Aging Anesthesiologists

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Planktonmd

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The economy has forced many older anesthesiologists to delay their retirement and continue to practice.
http://www.asahq.org/Home/For the P...ologists Have Higher Rates of Litigation.aspx
There is growing evidence that the performance and safety of older anesthesiologists is questionable.
On the other hand we can not deny the amount of experience and wisdom our older colleagues contribute.
Where do we draw the line?
How do we recognize cognitive impairment in the older colleagues and how do we deal with it?

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The economy has forced many older anesthesiologists to delay their retirement and continue to practice.
http://www.asahq.org/Home/For the P...ologists Have Higher Rates of Litigation.aspx
There is growing evidence that the performance and safety of older anesthesiologists is questionable.
On the other hand we can not deny the amount of experience and wisdom our older colleagues contribute.
Where do we draw the line?
How do we recognize cognitive impairment in the older colleagues and how do we deal with it?

One of my mentors who moulded me to be the anesthesiologist I am today is

MACK THOMAS M.D.

who is currently in his seventies, working semi-part time at Ochsner in New Orleans after an illustrious career full of big time contracts and at the same time teaching

FLEDGLING RESIDENTS LIKE ME (back in1992-1996)

THE ART OF BEING AN ANESTHESIOLOGIST.


Mack and I are still in touch. We go to the same gym.:D

My respect for that man is

SO HI

that when I have a difficult case or a difficult upcoming, scheduled airway requiring fiberoptic intubation

I CALL MACK

for feedback.

Seventeen years into private practice,

I KNOW

I AM NO HERO


of this subspecialist branch of medicine I love so much,

ANESTHESIOLOGY.

Yeah, I'm great at our craft, but I'm smart enough to know

HEROES OF OUR CRAFT EXIST.

Mack Thomas is one of my

IDOLS.

THE DUDE HAS FORGOT MORE ANESTHESIA KNOWLEDGE IN THE LAST FIVE MINUTES THAN I CAN LEARN IN THE NEXT FIVE YEARS.

I'm privileged to have Mack out there as a reference whenever I need him.

We speak of

FIBEROPTIC INTUBATION

on this forum occasionally.

Mack Thomas is the

KING

of fiberoptic intubation.

I have a

KNOWN DIFFICULT AIRWAY

for a spine surgery upcoming in June.

I'm privileged to have

MACK THOMAS

as my guiding wingman.

This is a humbling business.

If you're smart, you'll use all resources available to get the job done.

I'm lucky to have Mack in my corner.

My current practice is

ENRICHED AND STILL INFLUENCED BY HIS PRESENCE.

That's my answer to your question of

AGING ANESTHESIOLOGISTS,

Plank.
 
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Members don't see this ad :)
One of my mentors who moulded me to be the anesthesiologist I am today is

MACK THOMAS M.D.

who is currently in his seventies, working semi-part time at Ochsner in New Orleans after an illustrious career full of big time contracts and at the same time teaching

FLEDGLING RESIDENTS LIKE ME (back in1992-1996)

THE ART OF BEING AN ANESTHESIOLOGIST.


Mack and I are still in touch. We go to the same gym.:D

My respect for that man is

SO HI

that when I have a difficult case or a difficult upcoming, scheduled airway requiring fiberoptic intubation

I CALL MACK

for feedback.

Seventeen years into private practice,

I KNOW

I AM NO HERO


of this subspecialist branch of medicine I love so much,

ANESTHESIOLOGY.

Yeah, I'm great at our craft, but I'm smart enough to know

HEROES OF OUR CRAFT EXIST.

Mack Thomas is one of my

IDOLS.

THE DUDE HAS FORGOT MORE ANESTHESIA KNOWLEDGE IN THE LAST FIVE MINUTES THAN I CAN LEARN IN THE NEXT FIVE YEARS.

I'm privileged to have Mack out there as a reference whenever I need him.

We speak of

FIBEROPTIC INTUBATION

on this forum occasionally.

Mack Thomas is the

KING

of fiberoptic intubation.

I have a

KNOWN DIFFICULT AIRWAY

for a spine surgery upcoming in June.

I'm privileged to have

MACK THOMAS

as my guiding wingman.

This is a humbling business.

If you're smart, you'll use all resources available to get the job done.

I'm lucky to have Mack in my corner.

My current practice is

ENRICHED AND STILL INFLUENCED BY HIS PRESENCE.

That's my answer to your question of

AGING ANESTHESIOLOGISTS,

Plank.
for the love of everything holy on this earth can you please stop bolding and writing in big font. Is there a reason you do this? I cant even read anything you write anymore..
 
Hey... I absolutely agree with you Jet... our elders are a treasure of knowledge.
But we have to accept that people do get older and eventually lose abilities.
It's a fact of life and we all are on that road.
The question is how do we recognize that decline in function and how do deal with it?


