How to deal with Bi&*@ surgeons.

[Putmetosleep]

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I am new at this anesthesia thing and have experienced by first run in with an arrogant surgeon. This guy is the chair of his department and rode my ass from the beginning of the case, commenting on how the point of anesthesia is to not do anesthesia but to allow surgeons to operate, implying the actual operation is the only thing that matters. He was upset and basically ridiculed me in front of the RNs and his residents on how I should have known how the patient was to be positioned before starting the case. What set him off was having the christmas tree for the circuit in the wrong place! I retorted by stating that this was my first time doing this particular case and that I am learning. This bickering went on for a minute or so and I just said, "I am not going to argue with you. Shall I call Dr. ABC (my attending) so that you can discuss this?" He became quiet and proceeded to kiss my ass the remainder of the case. After the case the RN commented on how everyone always blames anesthesia for problems or delays. I just commented on how this is because they are all jealous and she responded, "yes, that is true. Keep telling yourself that." This experience ruined my week and is giving me second thoughts on this profession. All I ask is for a little respect.

 

[Noyac]

It doesn't go away. I have 2 gen. surgeons where I work that are the biggest dinguses I have ever met. They are always complaining about our vacation time and salary. This just tells me that they are sorry that they don't have what I have. They have never complained about the quality of care in my group. The administration has now gotten involved and effectively told the 2 dinguses to shut up or get lost. It hasn't changed and I don't expect that it will. Anyway, I wouldn't worry too much about it. Every job has its downsides and this is one that I can handle, jealousy from surgeons.

 

[fedor]

It doesn't go away. I have 2 gen. surgeons where I work that are the biggest dinguses I have ever met. They are always complaining about our vacation time and salary.

Just tell them that you'll put in a good word for them with anesthesia residency program directors.

 

[Laryngospasm]

Just tell them that you are there to provide anesthesia, keep the patient alive, and protect them from the surgeons. 😀 Youll have to deal with this all the time, however, I notice that it is much more prominent with the really old surgeons, the old school ones, who think people still give a **** about them and that they walk on rose petals.
Often if you just stand up for yourself they will leave you alone, just like the bully in the schoolyard. This is a fine line in residency though, but it can be pulled off. I think residency is a great time to develop a pair of balls and perfect it, so you will know when to stand up for yourself in practice. Good luck.

 

[supahfresh]

Just say something like if anything happens to this patient, I'm sure I'll be able to make you look bad in court. or, just tell him he needs to get laid. or if he asks to put the bed up, put the bed down.

 

[davvid2700]

doesnt get better.. You have to learn how they think and what they bitch about to avoid these.. OF course, every surgeon has their idiosynchrasies.. after a while you can anticipate every single thing that anybody would be bothered by and you will avoid this.. sometimes you are caught out there.. DOnt argue back .. you wont win.. so dont even try.. shrug it off.. occupational hazard.. But this is definitely the downside to anesthesia.. really not considered medicine in that we are not treating anything.. except for hemodynamic changes and the like..

 

[MDEntropy]

doesnt get better.. You have to learn how they think and what they bitch about to avoid these.. OF course, every surgeon has their idiosynchrasies.. after a while you can anticipate every single thing that anybody would be bothered by and you will avoid this.. sometimes you are caught out there.. DOnt argue back .. you wont win.. so dont even try.. shrug it off.. occupational hazard.. But this is definitely the downside to anesthesia.. really not considered medicine in that we are not treating anything.. except for hemodynamic changes and the like..

Justin? Is that you?

 

[VolatileAgent]

commenting on how the point of anesthesia is to not do anesthesia but to allow surgeons to operate, implying the actual operation is the only thing that matters.

this is mostly true. we provide a surgical service. however, you should have said something like, 'hey, i'm running my case up here, why don't you focus on running your case down there. isn't that what's best for the patient?' that usually shuts them up. at least if they keep bitching after you say that they just look like a blowhard @sshole to everyone else in the room.

He was upset and basically ridiculed me in front of the RNs and his residents on how I should have known how the patient was to be positioned before starting the case.

well, you should have. but you should have said, 'have i worked with you before? if you wanted a particular position, you should have found me before i put the patient to sleep and discussed it with me.'

This bickering went on for a minute or so and I just said, "I am not going to argue with you. Shall I call Dr. ABC (my attending) so that you can discuss this?"

never bicker with an attending. do what's best for your patient. you should have played your trump card earlier.

