What Do Anesthesiologists Really Do?

[Iso4ane]

‘Look surgery and anesthesia is risky, you may die. My job is to keep you safe. Here sign the consent if you want me to do my job.”

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[Bryan O’Blivion]

I don't disagree in total with your comments, and it appears a lot of other people here like them as you've gotten a lot of comment 'likes'. Its impossible to ignore however that many of your actions, in my opinion, cross the line and no one in ANY OTHER SPECIALTY would or should do that sort of nonsense for the sake of 'getting respect' or 'getting along'. Especially if your goal, as you say in the post, is to get understanding and help when a patient concern arises or to simply get along with your colleagues. How must it feel for all of your colleagues who don't buy every breakfast, lunch, and dinner for nurses or surgeons when they take over your rooms?

Anesthesiology is a service specialty and your post absolutely proves it, like nail in the coffin, proves it. No one in any other specialty would pull any of that nonsense, and almost with 100% assurance when you leave they'll praise you for a day then totally forget about you.

It's great to be nice, pleasant, and get along. But we are caring for patients. And getting them through their surgery is our goal. If you have concerns or need help from a nurse, then a listening ear and helping hands should be found immediately, and it shouldn't have anything to do with all the crap you typed up there.

So, yeah, if this person is extolling the virtues of being an obsequious lickspittle, that’s weird and disturbing. But I don’t read it that way at all. If you notice the OR times, there’s often a long delay between induction and the incision. Certainly, prep needs time to dry, and so forth, but what really really seems to cause delays is when the circulator can’t complete tasks due to distractions, or parallel tasks. Sometimes providing some quick assistance or facilitating parallel tasks can really move things along. That makes a difference when you are doing 6 cases a day. Also, being able to troubleshoot OR equipment will pay off. What I read in this person’s post is someone who has cognizance of the overall operating room workflow, understanding what each member needs to effectively and efficiently do their job, and helping to make that happen. Personally, I respect people who can think on their feet, are situationally aware, and get things done, and I don’t really respect people who can’t, regardless of their position.

 

[nimbus]

So, yeah, if this person is extolling the virtues of being an obsequious lickspittle, that’s weird and disturbing. But I don’t read it that way at all. If you notice the OR times, there’s often a long delay between induction and the incision. Certainly, prep needs time to dry, and so forth, but what really really seems to cause delays is when the circulator can’t complete tasks due to distractions, or parallel tasks. Sometimes providing some quick assistance or facilitating parallel tasks can really move things along. That makes a difference when you are doing 6 cases a day. Also, being able to troubleshoot OR equipment will pay off. What I read in this person’s post is someone who has cognizance of the overall operating room workflow, understanding what each member needs to effectively and efficiently do their job, and helping to make that happen. Personally, I respect people who can think on their feet, are situationally aware, and get things done, and I don’t really respect people who can’t, regardless of their position.

Yep. Don’t be a useless “not my job” type when you can help move things along.

 

[Consigliere]

Yep. Don’t be a useless “not my job” type when you can help move things along.

Not my job.

 

[Southpaw]

Yep. Don’t be a useless “not my job” type when you can help move things along.

Right right. Because we all constantly see surgeons assist with moving patients to stretchers at the end of surgery, push stretchers to PACU, mop floors between cases, and setup instruments for their next case. You know - because all that helps get through the day! Everyone has a story of some surgeon doing this or that to help out, but we need to be real here. 99.9% of them leave the room before the steristrips/dermabond is on the patient and would rather sit in the lounge and whine and moan about room delay this or slow room turnover that. Again, we are a service specialty and while we can be courteous, polite, and respectful to everyone there is no need (or room in my opinion....) for this questionably subservient BS that parts of this thread is teetering on.

 

[MoMoGesiologist]

I dont get why the scrub or circulator needs to be nursing, could literally be done by anyone. Is there a class in nursing school on how to get confused or slow things down? I think we'd see OR efficiency go up if we replaced nurses w/ pre-meds or med students or even prisoners...

 

[Neopolymath]

So, yeah, if this person is extolling the virtues of being an obsequious lickspittle, that’s weird and disturbing. But I don’t read it that way at all. If you notice the OR times, there’s often a long delay between induction and the incision. Certainly, prep needs time to dry, and so forth, but what really really seems to cause delays is when the circulator can’t complete tasks due to distractions, or parallel tasks. Sometimes providing some quick assistance or facilitating parallel tasks can really move things along. That makes a difference when you are doing 6 cases a day. Also, being able to troubleshoot OR equipment will pay off. What I read in this person’s post is someone who has cognizance of the overall operating room workflow, understanding what each member needs to effectively and efficiently do their job, and helping to make that happen. Personally, I respect people who can think on their feet, are situationally aware, and get things done, and I don’t really respect people who can’t, regardless of their position.

You mean act like a normal person? Apparently this does not compute for a lot of people.

 

[Bryan O’Blivion]

Right right. Because we all constantly see surgeons assist with moving patients to stretchers at the end of surgery, push stretchers to PACU, mop floors between cases, and setup instruments for their next case. You know - because all that helps get through the day! Everyone has a story of some surgeon doing this or that to help out, but we need to be real here. 99.9% of them leave the room before the steristrips/dermabond is on the patient and would rather sit in the lounge and whine and moan about room delay this or slow room turnover that. Again, we are a service specialty and while we can be courteous, polite, and respectful to everyone there is no need (or room in my opinion....) for this questionably subservient BS that parts of this thread is teetering on.

I guess I wouldn’t know, I don’t spend my time in the lounge listening to that b———t. I go there for the free food, not the conversation and ambience. If a surgeon departs leaving everyone with some colossus of a patient for transfer, have the circulator call them back to help. Or call them yourself.

 

[cockblockandrun]

100% agree, “medically induced coma” and here, sign this consent in the 5-10min I’ve known the patient isn’t really compatible.

But because of this marketing as you call it, everyone from patients to nurses to surgeons think it must be super simple. It’s the price we pay for being such good marketers.

