start with, and those that do lose it after a few years. That's different from saying IM people regret going into it in the first place.

 

[bronx43]

Starting salary for IM (55 hrs + call + paperwork + malpractice stress) < CRNA (4o hrs w/o call or final responsibility). A hard pill to swallow for those considering IM as securing a fellowship requires hard work and luck.

If you're a decent applicant in an academic residency, you're basically guarantee to land any fellowship that isn't GI. If you're a fringe applicant and you can't match into an academic institution, then yeah, go do anesthesia.

55 hours? For what? Which IM specialty pays less than CRNA with that collection of traits? Only nephrology, I guess...

Lol at doing paperwork for 4 hours at home... I guess if you're like partially paralyzed or are watching ESPN and drinking scotch while doing it, then that's reasonable. Most people get good enough to be done with documentation while in the room.

 

[amLOLdipine]

Lol at doing paperwork for 4 hours at home... I guess if you're like partially paralyzed or are watching ESPN and drinking scotch while doing it, then that's reasonable. Most people get good enough to be done with documentation while in the room.

This absolutely false in my experience. Maybe if you're seeing 15 patients a day, but every single FM/Peds/outpatient IM attending I've worked with so far has said they spend at least a couple hours a day finishing work after they go home at 5 or 6pm. You must be exceptionally efficient if you're seeing a decent # of patients a day and can finish all of the documentation before going home.

With anesthesia, you don't bring your work home with you.

 

[bronx43]

This absolutely false in my experience. Maybe if you're seeing 15 patients a day, but every single FM/Peds/outpatient IM attending I've worked with so far has said they spend at least a couple hours a day finishing work after they go home at 5 or 6pm. You must be exceptionally efficient if you're seeing a decent # of patients a day and can finish all of the documentation before going home.

With anesthesia, you don't bring your work home with you.

It's about how much you want to document and how neurotic you are about it... the vast majority of what people document makes no different whatsoever in patient care, especially if you are the only person that will read your documentation later on. From a billing perspective, you literally need to drop like 1-2 lines to bill 95% of what you need. Our department billing office has told us time and time again that it's not how much you write, it's what you write. You can fill up a tome and bill a level 3, or write 15 words and bill a 5.

 

[Doctor4Life1769]

It's about how much you want to document and how neurotic you are about it... the vast majority of what people document makes no different whatsoever in patient care, especially if you are the only person that will read your documentation later on. From a billing perspective, you literally need to drop like 1-2 lines to bill 95% of what you need. Our department billing office has told us time and time again that it's not how much you write, it's what you write. You can fill up a tome and bill a level 3, or write 15 words and bill a 5.

Amlodipine is one of those genius medical students who knows about all the goddamn specialties and spits them out like facts, then proceeds to type his usual stump line about specialties going in continuous cycles without outside forces influencing things as they are now and radiology job market improving (false - it is flat overall). He knows oh so well how his attendings spend their time after hours, how efficient they are with documenting, how in depth or to the point those notes are, etc. He knows everything there is to know about all the goddamn specialties and you know nothing as an attending. Accept that and you'll realize it's not worth your time getting into it with him.

 

[Doctor4Life1769]

This absolutely false in my experience. Maybe if you're seeing 15 patients a day, but every single FM/Peds/outpatient IM attending I've worked with so far has said they spend at least a couple hours a day finishing work after they go home at 5 or 6pm. You must be exceptionally efficient if you're seeing a decent # of patients a day and can finish all of the documentation before going home.

With anesthesia, you don't bring your work home with you.

Yeah, your n of 5 totally makes you qualified to make such an absolute assertion. Bravo. I should just block you, but unfortunately, blocking you wouldn't actually delete your posts but rather state that you've posted *something*

 

[Doctor4Life1769]

Not me. I'd rather not work.

Word. I'd much rather gym, travel, and have someone else do my laundry.

 

[Nivens]

. Except pain. Maybe I'll just escape to pain medicine.