I just commented on how this is because they are all jealous and she responded, "yes, that is true. Keep telling yourself that."

don't have such conversations with nurses. saying things like that will potentially come back to haunt you. just show up, be professional, stay above the fray, and don't go toe-to-toe with anyone. easier said than done sometimes, but that's how you get respect. i've said things when i've been pissed off that have somehow strangely seem to have come back to me in weird ways (like another resident or nurse when i'm in a different room on a different day making an allusion to something i said earlier). trust me, just stay above it.

This experience ruined my week and is giving me second thoughts on this profession. All I ask is for a little respect.

respect is earned not given, my friend. you're early in your training. don't let the idiocy of others have such an effect on you. having a good life is the best antidote to other people's stupidity.

 

[jetproppilot]

respect is earned not given, my friend. you're early in your training. don't let the idiocy of others have such an effect on you. having a good life is the best antidote to other people's stupidity.

Couldnt've been said better.

In my previous gig (well established, hard working group) that serviced about 30 surgeons, know how many gave us a hard time?........ZERO. They knew we ran a tight ship, did the work when it needed to be done, and took great care of our (their) patients.

1.5 years into my new gig, servicing about 20 surgeons, know how many give us a hard time?.......ONE. Old school orthopedic dude who is a legend in his own mind, knows everything about everything, and is very hard to keep happy, no matter what we do. A true, hardcore d-i-c-k-hole.
But you know what? He's even come around enough, due to the hard, efficient work of our group, that he's tolerable.

Had another surgeon we worked with who was difficult at first..made alot of waves about insignificant stuff, actually made a stink about one of my partners facilitating the case by calling for the patient from the floor...he was pissed that he wasnt called before we sent for his patient, even though he had posted the add on case.

The next day, my partners called him into our office, told him the proactive philosophy of our group, he had posted the case, we were just doing our job, he had nothing to be pissed about, and we werent gonna tolerate his behavior.
Havent had a problem with him since. Actually he goes way out of his way to be nice now.

Like Volatile said, respect is earned. Once you've earned it, problems minimize, and you address big problems with muscle prn. But the muscle part is very, very, very rare.

 

[Noyac]

In my previous gig (well established, hard working group) that serviced about 30 surgeons, know how many gave us a hard time?........ZERO. They knew we ran a tight ship, did the work when it needed to be done, and took great care of our (their) patients.

Just curious, Jet. Was that previous group (servicing 30 surgeons) in NO or a neighboring town?

 

[jetproppilot]

In my previous gig (well established, hard working group) that serviced about 30 surgeons, know how many gave us a hard time?........ZERO. They knew we ran a tight ship, did the work when it needed to be done, and took great care of our (their) patients.

Just curious, Jet. Was that previous group (servicing 30 surgeons) in NO or a neighboring town?

Not in NO, Noyac. Practiced in Alexandria. Right in the middle of the state.

 

[jetproppilot]

In my previous gig (well established, hard working group) that serviced about 30 surgeons, know how many gave us a hard time?........ZERO. They knew we ran a tight ship, did the work when it needed to be done, and took great care of our (their) patients.

Just curious, Jet. Was that previous group (servicing 30 surgeons) in NO or a neighboring town?

Not in NO, Noyac. Practiced in Alexandria. Right in the middle of the state.

 

[jetproppilot]

In my previous gig (well established, hard working group) that serviced about 30 surgeons, know how many gave us a hard time?........ZERO. They knew we ran a tight ship, did the work when it needed to be done, and took great care of our (their) patients.

Just curious, Jet. Was that previous group (servicing 30 surgeons) in NO or a neighboring town?

Not in NO, Noyac. Practiced in Alexandria. Right in the middle of the state.

 

[Noyac]

Not in NO, Noyac. Practiced in Alexandria. Right in the middle of the state.

Sounded like my group in Baton Rouge. The one I left 1 1/2 yrs ago.

 

[ALTorGT]

This feeling that all your doing is treating haemodynamic changes...How is that different in non procedural internal medicing. For eg. if you're a non procedural cardiologist, and all you do is echos or stress tests and manage heart failure, what are you really treating other than adjusting doses of drugs based on evidence based medicine?????

