I'm sitting here looking at my schedule tomorrow. It consists of three short cases scheduled to end by 10:00 AM. And I'm thinking to myself, I can't make my house payments or save for my children's college funds with schedules like this. We anesthesiologists are such whores. Follow me here.
Unless the anesthesiologist works as an employee in a university hospital setting or is employed by an HMO, we are all pretty much fee for service. Get my drift? And just like the world's oldest profession, we are at the beck and call of another person (the surgeon). If the surgeon has no cases that day, then we have no work either. If we arrive late for a case, the surgeon immediately demands another anesthesiologist, as we are all pretty much used the same way by him, just another faceless warm body hired to do the task at hand. If the surgeon is late, well we just have to sit around and wait. If we're lucky and the surgeon likes the "job" we do for him, we might be asked to become his private anesthesiologist, his exclusive.
I've seen some of these anesthesiologists that work in surgery centers for their surgeons. They pretty much kiss ass all the time. They learn to tell frat jokes to amuse their surgeon (surgeons like that). If the surgeon wants to start a case at 6:00 AM, well by gosh the anesthesiologist will be there too, even earlier, no matter if the next case is not until 1:00 PM. These anesthesiologists know who is writing their checks and unless the anesthesiologist owns the surgery center, he is going to pucker up until the day he retires.
Unfortunately that is just the nature of our profession. We anesthesiologists are completely dependent on another physician for our well being (pain doctors being an exception but they don't consider themselves anesthesiologists). I can't think of another specialty where there is this strange one way dependency. Radiologists and pathologists are employees of the medical center and everybody has to use them, whether you like them or not. Emergency physicians take care of whoever walks in through the door. Surgeons and internists rely on each other for referrals, but that doesn't necessarily mean they think highly of each other. We've all seen bad surgeons and internists and they still get referrals all the time. But we accommodate our surgeons in the hope we will get more work, and more income, from them. We can be whoever they want us to be. And that, my friends, is a whore.