I have been thinking this more and more recently as well as these docs own their patients and seem to have it pretty good. However, there is this little voice in the back of my head that continuously reminds me that midlevels are far more likely to undercut the reimbursement of injections and managing chronic pain in clinics than they are to manage single-lung ventilation in a thoracic case. Which is truly in the greatest danger? I don't think the answer is as obvious as it seems.

 

[amLOLdipine]

Yeah, your n of 5 totally makes you qualified to make such an absolute assertion. Bravo. I should just block you, but unfortunately, blocking you wouldn't actually delete your posts but rather state that you've posted *something*

I vote that we agree to disagree, but you are welcome to block me if that's what you want to do. At the end of the day, SDN is still just an internet forum and not real life. As medical students, I'm not going to deny that our knowledge about jobs is limited, but what I will say is that the n is much greater than 5.

Clearly, as someone who left anesthesiology to go into family medicine, your opinions are going to be very different from those of someone who is interested in anesthesiology. Confirmation bias exists for everyone, and you and I are no exception. Based on your posts here, it certainly seems switching to family medicine was the right decision for you.

 

[Doctor4Life1769]

I have been thinking this more and more recently as well as these docs own their patients and seem to have it pretty good. However, there is this little voice in the back of my head that continuously reminds me that midlevels are far more likely to undercut the reimbursement of injections and managing chronic pain in clinics than they are to manage single-lung ventilation in a thoracic case. Which is truly in the greatest danger? I don't think the answer is as obvious as it seems.

Agreed. It really isn't.
Pain reimbursement is getting cut currently (mainly interventional) and it's not due to mid levels. I'm not sure if CRNAs will ever fully immerse themselves in interventional pain or not (if they do, it might take awhile). However, it appears there are some CRNAs who feel prepared enough to needle the c-spine apparently. I can see them opening up shop and doling out opiates, but then again that wouldn't really affect my decision. You can be purely interventional. There's plenty of other non-interventional physicians who do provide pain meds, etc. It really comes down to whether or not you want to have clinics, own patients, potentially own a practice, ever take call, etc. Lots of interventional folks around where I am seem to be doing just fine at this current moment in time. The anesthesiologist groups have all been bought out by Sheridan.

CRNAs get to be in thoracic rooms, too. The experienced ones probably can manage SLV, until crapola hits the fan.

 

[pgg]

Maybe I'll just escape to pain medicine.

I'm skeptical of that particular exit strategy.

A significant percentage of the procedural interventions done in pain clinics are voodoo placebo, ineffective except perhaps in the very short term. As time goes by and outcome measures are increasingly used as the rationale (or just an excuse) to cut reimbursement, I have to believe that interventional pain is going to be a ripe target.

And with ongoing regulation and (appropriate) crackdown on the profitable but unethical pill mill style prescription of opioids to a captive addicted customer base, that source of income is going to plummet. Much is made on this forum of "owning" patients but we'll see how long those patients stay "owned" when you won't refill their oxy.

I know some people love it, and god bless them for falling on those grenades, but the ones who love it for the clinic and the patients, not the procedures, are a rare breed. When the procedure money dries up, the Federal Narcotics Gestapo are scrutinizing your prescription habits, and you're left on the hamster wheel with a clinic full of chronic pain patients, what's the next "exit" strategy?

 

[Nivens]

Deleted

 

[criticalelement]

I vote that we agree to disagree, but you are welcome to block me if that's what you want to do. At the end of the day, SDN is still just an internet forum and not real life. As medical students, I'm not going to deny that our knowledge about jobs is limited, but what I will say is that the n is much greater than 5.

Clearly, as someone who left anesthesiology to go into family medicine, your opinions are going to be very different from those of someone who is interested in anesthesiology. Confirmation bias exists for everyone, and you and I are no exception. Based on your posts here, it certainly seems switching to family medicine was the right decision for you.