Also longer term, (and I know the CRNA topic has been beaten to death), do you think it is possible that in a multi OR setup, the anaesthetist will be present only for take off and landing and he or she will be videoconferenced with CRNAs in all theatre, and observing them all at a bay (kind of like the monitored station on Coronary wards or ICUS) giving them instructions?

doesnt get better.. You have to learn how they think and what they bitch about to avoid these.. OF course, every surgeon has their idiosynchrasies.. after a while you can anticipate every single thing that anybody would be bothered by and you will avoid this.. sometimes you are caught out there.. DOnt argue back .. you wont win.. so dont even try.. shrug it off.. occupational hazard.. But this is definitely the downside to anesthesia.. really not considered medicine in that we are not treating anything.. except for hemodynamic changes and the like..

 

[jetproppilot]

doesnt get better.. You have to learn how they think and what they bitch about to avoid these.. OF course, every surgeon has their idiosynchrasies.. after a while you can anticipate every single thing that anybody would be bothered by and you will avoid this.. sometimes you are caught out there.. DOnt argue back .. you wont win.. so dont even try.. shrug it off.. occupational hazard.. But this is definitely the downside to anesthesia.. really not considered medicine in that we are not treating anything.. except for hemodynamic changes and the like..

Whats your definition of practicing medicine? Is seeing overweight, sedentary, noncompliant people in your clinic month after month and pleading with them to change their lifestyle and take their meds, is that practicing medicine?

 

[supahfresh]

never bicker with an attending. do what's best for your patient. you should have played your trump card earlier.

never?

 

[lvspro]

Whats your definition of practicing medicine? Is seeing overweight, sedentary, noncompliant people in your clinic month after month and pleading with them to change their lifestyle and take their meds, is that practicing medicine?

This is the thing that turned me off about IM, Surg, or any other field with continuity of care or any other follow-up for that matter. How many of you have had this conversation in clinic during rotations "I didn't fill my Rx b/c I didn't have the cash/time/transportation" while said Pt has a pack of newports in plain sight sticking out of their shirt pocket.
God... I love anesthesia!

 

[Beck928]

This is the thing that turned me off about IM, Surg, or any other field with continuity of care or any other follow-up for that matter. How many of you have had this conversation in clinic during rotations "I didn't fill my Rx b/c I didn't have the cash/time/transportation" while said Pt has a pack of newports in plain sight sticking out of their shirt pocket.
God... I love anesthesia!

No kidding! Currently, in my ER rotation (which I once thought I might like) I am constantly being blamed by patients that we are not doing anything to make them better, and all the while they never fill their scripts, follow up with PCP or the like. Since when is it my fault you don't give a $hit about your health? Thank God for anesthesiology!

 

[MD Dreams]

This is the thing that turned me off about IM, Surg, or any other field with continuity of care or any other follow-up for that matter. How many of you have had this conversation in clinic during rotations "I didn't fill my Rx b/c I didn't have the cash/time/transportation" while said Pt has a pack of newports in plain sight sticking out of their shirt pocket.
God... I love anesthesia!

I couldn't agree with you more. There is nothing more frustrating than sacrificing all of yourself to help people who don't care for themselves. Some even go out of their way to make things worst for themselves and society drug use, violence, etc.). One thing that is making me really question surgery and drawing me towards anesthesia is this issue. I believe that I would be able to tolerate the difficulties of surgery if at the end of the day I felt that my efforts really contributed to someones well being. But how can that be if the patients themselves are not interested in their wellfare (of course I'm generalizing a bit, but a lot of pts fall into this category). For example, if people simply took better care of themselves a lot of the medical problems we have these days would go away. In anesthesia one does not have the same emotional attachment and sense of sacrifice to patients. Thus one can take care of a pt. and ship them off. If they decide to wreck their own lives, that's their business. Plus you're not destroying yourself in the process. Now let's hope I listen to my own words and choose anesthesiology in the end, we shall see in a year. I wish I didn't love cutting and sewing so much, then I could concentrate all of my efforts unto anesthesiology. Sorry for the long post.

