Anesthesia Malpractice Risk

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Why is there a perception that anesthesia is a "high risk" field in terms of malpractice? I'm a fourth-year and I've had multiple people respond to my career desires with "oh.. anesthesia.. those guys pay a ton in malpractice". From this 2011 article (N Engl J Med 2011; 365:629-636) it looks like we're actually just at or below average in terms of risk and from what I can find online our premiums aren't terribly high compared to other specialties. Seems like anesthesia is actually the least risky part of a surgery (if you catch my drift).

 

[urge]

Why is there a perception that anesthesia is a "high risk" field in terms of malpractice? I'm a fourth-year and I've had multiple people respond to my career desires with "oh.. anesthesia.. those guys pay a ton in malpractice". From this 2011 article (N Engl J Med 2011; 365:629-636) it looks like we're actually just at or below average in terms of risk and from what I can find online our premiums aren't terribly high compared to other specialties. Seems like anesthesia is actually the least risky part of a surgery (if you catch my drift).

Used to be very high risk 30 years ago. The impression stayed in the collective mind.

Now we are on the lower side after better monitors became routine (pulse ox, capnography), better intubating tools became availabe ( fiberoptic, LMA, Glidescope), and the ASA came out with algorithms for the weaker anesthesiologists to follow (Difficult Airway Algorithm).

 

[Man o War]

I still find that patients are often more terrified about the anesthesia than the actual surgery.
I always try to remember what is routine to me is terrifying for them.
So, no surprise that people think this. Then we have media stories like Michael Jackson, Joan Rivers, etc. I was asked about propofol for months by patients for the first time ever in my career after Michael died.
And when I think about stuff I’ve seen, mostly from mid levels, screw ups can literally be life or death. Still plenty of room for error in what we do even with all the modern technology.

 

[Modanq]

CRNAs make it high risk

 

[2Fast2Des]

Anesthesia is safe when all is well and under the right hands, but as we all know, when things go south they go down fast and require someone who knows what the hell they're doing to correct the situation, if it wasn't preventable to begin with. People should be rightfully have some fear about an anesthetic, I mean when is it normal to be put into a coma and have your hemodynamics controlled artificially and then to have it all reversed without knowing a thing, amazing! Heck I'd be afraid if I was on the table even though I know how to administer it, always different when you're the patient...

 

[abolt18]

Anesthesia is safe when all is well and under the right hands, but as we all know, when things go south they go down fast and require someone who knows what the hell they're doing to correct the situation, if it wasn't preventable to begin with. People should be rightfully have some fear about an anesthetic, I mean when is it normal to be put into a coma and have your hemodynamics controlled artificially and then to have it all reversed without knowing a thing, amazing! Heck I'd be afraid if I was on the table even though I know how to administer it, always different when you're the patient...

We give lethal doses of medications to patients and catch them on their way down. We then leave them in a suspended state where they are completely in our hands and dependant on us for their every breath.

Yeah, I have no desire to undergo general anesthesia ever in my life, but I sure do love providing it!