how to deal with difficult attending

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
N

newchancegas

New Member
10+ Year Member
Joined
Feb 1, 2013
Messages
4
Reaction score
0
Members don't see this ad.
By "difficult" I would really prefer to substitute another D-words that is marginally profane but anyway...

I am a CA-2 resident in the last month of my cardiac rotation. While cardiac attendings at least at my program tend to micromanage, the good ones work with us so that they are in the background and we are taking the lead in managing the entire case as long as we are in control of everything. However, this particular attending micromanages to the point where I am barely involved in the case anymore--he tells me exactly what to give and when (e.g. exactly how much iso to use, how much phenylephrine, etc.) and frequently even shoves me out of the way to personally push drugs. We also have to perform procedures exactly the way he wants or we get it taken away from us. The final straw came the other day when he made me stop in the middle of the central line and took over because he didn't like the way i was HOLDING THE SKIN! I know everyone has their particular things to be anal about, but at this point in my training I think I should be allowed to do a fricking central line without interference--every other attending leaves us to do it any way we want as long as it's reasonably safe.

Mostly I guess this is just venting, but I am one step away from losing my cool. And I very well might next time this happens. Am I wrong to confront him and say that as long as I'm not doing anything obviously dangerous, I have the right to put the lines in my own style without interference?
 
This too shall pass.

newchancegas said:
Am I wrong to confront him and say that as long as I'm not doing anything obviously dangerous, I have the right to put the lines in my own style without interference?
Click to expand...

You don't - his license, do it his way. No good can come of arguing.
 
pgg said:
This too shall pass.



You don't - his license, do it his way. No good can come of arguing.
Click to expand...

Yeah, as much of a pain in the gluts as it is, it is his license when the lawyers start circling. One of the hardest things about training. Actually, some of my colleagues are needle grabbers/hip-checkers and I feel for out residents, caused I trained under some of them. Perhaps that's why the most frequent comment I get on Evals is "really like the independence he gives us".

Anyway, like Frank Costanza said "Serenity Now!"
 
Have you tried just talking to him out of the OR about your concerns? Much can be resolved from addressing an issue one on one with someone.

I would not go so far as to advise you to tell your attending you have the right to do a procedure any way you want as long as it is safe. You are there to learn. So be open and learn new ways. We all understand your frustration though.

In residency during my heart rotations I would be doing a central line differently every day based on the attending. Some would use ultrasound and some would not. Some would slip in the angiocath and some would not. Some would transduce. Some would use ultrasound and transduce. I had to vary the skin nick based on some attendings. The point is that they all have their preferences and for reasons they have accumulated over their experiences (which is much more than yours), so you should TRY and embrace the variety and then when you are doing it on your own, you can pick and choose the techniques you like and for the reasons you like. You will find too that sometimes you will be in a pickle and you will have to convert to another method that you learned from the "evil" attending.

Regarding the attending always taking over and being overly critical in your opinion...just professionally talk to him about that outside of the OR in private. I had a similar problem with an attending. I discussed it with him in private. I just said, Dr. So and So, I am having some problems when I am performing procedures with you and I want to improve. I am getting frazzled sometimes when in the middle of the procedure when you are telling me to do something differently that I have never done before. It is difficult because every time I do a procedure, I have to do it differently based on the attending. If you want me to do it a certain way can we go over it now, so when it is time I can just do it the way you prefer. Hopefully, too, if you know you've taught me the way you prefer, you can let me just try on my own without instruction in the moment, because I get kind of rattled when in the moment I am being told to hold the wire differently or to angle the bevel differently, and things can go downhill from there. Certainly though if I am doing something that you think is a critical mistake, let me know.

I had that conversation with my attending. He was open, and he had good feedback, and we were cool after that. In fact, he was one of my favorite attendings to work with after that
 
I echo what others have said here. Don't take yourself too seriously in training. You'll learn a lot more if your mind remains unclouded by feeling disrespected and your skills overlooked. In many cases attendings like those that you describe are only expressing their own anxiety by being impatient. Just because they are not 'growing' in the moment, doesn't mean that you cannot.
 