I never say "you will go to sleep". In fact, when patients say "I love anesthesia and the great sleep I am going to get"- I will correct them and say "you will be placed in a medically induced coma and a breathing tube inserted and a ventilator will breathe for you during this time".

I am not a technician or someone that just pushes medications into an IV and then leaves the room.

 

[Southpaw]

I guess I wouldn’t know, I don’t spend my time in the lounge listening to that b———t. I go there for the free food, not the conversation and ambience. If a surgeon departs leaving everyone with some colossus of a patient for transfer, have the circulator call them back to help. Or call them yourself.

I said EVERY patient. Not just some colossus of a patient. Don’t go to extremes. Certainly if there were some extenuating circumstance I’d ask them to stay, and guess what? They would! But routinely doing that isn’t their job!

And buying bagels for every call shift or routinely answering personal calls during surgery is not my job. There are people getting paid and making a living to do these tasks - let them do them.

 

[nimbus]

medically induced coma

I’ve never uttered those words out loud in my life. Patients are scared enough already.

 

[cockblockandrun]

I’ve never uttered those words out loud in my life. Patients are scared enough already.

Of course, I don't say that to everyone. Just the ones who I know are not taking the anesthetic part serious. Most patients always acknowledge the importance of what we do. Is it ego boosting? Sure but it also feels good to be respected.

 

[vector2]

So, yeah, if this person is extolling the virtues of being an obsequious lickspittle, that’s weird and disturbing. But I don’t read it that way at all. If you notice the OR times, there’s often a long delay between induction and the incision. Certainly, prep needs time to dry, and so forth, but what really really seems to cause delays is when the circulator can’t complete tasks due to distractions, or parallel tasks. Sometimes providing some quick assistance or facilitating parallel tasks can really move things along. That makes a difference when you are doing 6 cases a day. Also, being able to troubleshoot OR equipment will pay off. What I read in this person’s post is someone who has cognizance of the overall operating room workflow, understanding what each member needs to effectively and efficiently do their job, and helping to make that happen. Personally, I respect people who can think on their feet, are situationally aware, and get things done, and I don’t really respect people who can’t, regardless of their position.

Being helpful and facilitating workflow is one thing. I read that guy or gal's post and the first thing I wondered was "who is actually doing and/or supervising the anesthesia during the the full hour you're playing circulator's apprentice?"

 

[Iso4ane]

My 10 rules of the OR:
1) Patient Safety
2) Patient Safety
3) Patient Safety
4-10) Do what I can to get the cases done so I can go home sooner.

 

[kidthor]

My 10 rules of the OR:
1) Patient Safety
2) Patient Safety
3) Patient Safety
4-10) Do what I can to get the cases done so I can go home sooner.

My one rule of the OR:
1) Be a doctor


Then later I go home.

 

[kidthor]

I guess I wouldn’t know, I don’t spend my time in the lounge listening to that b———t. I go there for the free food, not the conversation and ambience. If a surgeon departs leaving everyone with some colossus of a patient for transfer, have the circulator call them back to help. Or call them yourself.

You get free food?!

 

[chocomorsel]

You get free food?!

Yes.
Poor you. You must be in the dreaded East Coast.

 

[MikeMerk-MtS]

Right right. Because we all constantly see surgeons assist with moving patients to stretchers at the end of surgery, push stretchers to PACU, mop floors between cases, and setup instruments for their next case. You know - because all that helps get through the day! Everyone has a story of some surgeon doing this or that to help out, but we need to be real here. 99.9% of them leave the room before the steristrips/dermabond is on the patient and would rather sit in the lounge and whine and moan about room delay this or slow room turnover that. Again, we are a service specialty and while we can be courteous, polite, and respectful to everyone there is no need (or room in my opinion....) for this questionably subservient BS that parts of this thread is teetering on.

Just because surgeons don't... you won't? That's a bit of a childish attitude to have.

I'm guessing those that decide to help out even if it's not in their job description and even tho others aren't doing the same overall have it pretty good and want to keep it that way. I'd buy bagels for $20 a weekend call if it made my day a little easier.

 

[Southpaw]

Just because surgeons don't... you won't? That's a bit of a childish attitude to have.

I'm guessing those that decide to help out even if it's not in their job description and even tho others aren't doing the same overall have it pretty good and want to keep it that way. I'd buy bagels for $20 a weekend call if it made my day a little easier.

Before you start this nonsense can you read the post I replied to and what I’ve said? Life is lived in the middle - not the extremes exhibited on this board.

Again, and last time - be kind, courteous, and respectful. But no one needs to double as a circulating nurse while being the anesthesiologist. The role is there for a reason. Let them do it. They’re making a living off of it. Does that mean NEVER help out? No, of course not.

I don’t care much what surgeons do or don’t do. I do care whether or not they are good surgeons. And I expect everyone in the OR to care whether or not I’m a good anesthesiologist. Not whether or not I bought bagels for the day or answered friggin’ phone calls to gain favor.

I’ve been doing this long enough to know both how to get through the day and how to provide good care. I don’t expect anyone to carry my weight, and in fact I’d be a little offended if it happened routinely, and I don’t much care who brings the food in.

 

[nimbus]

Last weekend I bypassed PACU with my COVID+ toe amputation so the PACU nurses bought the pizza.

 

[2Fast2Des]

My 10 rules of the OR:
1) Patient Safety
2) Patient Safety
3) Patient Safety
4-10) Do what I can to get the cases done so I can go home sooner.

