Monday, July 25, 2011

Anesthesia's "Easy" Reputation

If there is one thing anesthesiologists vehemently dispute, it is the reputation that anesthesia is a lifestyle choice--that working in anesthesia is "easy". I don't know when or why our specialty got this stigma, but anyone who actually administers anesthesia knows it is not true.

I'll always remember one particular candidate for our anesthesiology residency we interviewed while I was still a resident. He was an older applicant, switching over from Family Practice. He seemed real nice and intelligent. We asked him why he wanted to go into anesthesiology. Since we were just residents in the room, he must have felt he could speak frankly to us. He said that he had back pains from running around a busy office all day and thought anesthesiology would be much more relaxing and less stressful. He thought he wouldn't have to be on his feet as much. Stunned by his ill-informed opinion of what anesthesiology was about, we strenuously corrected his mistaken ideas of the work of anesthesiologists. We promptly reported this guy's attitude to our attendings. He didn't get a spot.

I can think of many medical fields that should have a reputation for being easy but usually aren't. How about Pathology? No live patient complaining about pain or nausea and vomiting in the middle of the night. No emergencies to attend to at 2:00 AM. Perhaps diagnostic Radiology could entice medical students who want an "easy" job. Sure you take calls in Radiology. But with the ubiquity of digital imaging, many radiologists now work from home, reviewing images at night from the comfort of their home computer. Plus they are one of the highest paying medical fields out there. Why aren't Hem/Onc or Allergy and Immunology written about in the same envious tone as Anesthesiology? These are fields where the doctors are rarely bothered at night. Yet people don't think about entering them because they are "easy".

For those who think Anesthesiology is a lifestyle field, let me tell you this. Our days are as busy as any surgeon's for the simple reason that surgeons need anesthesiologists in order for them to do their cases. So if a surgeon has a gun shot wound victim at 4:00 AM, the anesthesiologist also has a gun shot wound patient to take care of at 4:00 AM. If an obstetrician has to do a crash C-section for a decompensating fetus in Labor and Delivery, the anesthesiologist also has a crash C-section and sick infant to deal with at the same time. Anesthesiologists have advanced the quality of patient safety to such a degree that our work may look easy to those on the other side of the ether screen. But make no mistake, the patient's life is on the line every time we take a patient to the operating room. We take that responsibility very seriously. We work just as hard as any surgeon, probably because we are there to keep the patient alive when they are in the operating room. Our hours are no different from theirs. Nobody ever says surgeons have easy hours. Anesthesiologists don't either.


  1. We use anesthesiologists for our organ donor cases (the donors don't need anesthesia because they're brain dead, but the anesthesiologists maintain the donors hemodynamics) so I know we irritate them with 0200 cases.

    But we don't let pathology off very easily, either...quite often we call in path for a stat frozen section on these same 0200 cases. It's often amusing to hear their responses when called for such cases.

    Of course, the 2-3 times (in 18 years) I've had to call dermatology off-hours is even more amusing...seems they were given this little black box on the first day, told to keep it on their hip, but it never did anything for the preceding 5 years...

  2. Anesthesia is definitely not easy, and you're right when you say there is always an anesthesia provider for the 0200 cases, but unless you're referring to small rural hospitals where there are only one or two anesthesia providers, anesthesia does usually NOT keep the same hours as surgeons.

    Live in a house with a surgeon for a few years and you'll realize how often they get up and go into the hopsital. They spend weeks on call, whereas, most anesthesiologists and CRNA's I know, spend day/days on call. (unless rural).

    So while the ACT itself of anethesia is most definitely stressful and in no way a cake-walk, the hours the most anesthesiologists/crna's keep are a million times better than the average surgeon. Just my experience.

  3. Since when does Anesthesia have the same hours as surgeons?

  4. I'm an anesthesiologist, and I know plenty of surgeons (not general or trauma surgeons) who work WAY less than I do---no doubt!