While the surgeon only focuses on one specific part of the patient’s anatomy, it is the responsibility of the anesthesia provider to ensure that the patient has a safe and comfortable surgical experience. The reality is that anesthesia providers are more responsible for the patient’s overall experience than the surgeon. To this end, anesthesia providers take advantage of state-of-the-art monitoring technology, a powerful and evolving clinical pharmacology and ASA clinical standards and training resources to achieve such consistent results. Successful anesthesia practices are always vigilant in the investigation of unpredictable outcomes. They love to explain to their patients that getting to the hospital for a surgical procedure is riskier than undergoing general anesthesia.
No hospital O.R. suite can be run without consistent anesthesia care. Every provider is responsible for the health and welfare of each and every patient. As new techniques become available, providers must assume responsibility for their mastery. To this end, the various training programs provided by national and state anesthesia societies are a mandatory requirement of ongoing certification.
Because patients often experience a degree of anxiety about undergoing general anesthesia, it is essential that providers are effective communicators. The anesthesia provider must understand and appreciate patient concerns so that the patient is comfortable and has a positive experience. Obviously, the use of amnestic agents is useful, but the overall interaction with the patient must be positive. Anesthesia is, therefore, the quintessential service specialty, and providers must be constantly supporting the requirements and objectives of not only the surgeons but the administration.
Medicine Is a Science
It has often been said that anesthesia providers have the shortest decision cycle of any medical provider. The timely and reliable data provided by clinical monitoring allows providers to make clinical decisions in a matter of seconds. Even the administration of an uncomplicated anesthetic involves the use of a cocktail of agents intended to ensure “the three As”: amnesia, analgesia and absence of motion. It is the role of the anesthesia provider to ensure that the patient has no adverse reaction to the trauma of surgery. In other words, it is the responsibility of the provider to anticipate any potential complications and be able to resolve them. This is why it is often said that the anesthesia provider is often the most important provider in the operating room.
Anesthesia providers are also very well-trained diagnostic technicians whose understanding of human anatomy is extensive. While surgeons are specialized and may only focus on one organ or body system anesthesia providers must be prepared to address the needs of any patient undergoing any type of surgery. Many critical advances in medicine have often been the result of advances in anesthesia. A good example is cardiovascular surgery, which has benefited by the development of arterial lines, central venous pressure lines, Swan-Ganz catheters and transesophageal echocardiography. Also, the safety and comfort of orthopedic surgery has been greatly enhanced by the use of nerve blocks. In other words, anesthesia and surgery have always had a very symbiotic relationship.
Healthcare Is a Business
The reality of today’s medicine is that providing excellent clinical care is no longer sufficient to ensure the success of the practice. As medicine has evolved over the past few decades, anesthesia services have become a commodity that can be bought and sold based on a number of market factors. Quality is a given. As is true of any service, it is all about how the service is packaged. It is no longer about the individual; it is all about the total group practice. Hospital administrators contract with a team based on a wish list of services. Individual providers are hired to contribute to the team.
The business of healthcare has become very competitive. While anesthesia used to be distinguished by the individualism of its providers, it is now distinguished by the consistency of the services provided by the practice as a whole. Customer service is the key to success. What happens in the O.R. is now a given because what really matters is what happens outside the O.R. Individual anesthesia providers may play a significant role by virtue of their specific training and focus; but, like the players on a winning team, their value is based on how they collaborate and contribute to the success of the facilities they serve.
For many, this is a paradigm shift for which they were not really trained—which probably explains why so many are signing up for MBA programs. This also explains why the ASA Practice Management Programs have become so popular. It is not enough to monitor and manage the status of the patient; one must now be constantly monitoring the status of the practice. While the goal used to be what made good patient outcomes, now the goal is what makes the practice a valuable partner to administration.
It was always easier to just show up in the morning, perform a lineup of cases and check out at the end of the day. Giving anesthesia is not what it used to be. The goal of your providers used to be finding a good practice in a nice community where one could settle in for a long career. Anesthesia providers now change jobs more than at any time in the past as they try to find a practice where the economics support their personal goals.