Marketing "101"

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Noyac

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So I am a bit busted up from my last motocross adventure and I sitting around trying to recover ASAP. I found a stack of throw away journals and decided to thumb thru them. One article struck me.

Marketing "101" for Anesthesiologist by Amr Abouleish, MD.

HE STATES:
Like all workers, anesthesiologists must determine the best ways to serve their "customers"-the hospital, surgeons, patients and bill payers. It the real costumes and the hospital ( administrators). They are the ones that will renew your contract.
Side note: I'm employed but in reality, we are all employed since any hospital can cancel a contract essentially.
Amr states, administrators should know your value and how your practice is indispensable to the hospital.

He had some others points and examples but I'll stop there for now. My question is, does your group understand this? Is this just BS? What do you do to get this principle across to the administrators?

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Definitely not BS. Any exclusively hospital based specialty probably deals with the same thing, how to convey what it is we do to the suits. I find this to be fairly difficult. Most of them are not clinical, and since we don't bring in patients we have to work with what we have. They like numbers and graphs, improvement and growth. The metrics are pretty easy to look at but it's key to justifying your existence these days.
 
So I am a bit busted up from my last motocross adventure and I sitting around trying to recover ASAP. I found a stack of throw away journals and decided to thumb thru them. One article struck me.

Marketing "101" for Anesthesiologist by Amr Abouleish, MD.

HE STATES:
Like all workers, anesthesiologists must determine the best ways to serve their "customers"-the hospital, surgeons, patients and bill payers. It the real costumes and the hospital ( administrators). They are the ones that will renew your contract.
Side note: I'm employed but in reality, we are all employed since any hospital can cancel a contract essentially.
Amr states, administrators should know your value and how your practice is indispensable to the hospital.

He had some others points and examples but I'll stop there for now. My question is, does your group understand this? Is this just BS? What do you do to get this principle across to the administrators?
Your outcomes should determine your value, but in reality outcomes that matter are hard to measure.

They will look at your SCIP compliance, in room times, and not causing trouble with surgeons as surrogates. None of these correlate with hard outcomes in my opinion. Plus, it is very easy to find someone else to do these simple tasks.

Until we come up with a way to compare outcomes, like for CT surgeons, we will be deemed as interchangeable. You can look up NY state CT surgeons on Google and within 5 min have a short list of names of surgeons that you wouldn't mind operating on a relative.

Until we have that, we will be anonymous anesthesiologists.
 
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So I guess this thread was a bust.
Nobody is interested in "marketing" their position at their facility or they don't know how to.
No wonder so many groups are changing hands these days. We are easy targets.
Well, not at my facility. At least not as easy as most.
 
Not to depress anyone but.... My hospital is replacing me, when I leave, with two crnas. Some of the old guard surgeons had fought this and they are now to old/worn out to disagree anymore. New surgeons like that the crnas will do cases regardless of npo status, etc. my hospital, in Indiana - not an opt out state, allows crnas to practice independently. Admin says the surgeons are not liable or supervising the crnas unless the surgeon tells them what kind of anesthesia to give etc. I can't see how this is really possible? Anyone know anything about this?
 
Not to depress anyone but.... My hospital is replacing me, when I leave, with two crnas. Some of the old guard surgeons had fought this and they are now to old/worn out to disagree anymore. New surgeons like that the crnas will do cases regardless of npo status, etc. my hospital, in Indiana - not an opt out state, allows crnas to practice independently. Admin says the surgeons are not liable or supervising the crnas unless the surgeon tells them what kind of anesthesia to give etc. I can't see how this is really possible? Anyone know anything about this?
I know a few hospitals in southern Indiana that have done this. A friend who is echo boarded anesthesiologist couldn't even make the case for docs when he made a proposal and they are using CRNA's, even sending them to get echo training. They just want someone to steer the probe and shoot an occasional gradient. It's a very cardiac heavy facility. Race to the bottom.
 
Not to depress anyone but.... My hospital is replacing me, when I leave, with two crnas. Some of the old guard surgeons had fought this and they are now to old/worn out to disagree anymore. New surgeons like that the crnas will do cases regardless of npo status, etc. my hospital, in Indiana - not an opt out state, allows crnas to practice independently. Admin says the surgeons are not liable or supervising the crnas unless the surgeon tells them what kind of anesthesia to give etc. I can't see how this is really possible? Anyone know anything about this?

In non-opt out states my impression was that surgeons could supervise the nurses, but that are essentially on their own. Surgeon mainly just signs the chart.
 
