What Do Anesthesiologists Really Do?

[deleted171991]

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.

Good for you.

And if you make your decisions based on science, on evidence-based medicine, and not on politics or sycophancy (aka "keeping the surgeons happy"), you are a scientist (an expert in science).

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[BIGphysician]

We do quite a bit. Working on our own I think we have the most significant impact and ability to really benefit patient care dramatically. Unfortunately many groups have us supervising Anesthetists (basically specialized nurses or specialized PAs) - that turns the job into something more comparable to running for political office. It’s a lot of talking, and walking on egg shells. Usually in that situation you have to just back off, and accept your job is to just clear patients for surgery in the holding area, let the anesthetist do the case however they want, and then just wait for overhead anesthesia stats. It’s not bad. It’s a balancing act. I don’t really want to be sitting behind the drapes all day in some robotic sling case tbh. Still do all the blocks and the difficult airways, central lines, most of the art lines and difficult PIVs. Only difficult part is watching the anesthetist do everything sloppy and not be open to any guidance- it’s like most have zero aspiration to learn anything from you, it’s like if they learn anything from you it’s a sign of weakness. that part gets old.

 

[Mman]

We do quite a bit. Working on our own I think we have the most significant impact and ability to really benefit patient care dramatically. Unfortunately many groups have us supervising Anesthetists (basically specialized nurses or specialized PAs) - that turns the job into something more comparable to running for political office. It’s a lot of talking, and walking on egg shells. Usually in that situation you have to just back off, and accept your job is to just clear patients for surgery in the holding area, let the anesthetist do the case however they want, and then just wait for overhead anesthesia stats. It’s not bad. It’s a balancing act. I don’t really want to be sitting behind the drapes all day in some robotic sling case tbh. Still do all the blocks and the difficult airways, central lines, most of the art lines and difficult PIVs. Only difficult part is watching the anesthetist do everything sloppy and not be open to any guidance- it’s like most have zero aspiration to learn anything from you, it’s like if they learn anything from you it’s a sign of weakness. that part gets old.

I would suggest working in an ACT practice where the anesthetists work for you and not the hospital.

 

[Mad Jack]

If I feel disrespected, I tell them that I put them into a controlled coma, like in the intensive care unit. That gets their attention.

Why do I always say that intensivists are seen as doctors, but anesthesiologists just as techs, even by other doctors? Because anesthesiologists tend to behave like techs, not like highly-trained specialist physicians and consultants; one reaps what one sows.

People forget anesthesia used to be far more deadly. You're so good at your job you've made it look easy

 

[vector2]

I would suggest working in an ACT practice where the anesthetists work for you and not the hospital.

Your advice for most people is about as realistic as you also casually suggesting they go out and get a 90% MGMA job this afternoon.


Seriously, nationwide what percentage of anesthesiologists are in true PP, and what percentage of these PPs employ their CRNAs?

 

[Mman]

Your advice for most people is about as realistic as you also casually suggesting they go out and get a 90% MGMA job this afternoon.


Seriously, nationwide what percentage of anesthesiologists are in true PP, and what percentage of these PPs employ their CRNAs?

I do not know the answer to those numbers. There are a decent number in the southeast.

 

[deleted171991]

Spoken like a bitch.

Nope. Spoken like a very lucky person who doesn't realize not everyone is.

It's so easy to always blame the person, not the job(s), the market, or even the specialty. I used to think the same, and blamed myself, until I started working in the ICU. Suddenly, as an ICU fellow, I got more respect than the average young attending anesthesiologist in my residency program. Let that sink in.

The culture in anesthesiology and the OR is just rotten, in many places. That's the truth. Please show me another (developed) country where anesthesiologists push stretchers. In many countries, we don't empty Foleys, move patients, and generally do stuff that NURSES are supposed do.

So, yeah, we are reaping what we have been sowing for decades.

 

[MoMoGesiologist]

Nope. Spoken like a very lucky person who doesn't realize not everyone is.

