to those in or pursuing the field...

[deleted9493]

I saw a similar post on this a few months ago, but the question that I had wasn't really addressed.

Specialites like Ob/Gyn and orthopaedics are known to be full of practitioners whose medical knowledge is exceedingly focused on and isolated to their respective fields. For example, a patient on the orthopaedics unit has hypertension and the nurse calls the orthopaedist for course of action...and they're kind of clueless. The specialist just doesn't seem to be adequately equipped to be dealing with medical issues that have arisen. Maybe this is isolated in its incidence, but it certainly seems common in my experience. It is for this reason, that I feel I will likely avoid these and such fields in the future.

Anyway, my question--as it pertains to anesthesiology--is that of wondering how a practicing anesthesiologist is equipped to treat medical complications. I know that subspecialty in critical care is an option but what of those anesthesiologists that do not subspecialize? Do general anesthesiologists serve a role in the ICU's or is that the pulmonologist's realm? Finally, what is their capability in regards to treating problems in patients that have general, internal medicine needs? I guess this isn't really of practical relevance to the anesthesiologist's practice (or is it?) but may be in answering the questions of friends/family etc.

Thanks for your input.

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[deleted9493]

Nobody has answers...?

 

[gaslady]

There's a one year fellowship in critical care for anesthesiologists that is required for certification in critical care. I don't know if anesthesia attendings work in the ICU without having done a fellowship. The majority of ICU attendings in the US are pulmonary and critical care through internal medicine.

As an anesthesiologist you would be just as qualified to answer any questions outside of your field as other doctors outside of that particular area. The longer you are out of medical school the less qualified you become to answer general medical questions because your knowledge becomes outdated, unless you spend a lot of time and effort to read on a variety of subjects. Obviously there's a range of things you can and can't handle. For instance, you could likely provide guidance about conditions that should or shouldn't be treated and you have the framework to lookup things you don't know. However, you will not know what the latest first line agents are for treating hypertension and diabetes in 5 years even though you probably know them at graduation. New drugs and procedures are continually developing and unless you are in the field, you won't be able to keep up. As a doctor you will be hit up for medical advice by family and friends for the rest of your career. You can always look things up and if it's anything that you're the least uncertain of tell them that you think they should be seen by their doctor.

Good ethics deems that you don't treat family. I think for the most part this is true. There's no harm in giving limited advice acting as an advisor and it's great to help explain things that family doesn't understand. But there's a difference between offering guidance and treating. You shouldn't regularly be writing prescriptions for family members. The most puritan would say you should never write one. Others would say it's okay to write something like diflucan for a yeast infection, antibiotics for an ear infection, or anti flu prophylaxis. Also, the tricky thing with family is that you may not know all their medical history and they may not want or be able to tell you. I think it's important to err on the safe side and tell them to see their doctor.