Jerk Surgeons

[MedicinePowder]

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In my four weeks of an anesthsiology rotation at a county hospital, I was pleasantly surprised at the level of respect the anesthesia residents got from fellow surgeons (both attendings and residents). Things however have been less friendly while doing an anesthesia rotation at a private hospital. Kinda disappointed. I've seen two anesthesia residents get chewed up by attending surgeons--almost like it makes them feel good.

Anyone witness this dichotomy?

 

[lvspro]

In my four weeks of an anesthsiology rotation at a county hospital, I was pleasantly surprised at the level of respect the anesthesia residents got from fellow surgeons (both attendings and residents). Things however have been less friendly while doing an anesthesia rotation at a private hospital. Kinda disappointed. I've seen two anesthesia residents get chewed up by attending surgeons--almost like it makes them feel good.

Anyone witness this dichotomy?

This prototypical a$$hole is someday gonna start wondering why his cases always run late, and get turned down from anesthesia. Right about the point it dawns on him that anesthesiologists pretty much run the pace of the OR, he'll learn the value of respect for his OR partners.
Off soapbox

I have yet to see an environment of surgeons being pricks to the anes. team. The ones I met that seem a little more demanding are usually 5th yr surg residents, but even they get pretty cool once in practice. Even so, my sample size is small, and I'm sure these dudes still exist... in fact I've heard rumors that academic programs are more notorious for this than community.

 

[Hockeyguy]

just tell him you will see his a$$ in the parking garage if he disrespects you again.

 

[supahfresh]

i got chewed out much worse as a surgery resident from my attendings than as an anesthesia resident so it's not just a surgery disrespecting anesthesia thing. it's a surgery thing.

You definitely don't want to say anything like "meet me outside" because a neurosurgery resident did exactly that at our institution to one of our anesthesiology attendings. He was fired the same day.

you could perhaps ask him if he is sexually frustrated in a very clam voice.

 

[MedicinePowder]

i got chewed out much worse as a surgery resident from my attendings than as an anesthesia resident so it's not just a surgery disrespecting anesthesia thing. it's a surgery thing.

You definitely don't want to say anything like "meet me outside" because a neurosurgery resident did exactly that at our institution to one of our anesthesiology attendings. He was fired the same day.

you could perhaps ask him if he is sexually frustrated in a very clam voice.

or calmly ask if he has sex with men, women or both!

 

[svaefinga]

Why go down to that level and be vulgar? Show him that you are the one creating excellent conditions for doing good surgery - or not 😛

 

[Noyac]

Or you could explain to him that you make more money, get more time off, have a better lifestyle, and don't have to go to the clinic after the case. That usually either shuts them up or get them so furious that they hurry up and finish the case just to get out of there.

 

[jetproppilot]

Or you could explain to him that you make more money, get more time off, have a better lifestyle, and don't have to go to the clinic after the case. That usually either shuts them up or get them so furious that they hurry up and finish the case just to get out of there.

👍

 

[toofache32]

I'm an oral surgery resident hanging out here because I've really enjoyed my time on anesthesia. We do about 6 months of anesthesia and any of you training in places with oral surgery residencies have probably seen us around.

Anyway, my first day they paired me up with a real anesthesia resident to learn the ropes. There was a jacka$$ general surgery attending on the other side of the curtain. The machine started beeping when the BP trended down to about 85/50. The mean was still in the 60s in this young healthy ASA 1 patient. The surgery attending said "you need to call your staff in here right away." She didn't say anything and bent over behind the curtain to give a little phenylephrine (even though the patient probably didn't need it). The surgeon said "did you call your staff yet?" And without blinking she says "Look!....do you want me to push drugs or push numbers on a phone!?"

I had to hide behind the curtain to laugh. I didn't think she had it in her.

 

[DrDre']

Toofache, loved your story and your dyspareunia statement. Are you "broke?"

 

[jwk]

I'm an oral surgery resident hanging out here because I've really enjoyed my time on anesthesia. We do about 6 months of anesthesia and any of you training in places with oral surgery residencies have probably seen us around.

Anyway, my first day they paired me up with a real anesthesia resident to learn the ropes. There was a jacka$$ general surgery attending on the other side of the curtain. The machine started beeping when the BP trended down to about 85/50. The mean was still in the 60s in this young healthy ASA 1 patient. The surgery attending said "you need to call your staff in here right away." She didn't say anything and bent over behind the curtain to give a little phenylephrine (even though the patient probably didn't need it). The surgeon said "did you call your staff yet?" And without blinking she says "Look!....do you want me to push drugs or push numbers on a phone!?"

