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Canadian Journal of Anesthesia 52:208-209 (2005)
© Canadian Anesthesiologists' Society, 2005

Correspondence

Anesthesiology: the misunderstood occupation!

Ranee Y. W. Ho and David T. Wong, MD

Toronto, Ontario

To the Editor:

Previous studies done across the globe reveal that patients have numerous misconceptions regarding the anesthesiologist’s role.1–4 The purpose of this study was to assess Canadian patients’ knowledge of the role of anesthesiologists, anesthesia and their concerns regarding general anesthesia.

After approval from the Institutional Research Ethics Board, patients waiting for preadmission anesthesia consultation were asked to participate in a survey at a tertiary hospital. Eight-nine patients were asked to participate, 86 agreed. Thirty-nine percent had obtained postsecondary education, 69% had ≥ two anesthetics and 69% were ≥ age 55. Eighty percent recognized anesthesiologists as physicians (TableGo) compared to 65% in Britain1 and 67% in Spain.2 However, despite the increased recognition of anesthesiologists as physicians, the majority (38%) described the primary role of anesthesiologists as assistants to surgeons, 36% as physicians and 22% as technical experts. In Japan, more than half of participating patients believed that the only responsibilities anesthesiologists had were to put patients to sleep and provide pain relief.3


View this table:
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  		TABLE Results from survey performed on 86 patients. Numbers listed indicate percentages
 
Approximately one third stated that the anesthesiologist was the main person in charge of resuscitating a patient in the operating room while one third chose cardiologists. Only 11% knew anesthesiologists made decisions for blood transfusions. Only 4% indicated a preference for their attending anesthesiologist. More than half recognized iv injection as the technique used to induce unconsciousness and many incorrectly perceived iv injection as the primary technique to maintain unconsciousness. Twenty to 30% were concerned about awakening in the middle of the procedure, prolonged awakening time, negative reactions to drugs and overdoses.

When asked who or what would be responsible in the event that a patient did not wake up after the surgery, one third associated this complication with the anesthesiologist despite the lack of understanding of his/her role. Drugs and surgeons were also thought to be responsible.

More patients who obtained postsecondary education correctly identified the anesthesiologist’ s role and responsibilities (Table A, available as Additional Material at www.cja-jca.org). More patients < age 55 had concerns regarding awakening in the middle of the procedure (41% vs 20%, P = 0.04) and negative reactions to drugs (41% vs 15%, P = 0.01) compared to patients ≥ age 55. Previous experience with anesthetics did not affect their knowledge about anesthesia.

In summary, the majority of patients acknowledged anesthesiologists as physicians; yet, most patients thought anesthesiologists were assistants to surgeons and did not identify them to be the principle person responsible for resuscitation or blood transfusions in the operating room. Improved communication with, and education of, patients may help correct misconceptions about anesthesiologists in the future.

References

1 Klafta JM, Roizen MF. Current understanding of patients’ attitudes toward and preparation for anesthesia: a review. Anesth Analg 1996; 83: 1314–21.[Abstract]

2 Garcia-Sanchez MJ, Prieto-Cuelar M, Galdo-Abadin JR, Palacio-Rodriguez MA. Can we change the patient’ s image of the anesthesiologist? (Spanish). Rev Esp Anestesiol Reanim 1996; 43: 204–7.[Medline]

3 Adachi Y, Watanabe K, Satoh T. The evaluation of pre-operative anesthetic visit in our hospital (Japanese). Masui 1999; 48: 1037–42.[Medline]

4 Huang Y, Yang K, Ren H, Luo A. A survey of elective surgical patients’ attitudes toward anesthesia in PUMC hospital. Chin Med Sci J 2002; 17: 77–80.[Medline]





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