who is ultimately in charge in the OR: the anesthesiologist or surgeon?

[Dire Straits]

lately i have become interested in anesthesiology but have heard some negative things from students. one thing i've heard more than once is that if push comes to shove in the OR over a decision about the patient then it is the surgeon who has the final say about what will be done, even if the decision falls under the realm of anesthesia. in other words the surgeon can just pull rank and overrule the anesthesiologist. i'd like to know from anesthesiologists on here if this is really true.

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[2ndyear]

First off, don't believe everything you hear about the field from fellow students. You'll hear the same things I'm sure that I heard when in med school: it's boring, CRNA's are going to rule the world soon, surgeons hate you, you're not a real doctor, etc. None of these are true.

Now for who has the final say in the OR, from what I've seen on several anesthesia rotations as a student and intern, ultimately the decision on if a case should go on is anesthesia. It really is a team effort though. Surgeons don't like bad outcomes for their patients either.

 

[VentdependenT]

lately i have become interested in anesthesiology but have heard some negative things from students. one thing i've heard more than once is that if push comes to shove in the OR over a decision about the patient then it is the surgeon who has the final say about what will be done, even if the decision falls under the realm of anesthesia. in other words the surgeon can just pull rank and overrule the anesthesiologist. i'd like to know from anesthesiologists on here if this is really true.

Absolutely false. If the patient is a high ASA class (a.k.a. really sick with major perioperative risk) then one must find an anesthesiologist willing to proceed with the case. No anesthesiologist = no surgery. That whole risk vs. benefit thing comes into play.

Ideally it is a team effort in the OR with both sides of the curtain communicating for the patients' benefit. There are outliers however, as you may imagine.

 

[Gimlet]

Last night I flipped the channel to "Grey's Anatomy" right in the middle of a scene where a surgeon was bitching out an anesthesiologist in the middle of an operation for not paying attention. The surgeon told the MDA to find another doctor to relieve him and kicked him out of the operating room.

That kind of BS on TV really makes me mad...it just supports incorrect stereotypes the general public has about anesthesiologists.

 

[Leukocyte]

Last night I flipped the channel to "Grey's Anatomy" right in the middle of a scene where a surgeon was bitching out an anesthesiologist in the middle of an operation for not paying attention. The surgeon told the MDA to find another doctor to relieve him and kicked him out of the operating room.

That kind of BS on TV really makes me mad...it just supports incorrect stereotypes the general public has about anesthesiologists.

The surgeons vs anesthesia "war" does exist in the real world, but it is usually "behind closed doors", never that blatant. Now I have heard surgeons yell at CRNAs before, but never MDAs.

The thing that angers me, is that the surgeons ultimately always get what they want, since the anesthesiologists seem to always agree with them almost all the time. Rarely did I witness an anesthesiologist really arguing with a surgeons decision during surgery. Even when they do, they seem to always say, "Hey, if you want me to give him another unit, I will give him another unit, but just to let you know, from an anesthesia stand-point, he is stable and does not need it, but hey, he is your patient too". 😡

 

[Skip Intro]

Even when they do, they seem to always say, "Hey, if you want me to give him another unit, I will give him another unit, but just to let you know, from an anesthesia stand-point, he is stable and does not need it, but hey, he is your patient too". 😡

Yeah, Leuk, that's what happens, but as far as the anesthesiologist goes it's usually code for, "I disagree with what you are suggesting and I'm going to document the hell out of it in case something goes wrong, so if and when the patient has a bad outcome and this goes to court, I'm going to sit up in the witness stand and say, 'I told you so.' So, you better be sure you really want to do this."

Most surgeons understand this and will back down after they think about it more. On the other hand, if an anesthesiologist does this with every single order the surgeon suggests, they are going to fast get a reputation of being a pain in the ass and hard to work with. When an anesthesiologist is a respected, good clinician who has a reputation of raising issues when issues need to be raised, then they are listened to by the surgeon with a high level of respect. That's what this is about: mutual respect. When that is in place, the anesthesiologist is regarded as an equal member of the healthcare team.