No, do not confront him. It is his license so he has the right to do it his way but without inhibiting learning. If this guy is a complete douche, more than just 1 resident will pick up on this. You need to bring this up to your pd and or chairman (obviously not if he is either). Chances are some residents have already complained about him and the PD/chair needs to have a talk with him about the way he acts in the OR with the residents. Usually the ones who act that way are not confident in themselves. And yes, I agree with ventdependent that this is why he is in teaching.
 
The very first post I ever read on this forum was the "bow your head" thread by JPP. I kept saying that to myself every damn day for four years, but it got me through.
 
gasp said:
No, do not confront him. It is his license so he has the right to do it his way but without inhibiting learning. If this guy is a complete douche, more than just 1 resident will pick up on this. You need to bring this up to your pd and or chairman (obviously not if he is either). Chances are some residents have already complained about him and the PD/chair needs to have a talk with him about the way he acts in the OR with the residents. Usually the ones who act that way are not confident in themselves. And yes, I agree with ventdependent that this is why he is in teaching.
Click to expand...

If you have an issue with the attending, then talk to that attending!! You are both adults. The problem can likely be resolved between you two.

Why would you go to the PD first?? JUST TALK TO HIM. If he is super rude to you or becomes more of a d*ck, THEN you go to PD.

If the problem were reversed, and an attending had a problem with you, wouldn't you want the attending to address it with you first instead of complaining to the PD or reading the complaint in a resident progress report 3 months later??
 
Dont say squat. Commiserate with your peers and move on. The way I look at these situations is to learn what/who NOT to be like.

STAY under the radar dude. It isnt worth it. Teaching attendings like this one are often easily offended by trainees and you can easily be character assasinated by gossip in the staff lounge where he loiters, surfa the net, and drinks coffee. Although your intentions may be correct keep your complaints to yourself.

Graduate and move on dude. This goes for any resident in any field.
 
excalibur said:
If you have an issue with the attending, then talk to that attending!! You are both adults. The problem can likely be resolved between you two.

Why would you go to the PD first?? JUST TALK TO HIM. If he is super rude to you or becomes more of a d*ck, THEN you go to PD.

If the problem were reversed, and an attending had a problem with you, wouldn't you want the attending to address it with you first instead of complaining to the PD or reading the complaint in a resident progress report 3 months later??
Click to expand...

The guy is already rude and a d*ck from the op's description. It should not be the place of a resident to confront an attending about their micromanaging/rude behavior. This should be dealt with by someone higher up. Once a resident does this, word usually spreads (again, this is academia and attendings do talk about residents behavior with one another) and the resident gets labeled argumentative and or one of those residents who thinks he knows more than the staff. I have seen this happen to many residents. At minimum, you should ask your chief resident to speak with him first, but your best bet is PD/chair.
 
As an academic attending, if you were doing your best, and enjoyed what you did, and feel you are doing a good job, and felt you were helping the residents become better anesthesiologists...how would you feel if your chair asked to speak with you in private and then your chair tell you that he wanted to address an issue with you. He tells you that he received a complaint from a resident that you were too "argumentative" in the OR, and he asks for what you think about that. In the end of the conversation, you are asked to just be aware of it, and see what you can do. Now you leave that conversation not knowing what resident had an issue, if the incident was a one time thing or an ongoing issue, and now you feel like your chair has an eye out for you because it has been brought to his attention that you are argumentative. In my mind if the resident had that issue with me--a personality conflict--if you come to me and talk about your concerns, we could work out the kinks right away. After the conversation with the chair, I can't quite fix the problem, and I just feel bummed cuz someone has a problem with me, but I can't figure out who to try and resolve problem, and now the chair is aware. All this over a personality clash
 
newchancegas said:
While cardiac attendings at least at my program tend to micromanage, the good ones work with us so that they are in the background and we are taking the lead in managing the entire case as long as we are in control of everything. However, this particular attending micromanages to the point where I am barely involved in the case anymore--he tells me exactly what to give and when (e.g. exactly how much iso to use, how much phenylephrine, etc.) and frequently even shoves me out of the way to personally push drugs.
Click to expand...

