Third, the infrastructure of the traditional anesthesiology practice paradigms appears to be cracking, not at the national or state levels but in the local communities. Even though we know our profession is essential and that our supply is relatively diminishing, our daily practices change with every new piece of legislation or malpractice lawsuit making us perpetually dysphoric. In the next three to five years, we should have the last laugh, if this dismantling of health care were, indeed, a laughing matter. Our need for physician anesthesiologists and even nonphysician anesthesia personnel will intensify since there is no indication that surgery will lessen markedly. For those who have lived through previous anesthesia personnel shortages, however, laughter is not the prevailing emotion.
Days can be long, relief scarce, on-calls frequent and vacations limited.
It is now time to recruit new physicians, participate in local, state and national societal activities and forecast what changes need to be made in our current practice modes. For those anesthesiologists engaged in pain management, critical care or office-based anesthesia, resist the temptation of canceling memberships to traditional anesthesiology societies. Look closely at the politics and composition of your smaller specialty societies that ostensibly represent your practice interest better than ASA or your state society. In my experience, when the chips are down, physicians flock to their primary specialty for strength and influence in policy-making decisions. Otherwise, you may find that your interests are not of the majority opinion but those of a neurologist, psychologist or surgeon.