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