There's a lot more help in a teaching institution. In the private sector, it's pretty much all on the circulator to get the pt to the room, help with the intubation, put the foley in, do the pre-prep scrub, prep, and so on and so forth. In the teaching sector, there are anesthesia residents, SRNAs, EMTs, medical students, PA students, nursing students, and surg tech students and they're all dying to do "something". The circulator can pretty much delegate and oversee rather than do all the running around. Also, in the private sector, most hospitals bench mark for 15 minute turnovers, unless it's a joint. Our turnovers avg about 45min-1hr. I started out in the private sector and I have to say that a lot of the nurses here at my "teaching" hospital couldn't cut it in the private sector. It's a dog-eat-dog world, but the pay is soooooo much better.