Q: Has the propofol shortage affected the hospitals and surgery centers where you work or the way you practice?
Dr. James Geiger: There have been several specific days when no propofol was available at freestanding surgery centers, but not weeks on end. Hospitals and hospital-owned surgery centers seem to have a bigger supply. With three companies juggling propofol production and one [Teva Pharmaceuticals] dropping out of race, the supply is going to get tighter before it gets better.
Q: What is the impact of this shortage on patient care?
Dr. Geiger: Most patients can do well with the alternatives, but many of the alternatives are less comfortable for the patient. The alternatives often include stacking a number of other anesthetic drugs to get similar results. When you have patients with multiple pre-existing conditions, it places more risk on the patient, especially for upper endoscopies when airway monitoring is even more critical. It’s frustrating when the hospital or surgery center can’t provide you with the one drug that you can manage very well.
Q: What are other challenges currently facing anesthesiologists?
Dr. Geiger: Anesthesiologists are greatly discouraged with pay for Medicare cases, which has created a horrible morale effect on the industry as a whole. There is no permanent fix for the sustainable growth rate, which could cut our pay by more than 20 percent. Anesthesiologists could actually be paid less than some service trades on an hourly basis if the cut goes through.
Q: What are the biggest opportunities you see for the specialty at this time?
Dr. Geiger: There’re really aren’t any new anesthesia drugs or techniques even is these days of modern medicine. More is being taken away than given. More is expected of us. During a short operation, we are expected to enter an operative report and yet in some places still maintain a paper record while all at the same time we’re supposed to be monitoring the patient and maintaining the airway. More is expected.
Read other Becker’s coverage on the propofol shortage.
Anesthesiologist Dr. Alan Berk Discusses Alternatives to Propofol