There is one universal truth: You cannot let the animals run the zoo.

You are one of the animals, in case there is any question.
 
Stay under the radar. Could not agree more. # 1 piece of advice for getting through residency. I had situations like this that drove me nuts. But it all passes. 3 years goes by incredibly fast in hindsight.
 
Like the others have said. Your attending is allowing you to work under his direction so you have to respect that. One thing you'll find out in residency and beyond is there are many different ways to do things and no one way is necessarily better than the other. Your best experience will come by learning all these different methods and developing the ones that work best for you. Be open to criticism knowing that it will only make you better.
 
how about this, maybe hes trying to teach you something. when you have shown him you can do things the way he wants, maybe he will be a little more receptive to what you want. anesthesiologists are nothing if not particular
 
This happens all the time in all fields. I once had an anesthesia attending show up to a code, which never happens here, was like WTH are you lost?.....anyway, while I was throwing in a line my buddy was getting ready to tube the guy. RT hands him the Mac he requested and the gas attending yanks it out of his hand and says use a miller. He goes im sorry sir but I have alot of experience with Macs I strongly prefer them to Millers. Gas attending shoves him out of the way and sayd 'then you dont need to tube this guy get out'. Was like wow, what a Dbag. What did we do about it......nothing. Take your licks. Everyone who was beat up on the school playground or picked last for gym B-ball has their inner anger and personal vendettas. My advice, which mirrors everyone elses on this thread, even as an attending its not worth your time. But atleast them you can tell the dbag to go f' himself. As a resident, remember, AT ALL TIMES, you dont have a license yet, dont jeopardize your future over some dbags dbaggery.....go home and make yourself a stiff drink....and forget about it. tomorrows another day.
 
The boss/teacher gets what the boss/teacher wants as long as no one is getting hurt. I've watched a lot of people (in other fields) squander big opportunities due to telling someone how much of a right they had to do things their way
 
yeah, it sucks but you just have to BOW YOUR HEAD.

Soon enough, you'll finish training. We're both CA2's soon-to-be CA3's, so THERE IS AN END IN SIGHT.

Just thank god you're not a surgical resident.

I was doing a CEA and a senior gen surg resident on his vascular rotation got yelled at for his technique. Then he got complimented. After the case he says to me "I got yelled at for doing it one way and then he compliments me. I didn't do it anything different the second time...."

Just bow down and BUY your time. We still have a ton to learn from each case and each attending. Keep an open mind and bear with some of the inevitable bullsh.t.
 
Also, I'm very grateful for the many times I just STFU. In retrospect, I could have burned many bridges.

You have ZERO to gain be rocking the boat in residency. You never know who is sitting on the employment committee. Who knows whom at a fellowship or PP group you may wish to join. It's a very small world.

Keep up the faith my friend.
 
You are in residency for a purpose:

YOU ARE LEARNING A TRADE THAT WILL MAKE YOU A HIGHLY SOUGHT AFTER PHYSICIAN SPECIALIST.

Academic physicians stereotypically are known to be hard to deal with, especially if you are a resident. (Venty's post said "That's why he's in academics." There's alotta truth to that.)

Dude,

YOU'RE LOOKING AT THIS THE WRONG WAY MAN.

You are at a point in your training where...and I don't mean this diminutively...think of yourself as a

YES MAN

What's a YES MAN?

Did you see the movie FORREST GUMP? The part where he does whatever the drill sergeant says and

HE DOES IT BETTER AND FASTER THAN EVERYONE ELSE AND HE ALSO FREQUENTLY SAYS

"YES DRILL SERGEANT!!!"

