When adjectives obfuscate
A few years ago, at the misguided recommendation of a public relations consultant, many of us in America started referring to ourselves as “physician anesthesiologists”. That was a silly move. The term is cumbersome and does not flow trippingly on the tongue. It is also redundant. You don’t hear our colleagues referring to themselves as “physician cardiologists” or “physician urologists”.
There was never any need of an adjective to modify “anesthesiologist”.
Anesthesiology is a medical specialty, practiced by physicians who have completed residency training in anesthesiology. To become board-certified, we undergo a rigorous examination program conducted by the American Board of Anesthesiology.
In England, comparably trained physicians are called “anaesthetists”. In England, they also refer to their subway system as “the underground”, and to the hood of the car as the “bonnet”. It’s confusing, but we muddle through.
The term “nurse anesthesiologist” is an oxymoron.
I’m all done with the term “physician anesthesiologist”. I am the immediate past president of the California Society of Anesthesiologists, and a 30+ year member of the American Society of Anesthesiologists. I am a physician who is immensely proud to practice anesthesiology. My patients know I am a physician because I make it clear to them when I introduce myself and give them my business card.
Dr. Virginia Apgar was an anesthesiologist. It is an honor to follow in her footsteps, even if most of us will never match her achievements. That is all.
9 COMMENTS
Well said. The term “nurse anesthesiologist” is not only an oxymoron, it’s an attempt to confuse patients.
[Reply]I just don’t understand the need of others to try and confuse patients. Also proud to be an anesthesiologist and teach everyone, anything I know
[Reply]I’ve long used the terms: “anesthesia doctor”, and “anesthesia nurse”. It is plain language that aligns with other areas of health care: ICU doctor, ICU nurse. ER Doctor, ER nurse, etc. In this nomenclature, nurses with PhD’s are still nurses.
I find it more interesting to consider these questions: Who cares about this whole issue besides ourselves (and the anesthesia nurses, of course). We know that patients should care. But do they? If they don’t care, can we make them care? If the patients concern about MD vs. RN anesthesia provider is minimal, how can we possibly win this battle?
[Reply]Dear Dr. Lucas,
I am 100% convinced that patients DO care. It’s all about how the information is presented. How many people do we think would actually say, “I want the best care possible. No physician!” In an ICU setting, a physician is responsible for the care of multiple patients, working in conjunction with highly skilled nurses. This model doesn’t strike anyone as odd. Nurse practitioners in ICUs still have physician backup. Why is the operating room considered so different? At UCLA, we work collaboratively with a wonderful team of nurse anesthetists as well as residents and fellows, but there is still no question that the ultimate responsibility for each case I’m involved with rests with me.
Best, and thank you for reading and commenting!
Karen Sibert
[Reply]Well said Dr. Sibert! I always enjoy your writings!
[Reply]How do you explain our friends in dentistry, the “dental anesthesiologists”?
[Reply]I don’t know about the different (and proper) terms for the medical professionals who administer & monitor anesthesia in all its forms, but I’m thankful for the training & skills of those who help comfortably prepare their patients for medical procedures ranging from the diagnostic to major surgery.
I well remember the awful gas I was given around 1969, to sedate me for teeth extraction in preparation of getting braces within the next several months or year. That must have been ether? It was terrifying being sedated that way & I remembered the smell of that gas for a couple decades after.
Contrast that with the colonoscopy sedation I had this past year. I was terrified of the sedation part of the equation despite my friends assuring me Propofol was pleasant and really no big deal. But I had procrastinated long enough so at age 57 it was time for a deep dive into my colon.
I was impressed by how confident & diligent the anesthetist was, her computer setup, the technology used to monitor everything. As a techie I loved seeing all of that. And while my sedation wasn’t “the best 20 min nap I’ve ever had” as one friend described it, it’s only because the best nap I’ve ever had is the kind where you wake up and you’ve been drooling into your pillow and you don’t know where you are, if it’s day or night (that’s a *nap*). My sedation was comfortable, totally fine, with no weird sensations going under, no grogginess after, and I was just *so happy* I finally got that colonoscopy done. All turned out well.
So I tip my hat to some unsung heroes of the medical community, who are the backbone & foundation for a doctor/surgeon to be able to do their thing.
[Reply]Throughout my career I have had the opportunity to work with many wonderful and talented CRNAs. They referred to themselves as anesthetist, nurse anesthetist, or CRNA. They referred to me as Doctor or anesthesiologist.
Recently, a newly minted CRNA informed the staff that she was a doctor(DNP), wanted to be addressed by that title, and wanted the truth spoken to everyone including patients.
I will not hide from the truth; told her she can tell patients she a Doctor of Nursing Practice–not medicine–and the state has licensed her to practice nursing not medicine.
She soon quit.
[Reply]Thanks Dr. Sibert for this article. I totally agree. Possibly like you, I came to USA from UK and was faced with “you’re an anaesthetist? so you’re nurse?”. So I learned quickly that no, I am an anesthesiologist in this country.
I witnessed a male CRNA once introduce himself to a patient when asked if he was their “anesthesia doctor” by saying “I’m giving your anesthesia, yes” (!) His attitude was quickly squashed.
The continued ongoing turf war is not helped by surgeons and internists referring patients to independently practicing CRNAs for pain consults and injections, as I have learned happens in small towns in the midwest.
The physician anesthesiologist label has just served to confuse and obfuscate as you describe.
I am glad to have retired!