Personal Views

Visions of anaesthesia hell

BMJ 1996; 312 doi: (Published 20 April 1996) Cite this as: BMJ 1996;312:1045
  1. Peter Hambly

    As a result of my long held desire to spend some time working abroad, I find myself supplementing experience and income at a trauma centre in the United States. In Britain the chief medical officer, Sir Kenneth Calman, has offered his vision of training for the next millennium. I, too, have had a vision.

    I am employed as a visiting assistant professor and attending anaesthesiologist, a preposterous title for someone who was essentially a registrar, but it made me feel fairly impressed with myself. For about 10 minutes, that is. The most lasting impression of working in America hit me the day I started: if you are from anaesthesia you are dirt. Do not try to join in the conversation in theatre, do not expect to be informed or consulted on anything, never make a joke. Oh, and whatever your name used to be, it is now “anaesthesia”—pronounced “Annusteejer.” This came as something of a shock. I spent the following months examining the possible reasons.

    The low status of anaesthesiologists in the eyes of other professionals here has an effect that goes far beyond personal vanity. Anaesthesia has lost control of all three key areas of patient care that we in Britain take for granted. Firstly, the influence over preoperative care and preparation is non-existent. For example, when we try to cancel an inadequately prepared elective case all hell breaks loose. How dare we …

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