Current Understanding of Patients’ Attitudes Toward and Preparation for Anesthesia

Abstract

Nesthesiology as a medical specialty had its be- ginnings in the early part of this century when physicians began to manage vital functions dur- ing surgery in addition to simply performing the sur- gical prerequisites of inducing unconsciousness and waking patients at the end of surgery. Complex sur- gery performed on sicker patients became increasingly possible as physician-anesthetists developed tech- niques for critical care and active perioperative man- agement of vital functions. The general public under- stood little of these developments. At the 1939 New York World's Fair, the nascent specialty of anesthesi- ology announced itself to the nonmedical world (1). A committee of leading physician-anesthetists chaired by Paul M. Wood designed exhibits not only to illus- trate anesthetic techniques but also to explain the im- portant role of physician-anesthetists in medicine, thus conveying the message to the general public that anesthesiology was indeed a legitimate specialty. As the health care environment changes and the specialty of anesthesiology evolves, the need and challenges for educating the individual patient and the public at large have never been greater. As discussed later in this review, both the patient and the anesthesiologist are benefactors of this education. The problems of image and status of anesthesiolo- gists in the eyes of the medical and lay communities are not new (2). In the Rovenstine Memorial Lecture in 1979, Leroy Vandam spoke of the history of this prob- lem and offered his views on ways in which individ- uals can elevate the level of their practice to that of "anesthesiologist-clinicians" (3). Many, if not all, prac- ticing anesthesiologists have struggled at some point with issues relating to the status and image of the specialty. Recent network media exposure citing the lack of presence of anesthesiologists as cause for sev- eral patients' demise (ABC News "Day One," 1995) has cast doubt into the hearts of patients by portraying