Complacent midcareer slackers

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nimbus

nimbus

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These are the real reason anesthesia has a PR problem and why CRNAs are a threat.

I have colleagues who run the other way when a tough case rolls thru the door. They refuse to keep their skills up to date and are threatened by every new development even though they make our jobs easier, not harder. They practice 1990s anesthesia and have no desire to learn or change.

Sad to observe. Okay, rant over.
 
nimbus said:
These are the real reason anesthesia has a PR problem and why CRNAs are a threat.

I have colleagues who run the other way when a tough case rolls thru the door. They refuse to keep their skills up to date and are threatened by every new development even though they make our jobs easier, not harder. They practice 1990s anesthesia and have no desire to learn or change.

Sad to observe. Okay, rant over.
Click to expand...

+1

I have heard anesthesiologist poo poo techniques like regional blocks, TEE, and thoracic epidurals as "not useful" simply because they do not have these skills. They did not learn them in residency and then never bothered to acquire them later. On the other hand, I went to a week-long TEE course and met an anesthesiologist in his early 60's. He was a smart, self-deprecating type who joked that an old guy like him really had no business being in that course. I begged to differ. When I am near retirement age, I know which of the above anesthesiologists I like to be. I don't think that is the reason for the CRNA threat, but I agree with your general sentiment..
 
CRNAs run roughshod over these weaklings. I hope you are not in a practice that empowers this type of behavior.
 
Sometimes I wonder if I'm one of these guys. I don't pull out the US for blocks very often except for axillary and difficult interscalenes (this happened once now) and I used it for a popliteal last week for a change. Maybe some people here on SDN probably think about me more like your description above and that's fine with me. I have some younger partners from very good programs that probably think the same way. However, my peers in and out of my group seem to still come to me for the difficult issues so maybe I'm not like these people.

So, in defense of some of these folks you describe, just be sure they are pulling their own weight and not an anchor on the group. That is were the problem seems to be. I think some people are just naturally averse to change or somewhat threatened by it. Somehow you need to bring them along without making them uncomfortable. They are still more intelligent than a crna they just are losing some of the outward opportunities to show this.

BTW, anesthesia wasn't that bad in the 90's. At least from what I've heard. 😉 Everyone that trained me was from that decade.
 
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Some people are not self driven and have to be forced to keep their skills current. Absent pressure they fall behind the curve. Most practices have at least one or two like this.
 
Yeah, no kidding. We have "colleagues" in my group that only want to do endo every day. It's pathetic.
No kids, no regional, no hospital cases. But...they get paid!! Such an embarrassment. Glorified CRNAs.
 
And do they get fired/replaced? Nope. There's your answer. It's not what you know, it's who you know.
 
These are the realities that trainees fail to realize. They have only seen academics where education is the supposed answer, hence the "fellowship mania". In the PP world, being a good politician ends up opening as many if not more doors. Each environment (academics vs PP) places too heavy an importance on what best fits their own needs (understandably), when the ideal should fall somewhere in between. Welcome to anesthesia, where your entire career will be playing to other's expectations. Unfortunately, I was never good at kissing a$&.
 
gasdoc77 said:
These are the realities that trainees fail to realize. They have only seen academics where education is the supposed answer, hence the "fellowship mania". In the PP world, being a good politician ends up opening as many if not more doors. Each environment (academics vs PP) places too heavy an importance on what best fits their own needs (understandably), when the ideal should fall somewhere in between. Welcome to anesthesia, where your entire career will be playing to other's expectations. Unfortunately, I was never good at kissing a$&.
Click to expand...

This is not only true in anesthesia. How many yoyo surgeons have locked up referral networks because of good networking and politicking? Anybody who had been around the block a few times knows that being likeable and slick is an asset in any field. How many women are judged on their weight or the way the dress and not on their skills? How many people who are incredibly skilled lose out because of poor communication skills in whatever field? This is life.
 
It could also be that people realize that the job does not love them, they have things that are more important to them, family comes to mind.
 
Noyac said:
Sometimes I wonder if I'm one of these guys. I don't pull out the US for blocks very often except for axillary and difficult interscalenes (this happened once now) and I used it for a popliteal last week for a change. Maybe some people here on SDN probably think about me more like your description above and that's fine with me. I have some younger partners from very good programs that probably think the same way. However, my peers in and out of my group seem to still come to me for the difficult issues so maybe I'm not like these people.

So, in defense of some of these folks you describe, just be sure they are pulling their own weight and not an anchor on the group. That is were the problem seems to be. I think some people are just naturally averse to change or somewhat threatened by it. Somehow you need to bring them along without making them uncomfortable. They are still more intelligent than a crna they just are losing some of the outward opportunities to show this.

BTW, anesthesia wasn't that bad in the 90's. At least from what I've heard. 😉 Everyone that trained me was from that decade.
Click to expand...

Maybe not that good but we made up for it in volume after 80 hours
 
007livesforever said:
It could also be that people realize that the job does not love them, they have things that are more important to them, family comes to mind.
Click to expand...