I'll help get\do stuff in the room if surgeon or scrub needs when circular stepped out of the room. I'll bring the bed into the room after pt extubated to get people to get the urgency to turnover if they're not moving at the pace I'd like. If it's the last case of the day after a long day I'll do what I can to get things going to get the hell out of the hospital. Especially being on productivity, I'm motivated to get cases in and out as efficiently, so if it means tying up the scrub or plugging in the bovie because the nurse can't reach, I'll do it. But hell no to being a suck up biatch. To the circulator's apprentice, come on man have some dignity, jeez lol

 

[Status Sciaticus]

So, yeah, if this person is extolling the virtues of being an obsequious lickspittle, that’s weird and disturbing. But I don’t read it that way at all. If you notice the OR times, there’s often a long delay between induction and the incision. Certainly, prep needs time to dry, and so forth, but what really really seems to cause delays is when the circulator can’t complete tasks due to distractions, or parallel tasks. Sometimes providing some quick assistance or facilitating parallel tasks can really move things along. That makes a difference when you are doing 6 cases a day. Also, being able to troubleshoot OR equipment will pay off. What I read in this person’s post is someone who has cognizance of the overall operating room workflow, understanding what each member needs to effectively and efficiently do their job, and helping to make that happen. Personally, I respect people who can think on their feet, are situationally aware, and get things done, and I don’t really respect people who can’t, regardless of their position.

Because you do nothing between induction and incision? You dont place post induction arterial lines, second IVs, Bair huggers, additional drips, pre-incision ABx, make vent changes? Oh and that is to say nothing of chart documentation? If your surgical prep takes longer than that, then the reason for OR delay is that the surgical staff is inefficient. The foleys can be placed while youre doing the second IV/A-Line....

Also, the prep can dry while time-out is occuring. The circulator or the OR nurse cant place a simple foley and tuck the arms and put SCDs on while you are doing all that?

Just because surgeons don't... you won't? That's a bit of a childish attitude to have.

I'm guessing those that decide to help out even if it's not in their job description and even tho others aren't doing the same overall have it pretty good and want to keep it that way. I'd buy bagels for $20 a weekend call if it made my day a little easier.

Bruhh you serious? Do you want us to clean up the OR too because we can? Its not a matter of us not doing it because the surgeons dont. Its a matter of us not doing it because ITS NOT IN OUR JOB DESCRIPTION. Going through 11 years of training makes us specialized to do our jobs, which is to take care of the patient. I signed up to study anesthesiology and provide anesthesia and all things related to it, not to be distracted by putting 10ccs in a foley that the nurse can do on his/her own.

I'm guessing those that "that decide to help out even if it's not in their job description and even tho others aren't doing the same overall" will have more work to do, have people walk over them, and have other non-physician tasks assigned to them. You do something courteous once or twice, and people start expecting that of you regularly. Pretty soon, it becomes the cultural norm. I wouldnt be surprised if this is how we became the defacto transporters...

 

[deleted171991]

The psychological studies have shown that the best gameplan is tit for tat. People have to know they will reap what they sowed, otherwise they will take advantage. In all studies, tit for tat beats nice.

People who are not nice don't appreciate nice. They see it as a weakness. For those people, as Trump would say, @Zekchar is a loser.

I don't live in a dreamworld where all people are essentially good inside; that's Disney, not the real one. Most people are essentially bad and selfish; it's mostly the societal norms that force them to present a nice facade and do the right thing.

We, as a specialty, have been becoming more and more servile, in exchange for money. History has shown how good that's been for us, especially now that the money is drying up. Keep doing it, keep being losers, and we'll continue being treated like losers, more and more. This ain't a nice person's world.

Btw, true story from residency:
Arsehole borderline incompetent surgeon in emergency, scares the **** out of the patient preop about probably losing a limb (totally unlikely). Of course, the patient survives without limb loss. Guess who was the big hero and savior? But, hey, just keep pushing that stretcher for him...

It's all a matter of expectations. If you behave like a doctor, you will be treated like a doctor. If you make the patient expect the surgeon's bitch; you will be treated accordingly. I have walked away from preops, because the surgeon interrupted me to play superstar; came back 15 minutes and a coffee later. Guess who wasn't interrupted again? Have your FU money in the bank, and your self-respect. If you have no self-respect because you're afraid of losing your job most of the time, you're already in trouble.

The main reason I am approaching the point where I may give up anesthesia for critical care is exactly that I can't stand not being treated like a doctor, more and more. I am not just some greenhorn resident or fresh grad anymore; I do deserve some pretty good amount of baseline respect.

 

[Bryan O’Blivion]

I said EVERY patient. Not just some colossus of a patient. Don’t go to extremes. Certainly if there were some extenuating circumstance I’d ask them to stay, and guess what? They would! But routinely doing that isn’t their job!

And buying bagels for every call shift or routinely answering personal calls during surgery is not my job. There are people getting paid and making a living to do these tasks - let them do them.

Sure, I’m not trying to go to extremes, here. I guess I just can’t think of many times I need them around to help transfer. Shouldn’t they be using their time better anyway, like putting in orders or dictating an op note?

Ive never spent any time mopping the floors, either. I do try to keep my area clean and not be disrespectful to the staff. I’ll buy take out if it’s a rough call. A lot of times the surgeon does. I don’t really get anesthesiologists who feel uptight about this. Unless you’re really getting skinned, you make quite literally 5-10 times what they do. A lot of times, these same people are sharing food they made with you, like what’s wrong with buying Thai once in a while?

To answer a lot of the same questions, if I’m actively doing something, of course I don’t interrupt what I’m doing to tuck an arm, etc. I just don’t find my usual cases overwhelmingly busy. I do a lot of the same things. I have macros. It’s really not hard to manage a patient, chart, and help some poor circulator who is struggling. TBH, if some nurse is struggling all the time, it’s probably not just in your room, and chances are, she’s not gonna be around a lot longer. Be nice. What’s the harm?

 

[chocomorsel]

The psychological studies have shown that the best gameplan is tit for tat. People have to know they will reap what they sowed, otherwise they will take advantage. In all studies, tit for tat beats nice.

People who are not nice don't appreciate nice. They see it as a weakness. For those people, as Trump would say, @Zekchar is a loser.

I don't live in a dreamworld where all people are essentially good inside; that's Disney, not the real one. Most people are essentially bad and selfish; it's mostly the societal norms that force them to present a nice facade and do the right thing.

We, as a specialty, have been becoming more and more servile, in exchange for money. History has shown how good that's been for us, especially now that the money is drying up. Keep doing it, keep being losers, and we'll continue being treated like losers, more and more. This ain't a nice person's world.

