Thursday, August 18, 2011

The Most Powerful Person In Anesthesia

Who is the most powerful person in an anesthesiology department? You might guess that it would be the chairman of the department. If you did, then you would be wrong. As a matter of fact, the chair of the department is rarely involved with the nitty gritty of the daily grind that goes on in the operating rooms. He or she is too busy attending hospital committee meetings and hobnobbing with the other departmental chairs to really have an effect on the daily lives of anesthesiologists.

No, the real seat of power in an anesthesiology department is the person who is assigning the daily OR coverage to the other anesthesiologists. The scheduler, usually another anesthesiologist within the group, is the real godfather--he decides the fates of all the anesthesiologists on a day to day basis. If you are on his good graces, life is bliss. You could be placed in a room with the nicest surgeon who is doing three lap choles on healthy well insured patients as your lineup. If you're not, well woe to you. Your schedule for the day may be a single cardioversion scheduled at 2:30 in the afternoon. Or maybe an EGD at 8:00 AM followed by a second EGD at 1:00 PM.

If you're on the scheduler's disfavored list, this mental and fiscal torture could drag on for days, even weeks. You'll start pondering how you're going to pay next month's mortgage since billing a couple of pacemaker placements a day will not be adequate. You'll go through mental anguish as you try to figure out how you got on his bad side. Was it something you said to him at the last departmental meeting? Did he hear through the grapevine what you thought about his leadership qualities? Was it because you didn't invite him to your last barbeque? You'll start pondering about that great surgery center job you heard about a few months ago. You may start composing a resignation letter to the department and stress over explaining why you left without burning any bridges.

This self flagellation continues until one day, you receive your work schedule for the next day and you're working a full day again. In fact, you'll be working for at least fourteen hours the next day but you don't care. Your punishment has ended. The scheduler has brought you out of the ninth circle of hell and let you earn a real doctor's wage again. Hallelujah.

So as you can see, the anesthesia scheduler is rightly the most powerful person in anesthesiology. He can literally make or break your career and personal life. Get on his bad side and anesthesiologists have been known to disappear from a department almost overnight. Stay on his good side and now you can consider that Mercedes CL65 that you've been coveting to grace your circular driveway.

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