I want you to go into an anesthesia residency. I really do. I am not talking you out of it. When you are one of those people driving three hours round trip to work and back to be at home with your children and wife/husband I wanna take a polaroid of your face at that exact moment you realize you should have heeded other peoples advice. Should be a classic.

I dont hate my clinical work, but the whole dynamic sucks the life out of you. Maybe that is the whole of medicine perhaps but surely there has got to be something better than feeling like a chess piece on a daily basis.

 

[Temeraire]

what's the next "exit" strategy?

Academic pain?

In all seriousness, I do love the chronic painers. I think I'd still go into pain even if the procedures went way down and I had to manage pain without opiates. Ask me again in 10 years though haha

 

[Impromptu]

My strategy is to become financially independent so that I can leave or stay at my own pleasure. That should occur in 7 more years, which is about the same amount of time that I have been posting on SDN. While changes will occur in medicine, big drastic ones will just barely be starting to be implemented by then.

 

[Man o War]

This makes sense and don't doubt it.

I can see a situation where independent practice is actually good for MD/DO's. I've seen enough near miss situations to think that if CRNA's in mass were practicing independently the bad outcomes would add up pretty quick.

It would be horrible for patients of course but sometines you have to give people enough rope to hang themselves so to speak.

Give them all independence, and watch the bodies pile up. Terrible.
I will be happy to spend my money at the hospital that has anesthesiologists in the building when it's my turn to be on the table.
I suspect many other patients will be too when they learn that a nurse will be in charge of their anesthesia, not a doctor. This is where the ASA is missing the boat big time. Patients are often more nervous about being "put to sleep" than the actual surgery. Nobody would choose a nurse over a doctor if made aware that there is a choice.

 

[fianchetto]

MSIII here, long time lurker, but I've been following every thread closely, especially the ones that give an unfavorable outlook on anesthesia. I've even gone on to the nurses forum to get a sense of what their views are. There seems to be a lot of hate from both sides.

I really think I would enjoy this field. That's why I'm reading as much as I could about it.

Question:
The nurses really like to talk about how every study shows that there is equal outcome. And then we like to say that those studies are bogus because the study methods are flawed. Are there currently any studies going on that could put the issue to rest once and for all?

PS I think at one point someone said Taiwan isn't a true democracy because it's controlled by China. This is not true. Taiwan is as democratic as it gets. China claims Taiwan as a territory but has no power over it. But yes the healthcare system is singer-payer- great for the patients but terrible for the doctors.

 

[criticalelement]

Nobody would choose a nurse over a doctor if made aware that there is a choice.

Nobody would choose a nurse except this guy:

 

[Nivens]

Nobody would choose a nurse except this guy:

Except he didn't.

 

[Psai]

Nobody would choose a nurse except this guy:

You know this guy had the big name doctors tableside when he got his cabgx4
Aint no nurses for the vips, are you kidding me? Nurses playing doctor are for the hoi polloi

 

[donkeykong1]

Complex? This is world history 101. This is redneck-level ignorance.

"Taiwan is a self-ruling democracy since splitting with China in 1949 after a civil war, but has never formally declared independence, and Beijing sees it as part of its territory awaiting reunification, by force if necessary."

1/17/16 http://www.japantimes.co.jp/news/20...ote-causes-political-earthquake/#.VwJjqvkrLIU

Just saying its borderline ignorant to compare the economic and political system of Taiwan with that of the USA when you have an outside megapower in China playing the strings via the KMT party. I don't think the Reps or Democrats are outright Russian proxies, do you?

 

[donkeykong1]

If you're a decent applicant in an academic residency, you're basically guarantee to land any fellowship that isn't GI. If you're a fringe applicant and you can't match into an academic institution, then yeah, go do anesthesia.

55 hours? For what? Which IM specialty pays less than CRNA with that collection of traits? Only nephrology, I guess...

Lol at doing paperwork for 4 hours at home... I guess if you're like partially paralyzed or are watching ESPN and drinking scotch while doing it, then that's reasonable. Most people get good enough to be done with documentation while in the room.

