Physicians and anaesthetists

"There are clearly differences between how physicians and anaesthetists think and work, and it has become clear to me that working together as a team provides a very complementary viewpoint which is more effective for patient care. As a physician I have some experience in managing patients with a variety of medical conditions. However, close working with an anaesthetist has shown me that I really do not understand what goes on in theatre at a basic practical level. I am constantly surprised by insights from my anaesthetic colleagues which point to critical aspects of care which I would never have anticipated. From basic issues such as patient positioning, to more complex anaesthetic considerations relating to options for regional anaesthesia or airway management, there are a whole host of practical problems which must be overcome in order to get a patient through a surgical procedure, many of which I am simply not aware of.

"On many occasions my anaesthetic colleague will identify a critical issue which would not raise any concerns on the medical ward, but which would be likely to cause cancellation of surgery, or worse, a perioperative problem, if no plan is made pre-emptively. This expertise in the practical aspects of perioperative care and the intricacies of anaesthetic management are alien to physicians, just as the day to day management of a variety of medical problems may be less familiar for anaesthetists.

“Working together with an anaesthetic colleague and with our therapists, we can discuss these issues together and work with patients and their families to develop robust perioperative management plans which would not be possible if we were each working alone."

Dr Richard Biram, Consultant Physician and Geriatrician, Cambridge University Hospitals NHS Foundation Trust

_{Picture of Dr Biram and his anaesthetic colleague taken prior to COVID-19}