Btw, true story from residency:
Arsehole borderline incompetent surgeon in emergency, scares the **** out of the patient preop about probably losing a limb (totally unlikely). Of course, the patient survives without limb loss. Guess who was the big hero and savior? But, hey, just keep pushing that stretcher for him...

It's all a matter of expectations. If you behave like a doctor, you will be treated like a doctor. If you make the patient expect the surgeon's bitch; you will be treated accordingly. I have walked away from preops, because the surgeon interrupted me to play superstar; came back 15 minutes and a coffee later. Guess who wasn't interrupted again? Have your FU money in the bank, and your self-respect. If you have no self-respect because you're afraid of losing your job most of the time, you're already in trouble.

The main reason I am approaching the point where I may give up anesthesia for critical care is exactly that I can't stand not being treated like a doctor, more and more. I am not just some greenhorn resident or fresh grad anymore; I do deserve some pretty good amount of baseline respect.

Thought you couldn’t do critical care because you were stuck in a crappy location.
If that ain’t the case, good for you cuz you will probably be happier.

 

[Lidolover]

Don’t understand why a surgeon has to do something better Than transferring a patient and an anesthesiologist does not. Aren’t we both physicians? Getting super upset with this mentality and no wonder why we have reached the miserable point we have reached. Personally, I don’t start the trip to OR or from OR unless each rep of the team is present. Period. This is total BS.

 

[nimbus]

The psychological studies have shown that the best gameplan is tit for tat. People have to know they will reap what they sowed, otherwise they will take advantage. In all studies, tit for tat beats nice.

People who are not nice don't appreciate nice. They see it as a weakness. For those people, as Trump would say, @Zekchar is a loser.

I’d consider that a badge of honor. Guess I’m a loser. I’ll still be nice to everyone I work with. It’s worked well for me so far.

 

[We'llBeDoneIn15Minutes]

We don't really help our cause that much when the standard canned answer for "why anesthesia?" is that we hate dealing with awake patients, hate medicine and medicine wards, hate rounding, hate (pre-op) clinic, hate writing notes, hate follow-up.......aka hate all the things that comes with being a doctor in the vast majority of other specialties.

Head of a large group in a major city told me when I interviewed, "Let's be honest, we all go into anesthesia when we realize we don't like practicing medicine... and then we end up being an internist anyway."

 

[We'llBeDoneIn15Minutes]

Right right. Because we all constantly see surgeons assist with moving patients to stretchers at the end of surgery, push stretchers to PACU, mop floors between cases, and setup instruments for their next case. You know - because all that helps get through the day! Everyone has a story of some surgeon doing this or that to help out, but we need to be real here. 99.9% of them leave the room before the steristrips/dermabond is on the patient and would rather sit in the lounge and whine and moan about room delay this or slow room turnover that. Again, we are a service specialty and while we can be courteous, polite, and respectful to everyone there is no need (or room in my opinion....) for this questionably subservient BS that parts of this thread is teetering on.

There's not enough money in the world in the best location in the world with the best hours in the world to get me to work in an MD only anesthesia group where I have to sit on the stool all day long dealing with the bullcrap of arrogant miserable jackass surgeons all day long.

 

[nimbus]

There's not enough money in the world in the best location in the world with the best hours in the world to get me to work in an MD only anesthesia group where I have to sit on the stool all day long dealing with the bullcrap of arrogant miserable jackass surgeons all day long.

Believe it or not some surgeons are smarter, cooler and kinder than most anesthesiologists. Some nurses too.

 

[We'llBeDoneIn15Minutes]

Believe or not some surgeons are smarter, cooler and kinder than most anesthesiologists. Some nurses too.

I have worked with many surgeons and nurses that are some of the best people I have ever known. The surgeons tend to be better people in the community setting. But I have also worked with too many surgeons, particularly in the academic setting, that make life around them feel like a hell on earth that the good days away from them would not be enough to offset the days of being stranded on the stool with them. Care Team approach or bust for me.

 

[Mman]

Because you do nothing between induction and incision? You dont place post induction arterial lines, second IVs, Bair huggers, additional drips, pre-incision ABx, make vent changes? Oh and that is to say nothing of chart documentation? If your surgical prep takes longer than that, then the reason for OR delay is that the surgical staff is inefficient. The foleys can be placed while youre doing the second IV/A-Line....

Also, the prep can dry while time-out is occuring. The circulator or the OR nurse cant place a simple foley and tuck the arms and put SCDs on while you are doing all that?



Bruhh you serious? Do you want us to clean up the OR too because we can? Its not a matter of us not doing it because the surgeons dont. Its a matter of us not doing it because ITS NOT IN OUR JOB DESCRIPTION. Going through 11 years of training makes us specialized to do our jobs, which is to take care of the patient. I signed up to study anesthesiology and provide anesthesia and all things related to it, not to be distracted by putting 10ccs in a foley that the nurse can do on his/her own.

I'm guessing those that "that decide to help out even if it's not in their job description and even tho others aren't doing the same overall" will have more work to do, have people walk over them, and have other non-physician tasks assigned to them. You do something courteous once or twice, and people start expecting that of you regularly. Pretty soon, it becomes the cultural norm. I wouldnt be surprised if this is how we became the defacto transporters...

I don't think anybody is arguing you should do all of those things on every case. But if you can't ever do any of those things, you are probably just not a pleasant person to be in a room with. If someone is struggling to do something and you are twiddling your thumbs, it's nice to give them a helping hand for 10 seconds even if it is not in your job description. It's called being a decent person.

 

[Southpaw]

I don't think anybody is arguing you should do all of those things on every case. But if you can't ever do any of those things, you are probably just not a pleasant person to be in a room with. If someone is struggling to do something and you are twiddling your thumbs, it's nice to give them a helping hand for 10 seconds even if it is not in your job description. It's called being a decent person.

can you think of another forum that would fixate on whether or not a physician does things OTHER THAN THEIR JOB, the way we have here? I find it telling and unfortunate. Another example - do you think the surgeons, in their forum, have discussed how often they bring patients back, check vitals, do blood draws, run lab tests, etc. while they are in the office? If I were to guess, and I would love to be proven wrong, a surgeon NEVER does any of those things and they also don't dwell on the fact that they aren't doing them.

