An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine.
Terminology varies between different countries. In the United States, the term ''anesthesiologist'' refers to a physician who has completed an accredited residency program in anesthesiology after medical school training, while the term ''anesthetist'' is used for nurse anesthesia providers who have undergone specialized training in administering anesthesia under the supervision of a physician. By contrast, in the UK, most former Commonwealth countries and in Europe, the term ''anaesthetist'' refers only to physicians, who may be assisted by any of anaesthetic nurses, anaesthetic technicians, operating department practitioners or physician associates depending on local practice.
Anesthesiologists provide medical care to patients in a wide variety of (usually acute) situations, including preoperative evaluation, consultation with the surgical team, creation of a plan for the anesthesia tailored to each individual patient, airway management, intraoperative life support and provision of pain control, intraoperative diagnostic stabilisation, proper post-operative management of patients. Outside the operating room, anesthesiologists spectrum of action includes with in-hospital and pre-hospital emergencies, intensive care units, acute pain units and chronic pain consultations. Because anesthesiologists are physicians, in contrast to other anesthesia providers, they are able to utilize their extensive knowledge of physiology, pharmacology and diseases to guide their decision making.
In the USA, there has been a shortage of anesthesiologists historically. In order to better serve the population, residency positions in anesthesiology for physicians have been steadily increasing the past several years. In addition, US physicians supervise ACTs, or Anesthesia Care Teams, which are composed of a supervising physician with several certified registered nurse anesthetists (CRNAs) or anesthesiologist assistants (AAs). In other areas of the USA, anesthesiologists work in what is deemed a "solo" or "MD/DO only" practice, during which they provide anesthesia in a "one on one" relationship with the patient. In many areas of the country CRNAs work independent of an anesthesiologist.
A consultant anesthetist in the UK is a fully qualified doctor, who has spent at least 9 years (7 of which should be in anesthesia) after graduation as a trainee, and is appointed as a consultant. Trainee anesthetists in the UK are fully qualified doctors on their way to become consultants; they could be two years or even 10 years post graduation.
== Anesthesiologists/Anaesthetists and patient-informed consent ==
Patient-informed consent is a fundamental ethical and legal principle and is considered essential to patient autonomy. The American Society of Anesthesiologists, the American Osteopathic College of Anesthesiologists, and other professional organizations, such as the (American Academy of Anesthesiologist Assistants ) and American Association of Nurse Anesthetists, support the principle that patients should be fully informed regarding the manner in which their anesthetic will be administered. In Germany, the law requires that prior to anesthesia informed consent of the patient must be obtained by the anaesthetist.
Due to medications given before, during, and after surgery, a patient may sometimes not remember interacting with the anesthesiologist/anaesthetist, nurse anesthetist, or anesthesiologist assistant involved in their anesthesia care. The anaesthetic plan, as well as alternatives, risks, and benefits of the chosen anaesthetic techniques, should be discussed with the patient prior to surgery (This can be difficult or impossible in some situations, such as with unconscious patients, confused patients, or extremely urgent cases).
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