You know who the surgeon of record is because their name is on the consent form you sign before surgery. Hopefully no one really thinks that a surgeon, especially at a teaching hospital, is going to stake their reputation on letting an inexperienced resident do their surgery without supervision. The lingo I remember from training was that the attending had to be "readily available" (open for interpretation) and "present for the key portions of the procedure" (also open for interpretation--what is the "key" portion?).CULater wrote: ↑Thu Sep 28, 2017 9:20 amWhen having a procedure done at a teaching hospital, such as a university hospital, I'm not sure you know who is doing the procedure while you are unconscious anyway. An inexperienced resident or other might be your actual surgeon. At the University hospital near me, I was recently told that the rules were changed so that the staff surgeon actually had to be present during the procedure instead of flitting around between several operating rooms. Geez, until I heard that I had no idea that the staff physician might have actually not even been present except occasionally during a procedure. I think that a patient is able to request that the staff physician be the actual person doing the procedure, but I'm not really sure about that. How can I be sure that the person I think is performing the procedure in a teaching hospital is actually the one doing it?
In my experience the attendings hovered until they had confidence in you and then they'd let you do stuff directly supervised, then they'd let you do stuff while they were in the corner doing computer charting or catching up on dictations, and then they were present for the surgical timeout before going to sleep in the lounge in the middle of the night while the senior resident and junior resident were nailing the femur fracture in the middle of the night and would come back in for the final X-rays.
Where I did med school the chief of ENT would run two rooms simultaneously with huge head and neck cancer surgeries and would bounce back and forth between rooms to be present for the critical parts of the cases, while teams of 2 residents would be doing lots of the exposure or more mundane parts of the cases.
It's a dilemma, right? No one wants to be operated on by an inexperienced surgeon but then everyone expects expert care.
We always found it hilarious and stupid when patients would request to not have residents present for their surgery. So instead of an almost expertly trained assistant who cares and wants to be there and knows the preferences of their attending surgeon and can really help out (getting and keeping retractors in the right place so the surgeon can see, requesting to have the correct instruments so the surgeon doesn't have to interrupt their train of thought, etc.) you're now forcing the attending surgeon to use a team of scrub techs who are paid by the hour and don't give two sh^*s about what's going on.