I don't think anyone here is dwelling on or obsessing over whether or not we should all act like asses. That's pretty straightforward and generally all of us went into anesthesiology, at least partially, because we aren't so ego focused. We rarely, if ever, get the glory and we are almost always okay with that. We are all, generally speaking, pretty nice and laid back people.

But again, in reference to @Zekchar's post, which you yourself 'LOVED', what they are doing should be seen as excessive by any measure. No one should be expected to bring in meals for every call or weekend shift, or repeatedly answer private calls, simply to gain favor, be liked by surgeons, or get help when a patient needs it. And maybe you didn't see it that way, but I did, because it's in fact what they said.

 

[MikeMerk-MtS]

can you think of another forum that would fixate on whether or not a physician does things OTHER THAN THEIR JOB, the way we have here? I find it telling and unfortunate. Another example - do you think the surgeons, in their forum, have discussed how often they bring patients back, check vitals, do blood draws, run lab tests, etc. while they are in the office? If I were to guess, and I would love to be proven wrong, a surgeon NEVER does any of those things and they also don't dwell on the fact that they aren't doing them.

I don't think anyone here is dwelling on or obsessing over whether or not we should all act like asses. That's pretty straightforward and generally all of us went into anesthesiology, at least partially, because we aren't so ego focused. We rarely, if ever, get the glory and we are almost always okay with that. We are all, generally speaking, pretty nice and laid back people.

But again, in reference to @Zekchar's post, which you yourself 'LOVED', what they are doing should be seen as excessive by any measure. No one should be expected to bring in meals for every call or weekend shift, or repeatedly answer private calls, simply to gain favor, be liked by surgeons, or get help when a patient needs it. And maybe you didn't see it that way, but I did, because it's in fact what they said.

Best surgeon where I trained (ortho onc surgeon) helps place a second IV to help get things moving. He’s not the best but he gets it 9 times out of 10. He is one of the most highly respected physicians in the hospital and I always looked up to him. So yes, there are surgeons who do this stuff that is not in their job description and yes they somehow manage to be well-respected.

I had mentors who were of the same cloth so that’s why I choose to help out whenever/however I can.

 

[MikeMerk-MtS]

can you think of another forum that would fixate on whether or not a physician does things OTHER THAN THEIR JOB, the way we have here? I find it telling and unfortunate. Another example - do you think the surgeons, in their forum, have discussed how often they bring patients back, check vitals, do blood draws, run lab tests, etc. while they are in the office? If I were to guess, and I would love to be proven wrong, a surgeon NEVER does any of those things and they also don't dwell on the fact that they aren't doing them.

I don't think anyone here is dwelling on or obsessing over whether or not we should all act like asses. That's pretty straightforward and generally all of us went into anesthesiology, at least partially, because we aren't so ego focused. We rarely, if ever, get the glory and we are almost always okay with that. We are all, generally speaking, pretty nice and laid back people.

But again, in reference to @Zekchar's post, which you yourself 'LOVED', what they are doing should be seen as excessive by any measure. No one should be expected to bring in meals for every call or weekend shift, or repeatedly answer private calls, simply to gain favor, be liked by surgeons, or get help when a patient needs it. And maybe you didn't see it that way, but I did, because it's in fact what they said.

And what’s wrong with buying some pizza or Thai food once in a while? The nurses bring in baked goods all the time and no one frowns upon that... Double standard because we make more?

 

[Status Sciaticus]

The psychological studies have shown that the best gameplan is tit for tat. People have to know they will reap what they sowed, otherwise they will take advantage. In all studies, tit for tat beats nice.

People who are not nice don't appreciate nice. They see it as a weakness. For those people, as Trump would say, @Zekchar is a loser.

I don't live in a dreamworld where all people are essentially good inside; that's Disney, not the real one. Most people are essentially bad and selfish; it's mostly the societal norms that force them to present a nice facade and do the right thing.

We, as a specialty, have been becoming more and more servile, in exchange for money. History has shown how good that's been for us, especially now that the money is drying up. Keep doing it, keep being losers, and we'll continue being treated like losers, more and more. This ain't a nice person's world.

Btw, true story from residency:
Arsehole borderline incompetent surgeon in emergency, scares the **** out of the patient preop about probably losing a limb (totally unlikely). Of course, the patient survives without limb loss. Guess who was the big hero and savior? But, hey, just keep pushing that stretcher for him...

It's all a matter of expectations. If you behave like a doctor, you will be treated like a doctor. If you make the patient expect the surgeon's bitch; you will be treated accordingly. I have walked away from preops, because the surgeon interrupted me to play superstar; came back 15 minutes and a coffee later. Guess who wasn't interrupted again? Have your FU money in the bank, and your self-respect. If you have no self-respect because you're afraid of losing your job most of the time, you're already in trouble.

The main reason I am approaching the point where I may give up anesthesia for critical care is exactly that I can't stand not being treated like a doctor, more and more. I am not just some greenhorn resident or fresh grad anymore; I do deserve some pretty good amount of baseline respect.

Hey now, greenhorn residents and fresh grads deserve a good amount of baseline respect too!

Sure, I’m not trying to go to extremes, here. I guess I just can’t think of many times I need them around to help transfer. Shouldn’t they be using their time better anyway, like putting in orders or dictating an op note?

Ive never spent any time mopping the floors, either. I do try to keep my area clean and not be disrespectful to the staff. I’ll buy take out if it’s a rough call. A lot of times the surgeon does. I don’t really get anesthesiologists who feel uptight about this. Unless you’re really getting skinned, you make quite literally 5-10 times what they do. A lot of times, these same people are sharing food they made with you, like what’s wrong with buying Thai once in a while?

