Career Capital (i.e., Valuable skills worth learning)

[propofabulous]

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I recently read Cal Newport's book "So Good They Can't Ignore You", in which he simply proposes that:
1) Great jobs are rare and valuable
2) To find one, you need rare and valuable skills (career capital) to offer in return

As a CA-1, I was hoping to get some valued input from the more experienced. My two questions are:

1) Did subspecializing provide you "career capital" that you were able to trade for a better job (more autonomy, better compensation, more impact, challenge, diversity, respect/appreciation)?
2) Are there any other forms of "career capital" or rare skills that I should try to learn in residency (outside of subspecialty skills) that would make me a unique and more valuable practitioner? Things that come to mind are common blocks, pre-op management, point of care ultrasound, perioperative surgical home, enhanced recovery after surgery. Any others?

Looking forward to hearing from you guys! Thanks in advance!

 

[nimbus]

Things that come to mind.

1. Willingness to attend repetitive, mind numbing meetings where you discuss the same stuff you discussed 10 years ago in the same committee (if you want impact).

2. Willingness to work evenings and weekends with a smile. Not whining and being available. Also a willingness to do cases with inherently high complication rates because most people would rather not. This is more important than any particular clinical skill because it is relatively rare.

ERAS in practice is completely protocol driven. Surgeon just checks a box. Most people know how to do blocks and love to do them because it is fun, quick and well compensated. It is not rare.

Subspecializing is something you should do based on your inherent interests. Overall the supply of subspecialists seems to exceed the actual need so it won’t make you “special”.

Basically your willingness to do the things that nobody else wants to do will make you valuable to your practice. 80% of that is being available to work when others don’t wanna work. Everybody likes to do the fun glamorous stuff during normal hours so that won’t really distinguish you from a sea of other well trained anesthesiologists. Also it is VERY difficult if not impossible to make yourself indispensable as an anesthesiologist. I’ve witnessed first hand some exceptional anesthesiologists be quickly replaced for political reasons.

 

[anes121508]

Things that come to mind.

1. Willingness to attend repetitive, mind numbing meetings where you discuss the same stuff you discussed 10 years ago in the same committee (if you want impact).

2. Willingness to work evenings and weekends with a smile. Not whining and being available. Also a willingness to do cases with inherently high complication rates because most people would rather not. This is more important than any particular clinical skill because it is relatively rare.

ERAS in practice is completely protocol driven. Surgeon just checks a box. Most people know how to do blocks and love to do them because it is fun, quick and well compensated. It is not rare.

Subspecializing is something you should do based on your inherent interests. Overall the supply of subspecialists seems to exceed the actual need so it won’t make you “special”.

Basically your willingness to do the things that nobody else wants to do will make you valuable to your practice. 80% of that is being available to work when others don’t wanna work. Everybody likes to do the fun glamorous stuff during normal hours so that won’t really distinguish you from a sea of other well trained anesthesiologists. Also it is VERY difficult if not impossible to make yourself indispensable as an anesthesiologist. I’ve witnessed first hand some exceptional anesthesiologists be quickly replaced for political reasons.

Just to be a smart a””......

So in conclusion you would recommend not to be the guy that just smiles and goes the extra mile since you are at risk of being replaced at the drop of a hat not matter what? Indispensable is impossible therefore avoid complicated cases with risk and spend as much time away from work as possible?

 

[anes121508]

I recently read Cal Newport's book "So Good They Can't Ignore You", in which he simply proposes that:
1) Great jobs are rare and valuable
2) To find one, you need rare and valuable skills (career capital) to offer in return

As a CA-1, I was hoping to get some valued input from the more experienced. My two questions are:

1) Did subspecializing provide you "career capital" that you were able to trade for a better job (more autonomy, better compensation, more impact, challenge, diversity, respect/appreciation)?
2) Are there any other forms of "career capital" or rare skills that I should try to learn in residency (outside of subspecialty skills) that would make me a unique and more valuable practitioner? Things that come to mind are common blocks, pre-op management, point of care ultrasound, perioperative surgical home, enhanced recovery after surgery. Any others?