The surgeons don't sign the anesthesia record.

They don't have to sign the record, but in a non-opt out state, CMS guidelines state that the CRNA must be supervised by a physician. If they aren't, the hospital is not complying with CMS guidelines and it would be an Immediate Jeopardy issue if discovered which would cause the hospital to lose all CMS funding.
 
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That's what I thought as well.... The surgeon is supervising. The surgeons all think we are supervising.... But we are in our own cases so we aren't. Who's on the hook liability wise if something goes wrong with the crnas anesthetic?
 
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Not to depress anyone but.... My hospital is replacing me, when I leave, with two crnas. Some of the old guard surgeons had fought this and they are now to old/worn out to disagree anymore. New surgeons like that the crnas will do cases regardless of npo status, etc. my hospital, in Indiana - not an opt out state, allows crnas to practice independently. Admin says the surgeons are not liable or supervising the crnas unless the surgeon tells them what kind of anesthesia to give etc. I can't see how this is really possible? Anyone know anything about this?

I know a few hospitals in southern Indiana that have done this. A friend who is echo boarded anesthesiologist couldn't even make the case for docs when he made a proposal and they are using CRNA's, even sending them to get echo training. They just want someone to steer the probe and shoot an occasional gradient. It's a very cardiac heavy facility. Race to the bottom.

As a student very interested in the specialty and generally well inured to the tone on SDN, this is the first sequence of posts that have seriously made me fear for the future of anesthesiology and second guess my decision.
 
As a student very interested in the specialty and generally well inured to the tone on SDN, this is the first sequence of posts that have seriously made me fear for the future of anesthesiology and second guess my decision.

You should fear for the specialty. In all truth, you should fear for the future of medicine. The goal of nurses and beaurocrats is to replace us with more "cost effective" "providers" in other words CRNAs, NPs, etc. Everybody loves THEIR doctor, they just think doctors in general make too much money and can be replaced with cheaper options to help manage the high cost of health care. In truth, physicians only make up something like 9% of all dollars spent on health care. Not sure why trimming that tiny amount is supposed to save health care.
 
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I'm in an area with several hospitals that do heart cases, and it's not even remotely on anyone's radar to have CRNAs do hearts unsupervised. None of the hospitals here with the exception of one even have CRNAs in the heart room, they are doc only cases. I sure can't speak for the rest of the country, but the idea of totally unsupervised CRNAs in heart cases would never fly here with surgeons or administration.
 
You should fear for the specialty. In all truth, you should fear for the future of medicine. The goal of nurses and beaurocrats is to replace us with more "cost effective" "providers" in other words CRNAs, NPs, etc. Everybody loves THEIR doctor, they just think doctors in general make too much money and can be replaced with cheaper options to help manage the high cost of health care. In truth, physicians only make up something like 9% of all dollars spent on health care. Not sure why trimming that tiny amount is supposed to save health care.


Thanks for your reply. FYI Total spending on "physician services" as defined by CMS was 20% in 2013. That figure includes all provider overhead costs and outpatient lab costs, meaning that even 9% would be optimistic for the actual cost of doctors net pay. Bottom line: you're right -- it doesn't account for much.

My take is that medicine operates a lot like the natural world. Animals that herd stay strong, and the predators pick off those that fragment. Doctors, having been legally prohibited from collective bargaining, etc., have been so effectively splintered that driving down their cost makes strategic, if not great financial, sense.

I don't mean to hijack the thread, but if anyone here were a student today and valued:

- specialization
- not being a surgeon
- good balance of money and time off (I don't need to make 600K, but I'm not willing to work 60 hours a week for 50 weeks a year for $250K either. Oh, and $300 for 26 weeks of hospitalist work doesn't count).

What would you choose? I've seen all of blade's posts, and I get what makes the most "checkbox" sense, but I do not want to be a surgeon. Full stop. I'd love to hear what practicing anesthesiologists look at and say, "you know what, that would have been a good second choice if I were to do it over again", with the knowledge of how things are really going for your peers in those fields.

I still love what I see about anesthesiology and may well still end up there, but I'm curious nonetheless.
 
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My take is that medicine operates a lot like the natural world. Animals that herd stay strong, and the predators pick off those that fragment. Doctors, having been legally prohibited from collective bargaining, etc., have been so effectively splintered that driving down their cost makes strategic, if not great financial, sense.

