December 2, 2024
Ventilation of a training phantom by a mask and ambu baloon

There is a brewing disagreement in this country over expanding the role of nurse anesthetists in order to help make up the current shortfall of anesthesiologists. While that debate is going on, there are countries with such severe anesthesiology shortages that people are unable to get vital surgeries. Numbers from the World Federation of Societies of Anesthesiologists show just how serious the problem is. And those numbers demonstrate the need to prioritize anesthesiology.

The richest countries in the world have the largest volume of anesthesiologists per capita. That is to be expected. No one is surprised that Switzerland has more than 54 anesthesiologists per 100,000 patients while Russia and the U.S. both have close to 21. Take a look at India and you’ll discover just 1.26 anesthesiologists per 100,000 patients. Gambia is at the bottom of the list at 0.1 per 100,000 patients.

Why do the numbers matter? Because anesthesiology is a key component to successful surgery. While the world has been emphasizing the need to make surgery available to more people groups, they have forgotten the fact that anesthesiology needs to go along with it. The two cannot be separated. They are joined at the hip, so to speak.

What Anesthesiologists Do

Proponents of prioritizing anesthesiology suspect that some of the lack of attention is due to ignorance about what anesthesiologists actually do. Anesthesiologists are fully educated physicians who follow their general medical training with an additional three or four years of anesthesiology training.

Know that anesthesiologists do more than just knock people out and then wake them up after surgery. They are responsible for finding the safest and most effective way to anesthetize a patient in preparation for surgery. During the surgical procedure itself, the anesthesiologist continually monitors the patient’s condition and responds to any complications that may arise. And by the way, complications are more common than most people know.

For example, most people do not know that a patient’s blood pressure falls under anesthesia. That cannot be ignored during surgery. If not properly addressed, a patient could suffer brain damage, kidney damage, or some level of organ failure. The patient could even die.

We Need More Trained Professionals

When you look at the global shortage of anesthesiologists you suddenly realize that the debate over expanding the role of nurse anesthetists one definitely worth having. We need more trained professionals in both camps. More anesthesiologists would obviously ease the shortage, but they would also be able to oversee larger numbers of nurse anesthetists who could also help reduce the need for manpower.

A similar debate was fully raging a couple of years ago when the states began looking at the possibility of expanding the role of nurse practitioners and physician assistants. That debate eventually subsided when it became clear that expanding roles gave advanced practice nurses an opportunity to actually help solve some of the shortage problems among the primary care and family medicine specialties.

Perhaps doing the same in the field of anesthesiology would produce similar results. Expanding the role of nurse anesthetists could very well help alleviate the doctor shortage. It could encourage more people to go into nursing and free up anesthesiologists to focus on their most important work.

As the debate continues, one thing is for certain: anesthesiology needs to be prioritized one way or the other. Far too many patients are having to forgo much-needed surgery because there are simply not enough anesthesiologists to go around. It may not be a problem here, but it is a big problem in the most underserved parts of the world.