Until recently, the identity of the anesthesiologist involved in Joan River’s fatal surgery was unknown. That was until January 4, 2014 when New York Post reporter Susan Edelman publicly named Renuka Reddy Bankulla, MD, 47, as the anesthesiologist allegedly present on August 28 at Yorkville Endoscopy during the tragic procedure that led to the death of comedian Joan Rivers. While the name of the anesthesiologist makes for a great headline, there is much we can learn from this tragedy. Most people are unfamiliar with the field of anesthesiology, it’s one of those “behind the scenes” specialties like Radiology and Pathology and the majority of patients have very limited (if any) direct contact with these specialists. In the typical elective scenario, a patient meets their surgeon days to weeks prior to the procedure and meets the anesthesiologist on the day of surgery. It is presumed that all anesthesiologists have a basic competency level and are basically interchangeable. The same assumption could be extended to other specialties, but there’s an important difference– when a patient agrees to an elective procedure they have time to check out the surgeon’s credentials, training, reviews and malpractice history. Surprisingly though, patients rarely if ever can verify the same information for their anesthesiologist and most people just assume that the anesthesiologist will provide a standard level of care. Therein lies a critical issue regarding medical care transparency and we must thoroughly research the providers involved without exception; medical care is one area where it pays to be a highly educated consumer. While it may be tempting to blindly trust in professional credentials (board certification, licensure, professional memberships) it is a mistake to do so and one which could result a dire outcome. So what can you do? First of all, people need to educate themselves and they need to do so before they require medical care. Once they do, patients should familiarize themselves with everyone involved in their care from start to finish. A quick google search would have revealed several details about Joan River’s anesthesiologist (including where she had trained: Bankulla had received her MD from Gandhi Medical College in Hyderabad, India, as per state records, and had trained at Flushing Hospital and Beth Israel Medical Center). Whether or not that would have affected the outcome will never be known and whether or not doctor and patient ever met prior to the procedure remains a mystery. One thing is certain though– the anesthesiologist is no longer behind the curtain. The role of the anesthesiologist is critical in any procedure. Yet it is surprising that patients often have little to no specific information regarding the provider of their anesthesia. This fundamental lack of transparency is clearly an issue (and likely relates to an element of paternalism) but the bottom line is that you want to know who is going to providing your anesthesia. Anesthesiologists often liken their job to piloting a plane: “it’s 95% pure boredom and 5% sheer terror,” which basically means that everything is ok until there is a problem. It is the problems and the ability to handle them that are the true test of an anesthesiologists’ skills and individual differences play a role. Anesthesiologists are human, they react differently and have individual strengths and weaknesses, which is why you want to know who the individual is. One of the most horrific anesthesia stories centered around a drug addicted Spanish anesthesiologist who infected over 200 people with Hepatitis C. Unfortunately, such incidents are not isolated,; 14 people were infected with Hepatitis by a New York anesthesiologist. While such cases are highly unusual, it underscores the need to have better control and heightened visibility of specialties that provide critical care but which most patients are completely unaware of. Anesthesiology is only one such example. Radiology and Pathology are two specialties where patients rarely meet the provider much less know the name of who actually read their Xray films or Pathology specimen. Does it really make a difference you might ask? The amswer is a resounding yes, it definitely could. Interpretations vary between individuals and patients are often unaware that their Xrays, CTs, MRIs etc can be outsourced overseas where they are interpreted by whomever is employed there. The bottom line is that patients need to become better educated consumers, they need to familiarize themselves with the medical specialties and know their rights (please refer to our article on how to become an educated health care consumer). People need to realize their power in influencing their own medical care. Don’t wait until you have a medical issue to begin learning about it, start educating yourself now, it is time well-spent.