Looking forward to hearing from you guys! Thanks in advance!

I think it’s a great question as a CA-1 and I commend you for looking ahead. I think you will get a real wide variety of responses. Unfortunately I think there is in some ways a little truth to what nimbus said. Things I have seen that seem to have helped preople:

1. Mba
2. Committee positions
3. Real Tee skills beyond basic (3d / structural guidance)
4. regional / ultrasound skills
5. Works well with all other specialties including nursing
6. Comfortable with sick peds

I’m sure there are more.

I’m a glass of half full person, but I will admit that I work for a company and from their perspective (shortsighted and may bite them in the rear ultimately), we are all just cogs in the wheel and our most important skill is ability to sign chart and complete the billing.

 

[gasdoc77]

Availability >>>affability >>>>>ability
Especially now that AMC’s have relegated you to chart signing, you can be the Michael Jordan of anesthesia with boards coming out of your a$$ but your employer cares not. In fact, many AMC’s prefer to “churn” their docs. Newbies are cheaper to hire, churn prevents benefit vesting, and a rotating cast of characters perpetuates the appearance of insignificance while preventing a group from re-taking a facility. Churn also allows perpetual understaffing since they are “working on it” while you are salaried. LOL. Only work for an AMC for a clearly defined hourly rate.

 

[GravelRider]

The short answer: nothing. You are easily replaceable...even if you are on that very special committee. Be very aware of the fact that you are easily replaceable. That will guide how you act at work. You are not special. You are not a beautiful and unique snowflake. Do a fellowship if you really like that particular subspecialty.

Work on your life outside of medicine. Develop some non-medicine skills. Make sure you have a happy and fulfilling home life.

 

[Twiggidy]

Basically your willingness to do the things that nobody else wants to do will make you valuable to your practice. 80% of that is being available to work when others don’t wanna work. Everybody likes to do the fun glamorous stuff during normal hours so that won’t really distinguish you from a sea of other well trained anesthesiologists. Also it is VERY difficult if not impossible to make yourself indispensable as an anesthesiologist. I’ve witnessed first hand some exceptional anesthesiologists be quickly replaced for political reasons.

Best response. No further responses need.

Everything mention in OP is something I already know or can learn in a week.

OP, if you really want to distinguish yourself out of the pack, you have to have something that almost NO ONE else has and that can somehow improve a group or department. An argument can be made for a "degree", ie MBA or JD or MPH but even then I'm not totally sure. They'll likely separate you from practicing clinical medicine but if in the end you have those degrees and find yourself sitting the stool or covering 1:4 they could be a waste of time and money. .

 

[Twiggidy]

Work on your life outside of medicine. Develop some non-medicine skills. Make sure you have a happy and fulfilling home life.

Important.

As I said in another thread, have an effin' HOBBY. Even better if someday that hobby can lead to something that puts a little change in your pocket (art, music, acting, learn another language, sports, etc).

We're all waiters/waitresses in the restaurant called "medicine" and no matter what restaurant there's no restaurant waiter that's really better than another as long as you bring me my food fast and hot.

 

[anes121508]

Availability >>>affability >>>>>ability
Especially now that AMC’s have relegated you to chart signing, you can be the Michael Jordan of anesthesia with boards coming out of your a$$ but your employer cares not. In fact, many AMC’s prefer to “churn” their docs. Newbies are cheaper to hire, churn prevents benefit vesting, and a rotating cast of characters perpetuates the appearance of insignificance while preventing a group from re-taking a facility. Churn also allows perpetual understaffing since they are “working on it” while you are salaried. LOL. Only work for an AMC for a clearly defined hourly rate.

Not that I disagree with how the AMC views us, but why not say “work as little as possible for as much as possible no matter what”.

Cuz nothing else matters right? If you can be replaced at the drop of a hat, why go the effort to be available and work more and take more shifts. F it, be an underachiever, find a 40hr a week “mommy” track if you can for as much as you can get. And when the old guys who sold the group and put us all in this situation ask if you can take their call for the sh””” reduced rate , or ask you to cover an extra room , or ask you to stay past your defined time....tell them to shove it...in a politically correct way that keeps your job

 

[anes121508]

Things that come to mind.