To answer a lot of the same questions, if I’m actively doing something, of course I don’t interrupt what I’m doing to tuck an arm, etc. I just don’t find my usual cases overwhelmingly busy. I do a lot of the same things. I have macros. It’s really not hard to manage a patient, chart, and help some poor circulator who is struggling. TBH, if some nurse is struggling all the time, it’s probably not just in your room, and chances are, she’s not gonna be around a lot longer. Be nice. What’s the harm?

So, now we are expected to feed other gainfully employed people? I understand if its an occasional thing, but lets not pretend it doesnt become the norm. Perhaps you can do a potluck so no one feels entitled to free food everytime they see you on call.
Here is how the workflow goes for me. I intubate, the surgeon starts prepping the field, the nurse starts the foley if indicated. I place the second IV and leave the arm open. The nurse tucks in the arm with the sheet and removes the armrest while I am placing the Bair hugger and spiking the antibiotics.

If you have a circulator who is struggling to place a foley and tuck in arms, IDK what to tell you. You need to let them do their job so they can get better. If I have a problem intubating, the surgeon doesnt step in to intubate, I just ventilate and try a different approach. The same applies for the nurses jobs. Let them try and do their jobs so they can get better at it.

I think all this need to be liked by the surgeons and nurses is bitch behavior. If you do your job with skill, you will be respected. If people can get you to do whatever they want and you act like a bitch, they will treat you like one.

As far as the anecdotal "I knew a surgeon that did this" examples above, yes theres exceptions to every rule, but lets not pretend they are or will be the norm.

 

[nimbus]

I think all this need to be liked by the surgeons and nurses is bitch behavior. If you do your job with skill, you will be respected. If people can get you to do whatever they want and you act like a bitch, they will treat you like one.

If someone is this obsessed with “respect“, being a “bitch”, and being treated like a “bitch”, I don’t know what to say. I love going to work and feel appreciated and respected when I’m there. The topic of respect never crosses my mind. Maybe get a new job.

 

[Southpaw]

And what’s wrong with buying some pizza or Thai food once in a while? The nurses bring in baked goods all the time and no one frowns upon that... Double standard because we make more?

there's nothing wrong with buying food once in a while. I've done it plenty of times in fact. but in my opinion what's not what we're talking about.

 

[deleted162650]

If someone is this obsessed with “respect“, being a “bitch”, and being treated like a “bitch”, I don’t know what to say. I love going to work and feel appreciated and respected when I’m there. The topic of respect never crosses my mind. Maybe get a new job.

Spoken like a bitch.

 

[Bryan O’Blivion]

Hey now, greenhorn residents and fresh grads deserve a good amount of baseline respect too!



So, now we are expected to feed other gainfully employed people? I understand if its an occasional thing, but lets not pretend it doesnt become the norm. Perhaps you can do a potluck so no one feels entitled to free food everytime they see you on call.
Here is how the workflow goes for me. I intubate, the surgeon starts prepping the field, the nurse starts the foley if indicated. I place the second IV and leave the arm open. The nurse tucks in the arm with the sheet and removes the armrest while I am placing the Bair hugger and spiking the antibiotics.

If you have a circulator who is struggling to place a foley and tuck in arms, IDK what to tell you. You need to let them do their job so they can get better. If I have a problem intubating, the surgeon doesnt step in to intubate, I just ventilate and try a different approach. The same applies for the nurses jobs. Let them try and do their jobs so they can get better at it.

I think all this need to be liked by the surgeons and nurses is bitch behavior. If you do your job with skill, you will be respected. If people can get you to do whatever they want and you act like a bitch, they will treat you like one.

As far as the anecdotal "I knew a surgeon that did this" examples above, yes theres exceptions to every rule, but lets not pretend they are or will be the norm.
[/QUOTE/

Hey now, greenhorn residents and fresh grads deserve a good amount of baseline respect too!



So, now we are expected to feed other gainfully employed people? I understand if its an occasional thing, but lets not pretend it doesnt become the norm. Perhaps you can do a potluck so no one feels entitled to free food everytime they see you on call.
Here is how the workflow goes for me. I intubate, the surgeon starts prepping the field, the nurse starts the foley if indicated. I place the second IV and leave the arm open. The nurse tucks in the arm with the sheet and removes the armrest while I am placing the Bair hugger and spiking the antibiotics.

If you have a circulator who is struggling to place a foley and tuck in arms, IDK what to tell you. You need to let them do their job so they can get better. If I have a problem intubating, the surgeon doesnt step in to intubate, I just ventilate and try a different approach. The same applies for the nurses jobs. Let them try and do their jobs so they can get better at it.

I think all this need to be liked by the surgeons and nurses is bitch behavior. If you do your job with skill, you will be respected. If people can get you to do whatever they want and you act like a bitch, they will treat you like one.

As far as the anecdotal "I knew a surgeon that did this" examples above, yes theres exceptions to every rule, but lets not pretend they are or will be the norm.

Look. I don’t want to be disrespectful here, but if you feel like a bitch at your job, something is wrong. Maybe with the job, maybe with you. Lift some weights, learn to box, and maybe lighten up, Francis. Of course the surgeon doesn’t step in if you miss a tube. You are undoubtedly better at placing it than they are. Weird analogy.

Nobody expects you to feed anybody. when you have a small tight group of people who are working together, sometimes people get food. If some scrub tech who makes 1/10 of what you do is bringing, here’s an idea, maybe step up.

Yes, there are some sniveling weak servile anesthesiologists out there. Don’t let anyone walk on you. But honestly, I think lending a helping hand once in a while and moving things in the right direction is a reflection of this. I think it’s important to know the difference.

To be fair, I never transport patients to the OR. The circulator does that at my place. I would probably object to doing that, as I have better things to do at that time. So if that’s what people are worked up about, fair point.

 

[Status Sciaticus]

..

I think we are not saying different things. Once in a while, its ok to bring food or help out to move things along, but doing so repeatedly shows poor preparation on the staff's part (regarding doing their job). I dont feel like a bitch at my job. I brought it up because thats what Zekchars initial comment sounded like. I do not have any problems in my workplace with regards to professional behavior or people not knowing what their respective roles are.
Yes, there are several places where anesthesiologists are expected to transport patients to and from Pre-Op/PACU, hook up the monitors, when handing patients off, and other menial tasks.

