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Editorial

Empowering anesthesiologists the other hand, the median earning of an anesthesiologist in
the USA is $343,000 (which goes up to $363,000 with
bonuses) that is, approximately Rs. 21,266,000, which is
“The first cut from the inside was completed, and the bloody more than 20 times the Indian average.[3] As per the Medscape
blade of the knife issued from the quivering wound, the blood Physician Compensation Report 2014, anesthesiologists
flowed by the pint, the sight was sickening; the screams terrific; are among the top 6 earners and the only surgical specialty
the operator calm.” New York Herald (July 21, 1841) earning much more than the anesthesiologists is orthopedics.[4]
describing an amputation. Unfortunately, no agency in India has surveyed the earnings
of doctors in the private sector. Although it is well-known that
Anesthesiologists are the backbone of all surgical specialties and anesthesiologists are compensated lower than other physicians,
are the primary caregivers in critical care. Surgery before the days there are no published figures to highlight the same.
of anesthesia was gruesome. Advances in surgery would not have
been possible without the support offered by an anesthesiologist. Anesthesiologists in our country have not been able to get out
Till a few decades back, the image of an Anesthesiologist was that of the shadows of the surgeons. Remunerations for anesthesia
of a technician relegated to the background. Anesthesiologists services are linked to surgical fees, which is indicative of
have grown from being “junkies”[1] to skilled “perioperative anesthesia being a subservient service. The insurance payouts
physicians.” With advances in the techniques, equipment, have no provision for anesthesia fees as if the specialty does
knowledge, and training, anesthesiologists have come out of their not exist. In the private sector, remunerations for anesthesia
shells and are more visible today. service are generally a third of the surgical fee, treating
anesthesiologists as poor cousins. The fallout of this is that
Today, apart from delivery of anesthesia, anesthesiologists perform hospital managements treat anesthesiologists as second fiddle,
multiple duties, which include overseeing schedules for staff; while they pamper the surgeons.
resolving clinical care related issues; managing postoperative
care; participating in hospital committees or boards; interfacing There is a need to delink payout for anesthesia services from
with other departments; and overseeing quality assurance. the surgical fee. Anesthesiologists are independent physicians
Anesthesiologists are thus potential leaders in healthcare and administration of anesthesia is not just dependent on the
management. Many managers take inputs from anesthesiologists surgical process. Co-morbid conditions in a patient may make
to appraise the performance of other doctors. Physician colleagues a simple surgical procedure complex for the anesthesiologist. In
take their input to decide the need for surgery, and the surgeon most of the developed world, anesthesia billing is by Relative
to choose to perform the operation, as the experience of the Value Guide structure based on a unit system, which reflects
anesthesiologist about surgical processes is unmatched. Such the complexity of the service and the time the physician
exposure to management issues makes anesthesiologists ideally took.[5,6] Under this structure, fee for an anesthetic service
suited to lead as hospital administrators. comprises up to four unit components:
1. Basic unit value (based on the surgical procedure – listed
The specialty needs to grow out of its semi-visible status and
in a table issued by the Medicare Agencies or professional
be recognized as a prime player in healthcare. The place
association).
of anesthesiologists in the western world is well-established
2. Time unit value (based on time devoted by the physician for
today, and the specialty is much sought after. The same can’t
the procedure – generally 15 min is considered as 1 unit).
be said for the specialty in our country. One major reflection
3. Modifier unit (based on co-morbidity associated, emergency
of the difference, in the status of anesthesiologists, in the two
“in hours,” emergency “after hours” - where applicable).
worlds is the disparity in earnings. The average salary for
4. Therapeutic/diagnostic services (additional monitoring
an anesthesiologist is Rs. 967,325 per year in India.[2] On
or therapeutics such as arterial line, postoperative pain
relief - where applicable).
Access this article online
Quick Response Code:
Website: The anesthesia payout is calculated using the formula:
www.joacp.org Anesthesia payout = ([base unit value] + [time unit value] +
[modifying units]) × conversion factor. The conversion factor
DOI:
varies from state/country and presently is about US $20 in
10.4103/0970-9185.161651 most states. The payouts for therapeutic/diagnostic services
are added separately.

Journal of Anaesthesiology Clinical Pharmacology | July-September 2015 | Vol 31 | Issue 3 291

Healthcare Worker Salary.com/physicians/ policy needs to be drafted in collaboration with the Indian anesthesiologist-salary/. Freud and Cocaine – The Deal. Available from: http://www._Anesthetist/Salary. India. [Last accessed on 2015 Mar 15]. Physician/Doctor.com/yzlh2tc) and point the camera to the QR-code printed in the journal. Table of Contents. IP: 106.com/research/IN/ program to enhance the stature of our specialty. Medical Association.pdf.gov. Available E-mail: mukulanjali@gmail. Available from: How to cite this article: Kapoor MC.com/in_history/cocaine/. Saket City Hospital. August 14. 5. Each article on its first page has a “Quick Response Code”. Start a QR-code reading software (see list of free applications from http://tinyurl. India [Last accessed on 2015 Mar 15]. Payscale Human Capital.payscale.com/2bw7fn3 or http://tinyurl. New Delhi . Relative Mukul Chandra Kapoor Value Guide for Anaesthesia Billing Requirements. Conflicts of Interest: None declared.historyhouse. J http://www. Using any mobile or other hand-held device with camera and GPRS/other internet source. Anesthetist Salary (India). A national payout 3.com/ determination.[Downloaded free from http://www.com/3ysr3me for the free applications. Department of Anesthesiology. New Delhi. We need to Job=Physician_%2F_Doctor. 1.110 092. History House.cms. 3096. See http://tinyurl. Australian Government – Department of Human Services. achieving this is economic independence. Anesthesiologist Salary. (Rev. 10-17-14). Medscape Physician Compensation societies should take up this matter with ferment vigor and Report 2014. Dayanand Vihar.org on Friday. [Last accessed Anaesthesiol Clin Pharmacol 2015. Mukul Chandra Kapoor.medscape.com from: http://www. Practitioners. Empowering anesthesiologists.medicareaustralia. 292 Journal of Anaesthesiology Clinical Pharmacology | July-September 2015 | Vol 31 | Issue 3 . Announcement “QUICK RESPONSE CODE” LINK FOR FULL TEXT ARTICLES The journal issue has a unique new feature for reaching to the journal’s website without typing a single letter. Its time all of us rise from our slumber! features/slideshow/compensation/2014/public/overview#2. 2015.healthcareworkersalary. 6. It will automatically take you to the HTML full text of that article. Medicare Claims Address for correspondence: Dr. [Last accessed on 2015 Mar 15].251] Kapoor: Empowering anesthesiologists There is an emergent need to develop an anesthesia payout 2.pdf. Centers for Medicare and Medicaid Services. one can reach to the full text of that particular article on the journal’s website. Processing Manual Chapter 12 – Physicians/Nonphysician 6. on 2015 Mar 15].215. Available from: http://www. Medscape Anesthesiology. Available from: https://www. One can also use a desktop or laptop with web camera for similar functionality. [Last accessed on 2015 References Mar 15]. Source of Support: Nil.135.31:291-2. Available from: http://www. Our professional associations and 4.gov/Regulations-and-Guidance/Guidance/ Manuals/downloads/clm104c12.au/forms/10621.joacp. [Last accessed come out of the shadows of the surgeons and the first step to on 2015 Mar 15].