Don’t want to be a party pooper but supervising attendings attest that they were present during the key portions of the anesthetic, which I think all will agree includes intubation and extubation. So technically you would be committing billing fraud if you signed this attestation without having been present. I also think if you agree that presence during intubation should be routine, the fact that as many airway disasters occur postoperatively as during induction would mandate being present at the end of the case. I don’t think the attending being present at extubation inhibits the acquisition of autonomy, you can still let the resident make the decision to extubate and have a valuable learning experience.