Is there a difference between an anesthetist and an anesthesiologist? Is it safe to have a face lift, or neck lift under anethesia that was administered by an anesthetist, in a plastic surgeon's office facility? That is, they have operating rooms and say it has some qualifying certification.
Hi!
In our New York City ACCREDITED office surgical suite, we think it is safest to have anesthesia by board certified anesthesiologists. These are medical doctors who did a residency in anesthesia, and then passed rigorous testing.
Some anesthetists are good, but they are not doctors, and have not had nearly as much training.
Hi. An anesthesiologist is a physician. An anesthetist usually refers to a nurse. Both have training in administering anesthesia; however a physician has more training and education. The regulations vary from state to state. In some states, a nurse anesthetist can work on their own, without supervision by an anesthesiologist. In other states, nurse anesthetists must be supervised by an on-site anesthesiologist. This is so that if something goes wrong, the more skilled anesthesiologist is there to help. Some physicians use anesthetists because they are less expensive or more readily available.
The regulations governing office based surgery also vary state to state. Some states require that office based surgery can be performed only in operating rooms that are accredited by JAHCO, AAAA or AAA. These accrediting groups inspect the operating room facilities periodically to make sure that the facility and personnel meet all safety standards, etc. Other states do not require this and surgeons can operate in facilities that are not accredited. I do not recommend this.
Ask your plastic surgeon which group accredites the operating room. It should be one of the 3 mentioned above. You can ask to see the certificate of accreditation to make sure it is current.
Some surgeons consider both anesthesiologists and anesthetists to be equally safe. However, some surgeons will work only work with an anesthesiologist because they feel the level of safety is higher with the more highly trained anesthesiologist.
Some surgeons feel office based surgery is very safe and others prefer to use either an ambulatory surgery center or hospital because these facilities generally have more personnel and equipment to handle an emergency. Ask your plastic surgeon what they do in the case of an emergency. Do they have equipment available for general anesthesia, which is sometimes needed if there is an emergency. How many extra people are around to help in an emergency?
The MOST important thing in surgery is safety. If you have medical problems such a high blood pressure or diabetes, some surgeons will insist your surgery be performed in a non-office facility. If you are healthy, then either type of facility is usally OK. If someone is cutting corners to make the surgery less expensive, it is not worth it. For example, if the nurse anesthetist has very little experience but costs less. However, many surgeons operate safely in in-office facilities because they adhere to strict policies regarding personnel and choose carefully which patients and what surgeries are performed in their office. Do your research and ask questions as you are. Hope this helps.
Tracy Pfeifer, MD, MS
There are many highly qualified people who administer anesthesia and both an anesthetist (typically an RN) and an anesthesiologist (an MD) are capable. There are well trained and very competent people in both fields, just as there are people with poor skills in both fields.
In my own practice we use an anesthesiologist for sedation as I prefer having another physician to monitor the patient. In situations where the Surgeon uses an anesthetist, the surgeon would become the supervising physician.
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