I will repeat again: employed physicians CAN (and should) unionize. I have no idea why we don't.
 
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[QUOTE="repititionition, post: 16522942, member: 45482]

What would you choose? I've seen all of blade's posts, and I get what makes the most "checkbox" sense, but I do not want to be a surgeon. Full stop. I'd love to hear what practicing anesthesiologists look at and say, "you know what, that would have been a good second choice if I were to do it over again", with the knowledge of how things are really going for your peers in those fields.

I still love what I see about anesthesiology and may well still end up there, but I'm curious nonetheless.[/QUOTE]
I would consider interventional radiology.
There are no midlevels infiltrating this field and you get to do procedures. Lots of downside as well but everything has downsides.
 
I will repeat again: employed physicians CAN (and should) unionize. I have no idea why we don't.

Quite right, except that states like California and Texas (+ a few others which I don't recall offhand) do not let hospitals employ physicians, making unionization ipso-facto illegal there.

ETA: The Kaiser model is one way around this (kind of, obviously not perfectly analogous). But as I've said before... Kaiser is a rare bird and probably a function of a very unique set of historical circumstances that will never be repeated/replicated.
 
There are no midlevels infiltrating this field and you get to do procedures. Lots of downside as well but everything has downsides.

Cool field for sure. If the direct training pathway (similar to the CT I-6 pathway) were available I'd consider it, but I don't think I could hack a diagnostic radiology residency to get there. Who else has their "one that got away"?

PS Noyac you're a personal hero of mine for packing up and moving to the mountains... Deeply envious.
 
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As a student very interested in the specialty and generally well inured to the tone on SDN, this is the first sequence of posts that have seriously made me fear for the future of anesthesiology and second guess my decision.

As well you should! The future is here. Like I have said many times: as an anesthesiologist you are viewed as an overpaid tube monkey easily replaced by a CRNA. Glad you are seeing this and not immediately attributing it to "this poster is miserable and doesn't know what they're talking about." If you can do something other than anesthesiology, do it.
 
I'm not miserable.... Simply the facts. I've got to say, some of my partners just absolutely suck. The crna is better. we have to turn out better anesthesiologists - we have to attract the better candidates, teach them, and not be afraid to kick the ****ty ones out of residency programs. Some need an attitude adjustment as well.
Btw I make more than the general surgeons at my hospital.... But they have a better more predictable schedule... Although they would argue that I'm sure.
I'm giving up this crappy but high paying job for a huge pay cut to go back to academics.... Putting my money where my mouth is.... To make sure we don't have anesthesiologists running around like some of my partners.
 
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I'm not miserable.... Simply the facts. I've got to say, some of my partners just absolutely suck. The crna is better. we have to turn out better anesthesiologists - we have to attract the better candidates, teach them, and not be afraid to kick the ****ty ones out of residency programs. Some need an attitude adjustment as well.
Btw I make more than the general surgeons at my hospital.... But they have a better more predictable schedule... Although they would argue that I'm sure.
I'm giving up this crappy but high paying job for a huge pay cut to go back to academics.... Putting my money where my mouth is.... To make sure we don't have anesthesiologists running around like some of my partners.

That's awesome, Amyl. If the tide turns it'll be because of folks like you willing to stand up for the specialty.

I'd love to be part of the next generation that does the same from the student/trainee side, but I (and many others) want a reason to believe that we're not going to inherit a burned-out husk of a specialty. I do not mind hard work and relish big challenges, but do not want to spend 5 years (4+1) apprenticing myself as a buggy-whip maker, either.

I'm active on the national level of the AMA Medical Student Section, and to your point about how to attract better candidates... well, I'd love to hear your thoughts.
 
I'm giving up this crappy but high paying job for a huge pay cut to go back to academics.... Putting my money where my mouth is.... To make sure we don't have anesthesiologists running around like some of my partners.

Good for you. Money can't buy happiness. At some point after I'm burned out from working hard and have more than enough money to fund a high end retirement, I'll aim for a part time gig at an academic place so I can help teach upcoming residents real actual useful knowledge instead of just the academic BS they learn from many of their attendings. One of my favorite pearls I learned in residency from one particular attending is that I should always look for a reason to be able to do a case, not look for a reason to cancel (postpone) it.
 
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TO get back to the original intention, I think you could market yourself (your group) but it takes more than just doing cases and being good at SCIP measure, although those are an expected baseline.

1. sit on as many meaningful committees as possible. The chair of Anesthesia, the head of the OR, Medical Staff committees, ask to be on the hospital Board.

