Anesthesiologists are highly skilled medical doctors (M.D. or D.O.) who specialize in the field of anesthesiology. They have significantly longer and more extensive training than other classifications of anesthesia practitioners, so they are the most qualified to make anesthesia- related perioperative medical decisions.
Anesthesiologists are primarily responsible for the safety and well-being of patients before, during and after surgery. This may include:
- Placing the patient in the state of controlled unconsciousness called “general anesthesia”
- Providing “regional anesthetics,” in which only a portion of the body is made numb
- Administering sedation when indicated for the relief of pain or anxiety
All of these anesthetics provide continuous pain relief and sustain patients’ critical life functions as they are affected throughout surgical, obstetrical or other medical procedures.
The role of the anesthesiologist extends beyond the operating room. The anesthesiologist is responsible for the preoperative assessment of the patient, an evaluation process that carefully considers both the patient’s current state of health and the planned surgical procedure. This evaluation allows anesthesiologists to make judgments about the safest anesthesia plan for each individual patient. The anesthesiologist also is responsible for the well being of the patient postoperatively, while the patient emerges from the effects of anesthesia. They often are involved in the management of acute postoperative pain, as well as chronic and cancer pain; cardiac and respiratory resuscitation; blood transfusion therapies; and respiratory therapy.
Anesthesiologists in the United States complete a four year undergraduate college degree that includes satisfying pre-med requirements. Like other medical doctors, anesthesiologists must follow undergraduate education with four years of medical school. After medical school, a physician specializing in anesthesiology completes a four-year anesthesiology residency program. They are then eligible to sit for the American Board of Anesthesiology (ABA) exam. Almost 90 percent of anesthesiologists are board-certified.
Although anesthesiologists complete a minimum of eight years of medical training after college, many elect to spend an additional fellowship year of specialty training in specific areas such as pain management, cardiac anesthesia, pediatric anesthesia, neuroanesthesia, obstetric anesthesia or critical care medicine. They may also seek certification in one of following subspecialties, which require additional training and examinations: critical care medicine, hospice and palliative medicine and pain medicine.
Anesthesiologist assistants (AA) are highly skilled health professionals who have completed a four-year undergraduate pre-med program, followed by an accredited anesthesiologist assistant education program. A student may become certified by passing the National Commission for Certification of Anesthesiologist Assistants examination.
AAs are trained extensively in the delivery of safe and high quality anesthesia care, as well as advanced patient monitoring techniques. As nonphysician anesthetists, AAs work under the direction of licensed anesthesiologists to implement anesthesia care plans. An AA may not practice outside the field of anesthesia or apart from the supervision of an anesthesiologist.
A nurse anesthetist or CRNA is an advanced practice registered nurse who has acquired graduate level education and board certification in anesthesia. They are nonphysician anesthetists, specializing in the provision of anesthesia care and participate in the administration of anesthesia in a variety of surgical cases. They are frequently supervised by an anesthesiologist, but may also work under the supervision of other physicians.
A pediatric intensivist
is a medical doctor who specializes in caring for adolescents, children, and infants who have serious illnesses or injuries. Most intensivists work in critical care centers at hospitals to diagnose and treat emergency conditions. Some pediatric intensivists work exclusively with patients with very particular conditions, such as asthma
attacks or head injuries. Most physicians, however, provide expert care for young people with all types of life-threatening disorders.
When a patient is admitted into a critical care center, a pediatric intensivist makes a diagnosis by obtaining information about symptoms and conducting a physical examination. He or she may order diagnostic imaging tests to examine injuries or collect blood and tissue samples for laboratory analysis of diseases. With the aid of nurses and hospital technicians, pediatric intensivists ensure young patients are constantly monitored and kept as comfortable as possible while treatment decisions are being made.
After confirming a diagnosis, a pediatric intensivist can administer the appropriate treatment. The intensivist may need to administer intravenous fluids and medications or place a child on a ventilator to stabilize breathing. Depending on the urgency of a patient's condition, the doctor might decide to monitor the effects of medications over a few hours or arrange for immediate surgical procedures.
Treating life-threatening conditions in young people is often very different than caring for adults with similar conditions, as diseases and injuries affect developing body systems in unique ways. A young child's immune system, for example, is typically less effective at fighting off relatively common bacteria and viruses. The same pathogen that causes an adult to experience a simple cold can cause a child to have serious breathing, cardiac, and neurological complications. Pediatric intensivists receive extensive training in order to recognize and accurately treat health problems in young patients.
A person who wants to become a pediatric intensivist usually needs to complete four years of medical school
, participate in a three-year pediatric care residency, and enter a two- to three- year pediatric critical care fellowship. During residency and fellowship training, a new doctor has the opportunity to work directly with patients under the supervision of established pediatricians. He or she learns how to keep patient records, identify different conditions, and administer treatment. In addition, a doctor is required to pass certification exams upon completion of both the residency and the fellowship to gain licensure in his or her specialty.
Many pediatric intensivists conduct independent research when not treating patients. They review literature on different diseases and conditions, and compose original papers based on their own clinical and experimental findings. It is important for a pediatric intensivist to stay up-to-date on the latest innovations in medical technology and treatment techniques to ensure his or her patients receive the best possible care.
Pain Management Physicians
A pain management doctor must first become a Doctor of Medical (M.D.) or Doctor of Osteopathic Medicine (D.O.) and licensed in the state where they will practice. They are also usually certified by a board governing their specialty.
A pain management doctor focuses on your ability to function despite living with chronic pain
. Their goal is to help you manage pain so that the quality of your life improves. You should be able to perform your usual daily living activities, work activities, and leisure activities with pain under control -- at least, that's the goal.
A pain management doctor utilizes various treatment modalities to control chronic pain. Primary care doctors prescribe and use some of the same treatment modalities, but a pain management doctor is solely focused on pain control. When a primary doctor finds it difficult to bring a patient's pain under control, that's usually when a referral is made to the specialist.