 

[ThinkFast007]

Like Volatile said, respect is earned. Once you've earned it, problems minimize, and you address big problems with muscle prn. But the muscle part is very, very, very rare.

hey i got no probs getting along w/ others. in fact, most of the time i have to volunteer myself to go into the cases w/ the 'a$$'hole surgeons because everyone else is either scared to or plain dont want to. It's true at this level, all i'm doing is holding retractors,etc but....

but JPP and others, here's my point and the point that perhaps the OP is trying to mk. Why is it that 'we' must be the ones 'earning' the respect from the surgeon. I think it's suffice to say that surgeons and anesthesiologist are in a symbiotic relationship and as such need EACH OTHER for propagation.

just my thoughts. I think they ought to earn our respect just as much as we must earn theirs. 😉

 

[Noyac]

hey i got no probs getting along w/ others. in fact, most of the time i have to volunteer myself to go into the cases w/ the 'a$$'hole surgeons because everyone else is either scared to or plain dont want to. It's true at this level, all i'm doing is holding retractors,etc but....

but JPP and others, here's my point and the point that perhaps the OP is trying to mk. Why is it that 'we' must be the ones 'earning' the respect from the surgeon. I think it's suffice to say that surgeons and anesthesiologist are in a symbiotic relationship and as such need EACH OTHER for propagation.

just my thoughts. I think they ought to earn our respect just as much as we must earn theirs. 😉

This is true. They do have to earn respect as well. If a surgeon is a hack he gets very little respect. Especially from anesthesia cause we get to see who is good and who ain't. If he is a hack and an dingus then he can find another anesthesiologist.

 

[VolatileAgent]

never?

not when you're a resident, no. if you got a beef, call your attending.

and, to address thinkfast's point, blowhard surgeons have already likely burned enough bridges. their reputation precedes them. if you try to take them on, at worst you'll (most likely) only end up looking like a stupid jackass in front of a room full of people or, at best, an equally blowhard a-hole anesthesiologist. in other words, you've got nothing to win and everything to lose if that surgeon's reputation as a POS is already well established. just stay above it.

still, if you have to say something, i find that humor usually does the trick best. a little quip or dig usually gets the point across better than going toe-to-toe. or, if he/she is REALLY pissing you off, you can always use the line from 'reservoir dogs' (michael madsen saying to chris penn), "are you gonna bark all day little doggy, or are you gonna bite?" i guarantee you that'll shut 'em up. of course, you'll probably have to pay some consequences afterwards (like getting beat-up in the parking lot).

 

[militarymd]

This is true. They do have to earn respect as well. If a surgeon is a hack he gets very little respect. Especially from anesthesia cause we get to see who is good and who ain't. If he is a hack and an dingus then he can find another anesthesiologist.

There is a say that goes like this: "Great surgeons deserve great anesthesiologists.....Hacks (and dinguses) require one."

I think the right answern is always do the best for the patient.....right?

 

[Noyac]

There is a say that goes like this: "Great surgeons deserve great anesthesiologists.....Hacks (and dinguses) require one."

I think the right answern is always do the best for the patient.....right?

Absolutely, your right. The patient comes first. But after case is over and the guy is a hack and an dingus, refer to my previous post.

I am not saying to stop providing services to dingus surgeons. If I was saying that then we would all be out of business

 

[ThinkFast007]

If he is a hack and an dingus then he can find another anesthesiologist.

never heard the word 'hack' used in that context. Lol u must be a southerner or something 😛

Only 'hacking' I remember was in the day and age of playing 'hacky sac' in middle school. come on guys, u all remember that!!

 

[Pir8DeacDoc]

Hack is a term commonly used for a crappy golfer.. Not sure that it's location specific to the south.. 😎

 

[Tenesma]

1) if your group is the only group in town - you can tell him that your group will no longer provide anesthesia cases for him

2) if your group is one of a few then - you can tell him that

3) if you are a resident with minimal OR experience then you SHOULD call in your attending. If your attending is a wuss then call in your floorwalker... If your floorwalker is a wuss then I would discuss this with your program director. And then you can play hardball, by stating that you won't work with that surgeon due his inappropriate behavior because he creates a hostile work-environment and that you will report his ass to the board of medicine.