Little to no documentation with EMRs intra-op, watching ESPN and drinking scotch after the last days case sums up what most of the Attendings here do every night they're not on call. IM rounding, lecturing pts and nurses, social work etc. left me wiped out by the end of the day. The fast pace (PP not academic) and minimal pt interaction in Anesthesia is hard to replicate in IM unless youre scoping or stenting each day with occasional call and no clinic/rounding responsibilities, which I'm sure is possible.

 

[Man o War]

Nobody would choose a nurse except this guy:

Mama was a CRNA and he still had anesthesiologist led anesthesia. Nobody chooses a nurse when they're aware there's a choice!

 

[Wiscoblue]

Unfortunately if I went in for surgery at a hospital where they have an ACT model, I will not get a doctor. It will be a Crna and there's no two ways about it. Yes the Crna will be supervised etc. but what if I just wanted a doctor solo? Unless these groups go to an all MD model. But then the docs would have to take a pay cut. There lies the problem and our lack of interest in fighting the proliferation of the Crna profession. We need them. Then we teach them. Then they turn around and say I'm so good I don't need you any more.

 

[Temeraire]

We need them. Then we teach them. Then they turn around and say I'm so good I don't need you any more.

Can someone explain why we teach them to do everything including intubations, extubations, blocks, etc.? They are not residents. I don't see why they need to know how to independently administer an anesthetic when they are ostensibly there to keep things at cruising altitude while the attending steps out of the room.

 

[chocomorsel]

Unfortunately if I went in for surgery at a hospital where they have an ACT model, I will not get a doctor. It will be a Crna and there's no two ways about it. Yes the Crna will be supervised etc. but what if I just wanted a doctor solo? Unless these groups go to an all MD model. But then the docs would have to take a pay cut. There lies the problem and our lack of interest in fighting the proliferation of the Crna profession. We need them. Then we teach them. Then they turn around and say I'm so good I don't need you any more.

There are ACT models out there that have a blend of both. Supervision and physician provided anesthesia. Find one of those and pre plan for an anesthesiologist. I personally refuse to work in a model where I do greater than 70% supervision. I would find it hard to keep up my skills and I enjoy doing my own cases.

 

[BLADEMDA]

There are ACT models out there that have a blend of both. Supervision and physician provided anesthesia. Find one of those and pre plan for an anesthesiologist. I personally refuse to work in a model where I do greater than 70% supervision. I would find it hard to keep up my skills and I enjoy doing my own cases.

I"ve got no problem keeping up my skills. I get plenty of spinals, intubations, lines,etc every single day supervising crnas. But, I'd much rather be doing all my own cases or at least 30% as you have posted. It makes for a much more enjoyable day.

 

[deleted126335]

There are ACT models out there that have a blend of both. Supervision and physician provided anesthesia. Find one of those and pre plan for an anesthesiologist. I personally refuse to work in a model where I do greater than 70% supervision. I would find it hard to keep up my skills and I enjoy doing my own cases.

no matter what type of practice you join, it may rapidly change in this environment. Be prepared for the day when your 30% doing your own cases turns into 10% doing your own cases - the 10% being relieving CRNAs to go home in the afternoon/evening or pure after hours.

 

[Random Anesthesiologist]

First, I was talking about Western Europe only, and even there we should exclude some Mediterranean countries, which are poorer.

Second, you cannot compare incomes to compare lifestyle. Because of high taxes, a lot of free/cheap services the average European gets (higher education, healthcare, public transportation, retirement) are way more expensive in the US, if they exist at all (our public transportation system is a joke). Then the average American works 25-50% more than the average European (who works 40 hours). There is a much better social safety net in Europe. They seem to have a better work-life balance. I might be wrong, but we seem to have more poor people than they do.

I am not pleading for the superiority of the European model (I moved here, didn't I), I just don't consider it inferior. Only different. Young people should be more open-minded when judging other societies, not take everything they have been taught as gospel.

