Expert: Ronald Levy, M.D. - 2/3/2011

Question
Hi, I had surgery done by a resident in which she got me mixed up with another patient and did the wrong surgery.  Now I have to get another surgery at a teaching hospital, which has the patient rights statement "right to refuse to be examined, observed, or treated by students or other staff, without jeopardizing access to medical care." I don't want resident involvement.

However, when I called to find out about the anesthesia team, it seemed like they were not open to me not having a trainee (student or resident) involved with my surgery.  How can this be?  Could I be refused surgery if I don't agree to have a trainee?  I don't want to make a fuss and would be okay with a fellow, but not a resident.  My anesthesia is tricky because it's for a thoracotomy.  The person I spoke to said "oh yeah, they really like to have residents do thoracotomy anesthesia because it's interesting"  YIkes!  What would be my best approach?  The "patient rights" is forced on the hospital by state law, I don't think that they like it much, and find ways around it.  I would love to go to a non-teaching hospital but I have a rare, and metastatic cancer.

Answer
First of all, if you had a wrong surgery, it was not the fault of the resident. It was the fault of the entire surgical team (nurse, surgeon, resident, anesthesiologist and resident anesthesiologist). No resident operates independently. They must be supervised by a faculty. Furthermore, OR teams are required to perform a "time-out" to make sure that the correct patient, surgery and location of surgery are correct. That being said, let's deal with the current issue. All teaching hospitals with anesthesiology residency programs work in isimilar ways. Generally one faculty covers two ORs which are staffed by residents. The anesthesiologist must be present for all critical aspects of the procedure (which means they are tightly supervised). Some programs do not have the faculty manpower to allow a faculty member to provide one-on-one care. I would suggest contacting the anesthesiology department directly asn asking them if it is possible for you to have a faculty only anesthesiologist. Either way, you will be in good hands, but if it helps you psychologically, it's worth a try.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston