1. UNDER APPRECIATED ANESTHESIOLOGIST Dr. Ali H. Ahmad KBA R5

2. The scope

3. Patient Doctors Specialty

4. Most anesthesiologist feels that they are under appreciated,when you ask either a surgeon or the patient they will say : “ anesthesia is the MOST important thing in the show “ Yet the patient does not recall the name of his anesthesiologist or even thank him as he would do for the surgeon.

5. “ I often get frustrated when patients attribute to their surgeons more concern for their overall medical well-being and perioperative safety than I have observed” Notes of an anesthesiologist

6. Patient  Most of the time wearing surgical scrubs with out name tag or specialty  The first encounter just at the OR prior to surgery.  In recovery patient disoriented and does not recall events due to drugs.  Usually no post operative follow up by the same doctor.  Less contact between the anesthesiologist and the patient

7. Specialty  Patient approaching other services as primary  Anesthesia considered essential secondary service ( except in acute pain management )  The social trauma caused by misbelieve that anesthesia is the cause of failed surgery create a barrier ether due to pervious history or media.  Misbelieve of having Limited procedures and routine medication administration

8. Implication :  Less recruitment in to anesthesia practice.  Less mural.  Less self steam.  Less control.  Easy fatigue.  Depression.

9. How my patient see me

10. How some surgeon see me

11. What is the problem with other collogue ?  Under estimation of the specialty in real life.  Interfering with clinical dissections.  Use of inappropriate words.  Any sour surgery, anesthesia will be blamed

12. Words  Drug dealers.  Sleep doctor.  Give your milk quickly.  Su du cu guys.  Put him to sleep and read your news paper  You are delaying us.  You know nothing you are anesthetist !  You just put the tube.  Death squad

13. Implication of anesthesiologist surgeon conflict.  Indirect costs include negative publicity and media coverage, decreased morale, increased disability and worker’s compensation claims, increased turnover, and diversion of limited and valuable resources to dispute resolution, including legal remedies.

14. direct consequences of inadequate conflict resolution is an impediment to communication between the involved parties. If uninterrupted, such behavior fosters an unhealthy and dysfunctional work environment. Conflict and its resolution in the operating room Jonathan D. Katz MD (Clinical Professor)* Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06511, USA Received 7 December 2005; revised 12 July 2006; accepted 25 July 2006

15. Survey from Kuwait  34 doctors  Anonymous questionnaire  Different back grounds.

16. How many times did you have been insulted by other collage ?

17. How many times had you been insulted by other collage ?

18. How many times you felt under appreciated because you are anesthesiologist

20. Differential diagnosis 80 % 25% 50%

21.  Incorrect, inadequate, or poorly communicated information is a frequent source of misunderstanding among OR personnel.

22. 75 % 40 %

23. If hell brake through 1. Communicate. 2. Have mutual respect. 3. Explain potential issues. 4. Get to know each other. 5. Don't forget the goal. 6.Call the cavalry !

24. At the end ….  You may deal with disruptive behavior. (1) threatening or abusive language. (2) degrading or demeaning comment. (3) profanity or other grossly offensive language. (4) threatening or intimidating physical contact. public derogatory comments about quality of care. (5) inappropriate entries into medical records. (6) idiosyncratic requirements imposed on staff that are unrelated to improved patient care.

25. Our reality The best The elite The life guard Most focused When all others fail we stand up

26. They need you

27. Thanks “My profession to me is a ministry from God.” Dr. Crawford Long, M.D., the physician who discovered sulfuric ether as an anesthetic