Friday, July 31, 2020

What Anesthesiologists Hate

Recently there was a Twitter post by an emergency medicine physician who asked what it is that each medical specialty hates the most. This quickly went viral as doctors started piling on. That got me thinking. What do anesthesiologists hate the most? Well it didn’t take long before I had a fairly long list. Not surprisingly many of them relate to surgeons. But I dislike many things I have to deal with every day that can ruin my usual sunny disposition. Here are some of the items I came up with, in no particular order.

1. Surgeons who tell me how to do my job. I’ve written before that this is one of my biggest pet peeves. I don’t even like telling other anesthesiologists how to give anesthesia. What makes a surgeon think he can tell me how to do something he has no training or competence in?

2. Surgeons who lie. If you’re going to be late, then just own up to it. Don’t tell the OR you’ll be here in five minutes or you’re just parking your car then show up 45 minutes later. We can handle the truth. Stop acting like a lying three year old. 

3. Being called anesthesia. We have names. Surgeons get the courtesy of being called Dr. So and So. Why can’t the staff extend the professional courtesy to us too? If you don’t remember our names you can always ask or just address us as Doctor, which we are.

4. Taking calls. This is probably something all doctors hate. That’s why we’ve had colleagues who leave our group to work at surgery centers where there are no night calls, even if there is less job stability and you’re working at the whim of the surgeon.

5. Morbidly obese patients. If I had to choose between a patient who is 97 years old or a patient who is 500 pounds, I’d choose the 97 year old each time. A morbidly obese patient just makes everything more difficult and dangerous. It’s not just the airway that is problematic. Blood pressure and ECG monitors don’t work as well. IV access can be nearly impossible. Moving the patient becomes a massive team effort. There is potential for greater injury to the staff and the patient. Morbid obesity is the bane of healthcare and this nation.

6. ASA 4 or greater. Another reason why anesthesiologists flee to the surgery centers. Nobody wants to deal with an ASA 4 patient who comes to the OR in septic shock with a heart rate of 125 and hemoglobin of 7 with a single 22 gauge IV in one hand. And when you flush it, it blows. 

7. Patients who tell me where to start their IV’s. Most of the time it is helpful when patients tell me where they’ve had the most success in getting IV’s placed. But if all I see is one single vein that looks like it might not blow up after I poke it, don’t tell me that spot hurts and you always tell people not to start the IV there. You’d rather I poke you five times trying to find a vein then a single stick in one that is most readily accessible?

8. Colleagues who leave a mess of the anesthesia workspace. I can feel my frustration rising when I come in to work in the morning and the anesthesiologist from the previous night has left a complete mess on the anesthesia cart and anesthesia machine. Half filled syringes lie everywhere. Used drug vials are scattered on every surface. The cleaning crew are taught not to touch any anesthesia equipment so the mess stays until somebody decides to throw everything out. Please clean up after yourselves people when you leave the room. Show some courtesy to your fellow anesthesiologist.

9. Doctors who think we’re “just” anesthesia as if we’re not real physicians. It’s amazing how prevalent this attitude is. I’ve questioned specialists about their consultation note on a patient and they talk down to me like I have no business asking them since I’m “just” anesthesia. Like I have no clue about cardiac or pulmonary or renal physiology. 

10. Getting rushed by the OR. Why is it the anesthesiologist is called to come see a patient in preop ASAP but the surgeon can walk in 30 minutes late for a case and nobody dares utter a peep? Even the patient, who is complaining loudly to everybody within earshot about how his case is delayed will greet his surgeon with all smiles. This inequality in treatment always astonishes and frustrates me. 

This is just a quick list I jotted down. It is by no means comprehensive. There are a lot more if I wanted to bore you with the details. But suffice it to say the one redeeming factor that makes this job worthwhile is because anesthesiology is one of the best jobs in the country.

No comments:

Post a Comment