This is absolutely the problem. They are interested in everything BUT anesthesia. Stocks, golf, wine, and yes, family. But professionally they are on cruise control. It's just a job, getting by, punching the clock to put bread in the table. They have no passion or interest. It is cliche but you get out what you put in to it.
 
nimbus said:
This is absolutely the problem. They are interested in everything BUT anesthesia. Stocks, golf, wine, and yes, family. But professionally they are on cruise control. It's just a job, getting by, punching the clock to put bread in the table. They have no passion or interest. It is cliche but you get out what you put in to it.
Click to expand...

90% + of docs get less "gung ho" as they get older. Most residents are young singles with no responsibilities to anyone but themselves. Life happens: Marriage, kids, health issues with parents, troubled marriages and troubled kids, personal health issues, and yes taking the time to enjoy some of the fruits of previous hard work. Also, for many the work becomes less satisfying and emotionally fulfilling so people develop other interests.

Nobody on their death bed ever said "I wish I worked more"
 
nimbus said:
This is absolutely the problem. They are interested in everything BUT anesthesia. Stocks, golf, wine, and yes, family. But professionally they are on cruise control. It's just a job, getting by, punching the clock to put bread in the table. They have no passion or interest. It is cliche but you get out what you put in to it.
Click to expand...

That's me to a "T" and I'm glad it is. I'm a work to live not a live to work kind of guy. After a few years of dealing with this inane drudgery, you too, my friend, will be as well. The Jetproppilot-jump-out-of-bed types are an EXTREME minority.
 
Well this post has brought insight into why some people post in the manner that they do on this forum. And the jet pro pilot types are not an "extreme" minority...I would assume any group that is considered strong has many of the same driven personalities as the majority...if you find yourself in a group were the majority have interest in everything else but anesthesia....do yourself a favor and start looking for a stronger group.
 
Stank811 said:
Well this post has brought insight into why some people post in the manner that they do on this forum. And the jet pro pilot types are not an "extreme" minority...I would assume any group that is considered strong has many of the same driven personalities as the majority...if you find yourself in a group were the majority have interest in everything else but anesthesia....do yourself a favor and start looking for a stronger group.
Click to expand...
Please :uhno:
 
It's normal that the young guys want to hear positive and uplifting things about this field of medicine, everyone likes it when others agree with them and congratulate them on their wise choices.
Unfortunately we live in the real world and the real world is not so great... sooner or later we all learn to play the cards we were dealt.
 
Planktonmd said:
It's normal that the young guys want to hear positive and uplifting things about this field of medicine, everyone likes it when others agree with them and congratulate them on their wise choices.
Unfortunately we live in the real world and the real world is not so great... sooner or later we all learn to play the cards we were dealt.
Click to expand...

You don't have to pour yourself into your work to the exclusion of your family and other interests. I believe in balance. But I have partners that are constantly trying to dump cases on their colleagues, manipulate the schedule, and screw surgeons. They will do anything to get out of dodge. I have partners that are still practicing 1980's anesthesia. Sorry, while thats "the real world", I can't respect that.

We have a subset of partners that are faster, more flexible, more affable, more current in skills, and have a stronger work ethic. This subset is constantly getting requested by surgeons. And the whole OR notices.
 
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GasEmDee said:
You don't have to pour yourself into your work to the exclusion of your family and other interests. I believe in balance. But I have partners that are constantly trying to dump cases on their colleagues, manipulate the schedule, and screw surgeons. They will do anything to get out of dodge. I have partners that are still practicing 1980's anesthesia. Sorry, while thats "the real world", I can't respect that.

We have a subset of partners that are faster, more flexible, more affable, more current in skills, and have a stronger work ethic. This subset is constantly getting requested by surgeons. And the whole OR notices.
Click to expand...
👍

Balance and being part of the "subset" is key. Eventually, the dinasours die out.
 
Stank811 said:
...if you find yourself in a group were the majority have interest in everything else but anesthesia....do yourself a favor and start looking for a stronger group.
Click to expand...

Eff that nonsense. I WANT to be in a group where there aren't a bunch of hard-on, anesthesia-or-die types. Those folks are upper echelon douchebags.
 
IanMcGalt said:
Contact holding >>>>> ability
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Absolutely. One thing I've come to realize now in the 6 years since I've been in private practice is that the administrative skills are just as important as clinical. We have a couple of guys (everyone does) who might not be the fastest most up to date go getters in the OR. But they can sweet talk the administrators like no other and at the end of the day a contract is key. They're important. I tend to despise the suits and am not afraid to tell them as much, to a fault. Someone has to do it.
 
dr doze said:
Some of those slow moving lizards live a long time.
Click to expand...

There is definately some truth in that Doze. 👍

One of my favorite sayings in medicine and life in general:

“To be sure is to be blindsided”.