Remember, the MDA is not there to fix the problem, but to do their own job of taking care of the patient during the procedure and making sure conditions are ideal for surgery and patient safety. If they are not, then he/she better speak up and say so, or they will be explaining in court why they didn't stop the case.

-Skip

 

[bustbones26]

Last night I flipped the channel to "Grey's Anatomy" right in the middle of a scene where a surgeon was bitching out an anesthesiologist in the middle of an operation for not paying attention. The surgeon told the MDA to find another doctor to relieve him and kicked him out of the operating room.

That kind of BS on TV really makes me mad...it just supports incorrect stereotypes the general public has about anesthesiologists.

I agree, not just anesthesia, these shows give the public a very tainted and untrue view of all medical professionals.

 

[HomerSimpson]

Who is in charge in the OR? The patient is. In otherwords we do what is best for the patient no matter what our egos say. A bit trite I know. Otherwise...

Like a lot of things in medicine, the answer is that it depends. On the situation, on who you talk to, on the issue being delt with. In situations that deal with airway, breathing and circulation anesthesiologists are supposed to be the experts and so their opinion is the one that matters. Most good surgeons will agree with that. The surgeon is in charge of aspects of the case relating to the surery. e.g. Bougie dilator placement in a Nissen. You will have to deal with a lot of alpha type personalities in the OR so get ready to practice your diplomatic skills.

To an outside observer like a student it would seem like the surgeon is the captain of the OR and gives all orders concerning the patient's care. "table up" "what's the pressure" etc. This however is a very common misconception that is observed not only by students but also by the lay public. If something goes terribly wrong in the OR, The anesthesiologist is almost always the one who ends up being in charge. I mean how much does an opthamologist or a plastic surgeon really know about the essentials of patient care like fluid management?

One thing that is true about anesthesia as a specialty is that it is the most unappreciated of specialties yet it is also one of the most essential parts of medicine. If you get a lot of satisfaction by people saying how good of a doc you are then maybe it is not the field for you. I tell all students that.

So who is in charge in the OR? it depends.

 

[HomerSimpson]

Let me tell you about how I deal with a difficult surgeon.

Treat them like you would treat a 5 year old. Surgeons in general are alpha types. They have a sometimes delusional confidence in themselves. Sometimes to the point of being dangerous not often, but it happens. Kind of like a five year old.

If your five year old gets his kicks jumping off a couch then that's fine depending on the type of parent you are. If they start to jump off the roof then you have to stop them.

Surgeons especially in residency get their kicks by ordering people around. Makes them feel important. It is however important to note that this is mostly fluff. If this confidence and fluff gets in the way of patient care then I let them know about it and stop them. Most reasonable surgeons will agree with this. Some won't. In those cases they can find someone else.

By the way if someone yelled at me in the OR challenging my commitment to my patient's care they would have their ass kicked out of my coverage list. Good luck finding an anesthesiologist or even a CRNA in this market who will cover that kind of an dingus. Remember in private practice at least it can go both ways. Behavioral problems are easily corrected when they cannot find anesthesia for their cases.

 

[brains]

Wow! That is really nice to know. It's not suprising to know that surgeons think they're the captain of the ship at all times. 🙄 This info , however, will be very helpful to me later on down the road, so i thank all who have spoken their opinions,stories,etc. 👍

 

[Justin4563]

the only issue that i personally will never compromise is an airway. Everything else pales in comparison. I can usually hack through any circulatory problem and figure it out eventually. I agree with homer treat surgoens like a 5 year old. Would you argue with your 5 year old most things arent worth arguing with surgeons about.. Anesthesiologists have to deal with many people om a daily basis and everyone wants something different from you. If you argue with everyone you come into contact with you are going to be one frustrated person and you will not last long.. Play along.. its not gonna kill you and usually the issue has little to do with patient care. If you feel that it truly bothers you raise the issue with the surgeons nurses etc. other than that let it be. I can tell most people posting on here are in academic settings because in private practice people dont treat each other like **** because they have to live with each other. the surgeons want to come in do their case and go out to another hospital to find another case so they can get paid. They have neither the time nor the willingness, unless they are bipolar which a lot of them are..

