Volume 3, No. 3 • Fall 1988

Care Team Vs. Solo The Human Factor

Donald Mundy, M.D.

To the Editor

I have been so delighted to receive your publication and see the development of a scholarly approach to anesthesia patient safety. Each and every study of patient injury that I see elucidates the importance of the human factor in the prevention of anesthesia-related injuries.

I am increasingly concerned that there is developing view point which states that a sole anesthetic practitioner, usually a physician, is the best approach to anesthesia patient care The airlines clearly reject this view, and it is well known that two and sometimes more responsible professionals are in the cockpit of every commercial flight in this country and abroad.

Presently my practice involves the anesthesia team approach to anesthetic care involving an anesthesiologist and CRNA with our practice limited to usually supervising two operating rooms, but on occasion, a third operating room supervised by the same attending anesthesiologist. I have experienced in the last several years numerous occasions when the dictum “two heads were better than one” proved efficacious in patient care. Here were cases in which our nurses or our physicians in a joint effort were able to notice some factor of potential harm and corrected the problem prior to any injury. Our present clinical arrangement allows me to concentrate very carefully on medical work-up of patients, the medical aspect of their care, and without a question in my view, adds to the quality of our anesthetic care.

I would be most interested in your Foundation presenting relevant articles on the important issue of solo anesthesia practice as opposed to team anesthetic practice with a direct emphasis on solving the human factor of anesthetic-related injuries. Please seek responses from some of your knowledgeable colleagues. I hope to see an article or perhaps the results of a study specifically dealing with the human factor when compared between solo practitioners and team practitioners.

Donald Mundy, M.D.

Burlington, North Carolina