One of my mentors who moulded me to be the anesthesiologist I am today is

MACK THOMAS M.D.

who is currently in his seventies, working semi-part time at Ochsner in New Orleans after an illustrious career full of big time contracts and at the same time teaching

FLEDGLING RESIDENTS LIKE ME (back in1992-1996)

THE ART OF BEING AN ANESTHESIOLOGIST.


Mack and I are still in touch. We go to the same gym.:D

My respect for that man is

SO HI

that when I have a difficult case or a difficult upcoming, scheduled airway requiring fiberoptic intubation

I CALL MACK

for feedback.

Seventeen years into private practice,

I KNOW

I AM NO HERO


of this subspecialist branch of medicine I love so much,

ANESTHESIOLOGY.

Yeah, I'm great at our craft, but I'm smart enough to know

HEROES OF OUR CRAFT EXIST.

Mack Thomas is one of my

IDOLS.

THE DUDE HAS FORGOT MORE ANESTHESIA KNOWLEDGE IN THE LAST FIVE MINUTES THAN I CAN LEARN IN THE NEXT FIVE YEARS.

I'm privileged to have Mack out there as a reference whenever I need him.

We speak of

FIBEROPTIC INTUBATION

on this forum occasionally.

Mack Thomas is the

KING

of fiberoptic intubation.

I have a

KNOWN DIFFICULT AIRWAY

for a spine surgery upcoming in June.

I'm privileged to have

MACK THOMAS

as my guiding wingman.

This is a humbling business.

If you're smart, you'll use all resources available to get the job done.

I'm lucky to have Mack in my corner.

My current practice is

ENRICHED AND STILL INFLUENCED BY HIS PRESENCE.

That's my answer to your question of

AGING ANESTHESIOLOGISTS,

Plank.
 
Hey... I absolutely agree with you Jet... our elders are a treasure of knowledge.
But we have to accept that people do get older and eventually lose abilities.
It's a fact of life and we all are on that road.
The question is how do we recognize that decline in function and how do deal with it?

Plank, i think it's a

RARE OCCASION

that anesthesiologists...and physicians in other specialties for that matter...have to be removed. I think most are smart enough to realize when their time is up....

My father was an airline pilot. His industry has a

MANDATORY RETIREMENT AGE

that has recently been moved to 65 from age 60. Back in my dad's time, it was 60...so he retired at 60 even tho he could've

STILL DEFTLY PILOTED 747s

for at least another ten years.

Let's be thankful our industry doesn't have the

MYOPIC VIEW

of the airlines.
 
for the love of everything holy on this earth can you please stop bolding and writing in big font. Is there a reason you do this? I cant even read anything you write anymore..

You need to chill out. Don't come to a forum and spout out BS to dudes you don't know anything about. Do some research and have some respect.

Actually, I think he has written about RESPECT YOUR ELDERS
 
You need to chill out. Don't come to a forum and spout out BS to dudes you don't know anything about. Do some research and have some respect.

Actually, I think he has written about RESPECT YOUR ELDERS

do you have any idea how obnoxious writing in big font is?
 
One of my mentors...

I'm just curious as to how the conversation goes. Does he remind you to adequately topicalize the airway? Don't forget the glycopyrrolate?

Don't get me wrong, I'm all about learning from elders. I ask our oldest partner questions all the time about how things used to be done or why he does something a certain way. But I'm not sure how helpful a phone conversation would be about how to deal with an airway when that person isn't around to help.
 
for the love of everything holy on this earth can you please stop bolding and writing in big font. Is there a reason you do this? I cant even read anything you write anymore..

Not to sidetrack this thread, but I agree with you.

Everybody knows that ALL CAPS online is "shouting", and I don't like shouting.

Never mind Bold and Huge lettering.

I know he has good stuff to say because he is a smart guy, but because of his shouting, I never even read his stuff anymore.

And that's too bad.
 
Not to sidetrack this thread, but I agree with you.

Everybody knows that ALL CAPS online is "shouting", and I don't like shouting.

Never mind Bold and Huge lettering.

I know he has good stuff to say because he is a smart guy, but because of his shouting, I never even read his stuff anymore.

And that's too bad.

Jet is a great anesthesiologist and a prolific blogger who has contributed many amazing posts to this forum over the years.
Using the caps and different fonts is just his signature... it's not intended to be shouting or insulting.
His style is definitely less irritating than that of a particular crazy dude, who feels the irresistible urge to copy and paste 10 different web search results, containing full articles in every thread of this forum.
 
for the love of everything holy on this earth can you please stop bolding and writing in big font. Is there a reason you do this? I cant even read anything you write anymore..

If you don't like what he has to say or how he says it, you can easily put him on your ignore list. You wont see anything he post and you can then have a piece of mind and wont have to get worked up about him. :p
 
I'm just curious as to how the conversation goes. Does he remind you to adequately topicalize the airway? Don't forget the glycopyrrolate?

