Control - OR

[LIDO]

Question for any anesthesiologist attending, fellow, or resident:

Do you feel a lack of control / leadership in the OR due to the surgeon being the leader of the pack....along with hospital management and nursing staff scratching?

I have a pretty dominant personality and I am trying to figure out if gas is a good fit. Sometimes I feel like the personality of a surgeon fits me.....but I love the work in gas (the physio and pharm).

Any opinions?

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[RabbMD]

I have a pretty dominate personality and do fine. In fact I think you need some backbone to be a good anesthesiologist. It's just hard to need lots of affirmation and be an anesthesiologist in my opinion.

 

[Ignatius J]

Question for any anesthesiologist attending, fellow, or resident:

Do you feel a lack of control / leadership in the OR due to the surgeon being the leader of the pack....along with hospital management and nursing staff scratching?

I have a pretty dominant personality and I am trying to figure out if gas is a good fit. Sometimes I feel like the personality of a surgeon fits me.....but I love the work in gas (the physio and pharm).

Any opinions?

You can do well, but do yourself a favor and try and not be as dominating and relax. It will make you much easier to work with both inside and outside the OR.

 

[seinfeld]

Leadership and being in control are essential to be a good anesthesiologist. A big ego, requirements for constant affirmation, need to have ownership over a patient, and an inability to be flexible and work with an Doc in a team environment will be ones demise in anesthesiology.

 

[inmyslumber]

I think you are focusing on the wrong aspects of medical care. There are all types of personalities in every field.
If you want to work as a team-player while taking charge when necessary, Anesthesiology or Surgery will be good for you. If you always want to be "the leader of the pack" you will make a good Surgeon that no one wants to work with.

 

[SleepIsGood]

Leadership and being in control are essential to be a good anesthesiologist. A big ego, requirements for constant affirmation, need to have ownership over a patient, and an inability to be flexible and work with an Doc in a team environment will be ones demise in anesthesiology.

Well stated.

I would also add. Definitely as a resident you have to take it easy. Afterwards, things can change...

 

[PostCall]

If you always want to be "the leader of the pack" you will make a good Surgeon that no one wants to work with.

ummm, not really. the OR has to have a leader even if it's a team effort. that leadership position by default is on the surgeon, who's you know...operating on the patient and responsible for the postop care.

 

[urge]

You have two costumers. The patient and the surgeon. Good outcomes matter to the first, good outcomes and no fuzz atmosphere matter to the second.

Know which battles to fight.

BTW, I really don't know what you mean by dominant personality. I pretty chill but can easily tell you to go f yourself whenever I feel like. Nobody can force me to do something I don't want to. I'm very political though. I will convince you that you don't want to do whatever it is you want to do. I do it over and over. It is pretty easy.

 

[Idiopathic]

ummm, not really. the OR has to have a leader even if it's a team effort. that leadership position by default is on the surgeon, who's you know...operating on the patient and responsible for the postop care.

dont be so quick to pass the buck. the surgeon can be the leader of the belly and the femur and the prescription pad and if he/she wants to make suggestions during the operative course then they will be taken under advisement and I consider it a skill to be able to accomodate a surgeon when it is appropriate, but it is not always and if you are comfortable in your skills and knowledge then you should be able to handle such situations.

the other stuff is just BS - in medicine you ALWAYS have to subjugate your personality to someone elses, regardless of specialty, you should choose the specialty that provides you the most intellectual opportunity and that you think you will enjoy twenty years from now. ive never advocated picking a specialty based on your personality.

 

[NotAMD]

first time working with this particular CT surgeon on a CABG..