There's alotta parallels to the movie Forrest Gump and Residency. I'm not implying that just because you're a resident you are required to be someone's bitch....much to the contrary...

YOU GUYS ARE LOOKING AT THIS PERIOD OF YOUR LIFE

ALL WRONG MAN.

Yeah, I know I know you guys are DOCTORS and you dudes have been thru hell and back and now you're finally thru med school and you're a fu ckin g DOCTOR for chrissakes and

YOU'RE STILL NOT GETTING THE RESPECT LEVEL YOU THINK YOU DESERVE.

Here's where a little

EDUMACATION

will help you dudes. I won't sugar-coat it since I'm not good at sugar-coating. You residents out there reading this aren't gonna like what I have to say. I respect that. But trust me man if you listen to me and try and conform your line of thinking to what I'm about to reveal, I GUARANTEE your residency years will be more pleasurable for you.

I want you residency dudes out there to MAKE THE BEST OF YOUR RESIDENCY YEARS and be LESS PISSED OFF and find a way to BE MORE ACCEPTING TO WHAT IS ASKED OF YOU.

Why do I want the above? That's simple man. I know if you can accomplish the s h it I just rattled off you will be

HAPPIER and more at peace.

Dudes,

RESIDENCY IS A MIND GAME MAN.

I want you to get to the point emotionally where when encountered with a

DIFFICULT ATTENDING

you say to yourself

SO WHAT. I GOT THIS.

I'm gonna give you TWO FACTS that if you TRULY BELIEVE AND LIVE BY, seriously, these two facts will help keep you sane, they will improve relationships with your attendings, they will improve your relationships with the bitchy subordinate staff you work with at your academic institution that drive you crazy no matter who that staff is, Nurse OR Manager, Crazy Ass Hoe Circulator, Scrub Tech Who Thinks She Owns The Hospital,

Whoever.

I'M DONE SO I'LL CUT THRU THE CHASE.

RESIDENTS OUT THERE, DO YOU WANNA BE HAPPY DURING YOUR RESIDENCY YEARS? DO YOU WANNA LEAVE THE PISSED OFF "I'M BEING USED" s h it behind?

I've got The Answer man.

For The Answer to work, you've gotta really digest what I'm about to say...what I'm about to say encompasses not many words but the few words I'm about to say I want you to really

THINK ABOUT

In lieu of a big introduction, and in lieu of a big explanation of the words about to be said, I want the residents to DIGEST and THINK.

I'm hoping this message helps my resident colleagues out there.

Difficult to adhere to, but it's very simple:

RESIDENCY IS NOT YOUR TIME.

YOUR TIME IS COMING.

If you residents out there can adhere to this mindset I

ASSURE YOU

your life as a resident will be happier and more peaceful.
 
Last edited:
gasattack3 said:
yeah, it sucks but you just have to BOW YOUR HEAD.

Soon enough, you'll finish training. We're both CA2's soon-to-be CA3's, so THERE IS AN END IN SIGHT.

Just thank god you're not a surgical resident.

I was doing a CEA and a senior gen surg resident on his vascular rotation got yelled at for his technique. Then he got complimented. After the case he says to me "I got yelled at for doing it one way and then he compliments me. I didn't do it anything different the second time...."

Just bow down and BUY your time. We still have a ton to learn from each case and each attending. Keep an open mind and bear with some of the inevitable bullsh.t.
Click to expand...

gassattack3 just referenced a past post of mine...a very important post at that,

very poignant to this conversation.

Can one of you Computer Rokkstarrs please post a link to my post

BOW YOUR HEAD

Residency is a Mind Game. Play it right and you'll be happier.
 
jetproppilot said:
You are in residency for a purpose:

YOU ARE LEARNING A TRADE THAT WILL MAKE YOU A HIGHLY SOUGHT AFTER PHYSICIAN SPECIALIST.

Academic physicians stereotypically are known to be hard to deal with, especially if you are a resident. (Venty's post said "That's why he's in academics." There's alotta truth to that.)

