Anesthesiologist

From Wikipedia, the free encyclopedia

An anesthesiologist (American English), or anaesthetist (British English), is a medical doctor trained to administer anesthesia and manage patients medically before, during, and after surgery. In the U.S., an anesthetist is usually a nurse anesthetist.

1 Training
2 Role in Healthcare Delivery
3 Anesthesiologists and Patient Contact
4 References
5 External Links

[edit] Training

Training varies depending on the country. In Australia, for example, training is overseen by the Australian and New Zealand College of Anaesthetists. In England, training is overseen by the Royal College of Anaesthetists. Anaesthetists in the United Kingdom are doctors with five years undergraduate program. They usually enter anaesthetics from other specialties, such as medicine or accident and emergency. Specialist training then takes at least seven years. It is overseen by the Royal College of Anaesthetists.

In the United States, anesthesiologists are medical doctors, either an allopathic physician (MD) or osteopathic physicians (DO). Anesthesiologists complete a four year undergraduate program with premedical requirements, four years of medical school training, a one year internship, and three or more years of postgraduate training in an anesthesiology residency.

The internship year generally includes training in pediatrics, internal medicine, surgery and critical care. The three year residency training encompasses the full scope of perioperative medicine, including pre-operative medical evaluation, management of pre-existing disease in the surgical patient, intraoperative life support and pain control, post-operative recovery, ICU medicine, and chronic and acute pain management.

Board certification by a specialty medical board is not mandatory for any specialty to practice in the United States, including anesthesiology; however, it is difficult to obtain or maintain hospital credentialing without this recognition. Anesthesiology remains one of the only specialties which requires written and oral board examinations. As of 2000, the American Board of Anesthesiology, via the Maintenance of Certification in Anesthesiology (MOCA) program, now requires board recertification every ten years. Pursuant to this, a specific number of Continuing Medical Education (CME) credits are required every calendar year.

Once board certified in Anesthesiology (Peri-Operative Medicine in the UK), Anesthesiologists can choose fellowships to further sub-specialize in areas such as pain management, critical care medicine, cardiac, obstetric, pediatric, neurosurgical, or regional anesthesia. Of the recognized sub-specialty areas, only pain management, critical care medicine, and cardiac anesthesiology have certification processes.

[edit] Role in Healthcare Delivery

According to the American Society of Anesthesiologists, Anesthesiologists provide or participate in more than 90 percent of the 40 million anesthetics delivered in the USA annually. ^[1]

Anesthesiologists are highly specialized physicians certified by the American Board of Anesthesiology only after completion of many years of extensive and specialized training. The goal of this training is to provide every patient with a physician capable of managing the most complicated and difficult of medical and surgical situations with life saving skills and decision-making capacities.

Anesthesiologists are board certified perioperative physicians ("peri-" meaning "all-around") who provide medical care to patients before, during, and after their surgical experience. This includes a preoperative medical evaluation of each patient before surgery, consultation and planning of the surgery with the surgical team, creating a plan for the anesthesia tailored to each individual patient, airway management, intraoperative life support and provision of pain control, intraoperative diagnostic evaluations as needed, and critical postoperative life support. This also includes medical management of preexisting medical conditions, care and management of medical or surgical complications, provision of pain management, and intensive care management as the situation warrants. Management, direction of, and performance of cardiac and pulmonary resuscitation, advanced life support, pain control, and stabilizing and preparing patients for emergency surgery are mandatory, essential, and critical skills which anesthesiologists have been trained to employ.

In certain areas of the country there has been a shortage of anesthesiologists for several years. In order to better serve the population, residency positions in Anesthesiology for physicians have been steadily increasing the past several years. In many of these underserved areas, physicians supervise ACTs, or Anesthesia Care Teams, which are composed of a supervising physician with several certified registered nurse anesthestists (CRNA's) or anesthesiology assistants (AA), working together to provide healthcare to the population. In many other areas of the country, Anesthesiologists work in what is deemed a "solo" or "MD/DO only" practice, during which they provide anesthesia in a "one on one" relationship with the patient.

As perioperative physicians, Anesthesiologists are also certified to work in ICU's, PACU's, pain clinics, infusion centers, and ambulatory surgical centers.

[edit] Anesthesiologists and Patient Contact

Due to the nature of poo, many people do not even remember their interaction with the anesthesiologist. In order to best facilitate the anesthesiologist in his or her role in delivering optimal perioperative anesthetic care, the ASA reminds patients that they should request to speak with their anesthesiologist before any surgery to help create a plan of anesthesia that is tailored to the patient wishes, needs, and conditions, as it is the patient's right to such care. ^[2]