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Drawbacks of Anesthesiology?

Discussion in 'Anesthesiology' started by AK_MD2BE, Apr 7, 2007.

  1. AK_MD2BE

    AK_MD2BE New Member 10+ Year Member

    Jul 31, 2006
    Saint Louis
    Maybe I am biased...but what are the drawback of anesthesiology? I am still young in my medical career (MSI), but I have shadowed quite a few anesthesiologists and absolutely love it. The interaction of pharmacology and physiology, running codes, difficult procedures, good lifestyle...what's not to like? That's what I am trying to figure out b/c I know that not every field of medicine is perfect. So, if somebody who knows what they are talking about (i.e. current anesthesiologist), please let me know the drawbacks. Thanks for your time.:)
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  3. The_Sensei

    The_Sensei Banned Banned

    Dec 28, 2005
    Perhaps the only drawback that I can think of is having to answer questions like these!:smuggrin:
  4. JP2005

    JP2005 HOPKINS GAS PASSER 7+ Year Member

    May 20, 2001
    haha great answer:laugh:
  5. VentdependenT

    VentdependenT You didnt build thaT Physician Moderator Emeritus 10+ Year Member

    Oct 3, 2003

    1) Have to be congenial to your surgical colleagues even though you may be a bit tired of their cranky attitude that day.

    2) You gotta stand up for your clinical decisions concerning patient safety especially if it conflicts with the surgeons interest in getting the case going. I don't see how this is much different than other fields of medicine however.

    3) Nobody knows what the hell you do including the surgeon. Whatever..

    4) People may not know you are a doctor. Big deal..

    You'll change your mind a few times concerning what you want to do in medicine once you get your CORE rotations going. If you still have some interest c'mon check us out early your 4th year.

    For now focus on getting that USMLE step I outta the way.
  6. huron

    huron 2+ Year Member

    Nov 14, 2006
    Even with out the problem or Nurses asserting that they are your equal.

    Anesthesia has many other serious drawbacks, the worst of which is that you can’t leave residence and work for yourself you have to enter into an abusive employment relationship.

    In anesthesia you work hard and inevitably get screwed by the administration or the a$$hole who you have to work for who the administration gave the contract to. I just want to work for myself be my own boss and not have to kiss someone’s a$$. That does not seem like something you can do in Anesthesia any more.
  7. johankriek

    johankriek Banned Banned 2+ Year Member

    Jul 19, 2006
    you have wisdom beyond your years... (i dont know how old you are).

    you hit the nail on it's head.
  8. me454555

    me454555 Senior Member 7+ Year Member

    Mar 29, 2003
    New York
    You can always go into pain
  9. Trisomy13

    Trisomy13 ultra 10+ Year Member

    Apr 13, 2004
    mountain home

  10. huron

    huron 2+ Year Member

    Nov 14, 2006
    I wasted a year doing a Pain Fellowship. I consider Pain as it is practiced by most anesthesiologists to be ineffective. Injection and procedures make money but they do not help the vast majority of the patients for long. The patients endure them for two reasons; 1) New patients, they are in pain and were told by the pain doctor and their referring doctor that the injection would help. 2) More experienced patients, who have entered into an unwritten contract with the pain doctor, that they endure more ineffective injections and the doctor will prescribe the schedule CII meds they require.

    What helped pain patients is a talking to them, physical therapy, psychology and prescribing appropriate medicines. None of which pays very well. If you practice pain in a way that will help your patients you will be lucky to make as much as an internist.

    I could practice pain the way I was taught, and as the anesthesia pain literature describes. But, I became a doctor to help people, so I wouldn’t feel right about doing procedures on patients that I knew were ineffective.
  11. EtherMD

    EtherMD Banned Banned

    Dec 25, 2006
    Jerry Lewis and many others wouldn't agree with you. Quite a few patients get good pain relief with stimulators and pumps. Pain Medicine is not like Anesthesia because a good success rate is not 99.99% but more like 30-35%.
    That said, those getting significant relief DO MATTER and Pain Medicine can make a huge difference in their lives.
  12. cfdavid

    cfdavid Banned Banned 7+ Year Member

    Oct 24, 2004
    30-35% success is not unreasonable when options are few to nill. There are MANY surgical procedures in which patients have no other option, but they do offer a chance for relief. So, as long as the patients know the percentages and risk factors, 30-35% is reasonable and warranted for someone suffering from a life of pain.
  13. salmonella

    salmonella Gram-Negative Rods 5+ Year Member

    Dec 14, 2004
    Even acupuncture could achieve at least some pain relief in 60-70% of cases.
  14. huron

    huron 2+ Year Member

    Nov 14, 2006

    I guess I was being unrealistic to want to help more than half of my pain patients.