 

[Skip Intro]

They have neither the time nor the willingness, unless they are bipolar which a lot of them are..

-Skip

 

[IV Doc]

Last night I flipped the channel to "Grey's Anatomy" right in the middle of a scene where a surgeon was bitching out an anesthesiologist in the middle of an operation for not paying attention. The surgeon told the MDA to find another doctor to relieve him and kicked him out of the operating room.

That kind of BS on TV really makes me mad...it just supports incorrect stereotypes the general public has about anesthesiologists.

Now I think you missed the first half of the show where the anesthesiologist in question was drunk and he was allowed to do the case. So it wasn't that he wasn't paying attention but instead he was passed out. So this is a very different case which deserves bitching out. Now we can resonable complain about an anesthesiologist be portrayed in this way.

 

[jwk]

Now I think you missed the first half of the show where the anesthesiologist in question was drunk and he was allowed to do the case. So it wasn't that he wasn't paying attention but instead he was passed out. So this is a very different case which deserves bitching out. Now we can resonable complain about an anesthesiologist be portrayed in this way.

I was as much irritated by the prominent inclusion of crossword puzzles as a necessary tool for the anesthesiologist. Substance abuse by anesthesia providers is a legitimate problem, but was really out of place in the show since there was no real story line for this outside of this single event. Either way, they did a crappy job by portraying the anesthesia team as an insignificant sidelight to surgery, not as a vital component in the overall process.

 

[MechE]

I was as much irritated by the prominent inclusion of crossword puzzles as a necessary tool for the anesthesiologist.

I saw that too. I thought it was funny.

 

[Leukocyte]

.....portraying the anesthesia team as an insignificant sidelight to surgery, not as a vital component in the overall process.

During my Anesthesia electices, I used to get very frustrated by the surgical patients who used to come to the hospital for their pre-surgery appointment with the anesthesiologist.

Many did not know why they had to come to the hospital before their surgery day, and many thought that they were going to see their surgeon. I remember one patient who entered the examining room with a big smile on her face:

Anes. Resident: Hello, Miss xxx. I am Dr. yyy. How are you today?

Patient: Doctor, I have a question. First, how soon can I go back to work after the surgery?

Anes. Resident: Miss xxx. I am an Anesthesiologist, the doctor who will put you to sleep and will be taking care of you during the surgery. You can ask this question to the surgeon, when you meet with him.

Patient: The big smile on the patient's face is fading away, as she rolls her eyes. Then she says, "sir, could you please make this (meeting) quick? You see, I really have to go and pick up my kids from school, and I am very late.

Me: 😡 😡 😡 ...OK, so get up and leave, B****!!!!

 

[jetproppilot]

During my Anesthesia electices, I used to get very frustrated by the surgical patients who used to come to the hospital for their pre-surgery appointment with the anesthesiologist.

Many did not know why they had to come to the hospital before their surgery day, and many thought that they were going to see their surgeon. I remember one patient who entered the examining room with a big smile on her face:

Anes. Resident: Hello, Miss xxx. I am Dr. yyy. How are you today?

Patient: Doctor, I have a question. First, how soon can I go back to work after the surgery?

Anes. Resident: Miss xxx. I am an Anesthesiologist, the doctor who will put you to sleep and will be taking care of you during the surgery. You can ask this question to the surgeon, when you meet with him.

Patient: The big smile on the patient's face is fading away, as she rolls her eyes. Then she says, "sir, could you please make this (meeting) quick? You see, I really have to go and pick up my kids from school, and I am very late.