4) if you are a resident who knows his/her stuff - then you can easily create a dictionary of pithy retorts that should tell them shut the f* up. My favorites include: 1) pre-induction: "your case is now cancelled until you start talking like a mature person" 2) during the case: "Focus on cutting and sowing and I'll keep the patient alive"

HOWEVER - I have created an excellent work atmosphere by doing a few things pre-operatively. If I ever do a case that I have never done before I always discuss it with either the surgeon or a more experienced anesthesiologist the night before - I also do some reading on the subject so that I look up to date. If it is a switcharoo and I am thrown into a case I haven't done before, I will say: "hi guys, I am so-and-so. It has been a really long time since I have done a case like this, just let me know how you like things positioned and what things are very important to you."

there are things we respect in surgeons: 1) clinical decision making 2) technical skills etc...
there are things that surgeons respect in us: 1) cooperative 2) flexible 3) fast and efficient 4) clinical decision making and fund of knowledge 5) planning ahead 6) vigilance...

in private practice things in general are a lot better because it really isn't about egos anymore... it is all about doing as many cases as quickly as possible so that you can home early with as much money in your pockets as possible... and that view is SHARED by the Surgeon, the Anesthesiologist AND the OR STAFF!!!! wow what a new and strange concept 😀
in fact, in private practice most surgeons are so focused on doing their cases and seeing pts in clinic they often start forgetting some of their knowledge base from residency, and they often turn to us with questions about difficult pt critical care management...

 

[Noyac]

1) And then you can play hardball, by stating that you won't work with that surgeon due his inappropriate behavior because he creates a hostile work-environment and that you will report his ass to the board of medicine.

Stating that the surgeon is creating a "hostile work environment" really get attention from the administration. These are terms with legal ramifications. The surgeon usually gets to visit the admininstrators when this is brought up. Beware, things can get ugly at this point.

 

[ALTorGT]

I can understand how this applies to IM, but how much do you have to invest yourself in a patient's welfare in surgery. Surgeons mostly are just interested in whether its a surgical problem or not. If it requires intervention, they only take care of what they cut out, and after that its IM's problem. Isn't it? While there is post op care, it's almost an obligatory "how's you're wound doing" 5 minute consult isn't it.

I couldn't agree with you more. There is nothing more frustrating than sacrificing all of yourself to help people who don't care for themselves. Some even go out of their way to make things worst for themselves and society drug use, violence, etc.). One thing that is making me really question surgery and drawing me towards anesthesia is this issue. I believe that I would be able to tolerate the difficulties of surgery if at the end of the day I felt that my efforts really contributed to someones well being. But how can that be if the patients themselves are not interested in their wellfare (of course I'm generalizing a bit, but a lot of pts fall into this category). For example, if people simply took better care of themselves a lot of the medical problems we have these days would go away. In anesthesia one does not have the same emotional attachment and sense of sacrifice to patients. Thus one can take care of a pt. and ship them off. If they decide to wreck their own lives, that's their business. Plus you're not destroying yourself in the process. Now let's hope I listen to my own words and choose anesthesiology in the end, we shall see in a year. I wish I didn't love cutting and sewing so much, then I could concentrate all of my efforts unto anesthesiology. Sorry for the long post.

 

[Pir8DeacDoc]

You must not have seen any complicated post-op courses. Sure if all you do are hernias then your post op care is minimal but the big cases that a major center can do have the potential for a ton of post op care.

 

[stoleyerscrubz]

I've heard hack used in reference to people who practice a profession/skill without mastery/imagnination so it works here in that sense. did not see a reference to this webster's online though.

 

[VolatileAgent]

a 'hack' is a writer who is employed to write something primarily on the basis to earn a living. the connotation is that the by-product of a hack's work is average, at best, and most often uninspiring (ref: any of michael crichton's most recent drivel).

a 'hacker' is a term used for a golfer who sucks and hacks up the golf course.

in a similar vein (pun intended), a 'hack surgeon' would be one who pretty much is incompetent in that he hacks up the patient. truncating it to 'hack' is fine, imho.

 

[davvid2700]

hey i got no probs getting along w/ others. in fact, most of the time i have to volunteer myself to go into the cases w/ the 'a$$'hole surgeons because everyone else is either scared to or plain dont want to. It's true at this level, all i'm doing is holding retractors,etc but....

but JPP and others, here's my point and the point that perhaps the OP is trying to mk. Why is it that 'we' must be the ones 'earning' the respect from the surgeon. I think it's suffice to say that surgeons and anesthesiologist are in a symbiotic relationship and as such need EACH OTHER for propagation.

just my thoughts. I think they ought to earn our respect just as much as we must earn theirs. 😉

