“The more you explain it, the more I don’t understand it.”
– Mark Twain
Senior phsycian anesthesiologists in my peer group have participated in a fascinating evolution of our medical specialty. During our medical careers, technological and pharmaceutical innovations have produced an exponential reduction in perioperative mortality. Notwithstanding these spectacular developments, I wonder if the true value of our generation’s achievements will ever be fully appreciated, or fairly valued.
In this column, I will review some historical developments that have misvalued our medical specialty. It is my hope that a fuller understanding of these factors may ultimately contribute to solutions.
The so-called “33 percent problem” is a moniker applied by ASA leaders to describe the most important historical factor in undervaluation of anesthesiology services. Basically, physician anesthesiologists receive payment from Medicare at approximately 33 percent of the commercial rate. Comparatively, physicians practicing in other specialties receive about 80 percent of...