Show up to the hospital and its 545 to set up - the room is set up already - there was an emergency case that got canceled, and so Dr. A is going to just go early for a scheduled CABG that will happen now instead of the typical 730am.. ugh.. get through the CABG.. uneventful with a relatively otherwise healthy patient.. end time 220pm (after the super early start)

Now he wants to take back another case: open sternum to close it since he still has some time in the OR room (even though the staff has been working since 545a). Pt is 80F tubed and swanned from prior cabg (but with an open chest?). Annoying but fine, hook her up, run a little gas and paralytic.. after room turnover we are ready to go by 2:45. Add an additional 1 hr while he and another CT Anesth attending try to get femoral Alines while we have a pefectly good radial one because the surgeon "thinks its damp"

4:30pm my attending comes in with the on-call attending, gives report and leaves the room..

"Anesthesiology here is an absolute Joke. You just work shift work, with no commitment to the patient, if its quitting time, you leave, the whole department is a circus, its terrible, unbelievable" - Directly to me... and only after the attendings are out

I felt like i should at least tell someone about this? but i dont want to make waves.. thoughts?

 

[Idiopathic]

suck it up - the culture is pervasive and if he had been corrected before then you wouldnt be having this conversation

the biggest thing is that nobody fully appreciates what we do between cases, IMHO, when surgeons are sitting down, having lunch, urinating, etc, we are turning rooms over preparing, preopping etc.

my favorite is at the end of a long ortho day as Im getting relieved, the ortho attending (B****) says: "BOY WISH I COULD LEAVE IN THE MIDDLE OF THE CASE" to which i mutter something like "So does your patient"

 

[jetproppilot]

Question for any anesthesiologist attending, fellow, or resident:

Do you feel a lack of control / leadership in the OR due to the surgeon being the leader of the pack....along with hospital management and nursing staff scratching?

I have a pretty dominant personality and I am trying to figure out if gas is a good fit. Sometimes I feel like the personality of a surgeon fits me.....but I love the work in gas (the physio and pharm).

Any opinions?

OPINIONS?

Yes.

Leave your ego at the front desk.

Take your several hundred thousand dollar income, your twice-as-many-as-any-other-physician vacation weeks, your no clinic, your post call day off (or at least early), your ability to take care of patients for a finite time (i.e. the operation) then sign off.

Your personality "fits surgery?"

I hear you wanting to go to the fair and prove you can hit the bell with a sledgehammer before anyone else.

Know what the "prize" is for that kinda thinking?

A stuffed animal.

For you to adorn.

Because you were "better/faster/stronger."

With all due respect,

none of the ego s h it you feel as a med student pans out out here in real life. Turns out, five years outta residency everyone realizes medicine isnt EVERYTHING...we all have personal lives to live too....kids? wives? girlfriends? passionate hobbies?

These things will become important to you.

YOU will need to learn how to balance LIFE with medicine.

Regardless of what specialty you choose.

We are not robots.

Hard to believe, I know, sitting where you are.

Believe me its true.

Leave your ego at the door when selecting a specialty or you'll be a very unhappy person in the future.

Unless you are a sociopath.

Which does exist in medicine.

Hopefully you are not one of those unfortunate few.

 

[igottaquestion]

^ At the end of third year, and I see this is solid advice.

 

[Idiopathic]

Take your several hundred thousand dollar income, your twice-as-many-as-any-other-physician vacation weeks, your no clinic, your post call day off (or at least early), your ability to take care of patients for a finite time (i.e. the operation) then sign off.

jet you always give interesting advice and this is probably somewhat tongue-in-cheek but some might say this is the problem with anesthesia today.

 

[seinfeld]

first time working with this particular CT surgeon on a CABG..

Show up to the hospital and its 545 to set up - the room is set up already - there was an emergency case that got canceled, and so Dr. A is going to just go early for a scheduled CABG that will happen now instead of the typical 730am.. ugh.. get through the CABG.. uneventful with a relatively otherwise healthy patient.. end time 220pm (after the super early start)

Now he wants to take back another case: open sternum to close it since he still has some time in the OR room (even though the staff has been working since 545a). Pt is 80F tubed and swanned from prior cabg (but with an open chest?). Annoying but fine, hook her up, run a little gas and paralytic.. after room turnover we are ready to go by 2:45. Add an additional 1 hr while he and another CT Anesth attending try to get femoral Alines while we have a pefectly good radial one because the surgeon "thinks its damp"

4:30pm my attending comes in with the on-call attending, gives report and leaves the room..