If someone is this obsessed with “respect“, being a “bitch”, and being treated like a “bitch”, I don’t know what to say. I love going to work and feel appreciated and respected when I’m there. The topic of respect never crosses my mind. Maybe get a new job.

I tyhink you have the two things mixed up there, chief. Being respected and being courteous is one thing. Its expected in the workplace, and its not considered "being this obsessed". Its a societal norm. I love going to work and feel respected too. Doesnt mean that the behavior Zekchar described is not bitch behavior.

 

[chocomorsel]

I have worked with many surgeons and nurses that are some of the best people I have ever known. The surgeons tend to be better people in the community setting. But I have also worked with too many surgeons, particularly in the academic setting, that make life around them feel like a hell on earth that the good days away from them would not be enough to offset the days of being stranded on the stool with them. Care Team approach or bust for me.

Well, there’s your problem. Academic egos. Stay away from there and you will run into more normally behaved surgeons.
Screw care team and arrogant CRNAs. I would rather deal with an arrogant surgeon than an arrogant CRNA that doesn’t want to be told anything and has a bad attitude any day of the week.

Most surgeons I have worked with in PP are normal and nice and not douchebags.

 

[chocomorsel]

can you think of another forum that would fixate on whether or not a physician does things OTHER THAN THEIR JOB, the way we have here? I find it telling and unfortunate. Another example - do you think the surgeons, in their forum, have discussed how often they bring patients back, check vitals, do blood draws, run lab tests, etc. while they are in the office? If I were to guess, and I would love to be proven wrong, a surgeon NEVER does any of those things and they also don't dwell on the fact that they aren't doing them.

I don't think anyone here is dwelling on or obsessing over whether or not we should all act like asses. That's pretty straightforward and generally all of us went into anesthesiology, at least partially, because we aren't so ego focused. We rarely, if ever, get the glory and we are almost always okay with that. We are all, generally speaking, pretty nice and laid back people.

But again, in reference to @Zekchar's post, which you yourself 'LOVED', what they are doing should be seen as excessive by any measure. No one should be expected to bring in meals for every call or weekend shift, or repeatedly answer private calls, simply to gain favor, be liked by surgeons, or get help when a patient needs it. And maybe you didn't see it that way, but I did, because it's in fact what they said.

Or wash the surgeon’s car. No joke, I heard this happening in Vegas when I was there so that the surgeons don’t dumpy their anesthesiologist.
Yeah, I would move in a heartbeat if gaining favors from surgeons to work with me required me kissing their ass.
Oh wait, I did move.

 

[Mman]

can you think of another forum that would fixate on whether or not a physician does things OTHER THAN THEIR JOB, the way we have here? I find it telling and unfortunate. Another example - do you think the surgeons, in their forum, have discussed how often they bring patients back, check vitals, do blood draws, run lab tests, etc. while they are in the office? If I were to guess, and I would love to be proven wrong, a surgeon NEVER does any of those things and they also don't dwell on the fact that they aren't doing them.

I don't think anyone here is dwelling on or obsessing over whether or not we should all act like asses. That's pretty straightforward and generally all of us went into anesthesiology, at least partially, because we aren't so ego focused. We rarely, if ever, get the glory and we are almost always okay with that. We are all, generally speaking, pretty nice and laid back people.

But again, in reference to @Zekchar's post, which you yourself 'LOVED', what they are doing should be seen as excessive by any measure. No one should be expected to bring in meals for every call or weekend shift, or repeatedly answer private calls, simply to gain favor, be liked by surgeons, or get help when a patient needs it. And maybe you didn't see it that way, but I did, because it's in fact what they said.

I love the attitude of being willing to help out in whatever way necessary to make the day flow smoother and get done faster. I find the people who constantly scream about how they are a doctor and need to be treated with respect to be hilarious. I don't think anybody should do all of those small things all of the time. I do think anybody that thinks they are too big to do any menial job has the wrong attitude.

I consider myself a leader in the OR and that means I should do any task I would ask someone beneath me to do. That's what good leadership is.

Also if I found myself frequently answering the surgeons phone, I would probably tell them I'm going to just give their wife my personal cell number since she wants to talk to me so badly.

 

[Zekchar]

Gone fishing and return to a clusterf*ck. As with everything on the internet this became a cesspool of extreme takes which led to bickering and crass talk of being a "bitch." I do not advocate being the OR secretary nor do I urge the holding of surgeon jockstraps. With that being said real life happens and your attitude and effort goes a long way towards shaping the respect, camaraderie, and the overall pleasure you get from your job.

If you want to be island and ignore the rest of the OR staff and not help out in any way beyond securing the airway and charting, so be it. I won't fault you for that and wont call you whatever the opposite of a being a "bitch" is. All work culture is local and what works in once place may not fly in another.

I do the things I do to help move cases along. Patient safety is never jeopardized and unlike what others are suggesting, it makes me more likable and that gets reciprocated. My day is therefore lighter and quicker and I sleep well at night knowing that I lowered myself with my MD degree to help tie the scrub tech's gown or opened up some sutures while the circulator was out of the room. The steady 400k + 7 weeks vacay allows me the peace of mind to help the employees that I work with on a daily basis without losing my testicular fortitude or compromising my physician integrity.

 

[chocomorsel]

Gone fishing and return to a clusterf*ck. As with everything on the internet this became a cesspool of extreme takes which led to bickering and crass talk of being a "bitch." I do not advocate being the OR secretary nor do I urge the holding of surgeon jockstraps. With that being said real life happens and your attitude and effort goes a long way towards shaping the respect, camaraderie, and the overall pleasure you get from your job.

If you want to be island and ignore the rest of the OR staff and not help out in any way beyond securing the airway and charting, so be it. I won't fault you for that and wont call you whatever the opposite of a being a "bitch" is. All work culture is local and what works in once place may not fly in another.