1. Willingness to attend repetitive, mind numbing meetings where you discuss the same stuff you discussed 10 years ago in the same committee (if you want impact).

2. Willingness to work evenings and weekends with a smile. Not whining and being available. Also a willingness to do cases with inherently high complication rates because most people would rather not. This is more important than any particular clinical skill because it is relatively rare.

ERAS in practice is completely protocol driven. Surgeon just checks a box. Most people know how to do blocks and love to do them because it is fun, quick and well compensated. It is not rare.

Subspecializing is something you should do based on your inherent interests. Overall the supply of subspecialists seems to exceed the actual need so it won’t make you “special”.

Basically your willingness to do the things that nobody else wants to do will make you valuable to your practice. 80% of that is being available to work when others don’t wanna work. Everybody likes to do the fun glamorous stuff during normal hours so that won’t really distinguish you from a sea of other well trained anesthesiologists. Also it is VERY difficult if not impossible to make yourself indispensable as an anesthesiologist. I’ve witnessed first hand some exceptional anesthesiologists be quickly replaced for political reasons.

Since nothing matters, how about this:

1. Refuse to be on any committees outside of hourly paid work hours, unless it’s paid and the hours are convenient to you

2. Work as few weekends and as few nights as possible. Even if it means less $$, cuz the older guys who want you to work their nights and weekends already made their $$ and you bet they are willing to pay you whatever amc <200$/hr for a Saturday call.

3. Punt the high risk cases to someone else...do whatever you can to delay that case till the next day and play hot potatoe. If someone asks you to start a case for them, make sure it’s not a sick patient. If so, make up an excuse why you can’t and why you shouldn’t take care of that patient.

4. If nobody else is willing to do it, then don’t. Cuz ur not valuable

5. Do a fellowship... those who tell you that there is an over supply of sub specialty capable people are the guys “grandfathered in” and have zero self awareness that even though they’ve been doing “cardiac” for 15+ years are viewed by the surgeons and cardiologists as clowns. You won’t be special, but maybe you can find a way to use this and take less call or make more money or get fired last

 

[Twiggidy]

You won’t be special, but maybe you can find a way to use this and take less call or make more money or get fired last

TBH.....one of my attendings used this as a reason to do a fellowship.

I'm not sure where your posts are going, but in general a fellowship will open doors that may not be open for those that didn't do a fellowship. That horse has been beaten to death on this forum. With regard to the OP, does doing one provide "career capital"? I'm not 100% sure. It depends on where you practice and possibly if you go private practice vs academic. I will say if you want to be an academic subspecialist anesthesiologist, you better do a fellowship, and when departments do "cut back" you probably will be further down the last.

That theory is no so much in private practice. In private practice all people care about is the bottom line. Get the cases done and get them done safely. Everything else is a wash. Outside of the MBA, everything else you list here I can FIND or TEACH

1. Mba
2. Committee positions
3. Real Tee skills beyond basic (3d / structural guidance)
4. regional / ultrasound skills
5. Works well with all other specialties including nursing
6. Comfortable with sick peds

I maybe have a harder time finding an anesthesiologist with strong business skills, but 2-6 I can probably find with a Gasworks or SDN post, especially now that fellowship trained anesthesiologists are falling off trees.

 

[nimbus]

Not here to upset people.

The type of security/career capital that OP is referring to never existed for the vast majority of anesthesiologists, even in the glory days. Unless you’re a internationally recognized tenured professor with multiple R01 grants or one of the founders of NAPA, the rest of us are just cogs in the wheel. Still we provide a valuable service and enjoy excellent job security and a nonexistent unemployment rate.

 

[gasdoc77]

Not that I disagree with how the AMC views us, but why not say “work as little as possible for as much as possible no matter what”.