    If something only works 30% to 35% then is it worth the risk to the patient to perform the procedure? Given the significant psychological issues in this patient population there is no way to realistically tell if your pain procedure is doing any good. This may simply be another example of the placebo effect.

    You hear the academics complain about the 'feral practitioners' of pain management but if all you can expect to obtain is 30% of patients helped what difference does it make in how technically skilled or careful the pain physician is. I have seen fellowship trained private pain practitioners do facet injections without flouro because their flouro machine was broken and they needed to see patient and generate fees to pay the mortgage and pay the staff .

    But the vast majority of patients see no benefit and regret consenting to the procedure.
  15. ABCsMan

    ABCsMan PGY1 prelim - Anesthesia 2+ Year Member

    Feb 11, 2007
    As opposed to seeing the neurosurgeon, undergo a huge operation, get 6 months of pain relief, and then start right back from the beginning again.

    Pain is the number 1 complaint of all patients. Hopefully, research will allow that percentage to increase, but be mindful that the 30% of people in pain that it benefits still comes to millions of people who receive help.
  16. EtherMD

    EtherMD Banned Banned

    Dec 25, 2006
    You guys every heard of Jerry Lewis the comedian? He has a stimulator and tells evreyone it saved his life! He will tell you first hand the difference the stimulator has made in his life. That is the kind of "save" that makes a huge difference. Ever heard of "failed back syndrome"? Do you know how much money is spent on repeat back surgery? Pain Management is CHEAP compared to surgery and offers real relief.

    Chiropractic, Acupuncture, etc. are worth a shot but nothing works like a real pump or stimulator for some patients. Cost effective? No. But compared to Surgery it is a real option in the USA and worth considering for the right patient. Our citizens demand the best options and Pain Management is on that list. If you want "best bang for the buck" then go the British way and avoid everything expensive (surgery, pumps, etc.) because all you will get is Medication (Fentanyl patch, MS04, Lyrica, etc.).
  17. mille125

    mille125 7+ Year Member

    Dec 8, 2006

    what the hell are you smoking? your statements are imbued with mendacity

    I will forward you the letters of hundreds of my patients who would beg to differ with your statements. This includes medication management patients, ESI patient, intrathecal pump patients, radiofrequency ablation patient, etc.

    What makes you think that 33% is a bad percentage. This represents the percentage of patients who never see me again or see me very sparingly. If I look at patients in a three to six month window the percentage is near 85%. Go visit your local orthopedist, neurosurgeon, or general surgeon. You will be hard pressed to find a much higher overall patient satisfaction rate. What about PCP's. Do more than 30-40% of their diabetic patients reach their glycemic goals? What are their hypertension patients? hyperlipidemia patients?

    You must be in academics yourself. Academic anesthesiologists, in general, have no concept of the real world. They are good at writing grants though. Just look at how your chairmen continue to open up CRNA training school. Talk about "feral practitioners".

    You are obviously very "green" and at the beginning of your career. I am sorry that the pain fellowship did not work out for you. You were right to change careers. Chronic pain patients can really weigh on those who do not have their heart into it. However, there are many patients who feel that there lives are changed after seeing a pain management doctor (ie Jerry Lewis). I have several in my clinic. Before you make the above statements, I suggest that you talk to some of these patients.
  18. mille125

    mille125 7+ Year Member

    Dec 8, 2006

    unwritten contract???.....
    who have you been training under???..
    there are only a small percentage of my patients that go on to schedule 2's if there LESI fails

    I dont know who you have been practicing with or under but you are not seeing true pain management....come work with me for a few weeks and open your eyes...............
  19. GasMan72

    GasMan72 Bruins BBall 2+ Year Member

    Jan 19, 2007
    Westwood, CA
    Wow. That is a bleak outlook, and it sounds like you have been screwed. But it could always be worse. This might brighten your day (or maybe not).

    Today one of the transporters had to go get an elderly in house gentleman for an exploratory lap as the guy was having lots of abdominal pain and the surgeon finally said let's just take a looksie. So maybe it was the pain meds or maybe he is just senile, but the transport (a 21 year old kid who wants to be a doctor) walks in to find the guy masturbating. Disturbing enough, right? But then he gets the guy down to the O.R., and in the hall starts doing it again. The charge nurse sees it, thinks it is nasty, and walks into the break room where I am eating a doughnut to tell me how this perverted old man is out in the hall touching himself and breathing hard. And while she leaves, she tells the kid to stay with the guy. I walk out there to find the kid all red in the face, looking in the other direction, while this guy is obviously being amourous with his jr. member. I tell him to knock it off and he does, and I apologize to the kid for the nurse leaving him there. But she told him to stay, so he did. I guess it was funnier to see in person, but the point is at leastwe aren't the low man on the totem poll.

    And in a round about way, to answer the original question about the drawback, I would say early mornings. Despite 2 years of this now, that 5:45 alarm can still be a little painful.

    Cheers. :D


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