I do the things I do to help move cases along. Patient safety is never jeopardized and unlike what others are suggesting, it makes me more likable and that gets reciprocated. My day is therefore lighter and quicker and I sleep well at night knowing that I lowered myself with my MD degree to help tie the scrub tech's gown or opened up some sutures while the circulator was out of the room. The steady 400k + 7 weeks vacay allows me the peace of mind to help the employees that I work with on a daily basis without losing my testicular fortitude or compromising my physician integrity.

But really, answering nurses personal phone calls, blowing up foleys regularly, and buying food EVERY call?
Don’t you think that’s taking it too far? Nurses should not be taking personal calls in the OR. I never take personal calls in the OR. I find that rude and unprofessional.
The food thing gets expensive too. Do you have a work food budget for call?

 

[Status Sciaticus]

Gone fishing and return to a clusterf*ck. As with everything on the internet this became a cesspool of extreme takes which led to bickering and crass talk of being a "bitch." I do not advocate being the OR secretary nor do I urge the holding of surgeon jockstraps. With that being said real life happens and your attitude and effort goes a long way towards shaping the respect, camaraderie, and the overall pleasure you get from your job.

If you want to be island and ignore the rest of the OR staff and not help out in any way beyond securing the airway and charting, so be it. I won't fault you for that and wont call you whatever the opposite of a being a "bitch" is. All work culture is local and what works in once place may not fly in another.

I do the things I do to help move cases along. Patient safety is never jeopardized and unlike what others are suggesting, it makes me more likable and that gets reciprocated. My day is therefore lighter and quicker and I sleep well at night knowing that I lowered myself with my MD degree to help tie the scrub tech's gown or opened up some sutures while the circulator was out of the room. The steady 400k + 7 weeks vacay allows me the peace of mind to help the employees that I work with on a daily basis without losing my testicular fortitude or compromising my physician integrity.

Thanks for responding and clarifying. I do want you to take a step back and look at how your actions are interpreted. Lets say you do all this out of the goodness of your heart and, as you say, to move things along. Thats good for you. BUT, then those expectations, no matter how subconscious, get ingrained in those staff members and surgeons. Oh why didnt Zekchars colleagues help me with this foley? Why didnt this anesthesiologist tuck in the arm like Zekchar does? Oh no free food today? Guess Zekchar's colleagues are cheap. Regarding the workflow, I would point again to the sentiment I made earlier: you need to let the nurses do their jobs. You doing their job does not help them get better. Want to hand off sutures to the scrub tech because the circulator is out? Fine. Doing that because the circulator is taking a call or on the computer chillin? hard pass.

Next time you are doing a central line, leave your phone out in case it wrings and see if the surgeon picks up the phone to "move things along".

 

[DocMcCoy]

There's not enough money in the world in the best location in the world with the best hours in the world to get me to work in an MD only anesthesia group where I have to sit on the stool all day long dealing with the bullcrap of arrogant miserable jackass surgeons all day long.

its pretty awesome if you find a good group. No CRNAs to muddy the water so everyone in the OR understands they are talking to a doctor when they are talking to anesthesia in my shop.

Surgeons play nice or good luck trying to get your add ons covered.

sure beats kissing some CRNAs a$$ all day.

 

[deleted171991]

Gone fishing and return to a clusterf*ck. As with everything on the internet this became a cesspool of extreme takes which led to bickering and crass talk of being a "bitch." I do not advocate being the OR secretary nor do I urge the holding of surgeon jockstraps. With that being said real life happens and your attitude and effort goes a long way towards shaping the respect, camaraderie, and the overall pleasure you get from your job.

If you want to be island and ignore the rest of the OR staff and not help out in any way beyond securing the airway and charting, so be it. I won't fault you for that and wont call you whatever the opposite of a being a "bitch" is. All work culture is local and what works in once place may not fly in another.

I do the things I do to help move cases along. Patient safety is never jeopardized and unlike what others are suggesting, it makes me more likable and that gets reciprocated. My day is therefore lighter and quicker and I sleep well at night knowing that I lowered myself with my MD degree to help tie the scrub tech's gown or opened up some sutures while the circulator was out of the room. The steady 400k + 7 weeks vacay allows me the peace of mind to help the employees that I work with on a daily basis without losing my testicular fortitude or compromising my physician integrity.

I don't think anybody would argue against being a decent human being. That includes occasionally getting the sutures for the team, or tying somebody's gown. That includes knowing people's names, saying Hello and Bye. Good communication is the basis of patient safety.

This is all fine if, at the end of the day, you are seen as a doctor and the surgeon's equal. Only you can tell if that's true. If you become just another one of his monkeys, you have done a disservice both to your patients and your colleagues.

This ain't a popularity contest. This is a leadership contest. You can't lead if you don't get respect. You can't stand up to the surgeon, when needed, if there is no respect. Most good leaders are friendly but don't mix with the troops.

You're not a facilitator, OR runner, stretcher pusher, gown tier, urine emptier, intubator, "bartender" etc. You are a physician, you are a scientist, you are a consultant, you are an expert. Because, otherwise, you're just somebody's bitch, however you want to rationalize it.

 

[nimbus]

I don't think anybody would argue against being a decent human being. That includes occasionally getting the sutures for the team, or tying somebody's gown. That includes knowing people's names, saying Hello and Bye. Good communication is the basis of patient safety.

This is all fine if, at the end of the day, you are seen as a doctor and the surgeon's equal. Only you can tell if that's true. If you become just another one of his monkeys, you have done a disservice both to your patients and your colleagues.

This ain't a popularity contest. This is a leadership contest. You can't lead if you don't get respect. You can't stand up to the surgeon, when needed, if there is no respect. Most good leaders are friendly but don't mix with the troops.

You're not a facilitator, OR runner, stretcher pusher, gown tier, urine emptier, intubator, "bartender" etc. You are a physician, you are a scientist, you are a consultant, you are an expert. Because, otherwise, you're just somebody's bitch, however you want to rationalize it.

I never thought of my work as a contest at all. I also know that I am not a scientist or a bartender of any kind. I am a doctor and I enjoy being part of a team.