Don't get me wrong, I'm all about learning from elders. I ask our oldest partner questions all the time about how things used to be done or why he does something a certain way. But I'm not sure how helpful a phone conversation would be about how to deal with an airway when that person isn't around to help.

tumblr_m0liablz3C1rp5923o1_500.jpg

Angel-"Don't forget to topicalize the airway, Grasshopper"
Devil-"You don't need no stinking topicalization!"
Angel-"All of my good proteges use glycopyrrolate."
Devil-"Glyco is for wussies!! You can intubate a gravid ant with only a tongue depressor!!. If you were a real man, you would use an LMA for this spine case!!"
Angel-"Don't listen to him Grasshopper!"
Devil-"Psssst...use even bigger font"
Angel-<shaking head>"I give up"
 
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We know who has a sharp mind and who doesn't. It's fairly easy to tell by watching people. The hard part is approaching them and telling them they are not what they used to be. That's when being the chief sucks.
 
We know who has a sharp mind and who doesn't. It's fairly easy to tell by watching people. The hard part is approaching them and telling them they are not what they used to be. That's when being the chief sucks.

There are no objective criteria that we can use to say when somebody has lost too much of their skill due to cognitive decline. It is purely a judgement call.

At the Rovenstine lecture at the ASA more than 10 years ago, the keynote speaker mentioned as an anecdote in his closing remarks one of his greatest regrets. An aging anesthesiologist who was scheduled to retire in a few months, who was clearly in decline, the subject of forcing an advance of the retirment date was discussed and tabled. Subsequently this practitioner's substandard care was the cause of death of a young mother. These are the hardest calls to make. The problem is that they are often made (or not made) with secondary agendas in mind.
 
tumblr_m0liablz3C1rp5923o1_500.jpg

Angel-"Don't forget to topicalize the airway, Grasshopper"
Devil-"You don't need no stinking topicalization!"
Angel-"All of my good proteges use glycopyrrolate."
Devil-"Glyco is for wussies!! You can intubate a gravid ant with only a tongue depressor!!. If you were a real man, you would use an LMA for this spine case!!"
Angel-"Don't listen to him Grasshopper!"
Devil-"Psssst...use even bigger font"
Angel-<shaking head>"I give up"

:laugh::laugh::laugh:
That's about right, Gern LOLLLLL
 
Using the caps and different fonts is just his signature... it's not intended to be shouting or insulting.
His style is definitely less irritating than that of a particular crazy dude, who feels the irresistible urge to copy and paste 10 different web search results, containing full articles in every thread of this forum.

Amen to that
 
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There were a couple Professor Emeritus faculty that would wash up on the shores the OR from time to time at my old shop. One was sharp as ever and could outwork anyone there, the other was scary feeble. He was a former chairman and must know where the bodies are buried.
We have a few older part time faculty where I am now. They're solid as ever.
When the time comes, we have an obligation to show aging anesthesiologists the door. That time will be different for everyone. The University has a mandatory step down age for the Chairs.
 
There were a couple Professor Emeritus faculty that would wash up on the shores the OR from time to time at my old shop. One was sharp as ever and could outwork anyone there, the other was scary feeble. He was a former chairman and must know where the bodies are buried.
We have a few older part time faculty where I am now. They're solid as ever.
When the time comes, we have an obligation to show aging anesthesiologists the door. That time will be different for everyone. The University has a mandatory step down age for the Chairs.

What criteria will be used other than consensus of opinion? How many practitioners that are on the left side of the curve now that you would never send a family member to do you tolerate? How bad is bad enough to show someone the door, for age or for just low skill?
 
Bottom line:
Make everyone participate in MOCA-end of story. This exemption/grandfathering of older practicioners is absolutely ridiculous. If the general public knew that older anesthesiologists had no requiremoent for board recertification, I am certain that the majority would not be pleased about this. Someone call 20/20....
 
Bottom line:
Make everyone participate in MOCA-end of story. This exemption/grandfathering of older practicioners is absolutely ridiculous. If the general public knew that older anesthesiologists had no requiremoent for board recertification, I am certain that the majority would not be pleased about this. Someone call 20/20....

It's absurd to act like board certification is necessary at all in the age of 'advanced nursing practice', much less MOCA.
 
Interesting question Plank, don't know if there is a good answer i do think that past 60 you shouldn't be working in a busy private practice but in academics teaching/mentoring.
Personally i don't see myself working full time after 50 or 55 y/o.
 

Personally i don't see myself working full time after 50 or 55 y/o.

I've thought the same thing.

Problem is, we've all been deceived about

RETIREMENT.

I'm not referring to money. Let's assume all of us get to 55y/o with more money than we need.

