Advisory Law Group

Published in Anesthesiology News
March 2009

Dear Dr. Bryan-Brown:

I want to respond to your letter to the editor in which you state that your colleagues were perturbed by my advice that, "You must become the monkey."

First, I want to thank you for your comments.  I always appreciate receiving the thoughts of my readers, even if they do not agree with my position.

In reading your letter, however, I do not believe that we actually disagree.  Rather, I think that my analogy to the monkey, chosen because I have heard dozens of anesthesiologists use it over the course of close to thirty years of representing members of your specialty, is what caused the misunderstanding.

My point in the article is that anesthesiologists need to develop and nurture surgeon support and that the way to do it is to tie to the surgeons' goals. 

Your letter points out the highest of the goals that surgeons and anesthesiologists have in common:  The safety and wellbeing of their patient.

Unfortunately, at many hospitals, surgeons believe that anesthesiologists cancel cases in order to make life better for the anesthesiologists.  Although I can't possibly defend every instance, my anecdotal experience in representing my clients is that patient safety is the motivator.  But, the fact that surgeons do not often see it that way, with due deference to the Chairman in your example, supports the fact that anesthesiologists have to take a proactive role in explaining to surgeons that they are physicians seeking the same goal, the welfare of the patient upon whom the surgeons are performing the procedure.

In summation, I do not believe that the anesthesiologists with whom the Chairman worked were "monkeys" in a derogatory manner; rather, the way in which they interacted with him over the years convinced him that they were speaking for the patients' needs – those needs coincided with the Chairman's interests.  Your cited Dr. Macintosh apparently understood well how to engender surgeon support through delivering a safe anesthetic and that apparently contributed to his success, as well as to the success of the surgeons with whom he and his colleagues practiced. 

Mark F. Weiss

_____________________________

Mark F. Weiss is an attorney who specializes in the business and legal issues affecting anesthesia and other physician groups. He holds an appointment as clinical assistant professor of anesthesiology at USC’s Keck School of Medicine and practices with the Advisory Law Group, a firm with offices in Los Angeles and Santa Barbara, Calif. He can be reached by email at markweiss@advisorylawgroup.com and by phone at 800-488-8014. 

Article © 2009 Mark F. Weiss