Word: surgeon
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...know how many people are at the table with gloves on, when you have an operation? There's the surgeon and a scrub nurse, of course. A surgical tech may be there too, suctioning up those queasy fluids, holding the arm or leg we're working on, cutting sutures and holding retractors. But you have seen enough medical shows to know there's also always at least one other doctor present. We may not engage in the same kind of dramatic medical banter that fictional surgeons do (like flying a passenger jet, safe surgery should be a little bit boring...
...probably haven't heard much about the assistant surgeon, but all the same, it might interest you to know that we're running out of them. In teaching hospitals, the assistant surgeon in most operating rooms is a senior resident or fellow - a medical-school graduate who is in training to become a surgeon. (Sometimes a medical student or intern, a first-year resident, may scrub in as well.) The assistant role of the surgical resident is to learn and gain experience, from just watching to doing the whole procedure. There is some pressure on academic surgeons...
...combination of hard work, high risk and low pay has made the general surgery specialty nearly as unattractive to new doctors as primary-care medicine. The statistics are grim: a report in the journal Surgery places the nationwide general-surgeon shortage at 1,300 currently, and estimates that the country will be at least 6,000 surgeons short by the time you need your colon removed...
Most of the surgery in the country takes place in hospitals without residency programs. In these hospitals, the attending surgeon is paid by an insurance company to do the operation (in contrast, at most teaching hospitals, surgeons are either on a fixed salary or part of a group that pools and divides fees) - and he must arrange for another surgeon's help. This used to be easy, in 1985, when the standard assistant surgeon's payment of 20% of the primary surgeon's fee was a great incentive. Since then, the surgeon's expenses have more than doubled, while fees...
...flush can hire PAs to assist; the one where I work does. But most can't afford the hefty expense of PAs. Even the hospitals that have the funds don't have enough to hire PAs for every case. So I often end up begging older colleagues or a surgeon waiting for the start of his own case for a "freebie"; I'm playing on goodwill, friendship or the promise of his eventually getting a paying case...