2. Community involvement is a rare entity which often gets overlooked. Does your hospital have a community outreach program? If so get as much of the group involved and make sure your CEO knows your work efforts.

3. The concept of having a national "rating" system is interesting and scary at the same time. For those who frequently get request cases it can make a mess of your schedule. Also i can see surgeons being more annoyed and put off that they have to schedule a case when a certain anesthesiologist is around as compared to rolling the dice.

I wish we had an Academy award like process for doctors. The best resuscitation in a trauma award goes to ..... but who would decide that stuff?
 
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Thanks Seinfeld for bringing us back to the topic.

Those that you mentioned are truly the roles I'm getting at.

Other things to consider. Are you "present"? By present I mean, are you around to help when needed? Do you sit at your machine and watch everything happen around you or do you get involved? Tying up the surgeons gown while the RN preps, opening suture when the RN is out of the room, answering the phone if needed. Do you pay attention to the daily schedule and stay on top of things? Thing like, hey we are ahead of schedule, we need to notify pre-op so that the next pt is ready. Or hey room 2 is open can we move into there and start opening our next case in order to save some time here.

Or the more difficult things like talking with your partners about inadequacies that others may have mentioned whether real or not.

"Simply giving anesthesia care in the operating room will not differentiate you form any other provider". In order to be successful, you must understand what people ( surgeons, nurses, administrators,etc) expect from anesthesiologists. You need to improve OR throughput by tackling more cases, reducing turnover times, and preparing for procedures. You need to save money and decrease cancelations through pre-op assessments, provide acute pain care, and postop planning. You need to be good communicator and facilitators who work well with everyone. And, more importantly, you need to know how to get this all across to your administrator whether you are employed by them or not so that they understand your value.
 
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Thanks Seinfeld for bringing us back to the topic.

Those that you mentioned are truly the roles I'm getting at.

Other things to consider. Are you "present"? By present I mean, are you around to help when needed? Do you sit at your machine and watch everything happen around you or do you get involved? Tying up the surgeons gown while the RN preps, opening suture when the RN is out of the room, answering the phone if needed. Do you pay attention to the daily schedule and stay on top of things? Thing like, hey we are ahead of schedule, we need to notify pre-op so that the next pt is ready. Or hey room 2 is open can we move into there and start opening our next case in order to save some time here.
.

Even in academics, the surgeons notice this stuff and it seems to go a long way in building a good surgeon-anesthesiologist relationship. I try to do things like tie up gowns, get the patient prepped/positioned before the surgeon is in the room, change the bovie and insufflation settings, and tourniquet times/pressures if the circulator is busy. The scheduling efficiency is currently out of my domain, but the go-getter/problem solver attendings always seem to be highly regarded by the surgeons and I would hope the surgeons go to bat for them if the administration was trying to replace them.
 
Not to depress anyone but.... My hospital is replacing me, when I leave, with two crnas. Some of the old guard surgeons had fought this and they are now to old/worn out to disagree anymore. New surgeons like that the crnas will do cases regardless of npo status, etc. my hospital, in Indiana - not an opt out state, allows crnas to practice independently. Admin says the surgeons are not liable or supervising the crnas unless the surgeon tells them what kind of anesthesia to give etc. I can't see how this is really possible? Anyone know anything about this?
1 Are 2 CRNAs cheaper than an anesthesiologist? (I understand they can do 2 rooms during the day vs. 1, good for day cases but not good for call since they work fewer hrs.)

2 Why is it that they get to do cases not npo? Do you know this for a fact?
 
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Thanks Seinfeld for bringing us back to the topic.

Those that you mentioned are truly the roles I'm getting at.

Other things to consider. Are you "present"? By present I mean, are you around to help when needed? Do you sit at your machine and watch everything happen around you or do you get involved? Tying up the surgeons gown while the RN preps, opening suture when the RN is out of the room, answering the phone if needed. Do you pay attention to the daily schedule and stay on top of things? Thing like, hey we are ahead of schedule, we need to notify pre-op so that the next pt is ready. Or hey room 2 is open can we move into there and start opening our next case in order to save some time here.

Or the more difficult things like talking with your partners about inadequacies that others may have mentioned whether real or not.

