UNDER APPRECIATED ANESTHESIOLOGIST

Dr. Ali H. Ahmad

KBA R5

The scope

The scope

Patient

Doctors

Specialty

Most anesthesiologist feels that they are under appreciated ,when you ask either a surgeon or the patient they will say :

“ anesthesia is the MOST important thing in the show “

Yet the patient does not recall the name of his anesthesiologist or even thank him as he would do for the surgeon.

“ I often get frustrated when patients attribute to their surgeons more concern for their overall medical well-being and perioperative safety than I have observed”

Notes of an anesthesiologist

Patient

Most of the time wearing surgical scrubs with out name tag or specialty

The first encounter just at the OR prior to surgery.

In recovery patient disoriented and does not recall events due to drugs .

Usually no post operative follow up by the same doctor .

Less contact between the anesthesiologist and the patient

Specialty

Patient approaching other services as primary

Anesthesia considered essential secondary service ( except in acute pain management )

The social trauma caused by misbelieve that anesthesia is the cause of failed surgery create a barrier ether due to pervious history or media.

Misbelieve of having Limited procedures and routine medication administration

Implication :

Less recruitment in to anesthesia practice. Less mural. Less self steam. Less control. Easy fatigue. Depression.

How my patient see me

How some surgeon see me

What is the problem with other collogue ?

Under estimation of the specialty in real life.

Interfering with clinical dissections . Use of inappropriate words . Any sour surgery, anesthesia will be

blamed

Words

Drug dealers. Sleep doctor. Give your milk quickly . Su du cu guys . Put him to sleep and read your news paper You are delaying us . You know nothing you are anesthetist ! You just put the tube . Death squad

Implication of anesthesiologist surgeon conflict .

Indirect costs include negative publicity and media coverage, decreased morale, increased disability and worker’s compensation claims, increased turnover, and diversion of limited and valuable resources to dispute resolution, including legal remedies .

direct consequences of inadequate conflict resolution is an impediment to communication between the involved parties.

If uninterrupted, such behavior fosters an unhealthy and dysfunctional work environment.

Conflict and its resolution in the operating room

Jonathan D. Katz MD (Clinical Professor)*

Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06511, USA

Received 7 December 2005; revised 12 July 2006; accepted 25 July 2006

Survey from Kuwait

34 doctors Anonymous questionnaire Different back grounds .

Experience

1-5 years6-10 yearsabove 10

How many times did you have been insulted by other collage ?

0

1 to 5

6 to 10

more than 10

0 5 10 15 20 25

How many times had you been insulted by other collage ?

21%

68%

3%9%

01 to 5 6 to 10more than 10

How many times you felt under appreciated because you are anesthesiologist

0

1 to 5

6 to 10

more than 10

0 2 4 6 8 10 12 14 16 18 20

How many times you felt under appreciated because you are anesthesiologist

018%

1 to 553%

6 to 109%

more than 10

21%

Differential diagnosis

no respect not famelier with anes-

thesia

differnet clincal

prospective

no support power

yes 9 27 17 17

no 25 7 17 17

5%15%25%35%45%55%65%75%85%95%

Axis Title

80%

25%

50%

50%

Incorrect, inadequate, or poorly communicated information is a frequent source of misunderstanding among OR personnel.

work discruption

disciplinant comity

authority backup

conoined work shop

5% 15%25%35%45%55%65%75%85%95%

work dis-cruption

disci-plinant comity

authority backup

conoined work shop

yes 26 16 13 26

no 8 18 21 8

75 %

45 %

75 %

40 %

If hell brake through

1. Communicate.2. Have mutual respect. 3. Explain potential issues. 4. Get to know each other. 5. Don't forget the goal.6.Call the cavalry !

At the end ….

You may deal with disruptive behavior .(1) threatening or abusive language.(2) degrading or demeaning comment.(3) profanity or other grossly offensive language.(4) threatening or intimidating physical contact.

public derogatory comments about quality of care.

(5) inappropriate entries into medical records .(6) idiosyncratic requirements imposed on staff

that are unrelated to improved patient care .

Our reality

The bestThe eliteThe life guard Most focused When all others fail we stand up

They need you

Thanks

“My profession to me is a ministry from God.”

Dr. Crawford Long, M.D., the physician who discovered sulfuric ether as an

anesthetic