CSEN Survey : A New Definition to Anesthesia

 

On 20.3.98 we sent 500 emails to anesthesiologists in 60 countries asking them for a new definition/name for anesthesia.

We have suggested the following options:

1. Perioperative Medicine.

2. Surgical Internal Medicine.

3. Other ?

We received 308 responses (61.6% response rate).

- 189 anesthesiologists (61.3%) chose: Perioperative Medicine.

- 42 anesthesiologists (13.6%) chose: Surgical Internal Medicine.

- 77 anesthesiologists (25%) chose other names or definitions:

* Anesthesiology and Perioperative Medicine.

* Perioperative and Emergency Medicine.

* Perioperative Medicine and Intensive Care.

* Intensive Perioperative Medicine.

* Hospitalists

However, the most interesting definition came from Dr. Dani Eimerel, suggesting the name:

PAPEC Medicine

(PAPEC = Perioperative, Anesthesia, Pain, Emergency and Critical care Medicine).

Enclosed some of the comments:

Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Mon, 23 Mar 1998 18:14:54 +0700
From:
angeleea <angeleea@health.moph.go.th>
Organization:
moph
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>
References:
1


Joseph Eldor wrote:
>
> Dear Colleague,
>
> Thank you for your participation in the last CSEN Survey on the
> question: The practice of anesthesia - medicine or nursing?
> Please look at the summary of this survey at CSEN Website 5,
> Section 2050, or go directly to:
> http://www.csen.com/anesthesia/medicine-or-nursing.htm
> Further comments on these results are welcomed.
>
> On that occasion we would like to ask you to participate in a new
> CSEN Survey:
>
> The word Anesthesia/Anesthesiology doesn`t define exactly the scope
> of the profession. The anesthesiologist doesn`t only give
> anesthesia. He/she also cares for the patient`s medical problems
> before, during and after the operation. It includes also the all
> aspects of the postoperative pain and sometimes also the issues of
> the postoperative critical care medicine.
>
> Enclosed are two new definitions/names of the profession:
> 1. Perioperative Medicine.
> 2. Surgical Internal Medicine.
> 3. Other?
>
> Please answer by: 1 or 2. If you choose 3 - please add your new
> definition/name.
>
> Remember, the word anesthesia/anesthesiology doesn`t mention the
> fact that you need also to awake the patient at the end of the
> operation...
>
> Sincerely yours,
>
> Joseph Eldor, MD
> Editor, CSEN - The Global Regional Anesthesia Website
> http://www.csen.com/anesthesia
>
I think the old term ' Anaesthesiology' is just fine.


Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Sun, 22 Mar 1998 09:15:11 +1100
From:
Michael Bookallil <mbookall@mail.usyd.edu.au>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>
References:
1


>Michael Bookallil wrote:
>>
>> >Enclosed are two new definitions/names of the profession:
>> >1. Perioperative Medicine.
>> >2. Surgical Internal Medicine.
>> >3. Other?
>> >
>> Hi Jo,
>>
>> You are suffering from a philosophical disease which peaked in its pandemic
>> with the logical positivists which had their hay day in Oxford about the
>> 1950-1960s.
>>
>> Every definition contains at least one word that is not defined. :-( BUT
>> DON"T BE DEPRESSED OR COMMIT SUICIDE OR GO MAD. :-)
>>
>> Language does NOT define reality.
>>
>> Other philosophical diseases are PC, femenism, racism, communism etc etc.
>>
>> Michael.
>>
>> -----------------------------------------------------------------------
>> Michael Bookallil mbookall@mail.usyd.edu.au
>> Dept of Anaesthesia DO6 voice +61 2 9515 8925
>> University of Sydney 2006 Australia fax +61 2 9519 2455
>> -----------------------------------------------------------------------
>
>Dear Michael,
>For such a response is worth all the effort we put in these surveys.
>I absolutely agree with your definition that:
>Language does NOT define reality.
>However, you used LANGUAGE to say it...
>In any way, I ask your permission to quote your letter with your name in
>the summary.
>Regards,
>J. Eldor

That is one of the classical philosophical problems. Get the Confessions of
a Philosopher---Bryan Magee. Some of reality has to be converted to
language to be recorded and transmitted. :-)

When I started on philosophy at age 40+ I knew that I had some reality so
that those who could not cope with it and wanted definitions etc and
thought that with out them (and such novo-entities eg blind trials) there
is no reality are mad or worse.



Michael.