Unless you live in Spain, or Greece, or Portugal, or even the UK where the "free" services and retirement plans are beginning to become a burden to the working population. Enough so that there have been huge financial crises.

20-30 hour work weeks only go so far.

 

[deleted171991]

Unless you live in Spain, or Greece, or Portugal, or even the UK where the "free" services and retirement plans are beginning to become a burden to the working population. Enough so that there have been huge financial crises.

20-30 hour work weeks only go so far.

They generally work 35-45 hours, 40 on average. Please. And Spain, Greece and Portugal have always been poorer, hence the reason I did not include them above.

The problem with every annuity-type national retirement plan (e.g. Social Security) is that it's basically a Ponzi scheme (because politicians overpromise what it can deliver). So it pays out money mostly based on current contributions. The problem in many developed countries is that the population growth is too low, meaning that there are not enough active workers contributing per retiree withdrawing money, and it's only going to get worse. That's where immigration comes in, and that's why certain developed countries don't have the problem as bad.

 

[D P356]

Starting salary for IM (55 hrs + call + paperwork + malpractice stress) < CRNA (4o hrs w/o call or final responsibility). A hard pill to swallow for those considering IM as securing a fellowship requires hard work and luck.

Negative. Especially for a hospitalist. I wouldn't doubt you heard the above from another med student. It's okay, I was there, too.

A lot depends on the location and type of practice.
They may be similar at the same academic facility, but the IM attending has a team of residents doing the scut work.

PP IM/hospitalists haven't told you how many hours they work at home....because having a student with them will slow them down. Then as they progress in their practice, they make more.
Respectfully, your statement is not correct.

 

[pgg]

Unless you live in Spain, or Greece, or Portugal, or even the UK where the "free" services and retirement plans are beginning to become a burden to the working population. Enough so that there have been huge financial crises.

20-30 hour work weeks only go so far.

Especially when your national defense has been covered almost in its entirety for the better part of a century by some nice people an ocean away who weren't enthusiastic about getting sucked into yet another World War started by Europeans.

 

[deleted171991]

Especially when your national defense has been covered almost in its entirety for the better part of a century by some nice people an ocean away who weren't enthusiastic about getting sucked into yet another World War started by Europeans.

Don't use the plural (Europeans), please. There is a very limited number of nations who have started those wars (and many of the previous ones). They tend to be almost the same peoples, who think about themselves as superior to all others.

Now you were saying something about some other nice people (who hopefully don't think about themselves as being superior to all others)...

 

[pgg]

Don't use the plural (Europeans), please. There is a very limited number of nations who have started those wars (and many of the previous ones). They tend to be almost the same peoples, who just think about themselves as superior to all others.

Now you were saying something about some other nice people (who hopefully don't think about themselves as being superior to all others)...

I was indulging in a little bit of trollishness. Just a little bit. It gets a little tiring to hear (some) Europeans lecture us warmongering capitalist pigs about the virtues of their socialist paradises, having spent their defense budgets on social programs because they enjoyed the umbrella of our protection for many decades.

 

[deleted171991]

I was indulging in a little bit of trollishness. Just a little bit. It gets a little tiring to hear (some) Europeans lecture us warmongering capitalist pigs about the virtues of their socialist paradises, having spent their defense budgets on social programs because they enjoyed the umbrella of our protection for many decades.

I hope you didn't mean me.

I am not a big fan of socialism (also known as spending other people's money). I am a big fan of the "middle way", and I am not afraid to borrow good ideas from anybody, even from socialists. I used to be more libertarian, but that only works if you don't care about other people and their problems.

 

[pgg]

I hope you didn't mean me.

Not at all. Besides, you're a 'murican now.

 

[Carbocation1]

AmSurg’s Physician Services Division – Sheridan – Acquires North Florida Anesthesia Consultants, Inc.
http://www.businesswire.com/news/ho...rg’s-Physician-Services-Division-–-Sheridan-–

 

[Doctor4Life1769]

AmSurg’s Physician Services Division – Sheridan – Acquires North Florida Anesthesia Consultants, Inc.
http://www.businesswire.com/news/home/20160404006591/en/AmSurg’s-Physician-Services-Division-–-Sheridan-–

Still don't believe us?