Me: 😡 😡 😡 ...OK, so get up and leave, B****!!!!

Yeah, thats frustrating. But you know what? I think its inefficient to see Day Surgery patients days before their surgery. We see all day surg patients when they get to day surg on the day of the surgery. I know, thats shocking when you're used to an academic environment. I know you're saying..."geez! Youre gonna end up cancelling a million cases! Turns out thats not the case. Patients are educated in the day surg clinic by the RN on what meds to take, NPO stuff, blah blah blah. If the RN sees some kind of a problem, she calls us (which is about once a month). Works great.

 

[Skip Intro]

Last night I flipped the channel to "Grey's Anatomy" right in the middle of a scene where a surgeon was bitching out an anesthesiologist in the middle of an operation for not paying attention. The surgeon told the MDA to find another doctor to relieve him and kicked him out of the operating room.

I completely gave up on that show after the first fifteen minutes of the first episode where a brand-spanking new PGY-1 surgical resident - on his first day - was given an appendectomy to do by himself. Not only did he do the cut down, find, and then remove the appendix in about 30 seconds, he then had some bogus complication (which I can't even remember) that, if he'd actually been so gifted as to be able to do a "30-second appy" on his first day, he clearly could've handled without any problem. Next, we find out that the residents are on a 48-hour hospital call... all of them at the same time... at that point, I just decided to turn the program off, instead of getting really annoyed, realizing that it was more misleading Hollywood garbage that was nothing more than a sensationalistic and piss-poor reflection of what actually occurs in a hospital.

If you're going to tune in, I advise doing so - with friends and family around - only to get a good laugh and point out how patently wrong this show gets it.

-Skip

 

[jetproppilot]

The surgeons vs anesthesia "war" does exist in the real world. 😡

Couldnt've said it better myself. I strongly second this statement.

 

[Dire Straits]

thank you for the replies everyone. i can see that if i go into anesthesiology i will need to brush up on my diplomatic skills. a few people have said that things to the effect that an anesthesiologist can refuse to work with a certain surgeon. can surgeons do the same? if so, it could get pretty ugly if for example if it becomes known that a certain anesthesiologist refused to work with a certain surgeon and then the other surgeons say they don't want that anesthesiologist working on their cases. ugly hospital politics and all.

 

[MAC10]

During my Anesthesia electices, I used to get very frustrated by the surgical patients who used to come to the hospital for their pre-surgery appointment with the anesthesiologist.

Many did not know why they had to come to the hospital before their surgery day, and many thought that they were going to see their surgeon. I remember one patient who entered the examining room with a big smile on her face:

Anes. Resident: Hello, Miss xxx. I am Dr. yyy. How are you today?

Patient: Doctor, I have a question. First, how soon can I go back to work after the surgery?

Anes. Resident: Miss xxx. I am an Anesthesiologist, the doctor who will put you to sleep and will be taking care of you during the surgery. You can ask this question to the surgeon, when you meet with him.

Patient: The big smile on the patient's face is fading away, as she rolls her eyes. Then she says, "sir, could you please make this (meeting) quick? You see, I really have to go and pick up my kids from school, and I am very late.

Me: 😡 😡 😡 ...OK, so get up and leave, B****!!!!

LMAO

 

[Dupree]

As the surgeon operates and cures the patient, the gasmonkey brags to the naive 3rd year medical student about how he's the one really "taking care of the patient". This is broken up by the surgeon ordering the anesthesiologist to STFU and push some more gas and tell him the patient's vitals. The anesthesiologist does and goes back to reading his newspaper.

 

[jwk]

As the surgeon operates and cures the patient, the gasmonkey brags to the naive 3rd year medical student about how he's the one really "taking care of the patient". This is broken up by the surgeon ordering the anesthesiologist to STFU and push some more gas and tell him the patient's vitals. The anesthesiologist does and goes back to reading his newspaper.

