Friday, November 2, 2007


It is nice to know that somebody actually reads my blog as I got an email last month regarding my posts regarding The emailer expressed some disbelief that an anaesthesiologist would even be rated on such a site as nobody really knows who their anaes is.

That is quite correct and in fact the posts of RateMds relate to my work in the chronic pain field.

Anaesthesiologists are two-faced about the anonomity that comes with the profession. On the one hand, the lack of sustained patient contact is a significant factor in drawing many of us to the specialty. At the same time we resent the lack of recognition we get for the miracles we daily perform in the OR, we get really upset when nurses on the floor announce "anaesthesia is here" rather than Dr. BH is here, when we read about the latest surgical miracle in the hospital which mentions every member of the team except the anaesthesiologist etc etc we get really pissed off.

When I was a GP in small towns, you were very visible and people got to know you after a while. You were occasionally stopped on the street and asked for advice. On the other hand, you couldn't throw temper tantrums about bad service and you had to be very careful about drinking in public.

I always remember how in one small town, I treated a small child for what I felt on examination was a URTI, so I prescribed the usual nostrums. The child did not get better as most URTIs don't in the short term so the mother took the child to another doctor who informed her ( as doctors unfortunately do), "this is is the worst case of pneumonia I've ever seen and this antibiotic will cure it". So the child was sent home on antibiotics and got better as most URTIs eventually do. I will not even discount the possibility that the URTI may have developed into pneumonia.

At any rate, I obviously never learned of this developement until a couple of days later I was eating lunch with my wife in a somewhat cozy restaurant and heard the entire story from the next table complete with a description of how stupid the new doctor was. The lady then got up, saw me and turned beet red.

When I went into anaesthesia somebody told me that it was a good idea to make post-operative rounds on your patients. I actually tried that. One day I located all the patients I had done the day before which involved phoning admitting to find their locations and tried to visit them. This was in addition to the number of pre-operative visits I had to do in those days before same day surgery. I went into each patient's room introduced myself as Dr. BH who had put them to sleep the day before and "how are things going". And I got a lot of blank "who the hell are you" stares. Needless to say I have never made post-op rounds since.

Anyway our licensing body a few years ago decided that we needed our competency and other issues examined. Therefore presumable at great expense (using our dues) a program of assessing our fitness as physicians was initiated. So about two-three years ago I received in the mail a number of surveys about my abilities and personality as a physician. I was supposed to name 10 other physicians to evaluate me as well as 10 non-physicians. I must say I had a little trouble finding 10 surgeons who weren't pissed off at me but I did find 10 names. The 10 non-physicians (nurses) was a little more difficult but I found 10 names.

What was really difficult was that I was given 30 questionnaires that I was supposed to give to patients. I had about a month to do this. Now at the time I was working at the centre of excellence and typically did about one long case a day usually on a patient having some type of horrendoplasty. I thought to my self, these patients are not about to be able to complete a questionnaire about my bedside manner plus I don't do thirty cases in a month. Now at that time I worked 1-2 days a month at a community hospital doing day surgery. So I phoned up the survey company and explained my dilemma. After some negotiation, I was given extra time and over 2 months I was able to get rid of the 30 questionnaires.

Not a single one was returned!

As one of my non-physicians I named on the orderlies that I had befriended. One day, he pulled me out of the hall and said "Hey are you in trouble, I just got this questionnaire about you". I assured him I wasn't in trouble yet.

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