Wednesday, August 20, 2014

A Surgeon's Arrogance In Black And White

Why do anesthesiologists despise some surgeons in the hospital? Because they can be the cockiest SOB's you've ever met. While many will try to attempt at being civilized in our presence, we never know what they are saying about us and our profession behind your back.

Take for instance this blog post from Anesthesia Business Consultants titled, "What The Surgeon Wants From The Anesthesiologists and Nurse Anesthetist." It contains some of the most condescending attitudes I have ever come across on the written page. Tony Mira, and author of the post and President and CEO of ABC claims these words come from one of his favorite surgeons, an otolaryngologist. It lists by bullet points what this ENT thinks all anesthesia providers should do to better serve their masters, I mean surgeons. The surgeon's quotes are in bold.

1. I would like fast turn-over times; my time is valuable. If there is one chronic complaint that has absolutely no merit is this eternal grumbling by surgeons. They waltz into preop fifteen minutes late and wonder why the patient isn't in the room yet even though they haven't talked to the patient or marked the surgical site as required by all hospitals and surgery centers. At the end of case they leave early so their PA's or NP's can slowly and deliberately finish the closure while they go get a Starbucks. Afterwards everybody is frantically getting the room and patient ready for the next case. This work the surgeon never sees. He only notices that the clock is now thirty minutes later since he left the room and ripe for him to complain about extended turn-over times.

2. Sometimes the anesthesiologist is on the phone with his stockbroker, instead of paying attention to the patient. This is quite alarming. It is alarming to us too when the surgeon is too busy flirting with the scrub tech or arranging for another honorarium with his medical device rep to finish his case in a timely manner.

3. In my humble opinion, sometimes certain individuals are too aggressive; not every patient requires an arterial line, for example. While the surgeon gets to concentrate all his focus on one particular anatomic part, we anesthesiologists are responsible for the rest of the patient. If we feel the patient needs an invasive monitor, that is between us and the patient and none of the surgeon's damn business. Do they think we like to monitor a patient excessively? Those too carry inherent risks that we would rather not face if we don't have to.

4. I would like to be informed if there is a problem with a patient; some anesthesiologists just try to fix things without telling me. As the old saying goes, communication is a two way street. I hate having to discover by a massive suctioning sound that my patient is bleeding out in the operating field because the surgeon just nicked the aorta and nobody has bothered to inform me of the catastrophe.

5. STAY OUT OF MY WAY! We share the airway often and this can be a problem. Yes you can have the airway AFTER I'M FINISHED securing it to ensure the patient survives the operation. Until then just STFU.

6. I would like a non-traumatic intubation please--no bleeding to obscure whatever I need to do. This one really takes the cake. Does this ENT surgeon really believe we enjoy causing trauma to a patient when we intubate? We too want a non-traumatic intubation, 100% of the time if possible. But unfortunately life doesn't give us such easy situations. If there is any trauma it's because the airway was difficult, not because we want to make the surgery any more challenging for you tender-minded ENT's.

If anybody ever asks why anesthesiologists and surgeons sometimes have adversarial relationships, just point him to the attitudes of this one who was willing to put hers in print, albeit anonymously. While most surgeons wouldn't have the temerity to express these thoughts vocally, we can feel their anger and impatience readily in the operating room. For the two doctors in the room to truly have a collegial relationship, both of them have to be willing to check their egos at the door into the OR suite.

1 comment:

  1. Great post! I have been doing this for 15 years and could have wrote this post myself.