You forgot - there's also the surgeon right next door who hasn't noticed the 12mm trocar he just placed into the aorta - "nurse, clean off the end of this laparoscope, will ya? I can't see a thing...".

 

[jetproppilot]

As the surgeon operates and cures the patient, the gasmonkey brags to the naive 3rd year medical student about how he's the one really "taking care of the patient". This is broken up by the surgeon ordering the anesthesiologist to STFU and push some more gas and tell him the patient's vitals. The anesthesiologist does and goes back to reading his newspaper.

HEY VENT! HEY VENT! 😳 😳 😳 😳 😳 😳 😳
I JUST PUT UP YOUR DESIGNATED TROLL SIGN!!!!!!!!

 

[Dupree]

"Sometimes it's hard to tell the difference between the patient and the anesthesiologist in the OR, with both of them being asleep during the procedure and all."
-a surgeon during my rotation

 

[VentdependenT]

HEY VENT! HEY VENT! 😳 😳 😳 😳 😳 😳 😳
I JUST PUT UP YOUR DESIGNATED TROLL SIGN!!!!!!!!

ROFL.

We got one here folks!! Looks like a fat bottom feeder! Gonna have to reel this offal in and use it fer chum! 😍

 

[jetproppilot]

"Sometimes it's hard to tell the difference between the patient and the anesthesiologist in the OR, with both of them being asleep during the procedure and all."
-a surgeon during my rotation

Hi, I'm Bill Jet with the FBI. I understand you have a troll invading your site.

From my extensive experience profiling Site Trolls, and from the individual's posts, I can tell you he is male, short in stature, probably 5'5" or less, weight 130 lbs or less, has had multiple rejections from women, plays video games incessantly in his spare time, has a recurrent urge to act egotistical, albeit in a clandestine fashion. He is an intellect, but a loner. He lives in an on-campus dorm and drives a 1978 Ford Pinto, probably white with beige interior with obvious rust. He eats TV dinners most nights by himself, and never misses American Idol, Scrubs, ER, and Stacked with Pamela Anderson. He showers twice a week whether he needs it or not, and is the ultimate kiss-ass to upper levels and staff on rounds.
He bought a lab-coat during his sophomore year in college, and had it brazened GERN BLANSTON MD
General Surgery
, frequently parading around local Shop n Gos in impersonation.

I'll put out an APB to all Shop n Gos, and notify federal authorities to be on the lookout for the described Pinto.

 

[VentdependenT]

Jet you are killen me man!

This kid hasn't even taken step I yet and already he is starting in with the jive talking.

 

[Kim B]

Hi, I'm Bill Jet with the FBI. I understand you have a troll invading your site.

From my extensive experience profiling Site Trolls, and from the individual's posts, I can tell you he is male, short in stature, probably 5'5" or less, weight 130 lbs or less, has had multiple rejections from women, plays video games incessantly in his spare time, has a recurrent urge to act egotistical, albeit in a clandestine fashion. He is an intellect, but a loner. He lives in an on-campus dorm and drives a 1978 Ford Pinto, probably white with beige interior with obvious rust. He eats TV dinners most nights by himself, and never misses American Idol, Scrubs, ER, and Stacked with Pamela Anderson. He showers twice a week whether he needs it or not, and is the ultimate kiss-ass to upper levels and staff on rounds.
He bought a lab-coat during his sophomore year in college, and had it brazened GERN BLANSTON MD
General Surgery
, frequently parading around local Shop n Gos in impersonation.

I'll put out an APB to all Shop n Gos, and notify federal authorities to be on the lookout for the described Pinto.

Geeeezzz. That was harsh.... But since Jet started it, I'd like to add my $0.02.

1) Got in line three days before the premier of Star Wars: Revenge of the Sith to see the midnight showing while wearing his "Sith Happens" T-shirt.
2) Doesn't have any loans or debt b/c life has been spoon fed
3) the troll's idea of going out is going to Starbucks on a Saturday night to study
4) derives self-esteem from the initials behind his name
5) Tells all the ladies he is a pediatric cardiac surgeon or pediatric neurosurgeon (in training), but in reality has not even started clinical rotations

Vent, please do not close this thread! Maybe you could even make it sticky for a week or two?

