Internists of the OR??

[cfdavid]

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So, a couple of my mentors in anesthesiology (as well as a few guys on the interview trail) have stated that anesthesiologists need to be the "internists of the OR".

Frankly, I believe this is true. In other words, I believe that a well rounded medically based intern year is an integral part of our training to be physicians first, and consultant anesthesiologitst second (i'm speaking of myself in the future tense ofcourse).

Now, the question is are surgeons or surg residents becoming less trained in medical management versus operative skills/procedures?? Surely, new technology is ever coming to the OR, and this would necessitate a greater emphasis on surgeons in training spending the requisite amount of time in mastering new techniques and technologies, presumably at the expense of other skills/knowledge.

This is absolutely not an anti-surgeon thread. Where I trained, the surg residents absolutely took medical management of their patients by the horns. However, I'm wondering if this is the norm, and if there may be trends to the contrary.

Any thoughts, insight on this issue?

cf

 

[2ndyear]

I'll tell you that in private practice, the hospitalist phenomenon has really taken hold in many places. Ortho has just about every non-elective case admitted to the hospitalist service at our place (lots of hip/femur fractures). Admittedly most are elderly patients with multiple medical issues. Even the general surgeons ask that many of their non-elective cases be admitted to IM with a surgical consult. I would imagine that a lot of this will change now that the inpatient consult code is effectively gone in January.

 

[seinfeld]

Medicare is the big hurdle. They will not pay another party to manage a pt post op if the post op care is considered to be bundled in the procedure.

Once again, reimbursement for medical management is not worth time outside the OR