Health

The days when an “anaes­thetist” would put us un­der be­fore an op­er­a­tion could be about to end.

New Zealand Listener - - CON­TENTS - By Ruth Ni­chol

The days when an “anaes­thetist” would put us un­der be­fore an op­er­a­tion could be about to end.

When David Kib­ble­white first be­came an anaes­thetist, he would never have sup­ported a pro­posal to change the name of his med­i­cal spe­cial­ity to anaes­the­si­ol­ogy – let alone to its US spelling, anes­the­si­ol­ogy. “I saw it as an Amer­i­can­i­sa­tion and I think that would have been the same for most peo­ple.” More than 20 years later, Kib­ble­white, pres­i­dent of the New Zealand So­ci­ety of Anaes­thetists, is help­ing to lead a cam­paign that would see New Zealand and Aus­tralian anaes­thetists be­come anaes­the­si­ol­o­gists. Or pos­si­bly even anes­the­si­ol­o­gists: “I don’t know whether we’ll re­tain the ex­tra ‘a’ or not.”

His or­gan­i­sa­tion has teamed up with its Aus­tralian coun­ter­part and their joint pro­fes­sional body, the Aus­tralian and New Zealand Col­lege of Anaes­thetists, to have a crack at chang­ing their names. They plan to run an on­line poll of mem­bers this year. A fi­nal de­ci­sion re­quires 75% sup­port at the ANZCA an­nual meet­ing.

“We don’t want a Brexit sit­u­a­tion, where 51% say yes and 49% say no.”

Kib­ble­white is qui­etly con­fi­dent that, with or with­out the ex­tra “a”, Aus­tralasian anaes­thetists are ready to join the ma­jor­ity of their in­ter­na­tional col­leagues who are al­ready known as anaes­the­si­ol­o­gists and whose med­i­cal spe­cial­ity is known as anaes­the­si­ol­ogy.

“I think it’s time to change,” he says. “The only peo­ple who don’t call them­selves anaes­the­si­ol­o­gists are the Bri­tish, the Aus­tralians, the Ir­ish and our­selves.”

That name dif­fer­ence al­ready cre­ates con­fu­sion, par­tic­u­larly in med­i­cal pub­li­ca­tions. In the US, for ex­am­ple, the term anes­thetist refers not to doc­tors who have com­pleted at least 13 years of med­i­cal train­ing but to spe­cially trained nurses.

Kib­ble­white and his Aus­tralian col­leagues believe that adding “ol­ogy” to their name will make it clearer that they are in fact med­i­cal spe­cial­ists. A sur­vey car­ried out by the ANZCA in 2013 found that one in 10 peo­ple didn’t know that anaes­thetists are doc­tors and half thought only some anaes­thetists are doc­tors.

“It would bring us into line with many of the other med­i­cal spe­cial­ties such as car­di­ol­ogy, ra­di­ol­ogy, rheuma­tol­ogy, neu­rol­ogy and der­ma­tol­ogy.”

He be­lieves the name change would also help sig­nal the fact that anaes­thetists do a lot more than put peo­ple to sleep. “I’m sure the core

It used to be that the only in­ter­ac­tion you had with an anaes­thetist was a quick “hello” be­fore they put you un­der.

busi­ness will re­main in the op­er­at­ing theatre, but we do a lot of stuff out­side the theatre, such as pre-op­er­a­tive and post-op­er­a­tive work and pain man­age­ment. In smaller hos­pi­tals, in­ten­sive-care units are pre­dom­i­nantly run by anaes­thetists.”

Anaes­thetists face many more chal­lenges than they did in the past. Op­er­a­tions are longer and more com­pli­cated than they used to be and they can in­volve ad­min­is­ter­ing as many as 40 dif­fer­ent anaes­thetis­ing drugs. In many cases, pa­tients have a num­ber of co-ex­ist­ing med­i­cal con­di­tions, such as obe­sity and end-stage res­pi­ra­tory or car­diac dis­ease, which the anaes­thetist has to take into ac­count.

It used to be that the only in­ter­ac­tion you had with an anaes­thetist was a quick “hello” be­fore they put you un­der, but that is be­com­ing less com­mon. “We’re more in­volved with peo­ple pre-op­er­a­tively, op­ti­mis­ing them for surgery and also dis­cussing the ben­e­fits of surgery and whether it should even be done.”

One per­son who’ll be vot­ing for a name change is Alan Merry, head of the Univer­sity of Auck­land School of Medicine. He pre­vi­ously headed the Depart­ment of Anaes­the­si­ol­ogy, which changed its name more than a decade ago. He’s also in­volved with two in­ter­na­tional or­gan­i­sa­tions cam­paign­ing for bet­ter ac­cess to safe surgery for peo­ple in de­vel­op­ing coun­tries. Th­ese in­clude the so-called bell­wether op­er­a­tions – cae­sarean sec­tions, and surgery for acute ab­dom­i­nal con­di­tions and com­pound open frac­tures.

Merry sits on the boards of both Lifebox and the World Fed­er­a­tion of So­ci­eties of Anaes­the­si­ol­o­gists. Th­ese or­gan­i­sa­tions make an im­por­tant dis­tinc­tion be­tween anaes­the­si­ol­o­gists, who have many years of med­i­cal train­ing, and anaes­thetists, who can ad­min­is­ter anaes­thet­ics but have less train­ing.

Merry says the only way to in­crease de­vel­op­ing coun­tries’ ac­cess to bell­wether op­er­a­tions is to train more lesser-qual­i­fied anaes­thetists. “You can’t fill the gap by try­ing to train more doc­tors.” How­ever, a sit­u­a­tion in which some anaes­the­si­ol­o­gists are known as anaes­thetists in a hand­ful of coun­tries con­fuses mat­ters.

“Let’s use the name [anaes­the­si­ol­o­gist] that is widely ac­cepted and keep the term ‘anaes­thetist’ for the more generic ap­pli­ca­tion of any­one who gives an anaes­thetic.”

Qui­etly con­fi­dent:

David Kib­ble­white.

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