"Simply giving anesthesia care in the operating room will not differentiate you form any other provider". In order to be successful, you must understand what people ( surgeons, nurses, administrators,etc) expect from anesthesiologists. You need to improve OR throughput by tackling more cases, reducing turnover times, and preparing for procedures. You need to save money and decrease cancelations through pre-op assessments, provide acute pain care, and postop planning. You need to be good communicator and facilitators who work well with everyone. And, more importantly, you need to know how to get this all across to your administrator whether you are employed by them or not so that they understand your value.


Agreed. While I consider myself a foot soldier, I fully recognize the importance of being integrated into the very fabric of hospital systems/ASCs. Going to the hospital and providing exceptional anesthesia just isn't enough. Politics are always there and we should aim to be ahead of any looming storms that may present themselves. We should facilitate solutions to ongoing problems and attempt to make the system work better. This requires significant commitment outside of the OR and establishing strong relationships within our particular health care landscape (administration, surgeons, hospitalists, specialist, nurses, etc). These efforts don't go unrecognized.
We also need to evolve our own knowledge as much as possible. This may mean that the person who graduated 20 years ago needs to learn some new tricks.
Example: Pediatric anesthesia. Ultrasound usage. Regional anesthesia in adult and pediatric patients. 3D TEE and qlab/3DQ. TTE. TAVR. Mitral clips. Electronic anesthesia records. Robotic surgery. Neuroanesthesia. TEG. Platelet function tests. Ability to set up and run a Belmont... etc.
We need to evolve with the times if our current practice demands this. It isn't good enough to pass the boards and ride out our careers. Lifetime learning is expected- it makes our interactions with other health care providers more meaningful IMHO.
 
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I try to do things like tie up gowns, get the patient prepped/positioned before the surgeon is in the room, change the bovie and insufflation settings, and tourniquet times/pressures if the circulator is busy.

Jesus. Do you also make sure you put two coats of wax on surgeon Biff's car, McFly? What a b_itch. You must hang your testicles in your locker first thing in the morning.
 
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Jesus. Do you also make sure you put two coats of wax on surgeon Biff's car, McFly? What a b_itch. You must hang your testicles in your locker first thing in the morning.

Are you an a**hole in real life or only on SDN?
 
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Jesus. Do you also make sure you put two coats of wax on surgeon Biff's car, McFly? What a b_itch. You must hang your testicles in your locker first thing in the morning.
LMAO
 
1 Are 2 CRNAs cheaper than an anesthesiologist? (I understand they can do 2 rooms during the day vs. 1, good for day cases but not good for call since they work fewer hrs.)

2 Why is it that they get to do cases not npo? Do you know this for a fact?

The crnas work independently here, no supervision, which makes us basically interchangeable. The plan is to make the crnas take back up call.... We don't have backup at all now.
Yes the crnas will bend/break npo on a regular basis, they suck up to Sx all the time. I'll break npo if it's an emergency or the patient is in pain and suffering but I have a discussion about risks and I put it on the patient to say they don't want to wait. On two occasions I've said wait for a case.... The surgeon wanted to leave town or has something to w his kids or etc. and the crna will do it for surgeon convenience.
 
The crnas work independently here, no supervision, which makes us basically interchangeable. The plan is to make the crnas take back up call.... We don't have backup at all now.
Yes the crnas will bend/break npo on a regular basis, they suck up to Sx all the time. I'll break npo if it's an emergency or the patient is in pain and suffering but I have a discussion about risks and I put it on the patient to say they don't want to wait. On two occasions I've said wait for a case.... The surgeon wanted to leave town or has something to w his kids or etc. and the crna will do it for surgeon convenience.
Why do you think they are more willing to break npo guidelines? Is it because they believe they are working under the surgeon's license?

So, the MDs take all the in house call while the nurses take home call? If you say you are interchangeable, while not split the call evenly?

Your workplace sounds horrible.
 
I think they're just kiss ases that they will break it for surgeon convenience. No we take home call too. The crnas will take backup from home too if they go through with it.
 
Jesus. Do you also make sure you put two coats of wax on surgeon Biff's car, McFly? What a b_itch. You must hang your testicles in your locker first thing in the morning.
Not to hijack the thread, but I have heard of the gas docs doing this in my neck of the woods. 1099 follow the surgeon no exclusive contracts in my town. So people find their own surgeons. I was told this from a colleague who has been here a while. Disturbing that guys are resorting to this. Even more disturbing is the egotistical dingus surgeons that take advantage.
 
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Jesus. Do you also make sure you put two coats of wax on surgeon Biff's car, McFly? What a b_itch. You must hang your testicles in your locker first thing in the morning.

