Monday, May 4, 2015

Anaesthesiology 101?

By Pascal Dennis

‘Hierarchy, Intimidation, Outright Abuse’

Is this part of Anaesthesiology 101? According to a just-published Canadian study, it’s standard fare for anaesthesiologists in training.

The paper is based on interviews with 49 young resident at a couple of major Canadian hospitals.

Are these hospitals freakish outliers? Or does the study reflect a broader culture of shame and blame? If so, are Surgeries especially prone?

I must declare a bias. My team and I are lucky enough to work with fine hospitals in which such behavior is unthinkable. But we have the privilege of choosing who we work with.

The authors have done a great service. Hopefully, the study will trigger much-needed soul-searching, and more importantly, better checking.

To wit, at present surgery is a black box.

Here’s a binary question I’ve asked a number of senior surgeons:

How do you know a surgery is Okay or Not Okay?

And its corollary: What are the end-of-pipe and process measures that help to answer the question?

So far, nobody has been able to provide a satisfactory answer.

More to come.

Best regards,


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