hi everyone
i have confusion about choosing my medical field
i think to choose anesthesia
but i felt there are some disadvantages:
1- the work is boring because u are waiting for surgeons to finish their work
2- sometimes treated badly by OR stuff as he isn't a doctor
3- the competition in this field is low and i can't be unique in it because every one can get the patient sleep and awake !
4-icu ,,some people told me it's depressive as most case are terminal or hopeless
Four or more thoughts:
1. Boredom can be a danger in this field--a danger for patients. I was flabbergasted when I saw for the first time an anesthesiologist in private practice turning away from the patient, kicking his feet up on the anesthesia cart and opening the Wall Street Journal. It was kinda sickening. We get entrusted (and paid) to be vigilant, not surf the net, etc. For me, the temptation is not such a problem since I do a lot of shorter cases with quick, seasoned surgeons. As more and more cases become ambulatory, a more relevant concern is "are the surgeons waiting for anesthesia?" But boredom can be a problem for some cases, in training, in particular. Again, however, for me, I am full-throttle, hopping from 0600 until it's time to go. If there is "down time" in the OR, I enjoy the rest and try to keep my eye on the ball.
2. I've heard this is less an issue in Europe where the patient isn't the surgeon's; rather the surgeon's and the anesthesiologist's. It is true in my experience that the system (myself included) caters to the surgeons. We are a service profession in the U.S. Took a while for me to really understand this: our job is to safely, facilitate the conduct of surgery. I try to do more in hopes that patients and families see me as the "best anesthesiologist that has ever taken care of them," but I would not have a job long if I didn't focus on facilitating. We are definitely not the apex predator in the O.R. so if you cannot suppress ego, it will be more of a challenge. That is not to say that we are unappreciated. The real professionals, recognize the value of a capable anesthesiologist and one gets plenty of strokes for doing a good job, moolah included.
3. Competition for residency spots? I really don't know about this. Beyond residency, I would say you have a point that it is relatively difficult to find acknowledgement for the added-value brought by a really committed-to-excellence anesthesiologist. I suspect, our success is part of the difficulty in teasing out the exceptional. Basic U.S. medical market forces are huge also, IMHO. Even ortho surgery, e.g., where it is perhaps easier to distinguish an exceptional doc from a so-so one, the payors don't yet recognize this. The local forces--HMO, Health- or Payor-System, will send "THEIR" patients to the economical choice, not the person who does the best shoulder replacement, etc. So for us, even more difficult to distinguish ourselves. I think fellowship serves a role here. I'm sure that letting CRNAs do everything while we sit in the break room and shoot the bull is our demise.
4. I'm not an ICU doc and have limited experience. But I will say this: there are tremendous saves that occur in the units. There are plenty of patients that do walk out of the units. My most recent experience is with pedi-ICU training and the terrific strides that have occurred in improved outcomes leaves a lot more than a glass half full. One really is a physician nonpareil in the units, also.
