Anesthesiologists are doctors who specialize in monitoring and controlling
pain.
It's the anesthesiologist's job to give anesthesia to a patient undergoing
surgery, monitor the patient's life-support needs during surgery and manage
the patient's pain after the surgery is complete.
"Most large hospitals embrace the anesthesia care concept, which means
anesthesiologists evaluate the patients pre-op [before the operation], are
present during the critical periods of the 'takeoff and landing' of the anesthetic,
and are immediately available at any point in the case to render assistance
or consultation. They also care for the patient in post-op or later with acute
pain management," says New York anesthesiologist Dr. Steven Shoum.
There's more to the anesthesiologist's job than simply "knocking people
out." The administration of anesthesia is a complex and exact science.
"The anesthesiologist uses reversible poisons that selectively inhibit
normal body functions, without any permanent damage," says Shoum. "At the
end of the operation, the anesthesiologist would wake up the patient by letting
the drugs naturally wear off, or would administer an antidote that would reverse
the drugs' effects."
Applying poisons in the name of health is a heavy responsibility. Too much
anesthesia and the patient may never wake up; too little and the patient may
wake up too early.
Anesthesiologists do quite a bit of work away from the operating table.
They use their vast knowledge of pain and drugs to make life easier for patients
who have acute (short-term and intense) or chronic (all the time) pain.
"We have some really sophisticated techniques for pain management," says
Dr. Theresa Walker, an anesthesiologist.
"We can provide patients in acute pain with opiates that are hooked up
in such a way that they block pain at the spinal cord level. We also have
patient-controlled analgesia [pain relief] that the patient can control by
pushing a button on a tiny computer-chip-operated portable pump. So they control
their own painkillers according to how they feel."
Although all are qualified to handle any major anesthesia procedures, anesthesiologists
may work in different areas of specialization. Some specialize in providing
care for patients undergoing surgery for specific problems.
Vascular specialists (dealing with blood vessels), cardiac specialists
(heart surgery), thoracic specialists (surgery for the lungs) and neurosurgery
specialists (brain and spinal cord) are all anesthesiologists who have taken
extra training to focus on a specific area of medicine.
Other areas of specialization for anesthesiologists include pediatric (children),
obstetric (pregnant women), trauma (accident victims) and chronic pain.
Regardless of their area of specialization, all anesthesiologists must
be experts in what Shoum calls the "three As" -- affability (easy to get along
with), ability and availability. Walker agrees.
"We must be totally under control when complications occur, but keep alert
during six-hour procedures [ability]. And on many occasions, we have to be
available to work all night [availability]. Anesthesiologists also have to
be good team players, because we work so closely with the surgeon and other
members of the surgical team [affability]," says Walker.
Anesthesiologists are often expected to put in long hours. In most hospitals,
operating rooms are busy from 8 a.m. to 3:30 p.m., and they have to be present
long before and after surgical hours.
"I arrive at 7 in order to ensure the [operating room] is set up and all
the equipment I need is functioning properly," says anesthesiologist Dr. Ian
Zunder. "At the end of the day, I spend about an hour with administrative
responsibilities and reviewing the charts of the patients scheduled for the
following day. I usually leave by 5 p.m."
Anesthesiologists often work on call once a week, which might mean being
available to work from 6 p.m. to 8 the next morning.
Most anesthesiologists in America work in hospitals. However, some opportunities
exist for anesthesiologists in private or free-standing clinics.
In the U.S., nurse anesthetists can also give patients anesthesia. However,
these nurses work under the supervision of a doctor. Anesthesiologists are
doctors and anesthetists are nurses.