Dude,

YOU'RE LOOKING AT THIS THE WRONG WAY MAN.

You are at a point in your training where...and I don't mean this diminutively...think of yourself as a

YES MAN

What's a YES MAN?

Did you see the movie FORREST GUMP? The part where he does whatever the drill sergeant says and

HE DOES IT BETTER AND FASTER THAN EVERYONE ELSE AND HE ALSO FREQUENTLY SAYS

"YES DRILL SERGEANT!!!"

There's alotta parallels to the movie Forrest Gump and Residency. I'm not implying that just because you're a resident you are required to be someone's bitch....much to the contrary...

YOU GUYS ARE LOOKING AT THIS PERIOD OF YOUR LIFE

ALL WRONG MAN.

Yeah, I know I know you guys are DOCTORS and you dudes have been thru hell and back and now you're finally thru med school and you're a fu ckin g DOCTOR for chrissakes and

YOU'RE STILL NOT GETTING THE RESPECT LEVEL YOU THINK YOU DESERVE.

Here's where a little

EDUMACATION

will help you dudes. I won't sugar-coat it since I'm not good at sugar-coating. You residents out there reading this aren't gonna like what I have to say. I respect that. But trust me man if you listen to me and try and conform your line of thinking to what I'm about to reveal, I GUARANTEE your residency years will be more pleasurable for you.

I want you residency dudes out there to MAKE THE BEST OF YOUR RESIDENCY YEARS and be LESS PISSED OFF and find a way to BE MORE ACCEPTING TO WHAT IS ASKED OF YOU.

Why do I want the above? That's simple man. I know if you can accomplish the s h it I just rattled off you will be

HAPPIER and more at peace.

Dudes,

RESIDENCY IS A MIND GAME MAN.

I want you to get to the point emotionally where when encountered with a

DIFFICULT ATTENDING

you say to yourself

SO WHAT. I GOT THIS.

I'm gonna give you TWO FACTS that if you TRULY BELIEVE AND LIVE BY, seriously, these two facts will help keep you sane, they will improve relationships with your attendings, they will improve your relationships with the bitchy subordinate staff you work with at your academic institution that drive you crazy no matter who that staff is, Nurse OR Manager, Crazy Ass Hoe Circulator, Scrub Tech Who Thinks She Owns The Hospital,

Whoever.

I'M DONE SO I'LL CUT THRU THE CHASE.

RESIDENTS OUT THERE, DO YOU WANNA BE HAPPY DURING YOUR RESIDENCY YEARS? DO YOU WANNA LEAVE THE PISSED OFF "I'M BEING USED" s h it behind?

I've got The Answer man.

For The Answer to work, you've gotta really digest what I'm about to say...what I'm about to say encompasses not many words but the few words I'm about to say I want you to really

THINK ABOUT

In lieu of a big introduction, and in lieu of a big explanation of the words about to be said, I want the residents to DIGEST and THINK.

I'm hoping this message helps my resident colleagues out there.

Difficult to adhere to, but it's very simple:

RESIDENCY IS NOT YOUR TIME.

YOUR TIME IS COMING.

If you residents out there can adhere to this mindset I

ASSURE YOU

your life as a resident will be happier and more peaceful.
Click to expand...

F*ck. I like this post.
 
jetproppilot said:
I haven't read that post

BOW YOUR HEAD

in a lonnnnng time.

I wrote it circa 2008.

A VERY GREAT READ FOR RESIDENTS.
Click to expand...

I remember that original thread. I learned from it.

Honestly, re-reading this topic is a good refresher. We get close to CA3 year (and I can imagine all of CA3 year) and you feel pretty competent. You feel pretty "special"😀. Often, you may be better at some procedures than your attending. BUT, and I love the you way you put it Jet, IT'S NOT OUR TIME. lol (love it)

On another front, I think it's critically important for we residents not to have an OVER inflated sense of "i'm a bad a.ss". I'm confident but realize that you won't be at your peak until at least 5 years post-residency.

