4 0 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U N E 2 0 1 7
kinds of cases in and out.
• Preventing PONV. Pain and opioids are 2 of the most common causes of
nausea. Regional helps minimize both. Our post-op nausea rate is less than 2%.
• Facility expectations. You should insist that your anesthesiologists be
trained at least in the basics of regional anesthesia. Ideally, you want someone
who's not right out of fellowship, someone who has a bit of experience.
Unfortunately, only a fairly small percentage of anesthesiologists have that train-
ing. And most providers over age 40 are not going to be well trained at regional
— unless they've trained on their own.
• The right focus. If you contract with a big anesthesia group, you'll have dif-
ferent providers rotating through almost every day, most of whom aren't going
to be good at regional and who don't focus on the essence of ambulatory sur-
gery. They think ambulatory is easy, and they're not as aggressive as they should
be. You need a good regional anesthesiologist who can get your patients in and
out.
• Continuity. I've been at Andrews for 10 years, and it's the only place I've been
for 10 years. The surgeons know who's going to be here every day and they know
whom to talk to if there are any issues.
• Try recruiting. If you advertise for an anesthesiologist to work exclusively at
a surgery center, with no call and no weekends, you'll get bombarded with people
who are interested. But mindset is important. You want somebody who's trained
in regional and who really wants to make things run smoothly.
• Added benefit. If you have a primary anesthesiologist who's at your facility
every day, that person is also going to be more involved and more willing to
serve on committees. He'll have a vested interest in always doing things the
right way and the least expensive way that's both feasible and safe.
OSM
