I’ve been reading news articles lately about increased occurrences of patients who have to pay for costly anesthesiology services that are considered “out of network” with their insurance plans. Understandably, people are angry at these unexpected costs above what they’ve already agreed to pay or have paid for their surgical procedures. The insurance companies are taking advantage of all of us. As a doctor, I’m paid consistently less over time for the same hard work and medical expertise and as a patient I know that my insurance premiums and out of pocket costs keep going higher despite the fact that I have no health issues. Apparently, insurance companies are now unwilling to give fair reimbursement contracts to anesthesiology groups for their work and in turn anesthesiologists are deciding to not take less payment than they deserve. This is why the patient then is billed for something that is entirely out of their control and unfairly uncovered by some insurance plans. I believe the answer is to hold insurance companies accountable to offer affordable medical coverage for patients and a fair payment system for all doctors’ services. Something that I’ve also come to realize however, is that few people, even other physicians, understand who and what an Anesthesiologist actually does.
An anesthesiologist is a physician who has completed four years of medical school, four years of residency and in some cases up to three more years of fellowship for a specific specialty such as Pain Management, Cardiac or Pediatric anesthesiology, for example. The anesthesiologist’s role in the operating room is critical. We are there to make sure that you live through whatever surgical or non-surgical procedure you might need. In most cases surgery is a traumatic experience for the body, and depending upon the age, health status and type of surgery involved, the risk of complications or death can be immense. Unfortunately, even a seemingly healthy person can have an adverse outcome during or following surgery.
It is the anesthesiologist’s job to evaluate the patient in relation to the type of surgery needed, then devise a safe plan to successfully take them through the surgery with the least amount of stress, pain and side effects. We’re actually trained to have plans B and C in mind before going into the operating room with a patient to make sure that even the unexpected is expected.
“Putting people to sleep” is what most people know about anesthesiology. This is, in fact, an inaccurate synopsis of the specialty. A good doctor knows when not to put a patient to sleep and oftentimes the safest option is what is called a “regional anesthetic” which puts only the part of the body that is having surgery to sleep. A knee or hip replacement surgery, for example, is often done with an epidural or spinal injection that makes the person numb from the waist or groin down for the duration of the surgery. In this way, the patient is exposed to less anesthetic. An anesthetic is a medication or compound that causes loss of the ability to perceive pain.
All general anesthetics can affect heart, lung, kidney and liver function. In patients who are already ill or elderly, the anesthetic itself can be harmful. Anesthesiologists provide second to second monitoring during the surgery to ensure that a patient’s heart, lungs and kidneys are not being stressed. We are very knowledgeable of various specialties of medicine including cardiology, neurology, pulmonology, and nephrology because we need to anticipate how the body might be affected by surgical trauma and stress and know how to treat any emergencies that might arise to ensure the least possible harm from surgery. We are also real time pharmacologists as it is important for us to know how different drugs interact with each other and with the anesthetics we might need to use in addition to the medications that the patient might normally take.
Obviously, no one goes to the hospital to have anesthesia, but no one wants to have surgery without it either. Anesthesiologist services should never be an additional cost to the patient who needs non-elective surgery. Hopefully, we will eventually find a solution to the ongoing abuse by insurance companies on their insured members and medical providers.