This is the dynamic of the relationship.. The surgeon is the primary doctor and you are the consultant.. So basically he DOES have the ultimate say. It doesnt matter how much you know and how little he knows. He is the primary. Its his patient. If he or she wants Iron maiden played in the OR. He gets Iron maiden in the OR. regardless of what you say or dont say. IF you want OZZY OZbourne and he hates ozzy.. Guess what? you aint gettin ozzy. Just think of it this way, the surgeon is your customer, make him or her happy while keeping things safe. You Will be inconvenienced all the ****ing time but it comes with the territory learn to live with it. I did not invent these dynamics. I just play ball. If you have a problem with not getting your way or things not going according to what you wanted you should think about another specialty. I dont try to earn the surgeons respect. I try to earn my respect for doing a good efficient job with out any errors. And if I earn my respect I would hope I earned the surgeons respect if I dont at that point I dont give a darn. Learn to be flexible instead of complaining. IF the holding area nurse was supposed to put in the IV but didnt.. dont bitch about it.. just put it in..

 

[jetproppilot]

This is the dynamic of the relationship.. The surgeon is the primary doctor and you are the consultant.. So basically he DOES have the ultimate say. It doesnt matter how much you know and how little he knows. He is the primary. Its his patient. If he or she wants Iron maiden played in the OR. He gets Iron maiden in the OR. regardless of what you say or dont say. IF you want OZZY OZbourne and he hates ozzy.. Guess what? you aint gettin ozzy. Just think of it this way, the surgeon is your customer, make him or her happy while keeping things safe. You Will be inconvenienced all the ****ing time but it comes with the territory learn to live with it. I did not invent these dynamics. I just play ball. If you have a problem with not getting your way or things not going according to what you wanted you should think about another specialty. I dont try to earn the surgeons respect. I try to earn my respect for doing a good efficient job with out any errors. And if I earn my respect I would hope I earned the surgeons respect if I dont at that point I dont give a darn. Learn to be flexible instead of complaining. IF the holding area nurse was supposed to put in the IV but didnt.. dont bitch about it.. just put it in..

Davvid, if you are in an established anesthesia group, you don't have to concede as much as your post implies. That being said, with your attitude, you are on your way to a seven figure salary. 👍

 

[VolatileAgent]

yeah, anyone who bends over and completely takes in the @ss like that should get 7 figures.

i'm a doctor first, and an anesthesiologist second. if someone doesn't defer to my judgement on a critical issue concerning the safety of a patient, then it's my responsibility to stop the case. who gives a f*ck about iron maiden or ozzy. if the sh*ts too loud, you'll be damn sure i'm going to tell them to turn it down especially if i can't hear my monitors.

let your testes descend once in a while, dude. it might feel good.

 

[davvid2700]

its not a question about testes.. the thing about it is.. it takes more energy to be bothered than to not let things get to you.. Hey if the surgeon or the nurse thinks he or she is smarter and better than me hey more power to them.. I will oblige them.. let them believe that.. I will only kick them in the balls only if it i really believe patient safety is jeopardized.. anything else who gives a ****.. You should be in your own little world.. you have your own concerns.. unfortunately or fortunately they are just that.. YOUR concerns.. dont make it everyone elses concerns unless you have to. .. If you really think will need help with mention it to the surgeon.. or a colleague.. do the ****ing case and go the **** home and the bank and take your cds with you.

 

[jetproppilot]

yeah, anyone who bends over and completely takes in the @ss like that should get 7 figures.

i'm a doctor first, and an anesthesiologist second. if someone doesn't defer to my judgement on a critical issue concerning the safety of a patient, then it's my responsibility to stop the case. who gives a f*ck about iron maiden or ozzy. if the sh*ts too loud, you'll be damn sure i'm going to tell them to turn it down especially if i can't hear my monitors.

let your testes descend once in a while, dude. it might feel good.

WELLLLLLL, Volatile, I feel ya on your post. BUUUTTTTT.....

If I was a deaf-mute and couldnt hear s-h-i-t, I could still practice anesthesia. I've been in rooms where the closing music was so loud that nothing could be heard except...the music. Actually an enjoyable, and safe, experience. In touch visually with the patient and the monitors and I'd rather hear rave-type volume exuding The Chrystal Method than the surgeon talking about what a great surgeon he is.

I respect Davvid's post that pretty much infers that in non-clinical issues (music choice, etc etc etc), if you DEFER, you're actually benefitting yourself.