For most working dudes out there that are able to retire,

RETIREMENT IS NOT GOOD MAN.

Going from being productive

FLYING A 747

BEING AN ANESTHESIOLOGIST

BEING A CORONER

BEING

WHATEVER

to being

NOTHING

doesn't work so well for alotta people.

Being

PRODUCTIVE

keeps you alive.
 
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Interesting question Plank, don't know if there is a good answer i do think that past 60 you shouldn't be working in a busy private practice but in academics teaching/mentoring.
Personally i don't see myself working full time after 50 or 55 y/o.

Many anesthesiologists are working after 65 these days because of the economy.
Most of these guys are OK but some of them are pretty scary.
The problem is that there is no mechanism to verify their mental competence since they are exempt from MOCA and recertification.
 
I've thought the same thing.

Problem is, we've all been deceived about

RETIREMENT.

I'm not referring to money. Let's assume all of us get to 55y/o with more money than we need.

For most working dudes out there that are able to retire,

RETIREMENT IS NOT GOOD MAN.

Going from being productive

FLYING A 747

BEING AN ANESTHESIOLOGIST

BEING A CORONER

BEING

WHATEVER

to being

NOTHING

doesn't work so well for alotta people.

Being

PRODUCTIVE

keeps you alive.



Yup.

Reminds me of that scene from Kill Bill in which Bud says, "The number one cause of death is retirement."
 
I've thought the same thing.

Problem is, we've all been deceived about

RETIREMENT.

I'm not referring to money. Let's assume all of us get to 55y/o with more money than we need.

For most working dudes out there that are able to retire,

RETIREMENT IS NOT GOOD MAN.

Going from being productive

FLYING A 747

BEING AN ANESTHESIOLOGIST

BEING A CORONER

BEING

WHATEVER

to being

NOTHING

doesn't work so well for alotta people.

Being

PRODUCTIVE

keeps you alive.

Agreed. For those that have cultivated serious hobbies or an alternative career, it might not be an issue. I plan to work at least part time until I can't.
 
I've thought the same thing.

Problem is, we've all been deceived about

RETIREMENT.

I'm not referring to money. Let's assume all of us get to 55y/o with more money than we need.

For most working dudes out there that are able to retire,

RETIREMENT IS NOT GOOD MAN.

Going from being productive

FLYING A 747

BEING AN ANESTHESIOLOGIST

BEING A CORONER

BEING

WHATEVER

to being

NOTHING

doesn't work so well for alotta people.

Being

PRODUCTIVE

keeps you alive.

Very true words. I have seen it devastate many a person.
 
RETIREMENT IS NOT GOOD MAN.

Depends. If you've got a list of things to do, places to go, people to see, retirement can be great. You don't have to turn into a slug and watch Maury Povich reruns all day.

I enjoy anesthesia immensely but I'm not going to confidently predict I'll want to be doing it 30 years from now. If I was a billionaire I could fill my days with fun non-anesthesia activities tomorrow.

And any 65+ year old anesthesiologist who's working now because they HAVE TO is a ***** who spent too much, divorced too often, saved too little, or invested exceptionally poorly. Old timers who lived through two boom cycles of the specialty HAVE TO work?


Also, the idea of MOCA being a good screening tool to weed out old guys who can't hack it any more is silly. It's a bunch of CME and box checking, followed by a written exam with an astronomically high pass rate and no consequences for failure. I guess it's better than nothing. I guess.

I've seen one doctor (a surgeon) get forced into retirement because his performance became a risk. I think it was handled appropriately and with tact & courtesy, but it was still sad and ugly. I don't know if there is a perfect solution to assessing them. Some doctors suck right out of residency. I'd like to think that most older doctors know when it's time to slow down or quit.
 
I've thought the same thing.

Problem is, we've all been deceived about

RETIREMENT.

I'm not referring to money. Let's assume all of us get to 55y/o with more money than we need.

For most working dudes out there that are able to retire,

RETIREMENT IS NOT GOOD MAN.

Going from being productive

FLYING A 747

BEING AN ANESTHESIOLOGIST

BEING A CORONER

BEING

WHATEVER

to being

NOTHING

doesn't work so well for alotta people.

Being

PRODUCTIVE

keeps you alive.

maybe for some people. But I am about to end fourth year of med school, so I essentially have been "retired" since last September and have been enjoying it immensely. really am not looking forward to the start of residency.
 
notjohn is obviously yet another maceo/hivoltage reincarnate. I think it's telling when someone's negativity needs an outlet that badly.
 
To get back to the retirement question, even though this thread started out to be something different, I ask all the retired guys I meet in preop if they are happily retired and about a third of them say "not necessarily".

Which isn't comforting for us nearing retirement. Although, last yr I had my knee replaced and was off for two months. That taste of retirement tells me that I will be a happily retired guy.
 
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