It's so easy to always blame the person, not the job(s), the market, or even the specialty. I used to think the same, and blamed myself, until I started working in the ICU. Suddenly, as an ICU fellow, I got more respect than the average young attending anesthesiologist in my residency program. Let that sink in.

The culture in anesthesiology and the OR is just rotten, in many places. That's the truth. Please show me another (developed) country where anesthesiologists push stretchers. In many countries, we don't empty Foleys, move patients, and generally do stuff that NURSES are supposed do.

So, yeah, we are reaping what we have been sowing for decades.

If you supervise, you don’t have to do any of that “nursing” crap

PS: I also liked when people would ask my opinion as an ICU fellow

 

[ryanjmy]

That's the truth. Please show me another (developed) country where anesthesiologists push stretchers. In many countries, we don't empty Foleys, move patients, and generally do stuff that NURSES are supposed do.

Transporting pts is part of the gig. Bad things can happen on the way to the icu. Same with moving a pt after a case.

I haven’t emptied a foley bag since residency. **** that. I’ve had circulators try to hand me bottles and suggest it and I tell them the nurse can do it later. Most of the time they do it themselves.

 

[Status Sciaticus]

I do not know the answer to those numbers. There are a decent number in the southeast.

Decent number of 90%ile jobs or ACT w/ CRNA employees?

Transporting pts is part of the gig. Bad things can happen on the way to the icu. Same with moving a pt after a case.

I haven’t emptied a foley bag since residency. **** that. I’ve had circulators try to hand me bottles and suggest it and I tell them the nurse can do it later. Most of the time they do it themselves.

Your point is a valid one. But transporting patients TO the OR by an anesthesiologist isnt part of the gig. Realistically, if you're pushing the bed, youre focused on your driving, not seeing what the patient is doing. I recall several times when I've pushed patients from the OR to the PACU where theyve attempted to poke their eyeballs but I haven't been able to swat their hand away in time because I'm pushing the bed. Would be much easier to do if it was a transporter pushing the bed and I can focus on the patient entirely.

Ah yes, the foley emptying job. **** that. Empty when full in PACU/Floor.

 

[deleted171991]

Transporting pts is part of the gig. Bad things can happen on the way to the icu. Same with moving a pt after a case.

I haven’t emptied a foley bag since residency. **** that. I’ve had circulators try to hand me bottles and suggest it and I tell them the nurse can do it later. Most of the time they do it themselves.

They transport patients, too,... with a transporter (not a physician) pushing the stretcher.

 

[chocomorsel]

Transporting pts is part of the gig. Bad things can happen on the way to the icu. Same with moving a pt after a case.

I haven’t emptied a foley bag since residency. **** that. I’ve had circulators try to hand me bottles and suggest it and I tell them the nurse can do it later. Most of the time they do it themselves.

Someone can push the stretcher as you walk alongside it.
See @FFP beat me to it.

 

[chocomorsel]

Nope. Spoken like a very lucky person who doesn't realize not everyone is.

It's so easy to always blame the person, not the job(s), the market, or even the specialty. I used to think the same, and blamed myself, until I started working in the ICU. Suddenly, as an ICU fellow, I got more respect than the average young attending anesthesiologist in my residency program. Let that sink in.

The culture in anesthesiology and the OR is just rotten, in many places. That's the truth. Please show me another (developed) country where anesthesiologists push stretchers. In many countries, we don't empty Foleys, move patients, and generally do stuff that NURSES are supposed do.

So, yeah, we are reaping what we have been sowing for decades.

But who cares as long as we are making bank?
Isn’t that the sentiment with plenty of anesthesiologists? So brainwashed by the money that they don’t care how they are treated.

 

[BIGphysician]

If you supervise, you don’t have to do any of that “nursing” crap

PS: I also liked when people would ask my opinion as an ICU fellow

I’ve been mostly supervising but I have no problem moving patients and all that “nursing crap” if it gets everyone out the door 30 minutes sooner for the day.


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[BIGphysician]

But who cares as long as we are making bank?
Isn’t that the sentiment with plenty of anesthesiologists? So brainwashed by the money that they don’t care how they are treated.

Probably some level of truth to that


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