-----------------------------------------------------------------------
Michael Bookallil mbookall@mail.usyd.edu.au
Dept of Anaesthesia DO6 voice +61 2 9515 8925
University of Sydney 2006 Australia fax +61 2 9519 2455
-----------------------------------------------------------------------



Subject:
R: CSEN Survey: A new definition to Anesthesia?
Date:
Mon, 30 Mar 1998 19:12:02 +0200
From:
"Marco Ingrosso" <xc0590@xcom.it>
To:
"Joseph Eldor" <a1b2c3d4@netvision.net.il>


Well, I don't think necessary to change the name to our specialty, how
much to inform in capillary manner people on all the aspects of our job;
and how is important to have an anesthetist to the proper side in the
critical moments.
Dr. Marco Ingrosso
Via F. Galloppa 78
Salerno 84128
xc0590@xcom.it


Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Sat, 21 Mar 1998 12:47:42 +0100
From:
"maija" <maija@fivenet.ch>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>


>Dear Colleague,
>
>Thank you for your participation in the last CSEN Survey on the
>question: The practice of anesthesia - medicine or nursing?
>Please look at the summary of this survey at CSEN Website 5,
>Section 2050, or go directly to:
>http://www.csen.com/anesthesia/medicine-or-nursing.htm
>Further comments on these results are welcomed.
>
>On that occasion we would like to ask you to participate in a new
>CSEN Survey:
>
>The word Anesthesia/Anesthesiology doesn`t define exactly the scope
>of the profession. The anesthesiologist doesn`t only give
>anesthesia. He/she also cares for the patient`s medical problems
>before, during and after the operation. It includes also the all
>aspects of the postoperative pain and sometimes also the issues of
>the postoperative critical care medicine.
>
>Enclosed are two new definitions/names of the profession:
>1. Perioperative Medicine.
>2. Surgical Internal Medicine.
>3. Other?
>
>Please answer by: 1 or 2. If you choose 3 - please add your new
>definition/name.
>
>Remember, the word anesthesia/anesthesiology doesn`t mention the
>fact that you need also to awake the patient at the end of the
>operation...
>
>Sincerely yours,
>
>Joseph Eldor, MD
>Editor, CSEN - The Global Regional Anesthesia Website
>http://www.csen.com/anesthesia
>
3. In my opinion, anesthesiology as definition is o.k. At least it is well
established. What it contains depends on the country, the institution , the
hospital where you are working. For instance, the hospital where I'm
working now, is still living in the era when the anesthesiologists were
servants of the surgeons. We have little to do with the things that happen
pre-or postoperatively, often we find that our prescriptions are changed or
ignored. In intensive care, we have no word to say. Of course, when
everything goes badly we are called to help though obvious errors or
difficulties could have been avoided consulting the anesthesiologist
beforehand. This is totally the reverse when I think about my previous
place of work (other country) where we, the anesthesiologists were
responsible for pre-and postoperatory care and also the intensive care with
kind collaboration of the surgeons. We also served as internists and
nefrologist, as they were available only once or twice a week. Actually,
any problem that was not surgical, was ours, and all the work was done
together with the surgeons for the good of the patient, with no sense of
rivalry.
Its no worth changing a word. What it contains, depends on culture, which
is hard to change. We are trying.



Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Fri, 20 Mar 1998 22:56:34 +0000
From:
"A.Dr.Perl" <perlash@ibm.net>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>
References:
1


Joseph Eldor wrote:

> Dear Colleague,
>
> Thank you for your participation in the last CSEN Survey on the
> question: The practice of anesthesia - medicine or nursing?
> Please look at the summary of this survey at CSEN Website 5,
> Section 2050, or go directly to:
> http://www.csen.com/anesthesia/medicine-or-nursing.htm
> Further comments on these results are welcomed.
>
> On that occasion we would like to ask you to participate in a new
> CSEN Survey:
>
> The word Anesthesia/Anesthesiology doesn`t define exactly the scope
> of the profession. The anesthesiologist doesn`t only give
> anesthesia. He/she also cares for the patient`s medical problems
> before, during and after the operation. It includes also the all
> aspects of the postoperative pain and sometimes also the issues of
> the postoperative critical care medicine.
>
> Enclosed are two new definitions/names of the profession:
> 1. Perioperative Medicine.
> 2. Surgical Internal Medicine.
> 3. Other?
>
> Please answer by: 1 or 2. If you choose 3 - please add your new
> definition/name.
>
> Remember, the word anesthesia/anesthesiology doesn`t mention the
> fact that you need also to awake the patient at the end of the
> operation...
>
> Sincerely yours,
>
> Joseph Eldor, MD
> Editor, CSEN - The Global Regional Anesthesia Website
> http://www.csen.com/anesthesia

Dear Joseph,
Both new definitions of the profession you propose,are not including
many non surgical anesthesia procedures where I and many other colegues
are involved:
1.Anesthesia for ECT
2.Anesthesia for Diagnostic procedures like:CT,MRI,angiography(manly for
children)
3.In ophtalmology:examination,ERG
So,I think that that nither perioperative or surgical internal medicine
are including many othe duties of us.
Unfortunately I d'nt have an idea of a new name/definition to
Anesthesia.
Yours sincerely
Asher


Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Sat, 21 Mar 1998 09:25:06 +1000
From:
"Mike Bennett" <M.Bennett@unsw.edu.au>
To:
"Joseph Eldor" <a1b2c3d4@netvision.net.il>


Remember, the word anesthesia/anesthesiology doesn`t mention the
fact that you need also to awake the patient at the end of the
operation...


....but it does succinctly describe the main function we perform! Until we
are directing the routine post-operative care of patients, I would stronly
resist 1. as being even less accurate. 2. is a rather ungainly term and
not really accurate, we do rather more than internal medicine for our
patients.