"Anesthesiology here is an absolute Joke. You just work shift work, with no commitment to the patient, if its quitting time, you leave, the whole department is a circus, its terrible, unbelievable" - Directly to me... and only after the attendings are out

I felt like i should at least tell someone about this? but i dont want to make waves.. thoughts?

Choices, it comes done to the fact the surgeon choose to be a surgeon and chose to operate at that time on that day. You made a different choice, neither of you had to be there you could have been seeing pts in the office in a pediatric practice.

 

[SleepIsGood]

Choices, it comes done to the fact the surgeon choose to be a surgeon and chose to operate at that time on that day. You made a different choice, neither of you had to be there you could have been seeing pts in the office in a pediatric practice.

 

[fakin' the funk]

that leadership position by default is on the surgeon, who's you know...operating on the patient and responsible for the postop care.

So then why do they consult the hospitalists for postop care?

 

[fakin' the funk]

I felt like i should at least tell someone about this? but i dont want to make waves.. thoughts?

I might try something like..."If you have a concern about the attending anesthesiologists at this institution I would encourage you to take it up with them directly."

 

[fakin' the funk]

jet you always give interesting advice and this is probably somewhat tongue-in-cheek but some might say this is the problem with anesthesia today.

I don't think "the problem with anesthesia today" has to do with getting paid or having finite work hours. I think it has to do with a relative undervaluation of anesthesiology and anesthesiologists by other docs. And that, IMO, is due to low visibility in the hospital and non-OR settings, and poor continuity of care with the preoperative and postoperative primary docs whether they be the patient's PCP, internist, hospitalist, surgeon, whatever.

 

[Idiopathic]

I don't think "the problem with anesthesia today" has to do with getting paid or having finite work hours. I think it has to do with a relative undervaluation of anesthesiology and anesthesiologists by other docs. And that, IMO, is due to low visibility in the hospital and non-OR settings, and poor continuity of care with the preoperative and postoperative primary docs whether they be the patient's PCP, internist, hospitalist, surgeon, whatever.

ill just say that when youve completed some anesthesiology training, you tell me what the problem is. until then, understand that people in other areas know that we CANT do some of these things (although we are very visible around here, and do almost as much outside of the OR as we do inside of it) but when they figure we DONT WANT to do them is when they 'undervalue' us.

i wont argue with you that people dont understand what we do, and youll have to come to terms with that, but dont assume that you can have a certain attitude, and that when people dont give you the respect you deserve, assume its a flaw in the system.

 

[happyabe]

Given the importance of being a dominant person in the environment in which you'll work some day, I recommend you choose a different field. Sure, anesthesia can be fun with all of the cool stuff we do, but at the end of the day you are seen as inferior to the surgeon. The patient knows this, too. I can't tell you how many times I've seen my patient in preop, said, "Hi I'm Dr. Abe, I will be doing your anesthesia today." The response I often get is, "Where's my doctor?"

This is not a big deal for most, but this can be an issue for those with a more dominant personality. I think it's something tough to get over, so keep it in mind. There are very few other medical fields, probably none, that require you to interact so much with another professional. So unless you're good at it, it will be difficult to succeed in this profession. Just my 2 cents.

Question for any anesthesiologist attending, fellow, or resident:

Do you feel a lack of control / leadership in the OR due to the surgeon being the leader of the pack....along with hospital management and nursing staff scratching?

I have a pretty dominant personality and I am trying to figure out if gas is a good fit. Sometimes I feel like the personality of a surgeon fits me.....but I love the work in gas (the physio and pharm).

Any opinions?