One of the things I really enjoy about being an anesthesiologist is the wide variety of patients that I see. You never know who you're going to have the privilege to care for on a given day. Although my group is large, I will occasionally be assigned to a patient that I personally know. And occasionally, someone I know will request me as their anesthesiologist.
Last month I took care of a friend who requested me for her surgery. It was a very straightforward case, everything went smoothly, and she expressed abundant gratitude at the end of her experience. I was also asked to do anesthesia by a friend for a surgery that, knowing her history, was going to be fairly complicated. That one gave me pause, but I did it and everything turned out well.
Gizabeth recently wrote about being a doctor to her friend, and I'll bet that some of you have also taken care of friends (or have become friends with some of your patients). I would venture to say that being an anesthesiologist or surgeon to a friend adds an even further layer of complexity because there is an immediate "life and death" aspect to what we do. However, either fortunately or unfortunately, patients don't usually appreciate this.
On the "pro" side, patients can feel a great sense of empowerment in choosing their own anesthesiologist. A good attitude and sense of empowerment going into surgery can translate to less stress on the patient and better overall recovery. During my residency, I had a scary brain surgery. At first, I thought it would be awkward to personally know my surgeon and anesthesiologist, but out of convenience and timeliness, I chose to have the surgery at my own institution. I was able to choose my anesthesiologist - who at the time was one of my supervisors! In the end, I felt great comfort in personally knowing my healthcare team.
On the "con" side, there is a phenomenon in our specialty called VIP syndrome. Taking care of a VIP subconsciously makes people pause and do things slightly differently than they would normally do, rendering the whole process vulnerable to errors. What if your friend suffers an adverse event under your care? And are your decisions objective enough in the situation?
What do you think? Would you and/or do you take care of friends? How about family members? Let us know your experiences with requests for care by friends, acquaintances, or family.
If a case runs across my desk and I know the person, or if I am personally requested, I always show the case to another pathologist. While in residency I saw a seasoned pathologist call a close friend pathologist's breast cancer benign. Luckily everyone argued with him and the case was sent out to an expert and sure enough it was cancer. I think even if we believe we can be objective we shouldn't count on it entirely - at least in pathology. His eye saw what it wanted to see, not what was there.
ReplyDeleteOur VIP system can run smoothly, or it can be a nightmare. Of course no patient is better than another, but if it is a doctor or someone everyone at the hospital knows it can be crazy. My OB who delivered Cecelia, who is now hospital admin, told me he was so relieved the delivery went smoothly (he had to sub for his partner, my ob, bc she was on maternity leave). "You're a doc, your dad's a doc, your husband's a doc - something was bound to get screwed up!" VIP syndrome is real!
Wow. Compelling case for 2nd opinions. And I agree the VIP thing can go both ways! Another experience I've had is doing anesthesia for the 90 year old mother of 2 married hospital bigwigs. Anesthesia definitely can cause cognitive problems in someone that old, and we had a huge discussion about it!
DeleteWhen I was getting surgery, the anesthesiologist walked in and I realized it was someone I had trained as an intern when I was a senior resident. I made a joke about how I hoped I'd done a decent job training her then.....
ReplyDeleteYes! I have one time had a senior partner in my group under my care. It was nerve wracking for me, and I'm sure your former trainee felt that way too.
DeleteI recently recused myself from the care of a Med school classmate who came in to deliver her baby. I told her that she was getting the best resident in the department for her case (which was true). Fortunately the case went smoothly!
ReplyDeleteI can understand why, given what she was there to do - a very intimate time.
ReplyDeleteFor years, my PCP was a friend I had trained when he was in residency. I switched when he stopped taking my insurance and I think we were both relieved. I have been the PCP for people I know socially, but not my closest friends. And I've surprised people who know me only through my husband and didn't realize that the Dr Jay they had an appointment with is the same person married to Sam S.
ReplyDeleteMy father had spinal surgery and he chose my mother's cousin's husband to do it - I couldn't argue him out of it (Dad was also a doc). Cousin was awful to my mother and to my brother and condescending as hell to me. The surgery went fine, but there were post-op complications that I heard about by phone; I was two hours away and couldn't get there until the next day. Cousin never spoke to me directly - he had his PA call me - and when he told my brother Dad would be OK, he never bothered to have anyone tell me that. I went there the next morning expecting to find Dad essentially brain-dead. He was not. I have never, ever, forgiven Cousin. I doubt I ever will.
Wow, that is a powerful story. I'm surprised he chose a family member that you had problems with.
DeleteI am a family physician and do OB. I have a patient who I have now gotten to know socially as part of a moms group I am in. We have been through a lot together and she really wanted me to continue to be her doctor. With her recent pregnancy, she asked me if it was OK that I still be her doctor and I told her I was OK with it if she was. She had her baby a couple weeks ago and everything went fine. I have other people that I know socially who are also patients, but not any really close friends or family. I did see my mom in clinic one time for a URI. she wanted antibiotics, but she didn't need them and I stood my ground. =)
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