Anaesthesiology – the most attractive speciality also in 20 years

Abstract

The development of our speciality has been fast, ever since the famous demonstration of ether anaesthesia by William TG Morton in 1846. We provide the sine qua non for the development of surgery. Although a lot of what we do is common, the development until today has taken varied courses throughout the world. We have one speciality, but the specialist training varies between 0 – 7 years. In some countries, physician anaesthesiologists do mainly anaesthetics, with or without helpers like nurses or technicians, but in others, we are also involved in intensive care medicine, emergency medicine and chronic pain treatment. Anaesthesiologists are also popular as managers and leaders. Our prestige and attractiveness by young colleagues also vary, sometimes leading to lack of manpower. Both lack of manpower and financial restraints may lead health authorities to create shortcuts, for instance by reducing the duration of training. At the same time, availability of private practices, working time regulations and the general development in society might lead to reduced duty time for doctors. All these developments could lead to impaired quality of services and reduced patient safety. Other specialities also have interests in “our” turf/parts of our speciality like emergency medicine and intensive care medicine. Meanwhile, new teaching methods are also emerging and will be incorporated in our daily practice. There has always been change/development in medicine. For those countries that experience a shortage with recruitment problems, it might be useful to look to the success factors in the countries where anaesthesiology is popular - eg, in Scandinavia, like in Norway, where we enjoy higher prestige than general surgeons. We believe that the introduction of helicopter emergency medical services, with anaesthesiologists the as “medical problem solvers” in the field has played a role in that. The same is true for our involvement in intensive care and pain medicine. Another factor is that nurse anaesthetists are a natural part of our daily work, but not replacing the doctors (US), but being supervised by us. Hence, doctors often run several theatres simultaneously, or if the case is complicated, there will be two competent persons available at any one time. It is equally important that we are able to demonstrate to the medical students that anaesthesiology is – applied physiology, rewarding for our brains, hands and hearts. Rather than leaving to others to decide how our future should be, anaesthesiologists must be in the driver’s seat to develop our own speciality. This should be done by listening to anaesthesiology organisations in involved countries, assess what works well to improve attractiveness and quality, what development would we like to see concerning supra- or subspecialities, training, etc. Anaesthesiological organisations should work together to outline a roadmap for the future, and we should work with health authorities in a positive, constructive way, taking into account not only the status quo, but also potential positive changes to maintain and improve the quality of the organisation of our speciality.