Cuz nothing else matters right? If you can be replaced at the drop of a hat, why go the effort to be available and work more and take more shifts. F it, be an underachiever, find a 40hr a week “mommy” track if you can for as much as you can get. And when the old guys who sold the group and put us all in this situation ask if you can take their call for the sh””” reduced rate , or ask you to cover an extra room , or ask you to stay past your defined time....tell them to shove it...in a politically correct way that keeps your job

I agree with all that you say in any model where you are simply an employee. Unless you are putting in sweat equity to be a partner, efforts to gain favor or stand out as an employee will lead to frustration. They simply want someone who is capable of signing charts and not making waves. Some will give you a BS title in exchange for your efforts (that usually comes with more responsibilities) but little or no salary bump.

 

[GravelRider]

I agree with all that you say in any model where you are simply an employee. Unless you are putting in sweat equity to be a partner, efforts to gain favor or stand out as an employee will lead to frustration. They simply want someone who is capable of signing charts and not making waves. Some will give you a BS title in exchange for your efforts (that usually comes with more responsibilities) but little or no salary bump.

Plus, if you stand out too much then you get surgeons requesting you for their longer/tougher cases or the long, rapid turnover days. You’ll get the early ortho starts while the mediocre people continue to stroll in late. We work in a field where hard work is punished and not rewarded. It’s best to keep your head low, blend in, put in your 20 years, and get out. You’ll frustrate yourself by trying to “stand out” with “career capital.” It’s just simply not rewarded in most jobs.

 

[Twiggidy]

Plus, if you stand out too much then you get surgeons requesting you for their longer/tougher cases or the long, rapid turnover days. You’ll get the early ortho starts while the mediocre people continue to stroll in late. We work in a field where hard work is punished and not rewarded. It’s best to keep your head low, blend in, put in your 20 years, and get out. You’ll frustrate yourself by trying to “stand out” with “career capital.” It’s just simply not rewarded in most jobs.

I somewhat agree and it's the most interesting post.

 

[Man o War]

Plus, if you stand out too much then you get surgeons requesting you for their longer/tougher cases or the long, rapid turnover days. You’ll get the early ortho starts while the mediocre people continue to stroll in late. We work in a field where hard work is punished and not rewarded. It’s best to keep your head low, blend in, put in your 20 years, and get out. You’ll frustrate yourself by trying to “stand out” with “career capital.” It’s just simply not rewarded in most jobs.

Unless you’re in a group where you eat what you kill. We have a couple of those in my city, and the guys getting requested by the high turnover surgeons with good payor mix are making bank. These surgeons have a handful of anesthesiologists they will work with so those rooms are pretty much spoken for each day. Creates resentment within the group, but the chosen ones are doing well.

 

[hfzballer11]

Unless you’re in a group where you eat what you kill. We have a couple of those in my city, and the guys getting requested by the high turnover surgeons with good payor mix are making bank. These surgeons have a handful of anesthesiologists they will work with so those rooms are pretty much spoken for each day. Creates resentment within the group, but the chosen ones are doing well.

Excuse my ignorance (I'm currently applying to residency). What kind of things makes an anesthesiologist preferred by certain surgeons?

 

[nimbus]

This thread has taken an interesting turn. The OP was asking how they could stand out so they can’t be ignored. Now some of the replies say it’s better to keep a low profile so one does not stick out and can be ignored.

 

[nimbus]

Excuse my ignorance (I'm currently applying to residency). What kind of things makes an anesthesiologist preferred by certain surgeons?

Fast, smooth, doesn’t cancel cases, tells good jokes.

 

[Twiggidy]

Excuse my ignorance (I'm currently applying to residency). What kind of things makes an anesthesiologist preferred by certain surgeons?

Availability >>>affability >>>>>ability

Availbility == Are you there when I need you? If I add on a case can I count on you to be there with minimal resistance?
Affability == Are you easy to work with? Are you disruptive? Will you come to do my add on case with minimal resistance (see previous)
Ability == In a nutshell, are you going to kill my patient?

99.9% of us have no problem with the last "A", it's the first 2 "A" that can be an issue.

 

[Twiggidy]

This thread has taken an interesting turn. The OP was asking how they could stand out so they can’t be ignored. Now some of the replies say it’s better to keep a low profile so one does not stick out and can be ignored.

