Place for Anesthesiology CCM doc?

[timtye78]

Where do these people fit in? At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

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[militarymd]

Where do these people fit in? At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

OK.....don't do CCM....just be a tube jockey....and compete with the CRNAs for jobs in the next decade.

 

[cchoukal]

I recently attended the conference of the american society of critical care anesthesiologists and met anesthesia intensivists from all over the country and from europe. There are certainly fewer of them (1500 or so) than their surgical and medical counterparts, but they were working in all settings including medical, pediatric, and all manner of surgical ICUs. I even met one (the president of the organization) who is in a private practice which has among them 8 anesthesiologists that staff their hospital's ICUs.

The anesthesiologists I met worked as consultants at times (in the OP's words, "second to" the primary services), and as attendings in closed units at other times. Many of them are actively engaged in research running the gamut from basic/bench science to clinical/outcomes. In general, they were huge nerds, which I guess is what you'd expect. There was some talk of changing reimbursement patterns and likely future increases in the midlevelprovider-to-anesthesiologist ratios. There were a number of private conversations about the wisdom of allowing EM-trained residents into anesthesiology CC fellowships in order to fill the available spots. That's a whole other issue, but it was interesting to hear such divergent opinions among the group's leadership.

So, anyway, that's the place of the anesthesia intensivist. So, do what you love.

 

[militarymd]

Jerry Maccioli?

 

[cchoukal]

The very same.

 

[markneil]

greetings,

so if one is an anesthesiologist and did a fellowship in ccm, does he/she rotate between the OR and ICU or does one have to pick between the two? are there practices out there that do that/will do that in the future? i've read the posts that mention that anesthesiologists being the "head" of the ICU, so does that mean that he is still doing OR work or he's an intensivist exclusively?

 

[markneil]

and yes, i did read cchoukal's post but are those that are attendings in the ICU still work in the OR as anesthesiologists?

 

[militarymd]

The very same.

He is one impressive dude. I met him in 2000 I think...got his card...he told me to give him a call, but the pace of his practice intimidated me.

and yes, he does OR cases.

 

[cchoukal]

All of the intensivists I met also worked in the OR. Many did a week in the unit per month. The rest of the month was typically OR, research, non clinical time.

As for Dr. Maccioli, he and I were paired up as mentor/mentee. Really nice guy. It was a great opportunity to bend his ear all day. I will definitely be calling him.

 

[placebo_B12]

There were a number of private conversations about the wisdom of allowing EM-trained residents into anesthesiology CC fellowships in order to fill the available spots. That's a whole other issue, but it was interesting to hear such divergent opinions among the group's leadership.

What seemed to be the consensus on allowing EM residents to apply and fill anesthesiology CC fellowship positions? Are most anesthesiologists opposed to this idea or open to it? Will there likely be a change in the future?

 

[markneil]

All of the intensivists I met also worked in the OR. Many did a week in the unit per month. The rest of the month was typically OR, research, non clinical time.

i can't imagine a more perfect thing...

 

[cchoukal]

What seemed to be the consensus on allowing EM residents to apply and fill anesthesiology CC fellowship positions? Are most anesthesiologists opposed to this idea or open to it? Will there likely be a change in the future?

Honestly, no consensus. Some really in favor, some really opposed. I don't think the group has any official stance or plan.

 

[bullard]

The pace? How big is his ICU?

He is one impressive dude. I met him in 2000 I think...got his card...he told me to give him a call, but the pace of his practice intimidated me.

and yes, he does OR cases.