 

[coccygodynia]

1) Got in line three days before the premier of Star Wars: Revenge of the Sith to see the midnight showing while wearing his "Sith Happens" T-shirt ...

Hilarious! That can't be a real shirt ...

 

[Goose...Fraba]

Geeeezzz. That was harsh.... But since Jet started it, I'd like to add my $0.02.

1) Got in line three days before the premier of Star Wars: Revenge of the Sith to see the midnight showing while wearing his "Sith Happens" T-shirt.
2) Doesn't have any loans or debt b/c life has been spoon fed
3) the troll's idea of going out is going to Starbucks on a Saturday night to study
4) derives self-esteem from the initials behind his name
5) Tells all the ladies he is a pediatric cardiac surgeon or pediatric neurosurgeon (in training), but in reality has not even started clinical rotations

Vent, please do not close this thread! Maybe you could even make it sticky for a week or two?

LMFHO!!!!

and he probably has a blow up doll under his bed (aka his hot date) what a freakin tool, I used to eat pieces of s*** like you for breakfast...... (you eat pieces of s*** for breakfast?).....na...no..(runs away) (quote from the greatest movie made, if you dont know what it is your a tool too!) Jetprop man your the funniest freakin poster keep it up!
goose

 

[coccygodynia]

LMFHO!!!!

and he probably has a blow up doll under his bed (aka his hot date) what a freakin tool, I used to eat pieces of s*** like you for breakfast...... (you eat pieces of s*** for breakfast?).....na...no..(runs away) (quote from the greatest movie made, if you dont know what it is your a tool too!) Jetprop man your the funniest freakin poster keep it up!
goose

Happy Gilmore???

 

[Goose...Fraba]

Happy Gilmore???

BINGO!!!!!!!!!!!!!!!(your not a tool) 😉

 

[Kim B]

Hilarious! That can't be a real shirt ...

http://www.wackyplanet.com/sihasihat.html

http://www.cafepress.com/cp/browse/..._Ntk-All_D-sith+happens_Nao-1_CMP-KAC-googleh

http://www.cafepress.com/cp/browse/..._Ntk-All_D-sith+happens_Nao-1_CMP-KAC-googleh

http://justjared.blogspot.com/2005/05/hayden-christensen-sith-happens-t.html

http://www.toysrgus.com/index.php?action=disp_item&item_id=53845

 

[coccygodynia]

http://www.wackyplanet.com/sihasihat.html

http://www.cafepress.com/cp/browse/..._Ntk-All_D-sith+happens_Nao-1_CMP-KAC-googleh

http://www.cafepress.com/cp/browse/..._Ntk-All_D-sith+happens_Nao-1_CMP-KAC-googleh

http://justjared.blogspot.com/2005/05/hayden-christensen-sith-happens-t.html

http://www.toysrgus.com/index.php?action=disp_item&item_id=53845

Well I should have known ... here's my favorite t-shirt site:

www.tshirthell.com

It's where all the bad t-shirts go. My favorite one says "I support gay marriage (as long as the chicks are hot)".

 

[VentdependenT]

A little off topic but here's a website mocking those "go get em tiger" achievement posters we see all too frequently.

They make decent screen savers.

http://www.despair.com/humiliation.html

 

[JudoKing01]

My idea of a night out is eating magic mushrooms in my friend's backyard and then staring at the trees for 2 and a half hours while they convey their emotional wisdom upon me.

 

[Celiac Plexus]

though i see the old "who's the boss" question in the anesth. forum every couple of months, i've yet to see it even one time in the surgery forum...

huh.

 

[VentdependenT]

though i see the old "who's the boss" question in the anesth. forum every couple of months, i've yet to see it even one time in the surgery forum...

huh.