It really is an interesting topic the OP has brought up. We have a bit of a "political" group where I am and there's a handful of anesthesiologists that are real good with regional anesthesia. I admittedly am not. Yet, our vascular surgeon only wants the anesthesiologists who don't cancel case, can do an add on whenever, and are quick, meaning, don't waste times doing blocks for certain vascular procedures, knowing good well regional in some vascular patients are better for patients based on studies. He doesn't care what fancy block skills you have. He wants you to put them sleep fast and get the lines in fast and don't kill the patient.

 

[rakotomazoto]

OP: Twiggidy's reference to the three A's is something that shaped my mindset and has been extremely helpful to me. I honestly think that I landed my current great job because of doing my best to be available, affable, and able.

There is some interesting advice on this forum, take it all with a grain of salt and keep in mind that everyone comes from a unique perspective based on their personal experiences. My two cents is that you should find balance and moderation in life, don't vanish into the abyss of training and fellowships and extra degrees. One day, you will finish training and this will become a job so try to keep your personal life going, easier said than done during residency. If you like a certain subspecialty or want an academic career, do a fellowship. If you enjoy developing "career capital", then do it. But as you have probably noticed from the comments on this thread, there are no guarantees in this specialty (just like every other job in the world, not sure why we feel like our job should be different somehow). I was fired once from a job before medical school and it sucked, had nothing to do with my job performance. They actually fired me once they heard I had been accepted to medical school because it was better for them to start training my replacement right away rather than keeping me around for a few more months. The same day that they found someone to do my job, they told me to pack up and leave. This was in a "right to work" state, so they didn't even have to give me two weeks' notice or any heads up about their plans.

So many variables in life are out of our control, try not to lose too much sleep over the things that you can't control. We all face adversity and challenges and the future for all of us is uncertain. We are all just one car accident or heart attack or stroke away from our whole world changing, maybe even our life ending. Work hard and be a good resident, but don't kill yourself. We were just now talking about a surgeon at this hospital who retired, went to the gym, popped an aneurysm, stroked out, and died. There are also medical students committing suicide, residents I know who stopped because they got cancer, etc. Life is a short journey and we don't know when our time is up.

If you sincerely enjoy working on things like "career capital", then you should pursue those skills with a passion. If you are doing it out of fear, consider that your time and energy may be better spent on other things. In the end, we are all just trying to find a little bit of happiness in this crazy world. Spending all of your time trying to minimize potential future risk seems unlikely to yield a high return on your investment versus doing things that will definitely make you happy now and in the future, like spending time with family and friends or exercising or experiencing art or whatever other personal interests that you have.

My advice to chill and not stress about things is certainly skewed by the fact that I found a great job without a fellowship or any extra degrees. My life is not yours, so ultimately you have to walk your own path. Hope these random internet rants we are posting are helping you somehow.

 

[hfzballer11]

Availbility == Are you there when I need you? If I add on a case can I count on you to be there with minimal resistance?
Affability == Are you easy to work with? Are you disruptive? Will you come to do my add on case with minimal resistance (see previous)
Ability == In a nutshell, are you going to kill my patient?

99.9% of us have no problem with the last "A", it's the first 2 "A" that can be an issue.

Aren't these things true for all anesthesiologists in general? My question was moreso geared at the above post that mentioned some surgeons request a specific anesthesiologist for their rooms for the entire day. What makes a surgeon say, "I only want Dr. Twiggidy on my cases", when as you mentioned 99.9 percent of anesthesiologists are not lacking in ability.

 

[Twiggidy]

Aren't these things true for all anesthesiologists in general? My question was moreso geared at the above post that mentioned some surgeons request a specific anesthesiologist for their rooms for the entire day. What makes a surgeon say, "I only want Dr. Twiggidy on my cases", when as you mentioned 99.9 percent of anesthesiologists are not lacking in ability.