I'm starting the second coat right now. I just can't handle that kind of rejection.

Seriously though, if you're not busy and the surgeon needs something do you just stand there and wait for the circulator to come back in the room or do you try to be useful so tho things move along smoothly? It takes 2 seconds and gets things moving along.
 
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I try to do things like tie up gowns, get the patient prepped/positioned before the surgeon is in the room, change the bovie and insufflation settings, and tourniquet times/pressures if the circulator is busy.
Congratulations! You are doing the right thing. He's messing with you.
 
Seriously though, if you're not busy and the surgeon needs something do you just stand there and wait for the circulator to come back in the room or do you try to be useful so tho things move along smoothly? It takes 2 seconds and gets things moving along.

Congratulations! You are doing the right thing. He's messing with you.

That's fine and dandy but I don't want to be thought as"valuable" for being a good butler to the surgeon.

I would prefer to be valuable for good decision making and excellent outcomes.
 
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That's fine and dandy but I don't want to be though as"valuable" for being a good butler to the surgeon.

I would prefer to be valuable for good decision making and excellent outcomes.
S/He's not helping the surgeon. S/He's helping the OR team, the same team that will help him/her back when needed.

I am not a butler to the surgeon either. But that does not exclude being nice. Also, by doing these little things, such as adjusting the table for the surgeon even when not asked, I show (and maintain) vigilance.
 
That's fine and dandy but I don't want to be though as"valuable" for being a good butler to the surgeon.

I would prefer to be valuable for good decision making and excellent outcomes.
Personally, I think you are looking at this in the wrong way.
You're not there to be anyone's butler. Actually, if you are helping anyone it is the circulator since that would have been his/her job.
But the way I look at it is that I am improving OR efficiency. The OR is a place were we should check our egos at the door. Unfortunately, almost nobody understands this because we are all very ego driven people. I do these things I am talking about but I think everyone I work with knows that my ego is as large as anyone's in the OR.

It's a TEAM.
 
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S/He's not helping the surgeon. S/He's helping the OR team, the same team that will help him/her back when needed.

I am not a butler to the surgeon either. But that does not exclude being nice. Also, by doing these little things, such as adjusting the table for the surgeon even when not asked, I show (and maintain) vigilance.

Personally, I think you are looking at this in the wrong way.
You're not there to be anyone's butler. Actually, if you are helping anyone it is the circulator since that would have been his/her job.
But the way I look at it is that I am improving OR efficiency. The OR is a place were we should check our egos at the door. Unfortunately, almost nobody understands this because we are all very ego driven people. I do these things I am talking about but I think everyone I work with knows that my ego is as large as anyone's in the OR.

It's a TEAM.

I repeat: this is all fine, but it is not what makes you a great anesthesiologist. The outcome is what matters.
 
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But the way I look at it is that I am improving OR efficiency.

It's a TEAM.

Let's say the cleaning crew is delayed, are you going to mop the OR yourself to get the room ready sooner?
 
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I repeat: this is all fine, but it is not what makes you a great anesthesiologist. The outcome is what matters.
That's the point Urge. Administrators don't care so much about how great you are. In their eyes there hundreds of others out there waiting to take your place.
 
It's not just us that should be doing these things.
We have surgeons that actually do some of this. And yes I have even seen surgeons at my facility grab a mop. I'm not kidding either. They help us move the pt over to the stretcher. I have even had one or two try to change my circuit for me.

Like I said, we are ALL a team.
 
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No but I might turn over my circuit.

Completely agree. When our techs are busy helping my partners with lines and blocks and my circulator is about to change my circuit and set up my suction, I shoo her away to go interview the next patient so we can have a better turnover. It's better than me eating chips and getting fat in the lounge.
 
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That's the point Urge. Administrators don't care so much about how great you are. In their eyes there hundreds of others out there waiting to take your place.
Isn't the whole point of this thread about how to convince administration that you are great and hard to replace?

Tying the surgeon's gown and playing with the bovie doesn't cut it.

Great patient satisfaction and outcomes do.
 
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Isn't the whole point of this thread about how to convince administration that you are great and hard to replace?

Tying the surgeon's gown and playing with the bovie doesn't cut it.

Great patient satisfaction and outcomes does.

Actually most groups have great patient satisfaction and outcomes. This country is full of excellent well trained anesthesiologists. We are a dime a dozen. If your group sucks and is dysfunctional, that will make you more vulnerable. But the expectation in most places is excellence.
 
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