 

[Random Anesthesiologist]

They generally work 35-45 hours, 40 on average. Please. And Spain, Greece and Portugal have always been poorer, hence the reason I did not include them above.

The problem with every annuity-type national retirement plan (e.g. Social Security) is that it's basically a Ponzi scheme (because politicians overpromise what it can deliver). So it pays out money mostly based on current contributions. The problem in many developed countries is that the population growth is too low, meaning that there are not enough active workers contributing per retiree withdrawing money, and it's only going to get worse. That's where immigration comes in, and that's why certain developed countries don't have the problem as bad.

European countries aren't shy with immigration. But I agree, the amount of active workers is key. Something that is applicable to our country too, since the number of active workers has been declining (and you can't look at unemployment percentages to gauge that).

 

[Random Anesthesiologist]

Especially when your national defense has been covered almost in its entirety for the better part of a century by some nice people an ocean away who weren't enthusiastic about getting sucked into yet another World War started by Europeans.

I don't disagree with you there

 

[bashwell]

First, I was talking about Western Europe only, and even there we should exclude some Mediterranean countries, which are poorer.

Second, you cannot compare incomes to compare lifestyle. Because of high taxes, a lot of free/cheap services the average European gets (higher education, healthcare, public transportation, retirement) are way more expensive in the US, if they exist at all (our public transportation system is a joke). Then the average American works 25-50% more than the average European (who works 40 hours). There is a much better social safety net in Europe. They seem to have a better work-life balance. I might be wrong, but we seem to have more poor people than they do.

I am not pleading for the superiority of the European model (I moved here, didn't I), I just don't consider it inferior. Only different. Young people should be more open-minded when judging other societies, not take everything they have been taught as gospel.

FFP, if things get really bad with anesthesia in the US, can you move back to your home country in Europe and practice there? That might not be a bad way to go.

Australia is a lot more like some of these European countries I think you're alluding to (e.g., average work week is 38 hours, great work/life balance, great social safety net, etc.). Australia is my "Europe" if the future is truly going to be so bad in the US.

 

[bashwell]

If the future of anesthesiology in the US is so bad (e.g., more incompetent CRNAs, more CRNAs unwilling to follow direction), then it seems like it could become increasingly risky for people to have certain surgeries. At least it makes me think twice about having surgery in the US now. Unless I can somehow be guaranteed to have an experienced attending anesthesiologist do my case.

 

[Man o War]

If the future of anesthesiology in the US is so bad (e.g., more incompetent CRNAs, more CRNAs unwilling to follow direction), then it seems like it could become increasingly risky for people to have certain surgeries. At least it makes me think twice about having surgery in the US now. Unless I can somehow be guaranteed to have an experienced attending anesthesiologist do my case.

Not sure how things are where the rest of you practice, but I am in a good sized market...the hospitals here are so cut throat for business. They're constantly "one upping" each other in various ways to try and attract more patients. I can't imagine the PR nightmare if one of these hospitals decided to go unsupervised, CRNA only. The other hospitals would be all over that- any excuse to cut down the competition is fair game here. Rural hospitals that are the only show in town might be a different story, unless those residents have means to travel and have surgery in the city. There was a CRNA recently who got busted for stealing vials from the OR which were later found on her....it was in the paper, on the news, etc. I didn't think it was really going to be a huge story but it ended up being one. Lots of my coworkers think the story had some help being disseminated if you know what I'm saying.

 

[Temeraire]

I bet an overwhelming majority of people would choose having an anesthesiologist over an independent CRNA if given a choice. My parents are not doctor people at all, and they get spooked by stories passed on by their church friends. I actually just had this conversation with my mom over the phone yesterday, seriously...