Think about it. 99.9% of anesthesiologists can all pretty much "do the job" but the reality is a surgeon will only want things that make his day better/easier/faster=more lucrative. Just because one anesthesiologists is "faster" than another doesn't necessarily make that anesthesiologists "better" (as a matter of fact said anesthesiologist could possibly be more dangerous) but if it makes the surgeon's day "faster" he's always going to want that anesthesiologist. Another example is maybe one anesthesiologist is more "by the book", therefore he may cancel more cases out of safety vs a more "cavalier" anesthesiologists. Both have the same skill but one is willing to push the limits. That becomes part of affability, ie, "Do my case with as little resistance" and as Nimbus said, "Do a stand up routine while doing it".

 

[nimbus]

Aren't these things true for all anesthesiologists in general? My question was moreso geared at the above post that mentioned some surgeons request a specific anesthesiologist for their rooms for the entire day. What makes a surgeon say, "I only want Dr. Twiggidy on my cases", when as you mentioned 99.9 percent of anesthesiologists are not lacking in ability.

You are over worrying.

In my practice, the anesthesiologists pick their rooms for the next day. We pick the surgeons, the surgeons don’t pick us. (In reality, we go down the call list and pick lineups for the next day based on how lucrative they are.) We allow patient requests but don’t allow surgeon requests.

 

[Twiggidy]

OP: Twiggidy's reference to the three A's is something that shaped my mindset and has been extremely helpful to me. I honestly think that I landed my current great job because of doing my best to be available, affable, and able.

There is some interesting advice on this forum, take it all with a grain of salt and keep in mind that everyone comes from a unique perspective based on their personal experiences. My two cents is that you should find balance and moderation in life, don't vanish into the abyss of training and fellowships and extra degrees. One day, you will finish training and this will become a job so try to keep your personal life going, easier said than done during residency. If you like a certain subspecialty or want an academic career, do a fellowship. If you enjoy developing "career capital", then do it. But as you have probably noticed from the comments on this thread, there are no guarantees in this specialty (just like every other job in the world, not sure why we feel like our job should be different somehow). I was fired once from a job before medical school and it sucked, had nothing to do with my job performance. They actually fired me once they heard I had been accepted to medical school because it was better for them to start training my replacement right away rather than keeping me around for a few more months. The same day that they found someone to do my job, they told me to pack up and leave. This was in a "right to work" state, so they didn't even have to give me two weeks' notice or any heads up about their plans.

So many variables in life are out of our control, try not to lose too much sleep over the things that you can't control. We all face adversity and challenges and the future for all of us is uncertain. We are all just one car accident or heart attack or stroke away from our whole world changing, maybe even our life ending. Work hard and be a good resident, but don't kill yourself. We were just now talking about a surgeon at this hospital who retired, went to the gym, popped an aneurysm, stroked out, and died. There are also medical students committing suicide, residents I know who stopped because they got cancer, etc. Life is a short journey and we don't know when our time is up.

If you sincerely enjoy working on things like "career capital", then you should pursue those skills with a passion. If you are doing it out of fear, consider that your time and energy may be better spent on other things. In the end, we are all just trying to find a little bit of happiness in this crazy world. Spending all of your time trying to minimize potential future risk seems unlikely to yield a high return on your investment versus doing things that will definitely make you happy now and in the future, like spending time with family and friends or exercising or experiencing art or whatever other personal interests that you have.

My advice to chill and not stress about things is certainly skewed by the fact that I found a great job without a fellowship or any extra degrees. My life is not yours, so ultimately you have to walk your own path. Hope these random internet rants we are posting are helping you somehow.

I love this post.

I'll add one caveat. Anesthesiology is one of the few strange specialties in medicine, similar to Rads, where if you subspecialize you may not be doing you subspecialty everyday, unless you're in academics (and it can still happen there). I know plenty of "cardiac anesthesiologists" doing lap choles in a patient with a stent because they're "cardiac" or the peds trained person doing adult hips.

 

[Twiggidy]

You are over worrying.

In my practice, the anesthesiologists pick their rooms for the next day. We pick the surgeons, the surgeons don’t pick us. (In reality, we go down the call list and pick lineups for the next day based on how lucrative they are.) We allow patient requests but don’t allow surgeon requests.

And THIS is a good system. If there is a system where surgeons are allowed to pick and choose, it's a red flag.