Suggesting?

Just keep supplying blood and ANS innervation to my proximal ligament of treitz guts. 😉

 

[Dire Straits]

Suggesting?

celiac plexus may be suggesting that anesthesiologists question whether they are really "in charge" in the OR but surgeons don't need to ask such questions because they know they call the shots. that being said, i think one quality that separates anesthesiologists from surgeons is that anesthesiologists don't mind playing second fiddle in the OR so things run smoothly.

 

[jetproppilot]

celiac plexus may be suggesting that anesthesiologists question whether they are really "in charge" in the OR but surgeons don't need to ask such questions because they know they call the shots. that being said, i think one quality that separates anesthesiologists from surgeons is that anesthesiologists don't mind playing second fiddle in the OR so things run smoothly.

very well said. Hey, I'm not in this medicine gig for my ego. If the surgeon wants to play alpha male, I say go for it, unless the decision impacts the patient. If his/her decision is a deleterioous one to the patient, it won't happen. If it isnt, OK Mr Surgeon, you're the man, we'll do it your way.

Alpha surgeons just pushing their weight around doesnt happen much, folks, but it does happen. And when it does, I just go with the flow, looking for harmony. Let him get his rocks off for an insignificant decision. I could care less.

Seems the only alpha surgeons I know aren't the most deft individuals with sharp instruments. The good ones know our opinion is important, and they don't play the WHOS THE BOSS game. Par for the course. I laugh all the way to the $/lifestyle bank when the alpha surgeon barks at something I, and the patient, could care less about. 👍

 

[VentdependenT]

celiac plexus may be suggesting that anesthesiologists question whether they are really "in charge" in the OR but surgeons don't need to ask such questions because they know they call the shots. that being said, i think one quality that separates anesthesiologists from surgeons is that anesthesiologists don't mind playing second fiddle in the OR so things run smoothly.

I was meerly yanking Celiac's chain.

Anyways, you hit on a very important point. When I was first interested in anesthesia one of my astute attendings exposed this caveat.

She stated that she knew a few people who just shouldn't have gone into this field. Reason being that you are nameless and even faceless (mask, goofy hat, blue outfit, etc..) to pt's and that peers generally don't pat you on the back for doing a good job in the OR. A proclivity for ego stroking will make one disgruntled anesthesiologist.

You have to be a physician first and a facilitator second. Bluntly speaking, anesthesia carries the role of being a behind the scenes character. Dealing with the guts of the OR. Not only making the case run smoothly but also having impressive turn over times. Most of this generally goes unnoticed (as it should I suppose). However, the pay off is in...well....the pay. Least we not forget this.

Just emulate UT or Jetprop and you'll be fine.

 

[Leukocyte]

I think the reason there is this "tension" between surgeons and the Ansthesiologists is because EACH envy the other (on a sub-conscious level).

Surgeon - Envy the Anesthesiologist for his better lifestyle and higher income.

Anesthesiologist - Envy the surgeon for being the one who is "treating" the patient's disease/problem.

I know I will get flammed for this....so flame away. 🙂

 

[Willamette]

I think the reason there is this "tension" between surgeons and the Ansthesiologists is because EACH envy the other (on a sub-conscious level).

Surgeon - Envy the Anesthesiologist for his better lifestyle and higher income.

Anesthesiologist - Envy the surgeon for being the one who is "treating" the patient's disease/problem.

I know I will get flammed for this....so flame away. 🙂

OK. Consider yourself "flammed."

Willamette

 

[Leukocyte]

OK. Consider yourself "flammed."

Willamette

Dam, I was just about to correct the spelling, but you already have my post copied on your post. You are one smart cookie. 😉

 

[powermd]

I think the reason there is this "tension" between surgeons and the Ansthesiologists is because EACH envy the other (on a sub-conscious level).

Surgeon - Envy the Anesthesiologist for his better lifestyle and higher income.

