Davandra Patel, M.D.
Instructor in Anesthesiology from Manchester
It has almost become a tradition for one or two of the visiting faculty in the department to make a few comments of their experience in the Michigan Airway. So in keeping with this tradition here are my views of the Department of Anesthesiology in Ann Arbor.
The U-M is probably one of the largest and most impressive university hospitals I have ever seen. It's the only hospital that I have ever been in that has an escalator. If I didn't know better I could easily confuse it with a shopping mall. Every room, every corner of the hospital has a Macintosh computer terminal, I'm surprised they don't have one in the toilet (rest room). I suspect one or two of the "Chairs" have shares in Macintosh computers. I wonder if they have any plans to rename the hospital "University of Macintosh Hospital?"
To a more serious note, it appears I have come at a time of great uncertainty and change in the field of medicine. For the first time health workers in the U.S. are having to think about "competing for resources, cost effectiveness, saving money and last but not least jobs!" Having come from a health service where these issues are the norm I almost feel at home. There appears to be a lot of doom and gloom amongst some residents with respect to finding a job, maybe they would like to venture over to the United Kingdom, we are really short of Anesthetists!
Another fascinating issue that seems to dominate the discussions is resident recruitment. I find it almost incomprehensible that so much time, effort and money is spent recruiting residents. Back home it's completely the opposite, trainees would creep and crawl around consultants and anesthesia departments hoping they might be considered for the next interview. Most trainees in the United Kingdom would give their "back teeth" to train at an institute like the U-M.
What about anesthesia in the U.S.? Well, the difference between the two continents is not as large as the ocean that separates them or that's what I was led to believe. The striking difference seems to be the restricted role and distinct lack of control of the anesthesiologist in overall patient management. This is probably inevitable in a health system where the "buck and the lawyer" have more say than the physicians.
The constant battle between anesthesiologist and surgeon appears to be as fierce here as in the United Kingdom; it must be an inborn error of metabolism. Back home we usually have the last laugh. I suggest you should invest in our secret weapon "the anesthetic room", it keeps 99% of unwanted surgeons out and lets you do your work in peace.
Finally for those Latin scholars amongst you I wish you "In somno securitas".