I had to hide behind the curtain to laugh. I didn't think she had it in her.

Adjust your alarm limits or your alarm volume and turn the monitor so the surgeon can't see it.

 

[Adcadet]

I'm an oral surgery resident hanging out here because I've really enjoyed my time on anesthesia. We do about 6 months of anesthesia and any of you training in places with oral surgery residencies have probably seen us around.

We've got some OMS residents where I'm doing my anesthesiology rotation right now. Very nice people, and really sharp from what I can tell. Interesting how they know so much about somethings but not too much some other medical topics which even I know as an MS3. But that's why we're going to be doing different things.

 

[toofache32]

We've got some OMS residents where I'm doing my anesthesiology rotation right now. Very nice people, and really sharp from what I can tell. Interesting how they know so much about somethings but not too much some other medical topics which even I know as an MS3. But that's why we're going to be doing different things.

I noticed that too. We oral surgery residents do things in a different order than the other specialties. We come out of dental school operating alone from day one because that's we did our last 2 years of dental school, whereas when I was in med school there were 4th years who couldn't even suture without their hands shaking. On the other hand, when I started med school everyone else knew how to do a rectal but me. Mine were all guiac positive until someone told me to use lube, but that's another story...

Most oral surgery programs have us do Anesthesia at the beginning so we can do our own clinic anesthesia the rest of the program. It's often later before we do our Medicine rotations. We usually have a year or two of operating experience before we even do Medicine, etc. We definately do things in a different order and I'm sure it shows sometimes.

 

[jetproppilot]

Adjust your alarm limits or your alarm volume and turn the monitor so the surgeon can't see it.

A quote of wisdom from a true veteran.

 

[jetproppilot]

Most oral surgery programs have us do Anesthesia at the beginning so we can do our own clinic anesthesia the rest of the program.

If I ever have to go to a dentist/oral surgery's office for a procedure that involves anesthesia, I'm bringing one of my CRNAs. Dentists/oral surgeons doing their own anesthesia is extremely dangerous IMHO.

Anybody know any statistics on morbidity/mortality of "MAC" cases in a dentist's office?

 

[toofache32]

If I ever have to go to a dentist/oral surgery's office for a procedure that involves anesthesia, I'm bringing one of my CRNAs. Dentists/oral surgeons doing their own anesthesia is extremely dangerous IMHO.

Anybody know any statistics on morbidity/mortality of "MAC" cases in a dentist's office?

I've got an article in PDF format that addresses this exact question, but it was too large to upload. Here's the citation and abstract:

J Oral Maxillofac Surg. 2003 Sep;61(9):983-95

Purpose:
The delivery of office-based ambulatory anesthesia services is an integral component of the daily practice of oral and maxillofacial surgeons (OMSs). The purpose of this report was to provide an overview of current anesthetic practices of OMSs in the office-based ambulatory setting.

Materials and Methods:
To address the research purpose, we used a prospective cohort study design and a sample composed of patients undergoing procedures in the office-based ambulatory setting of OMSs practicing in the United States who received local anesthesia (LA), conscious sedation (CS), or deep sedation/general anesthesia (DS/GA). The predictor variables were categorized as demographic, anesthetic technique, staffing, adverse events, and patient-oriented outcomes. Appropriate descriptive and bivariate statistics were computed as indicated. Statistical significance was set at ≤.05.

Results:
The sample was composed of 34,191 patients, of whom 71.9% received DS/GA, 15.5% received CS, and 12.6% received LA. The complication rate was 1.3 per 100 cases, and the complications were minor and self-limiting. Two patients had complications requiring hospitalization. Most patients (80.3%) reported some degree of anxiety before the procedure. After the procedure, 61.2% of patients reported having no anxiety about future operations. Overall, 94.3% of patients reported satisfaction with the anesthetic, and more than 94.7% of all patients would recommend the anesthetic technique to a loved one.

Conclusion:
The findings of this study show that the office-based administration of LA, CS, or DS/GA delivered via OMS anesthesia teams was safe and associated with a high level of patient satisfaction.

PM me your email and I'll send it to you if you want the full article.

 

[Noyac]

Iwhen I started med school everyone else knew how to do a rectal but me. Mine were all guiac positive until someone told me to use lube, but that's another story...

Great. The perfect comeback. You are going to be stellar if you aren't already. There are more than one way to skin a cat. And who's to say theirs is best.