What we do, what we call ourselves, and how we spell it

What is in a name? However you spell it, anaesthesia, or at least the administration of anaesthetic drugs, is not solely the preserve of anaesthetists. British Anaesthesia Associates, American Certified Registered Nurse Anesthetists (CRNAs), and an international spectrum of specialist nurses and technicians all provide sedation and anaesthesia with varying degrees of medical supervision. The accountability frameworks may differ, but their practice is nevertheless lawful. Anaesthetic drugs (typically hypnotics) are prescribed by physicians in ICUs and emergency departments (and less frequently elsewhere). Medically qualified specialist anaesthetists regard these alternate providers with a range of emotions reflecting their perceived status as valued colleagues or unwelcome competitors. One approach is to emphasise the value of specialist postgraduate training in anaesthesia and to reflect that with a special name. Thus, in 1902, American physician anaesthetists became anesthesiologists,1 and their counterparts in continental Europe and Ireland are now anaesthesiologists.