This is an interesting quandry but one that can be avoided by using commercial spots/websites/etc. to laud our training. What has been said about the lay public not knowing the difference in who is providing anesthetic care is very true.
Case in point: One of my patients for the upcoming week spent an hour talking to me two days ago to make sure that I was aware of her heart disease, anxiety, allergies, and two near death experiences during surgery.
The very first question she asked me was about whether or not I was a physician. The next was to ask if another type of anesthetist was going to be present, to which I said no. Unsolicited, she told me that her last two procedures (breast implants, and redo breast implants) were near death experiences at plastic surgery centers using 90% CRNA's, requiring her to be transferred to tertiary hospitals for ICU stays, the latter of which included prolonged awareness under anesthesia during a severe hypotensive episode. This can happen to any anesthesia provider, but until the second of two events, she did not know that she could have had an anesthesiologist perform her anesthetic (the center she went to gives the patient that option IF THEY ASK which she discovered in the very fine print during her subsequent lawsuit, but otherwise defaults to CRNA's with surgeon oversight).
It is a matter of trying to blur the lines of training that is going on with many fields of medicine.
When does the public deserve to know that they can have physicians provide their care when they may be steered or influenced in another direction? It should be a matter of choice, but how can you choose when you are either not given that option, or one side tries to blur the lines of distinction? We do not have to start a flame war in the public eye, but neither should we abstain from raising our public profile to laud our minimum of 12 years of higher education including 8 years of grueling of training at the highest level.
It is an interesting situation that is affecting ophthamology, obstetrics, family and internal medicine, emergency medicine, etc.
"Dr. XXX XXXXX, O.D., Doctor of cosmetic optometrics and invasive vision correction" Saw that in Garland, Texas the other day. To read that makes one assume that optometrists can do surgical vision correction and perhaps cosmetic surgical procedures.
Let's take the high road with respect to attacking the other side, but like a cardiology spot I saw a couple of years ago, let us laud the strength, depth, and diversity of training that anesthesiologists receive and practice. General anesthesiology, cardiac anesthesiology, intensive care, pediatric anesthesiology, pain management, invasive pain management, obstetric anesthesiology, transplant anesthesiology, trauma care, total perioperative care, research in all types of physiology, etc.
EVERY anesthesiologist has to receive at least a minimum amount of training in each subject, as well as what they receive as a general resident during internship or other residencies.
That needs to be emphasized in a public but not necessarily combative or condemning fashion.
The commercial spot I saw was a positive, fast-paced spot set to a positive up-beat orchestral soundtrack lauding the variety of care provided by cardiologists in the different settings they practice in (invasive, general, electrophysiologic, chronic, emergent, etc.) with a final message of "Cardiologists of XXX, superior and cutting edge patient care of the past, present, and future."
