Circulation 37,100 • Volume 19, No. 2 • Summer 2004   Issue PDF

Surgeon Patient Suffers Poor Quality Care – Advocates for Professionalism

To the Editor

I would like to relate an experience I recently had at what is felt to be the premier hospital in our region. I am a surgeon at another institution and had a major elective procedure performed that was not available at my hospital. I participated in the usual preoperative screening and reported at 5:30 a.m. for my planned 7:30 case.

While in the holding area, a man pulled my chart, and on questioning, stated he was an anesthesiologist. He did not ask any questions, nor did he examine me in any way. After replacing my chart, he wandered off. A middle-aged woman next pulled my chart, and on questioning replied to me she was a nurse anesthetist. She asked no questions, neither did she check my airway or examine me in any way.

A few minutes later, the anesthesiologist came back with Versed and administered 1 mg (I asked). I have no memory lapse for that time period. Several minutes later, the crew came to take me into the OR. A completely new young man stated, as he pushed something else in my IV, that he was the student nurse anaesthetist. From that moment on, I have no recall of events until PACU.

I am a physician, and even as such, to this day I have no idea who actually administered my anesthetic, nor what was done. I am grateful there were no complications, as no one questioned nor examined me, much less informed me of the plan, options, or risks.

I feel this is an example of bad care and dangerous medicine. If anesthesia providers want to function as simply a machine that performs a task, they should expect to be treated, and reimbursed as such.

As a surgeon, I consider my anesthesia providers partners in the care of the patient. I am present for the induction and wake-up of my patients, and feel I can speak with some authority on the subject. I could not and would not take patients to an institution where what I experienced was thought to be an acceptable standard of care.

Name withheld by request.

The Editor of the APSF Newsletter invites readers’ comments on this letter and this physician’s experience.