I'm afraid my response is:

3. Anaesthesia


Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Fri, 20 Mar 1998 23:52:15 +0100
From:
"Ozan Akca" <ozan.akca@netway.at>
To:
"Joseph Eldor" <a1b2c3d4@netvision.net.il>


Dear Dr. Eldor:

My answer is 3. I reccomend the name Perioperative Medicine and Intensive
Care. Perioperative medicine,even alone,is a good name, but please donīt
forget that we DO intensive care other than the postoperative care units .
Especially in Europa, majority of multidisciplinary intensive care units
are directed by anesthesiologists.

Sincerely,

Ozan Akca

----------
> Von: Joseph Eldor <a1b2c3d4@netvision.net.il>
> An: ozan.akca@netway.at;
> Betreff: CSEN Survey: A new definition to Anesthesia?
> Datum: 20 March 1998 17:17
>
> Dear Colleague,
>
> Thank you for your participation in the last CSEN Survey on the
> question: The practice of anesthesia - medicine or nursing?
> Please look at the summary of this survey at CSEN Website 5,
> Section 2050, or go directly to:
> http://www.csen.com/anesthesia/medicine-or-nursing.htm
> Further comments on these results are welcomed.
>
> On that occasion we would like to ask you to participate in a new
> CSEN Survey:
>
> The word Anesthesia/Anesthesiology doesn`t define exactly the scope
> of the profession. The anesthesiologist doesn`t only give
> anesthesia. He/she also cares for the patient`s medical problems
> before, during and after the operation. It includes also the all
> aspects of the postoperative pain and sometimes also the issues of
> the postoperative critical care medicine.
>
> Enclosed are two new definitions/names of the profession:
> 1. Perioperative Medicine.
> 2. Surgical Internal Medicine.
> 3. Other?
>
> Please answer by: 1 or 2. If you choose 3 - please add your new
> definition/name.
>
> Remember, the word anesthesia/anesthesiology doesn`t mention the
> fact that you need also to awake the patient at the end of the
> operation...
>
> Sincerely yours,
>
> Joseph Eldor, MD
> Editor, CSEN - The Global Regional Anesthesia Website
> http://www.csen.com/anesthesia
>
>


Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Mon, 23 Mar 1998 10:42:54 +0300 (IDT)
From:
"Dr. Dan Eimerl,M.D." <eimerl@cc.huji.ac.il>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>


Yossi,Hi again.
The Q. you ask has already been answered by Mark Rogers.
He defined modern Anesthesia as: "P.M. & P.M.", the meaning of
which is, not Post-Mortem,but -" Perioperative Medicine & Pain
Management".
If you want to add Emergency Medicine, Critical Care Medicine,and such-
-some people will agree.
In my mind, "P.M & P.M.", as the above is the best.
Best regards ,
Dani Eimerl.



Subject:
Re: CSEN Survey: A new definition to Anesthesia?
Date:
Fri, 20 Mar 1998 12:25:38 -0400 (AST)
From:
Allen Finley <gafinley@is.dal.ca>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>


On Fri, 20 Mar 1998, Joseph Eldor wrote:

> Enclosed are two new definitions/names of the profession:
> 1. Perioperative Medicine.
> 2. Surgical Internal Medicine.
> 3. Other?
> Please answer by: 1 or 2. If you choose 3 - please add your new
> definition/name.
________________________________________________________________

3. Anaesthesia/Anesthesiology

Everything we do doesn't relate to the perioperative period or to surgical
patients, either. How about Anesthesiologists who specialize in Pain
Medicine, Critical Care, or Obstetric Analgesia? So what?

Why is there this urge to apply new terms to well understood
concepts? ("Sanitation Engineer" for "Janitor"; our hospital now has
"Protection Services" instead of a "Security" Department). Dorland's
Medical Dictionary gives the derivation of "surgery" as "...from Greek
cheir (hand) + ergon (work)", i.e. "hand-work". I expect that most
surgeons would resent the suggestion that they worked only with their
hands (and not their heads), yet I don't hear of any movements to change
their specialty to "Clinical Anatomy", "Anatomical Medicine", "Anatomical
Therapeutics" or something equally ridiculous.

/|
/_|llen..
/ | ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
| G. Allen Finley, MD FRCPC <allen.finley@dal.ca>
Associate Professor % Paediatric Anaesthesia/Pain
Anaesthesia & Psychology % IWK Grace Health Centre
Dalhousie University % Halifax, NS, B3J 3G9 CANADA
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Subject:
Re: [Fwd: Re: CSEN Survey: A new definition to Anesthesia?]
Date:
Tue, 24 Mar 1998 12:39:29 +0300 (IDT)
From:
"Dr. Dan Eimerl,M.D." <eimerl@cc.huji.ac.il>
To:
Joseph Eldor <a1b2c3d4@netvision.net.il>


Yossi Shalom,
How about "P A P E C" = Perioperative + Anesthesia + Pain + Emergency +
+ Critical Care Medicine?
It seems to me that we have to find an abrreviation which is easy to
pronounce.
Regards,
Dani Eimerl.



Joseph Eldor, MD

Editor, CSEN - The Global Regional Anesthesia Website