Edit: It also goes both ways. Sometimes an anesthesiologist may pick a room because the surgeon is fast and easy to work with. It's win - win

 

[deleted162650]

What makes a surgeon say, "I only want Dr. Twiggidy on my cases"

Affirmative Action?




I kid, I kid.

 

[Man o War]

Excuse my ignorance (I'm currently applying to residency). What kind of things makes an anesthesiologist preferred by certain surgeons?

Examples of partner characteristics/behaviors that surgeons did not want to work with that I’ve seen:
-very stringent criteria for canceling cases, and never bent from those (end result, canceling cases on a regular basis)
-partners who were regularly not responsive enough to a struggling CRNA who got in over their head
-took too long to do lines or blocks
-took an excessive amount of time interviewing the patient pre op, slowing the surgeon down
-Scared the s@@t out of the patient during the consent portion of the interview to the point that they no longer wanted surgery- created a lot of drama in turn for the surgeon
-showing up late on a regular basis
-too much post op nausea/vomiting or other complications which resulted in the surgeon dealing with phone calls all night; or in the case of ortho, not able to start their PT/mobilization to meet criteria for discharge
-screwing the surgeon’s wife (yes this actually happened in my group)

I’m sure there are others, this is what I recall off the top of my head

 

[hfzballer11]

Examples of partner characteristics/behaviors that surgeons did not want to work with that I’ve seen:
-very stringent criteria for canceling cases, and never bent from those (end result, canceling cases on a regular basis)
-partners who were regularly not responsive enough to a struggling CRNA who got in over their head
-took too long to do lines or blocks
-took an excessive amount of time interviewing the patient pre op, slowing the surgeon down
-Scared the s@@t out of the patient during the consent portion of the interview to the point that they no longer wanted surgery- created a lot of drama in turn for the surgeon
-showing up late on a regular basis
-too much post op nausea/vomiting or other complications which resulted in the surgeon dealing with phone calls all night; or in the case of ortho, not able to start their PT/mobilization to meet criteria for discharge
-screwing the surgeon’s wife (yes this actually happened in my group)

I’m sure there are others, this is what I recall off the top of my head

I'll keep these in mind when I'm in practice, but no promises on that last one

 

[Twiggidy]

Affirmative Action?




I kid, I kid.

 

[GravelRider]

Aren't these things true for all anesthesiologists in general? My question was moreso geared at the above post that mentioned some surgeons request a specific anesthesiologist for their rooms for the entire day. What makes a surgeon say, "I only want Dr. Twiggidy on my cases", when as you mentioned 99.9 percent of anesthesiologists are not lacking in ability.

You are overestimating the skill of the majority of anesthesiologists. It’s not 99.9% who can do any case...not even close. There are some real sketchballs out there who are scary bad and they are not rare. Certainly not <0.1% of anesthesiologists.

Otherwise, I would say that in most jobs you don’t want to stand out in either good ways or bad ways. Sure, there are “eat what you kill” jobs, but the vast majority are positions where you will be employed by someone else. Being the “go to” guy just leaves you with more work. Being the “go to” guy is not hard at all, but in the end it’s not worth it. The moral is just don’t think about it and do your job well. “Career capital” is really not worth thinking about or stressing about.

 

[Psai]

Examples of partner characteristics/behaviors that surgeons did not want to work with that I’ve seen:
-very stringent criteria for canceling cases, and never bent from those (end result, canceling cases on a regular basis)
-partners who were regularly not responsive enough to a struggling CRNA who got in over their head
-took too long to do lines or blocks
-took an excessive amount of time interviewing the patient pre op, slowing the surgeon down
-Scared the s@@t out of the patient during the consent portion of the interview to the point that they no longer wanted surgery- created a lot of drama in turn for the surgeon
-showing up late on a regular basis
-too much post op nausea/vomiting or other complications which resulted in the surgeon dealing with phone calls all night; or in the case of ortho, not able to start their PT/mobilization to meet criteria for discharge
-screwing the surgeon’s wife (yes this actually happened in my group)

I’m sure there are others, this is what I recall off the top of my head

I didn't realize until just now that the quality of surgical spouse was part of my job search requirements.