Still have lot's of s.hit to hit the fan during overnight calls, when YOU are making all the decisions, and maybe the only anesthesiologist in house......... That just take time and nightmares (inevitable) to develop.
 
Definitely do NOT say anything negative to him! The extra procedural experience he "might" give you, wont be worth the negative evaluation he might give you. Just move on with your life.
 
jetproppilot said:
I haven't read that post

BOW YOUR HEAD

in a lonnnnng time.

I wrote it circa 2008.

A VERY GREAT READ FOR RESIDENTS.
Click to expand...

It's a great read, thank you. I pulled it up the first time it was mentioned on the thread since I had never seen it. Should have re-posted it then.
 
newchancegas said:
By "difficult" I would really prefer to substitute another D-words that is marginally profane but anyway...

I am a CA-2 resident in the last month of my cardiac rotation. While cardiac attendings at least at my program tend to micromanage, the good ones work with us so that they are in the background and we are taking the lead in managing the entire case as long as we are in control of everything. However, this particular attending micromanages to the point where I am barely involved in the case anymore--he tells me exactly what to give and when (e.g. exactly how much iso to use, how much phenylephrine, etc.) and frequently even shoves me out of the way to personally push drugs. We also have to perform procedures exactly the way he wants or we get it taken away from us. The final straw came the other day when he made me stop in the middle of the central line and took over because he didn't like the way i was HOLDING THE SKIN! I know everyone has their particular things to be anal about, but at this point in my training I think I should be allowed to do a fricking central line without interference--every other attending leaves us to do it any way we want as long as it's reasonably safe.

Mostly I guess this is just venting, but I am one step away from losing my cool. And I very well might next time this happens. Am I wrong to confront him and say that as long as I'm not doing anything obviously dangerous, I have the right to put the lines in my own style without interference?
Click to expand...



You just described my cardiac rotation in residency. I did 2 months as a CA-2, and one attending would raise issue with me pushing the last 100 mcg of fentanyl on the way to the unit. Another would question every pressor I used. Another used to write the ASA Refresher Course for PAC/CVP analysis. Those were fun cases.

Things improved somewhat as a CA-3 two months before I finished residency. Most of them let me make my choices, but they still kept a very close eye on me. As in, they never left the room unless we were on pump. Most still questioned my central line technique.

Two months later, I started fellowship. Guess what? They questioned every move I made. They told me to pick another pressor. Basically everything I learned in residency had to be relearned for the new place. A few months into that, they loosened the reigns.

Twelve months later, I started my job. Guess what- the Division chief stood in the OR with me for the first couple cases, telling me exactly how "we" did hearts. Do this, pick that drug, move the bed up now, push more of that. Now that I've been there almost a year, I can recite to you how hearts are "done" at 3 different institutions. I use a little bit of each of them in my daily practice.

If you think, as a CA-2, that you have nothing to learn from this attending, then you are greatly overestimating your capabilities. And you are limiting your education. Understand that, unlike most rooms you sit in, you can very easily end a life picking a wrong drug in a heart room. "Hey, he's a little hypotensive coming off pump. I'll just give 2 cc of ephedrine. That worked well on my lap chole the other day." You better stand back when that happens and watch everyone else in that room bust their asses to recover from one poor choice on your part.

Your own style of learning may not mesh well with your attending's style of teaching, but that doesn't mean you shouldn't swallow your pride, ego, or whatever, and do what you are supposed to do- Listen, learn, and become the best anesthesiologist you can in 3 years. You won't realize how far away from that you are right now until you look back in your rearview mirror in a couple years.
 
jetproppilot said:
I haven't read that post

BOW YOUR HEAD

in a lonnnnng time.

I wrote it circa 2008.

A VERY GREAT READ FOR RESIDENTS.
Click to expand...