Funny thing is, after you've worked with the same surgeon over and over, your deferrment attitude dissolves unconsciously...you become equals ...even though you are a consultant, after 6 months or so in the trenches with most surgeons, they don't f&uck with you anymore (keep in mind this is referring to the old-school, hard core surgeons...most "new-school" surgeons don't f&uck with you at all).

Just another testament to the old addage that respect is earned...and when it IS earned, feel free to walk over to the CD player, take out the IRON MAIDEN cd, tell the surgeon he's a covert woosy for listening to same CD, and insert your KORN, and resume rokking out with your c*ock out.

 

[jetproppilot]

yeah, anyone who bends over and completely takes in the @ss like that should get 7 figures.

i'm a doctor first, and an anesthesiologist second. if someone doesn't defer to my judgement on a critical issue concerning the safety of a patient, then it's my responsibility to stop the case. who gives a f*ck about iron maiden or ozzy. if the sh*ts too loud, you'll be damn sure i'm going to tell them to turn it down especially if i can't hear my monitors.

let your testes descend once in a while, dude. it might feel good.

Volatile,

Again, I respect your post. But BELIEVE me, if you are secure with yourself, then it really doesnt matter what a surgeon says to you. The most successful anesthesiologists I know are the one's who's identity is elucidated OUTSIDE of the OR....THIS IS THE KEY TO ANESTHESIA IN THE PRIVATE SETTING.

My pilot skills actually mean more to me than my anesthesia skills.

And the fact that I'm around the house so much that my 2 year old says DADDA as much as he says MAMA means more to me than ANYTHING.

Doesnt mean you have to eat s&hit....quite the contrary..again, in a strong group, you will have respect....you won't have to demand it.

BUT, occasionally, let the surgeon go off on his egocentric tangent, and you'll laugh all the way to the financial/emotional/family-time bank.

Keep your ego out of the OR.

 

[jetproppilot]

its not a question about testes.. the thing about it is.. it takes more energy to be bothered than to not let things get to you.. Hey if the surgeon or the nurse thinks he or she is smarter and better than me hey more power to them.. I will oblige them.. let them believe that.. I will only kick them in the balls only if it i really believe patient safety is jeopardized.. anything else who gives a ****.. You should be in your own little world.. you have your own concerns.. unfortunately or fortunately they are just that.. YOUR concerns.. dont make it everyone elses concerns unless you have to. .. If you really think will need help with mention it to the surgeon.. or a colleague.. do the ****ing case and go the **** home and the bank and take your cds with you.

Dude, you have my utmost respect. Best of luck in your no-doubt prosperous career.

 

[rufio173]

Dude, you have my utmost respect. Best of luck in your no-doubt prosperous career.

This is what I love about medicine, you see all kinds of varying attitudes toward certain things. Some people are more willing to let things blow over and some are not.

I think I lean toward more letting things blow over, but when things get too out of hand, then you definitely have to do something about it. I've just been in the OR to observe and retract and maybe throw down some staples and do a little bit of sewing, but it's interesting to see the politics of it all.
A balance must be struck and I definitely think that focusing on finishing the case and doing what's best for the patient is always the way to go. Everybody is happy when the case finishes on time and you quickly push through the day. 🙂

However, I definitely don't want to take it up the ass! Haha

Peace,
John

 

[VolatileAgent]

its not a question about testes.. the thing about it is.. it takes more energy to be bothered than to not let things get to you.. Hey if the surgeon or the nurse thinks he or she is smarter and better than me hey more power to them.. I will oblige them.. let them believe that.. I will only kick them in the balls only if it i really believe patient safety is jeopardized.. anything else who gives a ****.. You should be in your own little world.. you have your own concerns.. unfortunately or fortunately they are just that.. YOUR concerns.. dont make it everyone elses concerns unless you have to. .. If you really think will need help with mention it to the surgeon.. or a colleague.. do the ****ing case and go the **** home and the bank and take your cds with you.

man, you are the archetype for the 'loner' anesthesiologist. more power to you.

jet, with all due respect, go back about 20 posts in this thread and read what i previously wrote. i'm glad you can practice anesthesia blindfolded with one arm tied behind your back. i can't (at least not yet). and, if i can't do my job properly or safely because of the conditions created by the surgeon, i'm going to say something.

 

[Noyac]

i'm glad you can practice anesthesia blindfolded with one arm tied behind your back. i can't (at least not yet).