The former Chief of Surgery and Chief of Orthopedics as well as my next door neighboor was let go and walked out of the hospital on a Friday a couple months back. His productivity was at the very bottom out of a group of 10 orthopods. He thought he was an “untouchable” and abused the system. Pissed off his group in more ways than one. Guess what? They got together and voted him out in secret. He was there one day in a position of power and gone the next. Never saw it coming.
Too bad too because the ortho dpt. here is a super-sweet gig. 1:10 weekends, 1:10 call + big $$$. So... for you lizards out there...

“To be sure is to be blindsided”

Work hard, be the best you can be, be a team player and as Noy said, pull your weight. These attributes should be the focus. If you are a lizard in a strong group, you might be let go. If you have a lizard group, be prepared to be gobbled up by an AMC. Being a lazy dinasour group detracts from the groups potential.

Dinasours do die out… eventually. One way or the other.

Balance + Strong work ethic is a good formula for suceess in life.


Post call today. Worked all day and night. Arrived home @ 5 am (3 GSW popped in to our ER @ at the same time). All three with chest injuries, 2/3 with chest and abd. injuries. Busy and today I was also available until 3pm.

Easily found my morning "balance".

IMG_7051_zps7b8d3de4.jpg



Life is good. Anesthesia is good.

Keep the big picture in mind as you don't want to grow old and miss out on the fine points in life.
It's easy to do in this business.


IMG_6998_zps1fdba7ea.jpg
 
"Post call today. Worked all day and night. Arrived home @ 5 am (3 GSW popped in to our ER @ at the same time). All three with chest injuries, 2/3 with chest and abd. injuries. Busy and today I was also available until 3pm"

I'm sorry, but that sounds like the EXACT opposite of a life-is-good scenario. You're working like a dog trying to save the life of some derelicts who more than likely brought it upon themselves? That's nirvana to you? Wow. No thanks.
 
C'mmon dawg. Balance is a personal preference!

I like to work hard and play hard... and enjoy my time at work.

Working hard for 12 weeks vaca is worth it in my life. Maybe later in life I'll consider the mommy gig. 😛
 
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sevoflurane said:
C'mmon dawg. Balance is a personal preference!

I like to work hard and play hard... and enjoy my time at work.

Working hard for 12 weeks vaca is worth it in my life. Maybe later in life I'll consider the mommy gig. 😛
Click to expand...
How far to your nearest neighbor? It looks like you have a nice little spread there. And your pup looks like she can find all kinds of fun trouble all on her own.
 
Stank811 said:
Was I to harsh? What aspect of my statement do you disagree with? How does being part of a group were the majority of your partners care less about anesthesia going to benefit anyone long term?
Click to expand...

This
Consigliere said:
Eff that nonsense. I WANT to be in a group where there aren't a bunch of hard-on, anesthesia-or-die types. Those folks are upper echelon douchebags.
Click to expand...
 
Consigliere said:
Eff that nonsense. I WANT to be in a group where there aren't a bunch of hard-on, anesthesia-or-die types. Those folks are upper echelon douchebags.
Click to expand...

So let me guess the majority of people who found success in their careers are upper echelon douchebags….but whatever I will continue to be the douchbag that enjoys anesthesiology and has pride in being an anesthesiologist.
 
GasEmDee said:
You don't have to pour yourself into your work to the exclusion of your family and other interests. I believe in balance. But I have partners that are constantly trying to dump cases on their colleagues, manipulate the schedule, and screw surgeons. They will do anything to get out of dodge. I have partners that are still practicing 1980's anesthesia. Sorry, while thats "the real world", I can't respect that.

We have a subset of partners that are faster, more flexible, more affable, more current in skills, and have a stronger work ethic. This subset is constantly getting requested by surgeons. And the whole OR notices.
Click to expand...

^ This.

Work hard, play hard. Keep current. Otherwise you will be assimilated (AMC).

Also make friends with the surgeons. Not in going out to dinner or inviting over to your house etc. Make friends in that you communicate as well as discuss and agree on a plan. It's amazing what talking to them before the case about their patient for even 15 seconds will do for your rapport.

This field right now is full of a lot of lazy gray hairs that either have been beaten down by the system or are just cashing in on the work of the CRNAs. It's not sustainable for the rest of us. It's certainly not a happy work environment for people that have to observe and endure it, both the CRNAs who sit in the room for eight hours straight without a lunch or a pee break as well as the junior anesthesiologists who are busting their a$$e$ so fat grampa can keep his second vacation home.

I'm with GasEmDee and Sevo. You come to work, put on your workboots and get to work. Play time is for play time. I too am one who can't tolerate lazy slackers who are cashing in simply because they are burnt out or don't want to learn anymore. You know what? Cash out, go part time, or otherwise move out of the way. What it comes down to is that, at some point, they just stopped caring. I'll be 38 this August and I'd like to have a career for a few more years that doesn't involve me being replaced because you proved we weren't necessary.
 
At the gig I just left they used to feed the doctors. The free chow started at 11:00 AM. There was a cohort of 4-5 anesthesiologists who every day without fail were there lined-up at the door waiting for them to put the food out. The same 4-5 without fail.

You think people don't notice that ****?!?? It was just like that Wall-E movie.
 
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