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SYLOH OP t1_jb37frs wrote

Full article from u/sneakpeak_sg: > # Not forbidden for anaesthetists to leave surgery to take phone call but surgeons prefer those who don’t

> SINGAPORE – Anaesthesiologists are trained to properly monitor a patient under anaesthesia, said two bodies representing the speciality, responding to queries about how some leave the operating theatre during an operation, for instance to take a phone call, which they are not expressly forbidden to do.

> Noting that Singapore has had very few mishaps related to anaesthesia, the College of Anaesthesiologists and the Singapore Society of Anaesthesiologists said jointly: “Regardless of the level of risk of the surgery, the level of monitoring takes into account the clinical risk and medical complexity for the patient which is within the purview of the professional expertise of the attending anaesthesiologist.”

> Surgeons, however, while acknowledging that anaesthesiologists sometimes do leave the theatre, said they would prefer to work with someone who is present throughout a procedure.

> In January, an anaesthetist was suspended for 2½ years by the Singapore Medical Council (SMC) for repeatedly walking out of an operation at Gleneagles Hospital in 2016 to answer phone calls.

> The 64-year-old cancer patient, who had many other health problems, suffered an embolism on the table and died the following day.

> The SMC said the patient’s already low chances of survival were further reduced by the anaesthetist’s delay in taking action.

> A disciplinary tribunal agreed with the SMC that such behaviour “would shock the public and harm public confidence in the medical profession”.

> Dr Islam Md Towfique had previously been suspended for six months by Parkway Pantai, which owns Gleneagles and reported the incident to the SMC.

> In his defence, Dr Islam said his action “accorded with a common practice among anaesthetists in the private sector” and that “there are no official guidelines or notices regarding the making of phone calls while anaesthetists are taking care of their patients”.

> Though the college and society of anaesthesiologists did not say whether doctors are permitted to leave in the middle of surgery, they noted: “For medical procedures requiring anaesthesia, the attending anaesthesiologist ensures a level of monitoring that is commensurate with the clinical risk and medical complexity for the particular patient. Low-risk procedures have a reduced propensity for intraoperative and postoperative adverse events.”

> Low-risk surgery includes cataract surgery, lump excisions, gastroscopy, colonoscopy, reduction of dislocations, and circumcisions.

> The National University of Singapore Yong Loo Lin School of Medicine did not respond to queries about the issue.

> Several senior surgeons told The Sunday Times that if it were up to them, they would always choose an anaesthesiologist who is present throughout the procedure, whether high or low risk.

> However, it is not always possible to choose, especially after regular hours, when fewer anaesthesiologists are available.

> The surgeons said a number do leave the surgery to answer phone calls from other patients, particularly if they do not have an answering service. Some also spend time reading or playing games on their phones, especially during long procedures, when they are not actively needed for stretches of time.


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ornithocheirus t1_jb4pi7q wrote

I can see why this happens. The anaesthetist is really interested in the going to sleep and waking up bits, and maybe any crucial bits of surgery if the surgeon is about to do something quite funky.

The rest of it is just sitting there at the head of a sleeping patient. They often have a little machine which gives your face a little electric pulse and you can tell how deep the anaesthesia is by how much their face twitches and adjust things from there. I'm not saying it's simple, but if you've done it a million times then it becomes trivial.

Anaesthetics is a great lifestyle because between all that you can answer your emails and get admin done in little chunks (I work on a ward where it's nonstop 8:30 - 6 and I basically answer my emails at home in my 'free time').

You can see how you get adapted to that lifestyle and unless you're mindful of your own thought processes, you come to see that time mid-surgery as "your" time and wouldn't think twice about stepping out for a phone call (that you expect to be brief) to avoid distracting the surgeon, which may well be work related about something happening with another patient.

Not saying it's right. It's crazy. The human mind can get accustomed to any amount of responsibility and pressure to the point where the life signs of a frail cancer patient are completely your responsibility while a surgeon tries to do their thing, and you're popping out to grab a coffee and a catch up.

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