Mom: so I have a friend of a friend whose brother's wife is an anesthesiologist
Me: uh huh ok
Mom: and she was taking care of uh... 2 to 3 patients in an operating room? I've never heard of this... why would they put 2 to 3 patients in the same room?
Me: she was probably supervising 2 to 3 operating rooms. Each room has one patient, and the anesthesiologist goes around to each room checking on them during surgery. This is common.
Mom: oh ok that makes sense... and there was a nurse practitioner? helping the anesthesiologist?
Me: a certified registered nurse anesthetist
Mom: a what?
Me: *explains for 2 minutes*
Mom: oh ok, so the nurse saw that the patient's heart stopped beating on the EKG, and she just thought the machine wires stopped working
Me: EKG leads fall off a lot. that happens frequently
Mom: no but, the patient's heart actually stopped beating! and the nurse didn't call in the anesthesiologist for a long time because she thought it was an EKG problem
Me: what.
Mom: so the patient died, and the patient's family is suing the anesthesiologist and the nurse
Me: that makes no sense mom--what--how--wouldn't they see--
Mom: that's so scary! how is this allowed to happen? why can't the anesthesiologist be in the room the entire time???

 

[Psai]

I bet an overwhelming majority of people would choose having an anesthesiologist over an independent CRNA if given a choice. My parents are not doctor people at all, and they get spooked by stories passed on by their church friends. I actually just had this conversation with my mom over the phone yesterday, seriously...

Mom: so I have a friend of a friend whose brother's wife is an anesthesiologist
Me: uh huh ok
Mom: and she was taking care of uh... 2 to 3 patients in an operating room? I've never heard of this... why would they put 2 to 3 patients in the same room?
Me: she was probably supervising 2 to 3 operating rooms. Each room has one patient, and the anesthesiologist goes around to each room checking on them during surgery. This is common.
Mom: oh ok that makes sense... and there was a nurse practitioner? helping the anesthesiologist?
Me: a certified registered nurse anesthetist
Mom: a what?
Me: *explains for 2 minutes*
Mom: oh ok, so the nurse saw that the patient's heart stopped beating on the EKG, and she just thought the machine wires stopped working
Me: EKG leads fall off a lot. that happens frequently
Mom: no but, the patient's heart actually stopped beating! and the nurse didn't call in the anesthesiologist for a long time because she thought it was an EKG problem
Me: what.
Mom: so the patient died, and the patient's family is suing the anesthesiologist and the nurse
Me: that makes no sense mom--what--how--wouldn't they see--
Mom: that's so scary! how is this allowed to happen? why can't the anesthesiologist be in the room the entire time???

Thats really sad. Things like this will happen with the good enough for the computer healthcare we have these days

 

[Mman]

At least it makes me think twice about having surgery in the US now. Unless I can somehow be guaranteed to have an experienced attending anesthesiologist do my case.

So not only do you want MD only care, a board certified anesthesiologist isn't good enough, you want an experienced anesthesiologist? How many years of practice are necessary beyond residency for you to feel comfortable with them caring for you?

 

[nimbus]

So not only do you want MD only care, a board certified anesthesiologist isn't good enough, you want an experienced anesthesiologist? How many years of practice are necessary beyond residency for you to feel comfortable with them caring for you?

Depends on the individual....but 5 years would be nice.

 

[bashwell]

So not only do you want MD only care, a board certified anesthesiologist isn't good enough, you want an experienced anesthesiologist? How many years of practice are necessary beyond residency for you to feel comfortable with them caring for you?

Well, "experienced" isn't necessarily dependent on being BC. I never said that. You could be "experienced" with less. It depends on the individual.

More importantly, best to read the "spirit" of what I said rather than the exact "letter" of what I said. The point is not to nitpick over qualifications. Rather my larger point was if what people here are saying is true about the future of anesthesiology in the US, such as about CRNAs being incompetent and/or unwilling to follow direction, then it seems reasonable to think certain surgeries could become more risky to undergo.