I would also advise you just shrug it off and not waste your energy and say anything. At best (or worst, depending how you look at things), I would ask the attending the background for his techniques (in a non-threatening manner of course), to see the reason why he/she prefers that way to do it, and to let the attending wax poetic on their Anesthetic acumen and make it seem you are so interested in their D-Face skills (personal and technical).

As far as Jet and the others have been saying regarding approaching the attending, don't even bother. Residency goes by quickly, even though when we are in the day to day grind, it seems like it will never end. I'm done next month, and can't believe how fast it went by. I chose to not confront attendings with personality disorders. They just weren't worth the thought. You should take the easy path and you'll have one less issue to worry about. And I believe when you show no emotion or worse are oblivious to their hostility, they get the idea that you will not be intimidated

Anesthesia residency is building on the sciences we studied in medical school and incorporating creativity (the art of medicine), when the situation does not lend itself to the standard patient we read about in medical school. Who knows, maybe that attending may teach you something slick that you can carry with you once your done with residency. If you do pick up something from the a-hole, bow your head and keep it moving.
 
Bertleman, that was a nicely written, well-considered, and helpful post.

You have a good attitude towards learning. I tried to have a similar attitude when I get was training and to try to impart this point of view to my residents..some get it, others most likely never will.


-in my slumber
 
jetproppilot said:
YOU ARE LEARNING A TRADE THAT WILL MAKE YOU A HIGHLY SOUGHT AFTER PHYSICIAN SPECIALIST.
Click to expand...

Whatever. You will be an easily replaceable cog in the wheel of the medical establishment. We are so undervalued and underappreciated that NURSES with an additional 28 months of training are competing with us for jobs. Seen any recent job offers? Know any anesthesiologists looking for jobs? Highly sought after my ass....most places will take a CRNA over an anesthesiologist any day. Just look at the number of opt out states and the increasing number of CRNAs practicing independently. Don't blow smoke up these kids' impressionable asses; you are doing them a disservice.
 
Try to swallow hard and eat the humble pie my man. In my cardiac rotation, way back when, the chief was there for induction then got me out for lunch at 4:30, which was mealtime at the vending machine at the VA spa. Guy wrote a bunch of papers though. Nothing significant per usual.
 
Consigliere said:
Whatever. You will be an easily replaceable cog in the wheel of the medical establishment. We are so undervalued and underappreciated that NURSES with an additional 28 months of training are competing with us for jobs. Seen any recent job offers? Know any anesthesiologists looking for jobs? Highly sought after my ass....most places will take a CRNA over an anesthesiologist any day. Just look at the number of opt out states and the increasing number of CRNAs practicing independently. Don't blow smoke up these kids' impressionable asses; you are doing them a disservice.
Click to expand...

BLOW SMOKE??:laugh:

I blog about the industry as I see it. I've been accused of alotta things but

BLOWING SMOKE

isn't one of them.

I'm UP FRONT.

My opinions, my life experiences, my feelings.

Take it or leave it brother. It's all good.
 
Consigliere said:
Whatever. You will be an easily replaceable cog in the wheel of the medical establishment. We are so undervalued and underappreciated that NURSES with an additional 28 months of training are competing with us for jobs. Seen any recent job offers? Know any anesthesiologists looking for jobs? Highly sought after my ass....most places will take a CRNA over an anesthesiologist any day. Just look at the number of opt out states and the increasing number of CRNAs practicing independently. Don't blow smoke up these kids' impressionable asses; you are doing them a disservice.
Click to expand...

This scares the **** out of me.
 
Baller MD said:
This scares the **** out of me.
Click to expand...

Just be aware my man. And consider strong fellowship training if you don't have a super solid position lined-up.

Anecdote: Not so long ago "a guy I knew" that trained at one of the big shot places looked at a metro area when he finished training where his wife's family lived. It was basically an MD-only city. It was after medicare whacked anesthesia and the partners told this guy "sure come on down, give us a $3/4M over a few years for our partnership track, we'd love to have you." The guy said, "thank you for the generous offer, but no thank you" (and thought, "I got loans and don't think I'd do well getting abused by people that are extorting from me for the privilege of taking care of the patients anyway.") He went elsewhere.