Don't worry Volatile, You soon will be able to do these things as Jet can. I'm not sure were you are in your training but it doesn't take long to learn to multi task in the manner talked about.

PS: In my hosp. Anesthesia rules the tunes. TOOL all the way.

 

[Tenesma]

you are right that we are consultants to a certain degree (ie: pre-operative and post-operative care). But in the OR we are no longer consultants but anesthesiologists performing a crucial job.

Just like we consult Nephrology in the ICU for their recommendations (and then often ignore them), if we try to mess with their dialysis machine they'll be hopping mad and will let us know it.

Anything that is remotely anesthesia related I don't give one inch... and in private practice that is what is expected.

Now you are right that surgeons are our customers to a certain degree and they need to be coddled in a business like fashion - but that doesn't mean you need to put your lips where the sun don't shine. By the way, if i don't like the music I go over to the CD box and turn it off and tell them to bring something better next time. They always end up bringing the CDs that I like 🙂

 

[svaefinga]

Whatever CD is played, ignore the nagging surgeon. It is no fun to have a go at an indifferent anesthesiologist and after some time he'll either like your calm attitude or give up on you.

 

[jetproppilot]

man, you are the archetype for the 'loner' anesthesiologist. more power to you.

jet, with all due respect, go back about 20 posts in this thread and read what i previously wrote. i'm glad you can practice anesthesia blindfolded with one arm tied behind your back. i can't (at least not yet). and, if i can't do my job properly or safely because of the conditions created by the surgeon, i'm going to say something.

More power to you, Dude. Totally agree.

 

[militarymd]

I don't know. There seems to be a lot of "I'm in charge...listen to me, or else" attitude I'm reading here.

Perhaps, that will work when you're the ONLY game in town, but there is always other game in town....even non-physicians who can do anesthesia.

As someone who has moved from academics to private practice, one of the major things that I learned is this......private practice anesthesia is EASY....there is almost no "practice of medicine" involved.

It's just about getting the job done.....too much "I'm in charge" attitude, you won't make partner (we have one now)....too little, and no one will listen to you when there is something that needs to be listened to.

I personally don't care what music is played, but then I almost never sit in a room.

Decide on your own style, but remember that anyone who doesn't compromise won't do well in private practice.

 

[davvid2700]

I don't know. There seems to be a lot of "I'm in charge...listen to me, or else" attitude I'm reading here.

Perhaps, that will work when you're the ONLY game in town, but there is always other game in town....even non-physicians who can do anesthesia.

As someone who has moved from academics to private practice, one of the major things that I learned is this......private practice anesthesia is EASY....there is almost no "practice of medicine" involved.

It's just about getting the job done.....too much "I'm in charge" attitude, you won't make partner (we have one now)....too little, and no one will listen to you when there is something that needs to be listened to.

I personally don't care what music is played, but then I almost never sit in a room.

Decide on your own style, but remember that anyone who doesn't compromise won't do well in private practice.

i wouldnt call it easy...although i DO sit in the room all day long

 

[VolatileAgent]

Decide on your own style, but remember that anyone who doesn't compromise won't do well in private practice.

i hear ya, but i think you (slightly) miss the point. it's not an 'all or none' or 'black and white' thing. we're talking about not being a doormat, and not about purposely acting like a d!ckhead. of course we're a consultant service. but we also have the unique situation where we're also expected to provide care. yes, some surgeons forget this. but, most surgeons in my experience respect and appreciate what we do and are cool. this thread is about the ones who aren't. and, yes, one shouldn't get their panties in a bunch over some blowhard with microphallus who probably got too much positive reinforcement as a child and never learned how to 'play nice' because he was always the 'gifted' and 'special' one in whatever he did and was constantly told that. you can't combat years of poor social modeling with confrontation or even witty repartee. you should best ignore them, unless they jeopardize patient safety or in any other way significantly interfere with you doing your job. that's all i'm getting at.

in other words, it has nothing to do with an anesthesiologist's unwillingess to compromise and everything to do with effectively dealing with a surgeon who can't or won't. sometimes you gotta flex your muscles, especially when you find yourself in a battle that picked you (and not vice versa). that's just the way it is.

 

[militarymd]

Do you know what the A S S h o l e surgeons get?

slow turnovers

case delays

missing instruments


That's what I notice as an innocent observer.