Anesthesiologist - Envy the surgeon for being the one who is "treating" the patient's disease/problem.

I know I will get flammed for this....so flame away. 🙂

Okay dude, you suck.

We are all cogs in the health care system. Whether you are a surgeon, anesthesiologist, or in any other field. We are all expendable. If we don't show up to work one day, the same procedures will get done to the same patients, just by another masked miracle man, sword, scalpal, or syringe of propofol in hand. Like sous chefs, we spend our lives preparing recipes we probably wouldn't have conceived ourselves. The true doctors, for lack of a better term, are the creative risk takers who invented the procedures and drugs we push on patients every day. All we have to offer is our personalities, and our best shot at delivering the 'standard of care' upheld by our fellow medical craftsmen.

 

[jetproppilot]

I think the reason there is this "tension" between surgeons and the Ansthesiologists is because EACH envy the other (on a sub-conscious level).

Surgeon - Envy the Anesthesiologist for his better lifestyle and higher income.

Anesthesiologist - Envy the surgeon for being the one who is "treating" the patient's disease/problem.

I know I will get flammed for this....so flame away. 🙂

I humbly disagree with you. I have no clandestine envy of surgeons. Wouldn't enjoy the work, the clinic time, rounding every day, incessant phone calls, etc. Sorry, just not my type of gig. I'd rather be a Taco Bell manager.

 

[Leukocyte]

Okay dude, you suck.

We are all cogs in the health care system. Whether you are a surgeon, anesthesiologist, or in any other field. We are all expendable. If we don't show up to work one day, the same procedures will get done to the same patients, just by another masked miracle man, sword, scalpal, or syringe of propofol in hand. Like sous chefs, we spend our lives preparing recipes we probably wouldn't have conceived ourselves. The true doctors, for lack of a better term, are the creative risk takers who invented the procedures and drugs we push on patients every day. All we have to offer is our personalities, and our best shot at delivering the 'standard of care' upheld by our fellow medical craftsmen.

I agree with you. There is no "true" doctor, and niether is more important than the other. I am not talking about who is more important.

All I am saying is that, there is no such thing as a PERFECT speciality. Each speciality has its advantages and disadvantages. And since it is human nature to never be satisfied with what we have, we tend to "envy" others who have what we don't.

So in Surgery, they have the opportunity to treat the disease surgically, but do not have the lifestyle nor the salary of Anesthesia. And since it is human nature to "want it all", they "envy" Anesthesia for what they do not have.

The same logic applies to Anesthesia.

People who are mature, with mature ego defence mechanisims (remember psychiatry), do not think often about this. But since it is in our "id" to be jelouse, people (both Surgeons and Anesthesiologists) with less strong ego defenses tend to show their repressed thoughts, and thus result in this "tention" that we sometimes see, and is the point of this thread.

 

[Frank Rizzo]

I humbly disagree with you. I have no clandestine envy of surgeons. Wouldn't enjoy the work, the clinic time, rounding every day, incessant phone calls, etc. Sorry, just not my type of gig. I'd rather be a Taco Bell manager.

MMMMmmmm... all the grilled-stuffed-steak burritos I could eat... Not too bad!

 

[VentdependenT]

All I am saying is that, there is no such thing as a PERFECT speciality. Each speciality has its advantages and disadvantages. And since it is human nature to never be satisfied with what we have, we tend to "envy" others who have what we don't.

So in Surgery, they have the opportunity to treat the disease surgically, but do not have the lifestyle nor the salary of Anesthesia. And since it is human nature to "want it all", they "envy" Anesthesia for what they do not have.

The same logic applies to Anesthesia.

Interesting theoretically however I don't believe this to be the origin of OR tension. Much more simplistically it has to do with spatial proximity and the psychological burdeon which operations place on physicians in the OR. Some folks internalize and just TCB, others flip out. I am the former.

I, and neither do any of my colleagues which I have met so far, do not envy surgeons. I respect them but it ends there.