Years later, with his in-laws ailing, he goes back to that city to see about working again. Bigger city, more volume, but there is no job for an anesthesiologist in this town. Why? "Thanks for your interest but our groups are fully staffed and don't 'need' any MDs." But they are hiring CRNAs--and bookoo lots of 'em.

The same is happening in academics too. Ask someone that trained when the big centers had no CRNAs.

Moral of the story? Wish I knew.
 
Last edited:
jetproppilot said:
BLOW SMOKE??:laugh:

I blog about the industry as I see it. I've been accused of alotta things but

BLOWING SMOKE

isn't one of them.

I'm UP FRONT.

My opinions, my life experiences, my feelings.

Take it or leave it brother. It's all good.
Click to expand...

Right. As YOU see it - which doesn't reflect what the majority of new grads will experience. How many new grads do you think will be able to start their own anesthesia group with a bunch of lucrative spine surgeries and low Medicare/Medicaid penetrance?

Not many.
 
Consigliere said:
Right. As YOU see it - which doesn't reflect what the majority of new grads will experience. How many new grads do you think will be able to start their own anesthesia group with a bunch of lucrative spine surgeries and low Medicare/Medicaid penetrance?

Not many.
Click to expand...

I worked for an AMC for several years before I started this gig, Doctor, and I still loved my job.
 
Consigliere said:
I know, DOCTOR. You were also making 600 large. I'd love my job too.
Click to expand...

FOR THE RECORD,

I came out of residency and was lucky enough to

MAKE IT BIG

Why did I make it big right outta residency?

I was lucky enough to partner with a group that held

HONESTY

at the forefront.

KNOW WHAT?

I'm gonna

PUBLISH

the dude's name.

THAT TOOK CARE OF ME AS AN

INCOMING PARTNER

Actually there's

TWO DUDES

responsible for my success in private practice.

I have NO QUALMS publishing their names, since

THEY MOULDED ME MAN.

THESE MO FO'S

TAUGHT ME

HOW TO BE AN

ANESTHESIOLOGIST:


JERRY PATTON

FRANCIS ROBICHEAUX

I'm sure I spelled Francis's last name wrong.

He didn't go by Francis. He went by ROBI.

HEY HOSPITAL ADMINISTRATORS out there

LOOKING FOR THE HOLY GRAIL?????

HAVING ANESTHESIA PROBLEMS???

Call

ROBI man.

BEFORE ME.

HE'LL FIX YOUR PROBLEMS AND ROBI WILL HEIGHTEN YOUR ANESTHESIA EXPERIENCE.

That's the level of

RESPECT

I have for that dude.

ROBI AND JERRY WERE PARTNERS.

THEY BROUGHT ME IN SUBSEQUENTLY.

THEY COULD'VE

**** ED ME EASILY.

THEY DIDN'T.

INSTEAD, THEY OFFERED ME

EQUAL PARTNERSHIP

WITH A REASONABLE BUY IN

TO BOTH THE AR's AND THE BUILDING

WOW.

DON'T GUYS LIKE

ROBI AND

JERRY PATTON

EXIST

ANYMORE????
 
Last edited:
You must log in or register to reply here.

Similar threads

M
Difficult Spinals coverage?
Replies
33
Views
3K
psychbender
psychbender
L
Whats the deal with crnas giving every drug in the pyxis??
2
Replies
73
Views
7K
coffeebythelake
coffeebythelake
S
Short term health insurance coverage between residency and attending job?
Replies
5
Views
945
maxxor
M
G
How to Reduce Group's BLOATING Overhead Cost
Replies
3
Views
1K
deleted1130227
D
G
Coming to terms with Being Middle Class
2 3 4 5 6
Replies
275
Views
25K
coffeebythelake
coffeebythelake
Top