|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 282-283
The invisible frontrunner: Anesthesiologist 5.0
Bambang Tutuko1, Marilaeta Cindryani2
1 Department of Anesthesiology and Intensive Care, Premier Hospital Bintaro, Tangerang, Indonesia
2 Department of Anesthesiology and Intensive Care, University of Indonesia, Depok, Indonesia
|Date of Submission||23-Feb-2021|
|Date of Decision||17-Apr-2021|
|Date of Acceptance||28-Apr-2021|
|Date of Web Publication||24-Nov-2021|
Dr. Marilaeta Cindryani
Department of Anesthesiology and Intensive Care, University of Indonesia, Depok.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Tutuko B, Cindryani M. The invisible frontrunner: Anesthesiologist 5.0. Bali J Anaesthesiol 2021;5:282-3
Since 30 years of its birth as a professional specialty, anesthesiologist or anesthetist has overcome many burdens of patient and collegial problems. It arose from surgical department and remained friends, sometimes foes, and got higher appreciations along with the times. Anesthesiologists used to depart from the need for adequate perioperative assessment considerations, popped-up emergency handlings, spare-time intensive care consultations, and situational pain management. However, in the last decade, anesthesiologists have increased roles in covering almost all matters of patient safety. Their responsibilities ranging from ensuring surgical workload of patients, solving emergency situations, pain, and postsurgical patient management and even participating in continuing medical education and research.
In 2015, Meara et al. addressed the urgency of investment in human and physical resources for surgical and anesthesia care in low-to-middle income countries (LMICs). If LMICs were to scale-up surgical services at rates achieved by the present best-performing LMICs, two-thirds of the countries would be able to reach a minimum operative volume of 5000 surgical procedures per 100,000 population by 2030. Without urgent scale-up, LMICs will continue to have losses in economic productivity, estimated cumulatively at US$12, 3 trillion between 2015 and 2030. Apparently, we did not have to wait longer. In 2020, COVID-19 had started to decrease world productivity and still become our number one specter in the past 2 years.
In her last letter for WFSA, Dr. Jannicke Mellin-Olsen had stated, “As I review WFSA’s work in 2019 within this harrowing context, it strikes me how vital WFSA member societies are for protecting, strengthening, and expanding health systems. The need for these networks will only increase as we adapt and respond to a post-COVID-19 world. WFSA’s vitality and collective strength comes from our ability to effectively utilize the expertise of hundreds of thousands of anesthesiologists represented by our 137 member societies in over 150 countries.” She had also addressed that, “We are able to bring together international experts in our field to design and lead training programs and educational materials; we are an authoritative voice to push for global anesthesia at key decision-making forum including the WHO, and we are able to build the evidence-based and networks to expand quality anesthesia care worldwide.” It was a strong encouragement from a former WFSA president in order to support and boost our roles in these conflicting years.
Old fashioned anesthesiologist had been trained to encompass themselves most of the times with the Bellwether procedures (cesarean section, laparotomy, and open fractures). They would have been trained to work for most popular cases and did not have time to learn for different side of the coin. Research probabilities and occupational welfare would sound like magic from another universe.
On the other hand, newer generations of anesthesiologists would consider themselves as a part of patient safety campaign to build safer practice by all means to reduce near misses and sentinel incidents. They would change roles, never hide behind curtains, they would become frontrunners, slightly seen yet their impacts are greatly felt.
We are not concern anymore of reduced number of patients because we could still find plenty of them in different situations. Moreover, somehow, this pandemic time would enhance and train a good anesthesiologist to improvise his or her skills to modify anesthesia technique ranging from smooth general anesthesia to sophisticated regional anesthesia. In their spare time, anesthesiologists could always evaluate their technique by reading journals, consulting with colleagues or making an appraisal or article of their developing journeys.
Anesthesiologist is undeniably pure example of WHO-5-star-doctor, in which covers care provider, decision maker, communicator, community leader, and competent manager in revising and combining all treatment for their patients. The implementations of these inputs are not based on one-part responsibility. This should be done from bottoms-up and also top-down policy. Professional anesthesiologists may give their best ideas and inputs and also formulas to redefine their professional burdens and workloads. Whether to continue to work with a risk of infections or postpone surgeries and threaten the productivity.
One of the ideas is to make a group of coworkers or teammates that could work together as a team but also being handled professionally to earn each other respects. Financial and safety assurances are two most sought components in every team-up building. Two components would contribute to occupational hazards and risks when they are not well managed. Small group with trustworthy and accountable service would serve as a good example to build prosperous and healthy teamwork.
Stakeholders as hospitals, governments, foundations, and institutions would also give another light of enhancements. Feedbacks or postservice inputs in questionnaire format or in-depth discussion would also give brighter perspectives on how well the safe practice of anesthesia should or would want to be done.
Professional board or organizations could also help those practicing anesthesiologists by providing close consultations, mentoring program, assurance service and also, most important, legal service. Handling cases of medical disputes and malpractices related with anesthesia would mean as tons of paperwork, mediations, court standing, hearings, conferences, and many more. The consecutive board should make standard precautions of service and consultation to prevent eventful difficulties.
Seniors anesthesiologists should help their peers and protégés, providing them with suggestions and advices, not only exposing mistakes but also adding examples and motivations. The board should unify both seniors and juniors in order to seek for positive change and development. Policy and approach to put anesthesiologists forward as one of policy managers, main person in charge of patient surgical and safety unit would require a great deal of work from compatible seniors and executive professional committees to show and ensure responsibilities and working ethics which will be paid off with a guarantee or insurance that is commensurate with the work.
We believe that these raw ideas would intrigued the colleagues and peers to think of best method to ensure professionalism, patient safety, and the assurance of anesthesiologist’s welfare in the new normal era. Our unity and joint opinions would help us securing positions not only in the operating theaters but also our professional levels in health-care environment.
| Financial support and sponsorship|| |
| Conflicts of interest|| |
There are no conflicts of interest.
| References|| |
Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al
. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth 2016;25:75-8.
Mellin-Olsen J. WFSA Annual Report 2019/20. Available from: https://wfsahq.org/wp-content/uploads/Annual_Review_2020_WEB.pdf. [Last accessed on 19 Feb 2021].
O’Neill KM, Greenberg SL, Cherian M, Gillies RD, Daniels KM, Roy N, et al
. Bellwether procedures for monitoring and planning essential surgical care in low- and middle-income countries: Caesarean delivery, laparotomy, and treatment of open fractures. World J Surg 2016;40:2611-9.