I had to read the title of this post several times to figure out what it meant. Maybe you did too. Check this out. What you will see is a conversation between an anesthesiologist and a confused patient and his wife. Quite simply, these people were confused because they believed that only CRNA’s/nurse anesthetists gave anesthesia. The idea of a “doctor” giving anesthesia was apparently totally new to them.
So what caused this confusion? The posting physician wonders if sex bias was the cause. Or maybe both the anesthesiologists and the anesthetists who had cared for the patient previously had introduced themselves by their first names, muddying the waters. Based on a recent personal experience, I think that the answer is more fundamental.
So here I was, a week or so ago, at the Surgicenter on Hilton Head Island. Like the patient described here, I was in for an outpatient endoscopy. In pre-op, the anesthesiologist stopped by my cubicle, asked me the usual trick questions like “What did I have for breakfast that morning?” (I gave the correct answer… Nothing!), etc. He introduced me to a young lady who, he said, would be “My anesthetist.” All good.
As my gurney got pushed into the endoscopy suite, both the anesthesiologist and the CRNA were in the room. A quick discussion between my gastroenterologist and the anesthesiologist came to the bottom line of the latter saying “I’m going to do this one.” The MD rather than the CRNA. He then told me he was going to administer the propofol, and off I went to lala land with no opportunity to inquire as to why he had stepped in for the CRNA in my case.
Bottom Line. Given the verbal exchanges described above, it is little wonder that the average patient could be confused about the roles of the anesthesiologist and the CRNA. Who does what? When? Why?
Interestingly, the piece concludes with the perspective that it is really important for anesthesiologists to “promote their brand” as effectively as CRNA’s do. Make sure to introduce themselves as “doctor.” Explain that they will be “supervising” the CRNA.
The benefit of this communication? Letting the patient know that he has not one but two people involved in administering his anesthesia and in monitoring other vital functions. Such clarity, I would argue, would be far preferable to the situation in which I found myself last week, with my last waking thought being “Why the last-minute crew change?”
In brief, while the author seems to believe that this discussion is about respect, I believe it is more fundamentally about patient confidence.