Difference Between Anesthetist and Anesthesiologist?

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.

Doctor Answers 24

An Anesthesiologist is a doctor and an Anesthetist is a nurse

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This is a significant difference you have touched upon! Such an important difference, in fact, that the AAAASF (the most demanding of all accreditation agencies for a plastic surgeon's OR) requires that you have an MD Anesthesiologist. The doctor clearly has a higher level of training and responsibility and this is a saftey issue for the patients in sorting out who to go to for your surgery.

Your care with an anesthetist might actually be better

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Dear Researcher

I have worked with many anesthesiologist and anesthetists. The anesthesiologist is a physician who has completed a residency in anesthesiology.

A Certified Nurse Anesthetist is a nurse with a four year degree (BSN) and a minimum of 1 year of critical care nursing. However, I believe that the average is about 5 years. This experience is often minimized by anesthesiologists who feel they are financially competing with the CRNA. However, critical care nurse operate under very broad treatment protocols and essentially run life saving emergency codes on highly unstable patients in critical care units. Then, the nurse completes a 3 year training program to become an anesthetist. So these are highly skilled individuals with a great deal of critical care experience and judgement.

I currently operate at the UCLA surgery center, an 8 operating room surgery center. Anesthetists run anesthesia cases with the immediate availability of a supervising anesthesiologist. I generally feel that it is much safer doing my longer cases in this setting rather than an office operating room because, should there be a rare emergency, there is a vast array of highly capable and experienced medical staff available to assist and the resources to handle virtually any emergency.

Emergencies are very rare but if you have one in your surgeon's office operating room, will your surgeon and his/her anesthetist or anesthesiologist have the resources to handle the issue?

Also, I find that nurse anesthetists tend to be a little more patient than anesthesiologists. For sure, this is a very broad generalization that does not apply to every individual. However, it is usually the anesthesiologist who are busy responding to emails, reading the wall street journal, or doing other nonsense during the case. I am sure they are great multitaskers and when someone is under general anesthesia the anesthesia does automate a number of critical care functions making it possible for the anesthesiologist to safely be distracted for a moment or two.

However, I do a number of cases under IV sedation and this is one type of anesthesia where the "anesthesia provider" has to be present moment by moment. To be fair, there are anesthesiologist who are great at this, but as a rule of thumb, I find the capable nurse anesthetists are more willing to be present in the moment to provide this time of care.

Hope this gives you a little better insight.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Anesthesiologist vs Anesthetist

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An anesthesiologist is an MD; an anesthetist is an RN. With proper training both are qualified to administer anesthesia in a surgeon's accredited office operating room. Over the past 30 years I have used both.

Make sure the operating rooms are accredited or certified. Here in California we have made this a legal requirement.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

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Yes! Difference Between Anesthetist & Anesthesiologist

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An Anesthesiologist is a MD (Medical Doctor) who has years of training in anesthesiology (medical school, internship and accredited residency training program AAAASF).

An Anesthetist is a nurse who has some experience in the field before returning to a 2 year anesthesia training program.

While an Anesthetist can be very qualified in administering anesthesia, I suggest making sure you are under the supervised care of a board certified anesthesiologist.

If you have any underlying medical condition, I strongly recommend you seek an Anesthesiologist who would be prepared for any emergency, should something occur during your surgery.

Wishing you the best of luck,

Dr. Franco-Webb

Anesthetist vs. Anesthesiologist

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The difference between a nurse anesthetist and an anesthesiologist is the level of training. A nurse anesthetist is typically an ICU nurse that has completed additional training to provide anesthesia. Often they work in the hospital setting under the supervision of an anesthesiologist. And they also can work in the private practice setting such as with a plastic surgeon under the supervision of the surgeon.

I can say with great confidence that it is safe to have your procedure performed in a plastic surgeon's office OR facility with a CRNA. It can also be quite unsafe if the anesthetist is not certified or skilled or the outpatient facility is not accredited. It can also be quite unsafe to use an anesthesiologist that is not skilled at outpatient procedures.

I have been using deep sedation anesthesia for all of my plastic surgery procedures for 12 years (6 years of residency and 6 in private practice)  and have found that many CRNAs, including the ones that I use currently, are far more skilled at their particular trade than many, if not most, anesthesiologists that I work with in the hospital setting. I mean no offense to any anesthesiologists, but many of them simply are not highly skilled at outpatient procedures, particularly when MAC or deep sedation anesthesia is utilized, which is what I highly prefer for many reasons.  

I have read another post regarding this question stating that no corners should be cut when providing anesthesia care. And I absolutely agree. That is why I treat my patients with the same level of care that I would provide for my family members and use a highly skilled nurse anesthetist for my surgical procedures.  

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 90 reviews

Anesthestist Vs. Anesthesiologist

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When cosmetic surgery is performed in an outpatient surgery center safety has to be everyone’s first priority. For this reason, we only utilize physician anesthesiologist in our outpatient surgery center.
There are significant differences in the training, responsibilities, and experience of anesthesiologist and anesthetists. An anesthesiologist is a physician who has specialized in the practice of anesthesia. In most cases this involves completion of at least four years of additional training in this area of specialization. This additional training prepares anesthesiologists to handle almost any situation that may arise during and after surgical procedures. In addition, these practioners are able to practice independently.
In contrast, anesthetists are nurses who have undergone an additional two years of training in anesthesia. Nurse anesthetist can’t practice independently of a physician. In most cases, they’re supervised by an anesthesiologist in a hospital setting.
Unfortunately, nurse anesthetists are often used in outpatient cosmetic surgery centers in an effort to contain costs. Under these circumstances, the supervising physician is the plastic surgeon, who in all probability, knows less about anesthesia then the nurse anesthetist.
In the vast majority of cases, this will probably result in a safe anesthetic experience. In rare cases where anesthetic complications occur, the plastic surgeon is the supervising physician rather than an anesthesiologist. For this reason we feel that the safest approach always involves utilization of a physician anesthesiologist when surgery is performed in an outpatient surgery center.

Nurse Anesthetist vs MD Anesthesiologist - I want m patients to have an MD Anesthesiolost at their bedside for the duration of t

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There are many capable nurse anesthetists who work in a hospital environment under the direct supervision of board certified anesthesiologists. However,  it is critical that nurse anesthetists are always supervised by a board anesthesoligist. Sometimes, in private surgical suites, Nurses provide anesthesia. 

 In my practice I do for my patients what I would want to be done for me or my family members if they were the patient. We don’t cut corners just because we’re not related to you. So I use experienced, board-certified anesthesiologists (MDs) for the anesthesia care of my patients.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Anesthesiologist vs Nurse Anesthetist

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Anesthesiologists are physicians and anesthetists are nurses with advanced (and usually quite good) education and training.  State law dictates whether or not nurses can work alone, without anesthesiologists, and the operating surgeon supervises them when an anesthesiologist is not mandated.  Most hospitals and facilities use a combination of both to control costs.  My feeling is that healthy patients almost always do well with either because the risk is so low to begin with.  And patients with poor health probably shouldn't be undergoing procedures they don't really need (cosmetic surgery) when there is some significant concern for patient safety.  Overall, I tend to prefer that an anesthesiologist be present in case any untoward event arises.     

Brian M. Braithwaite, MD
Chicago Plastic Surgeon

Anesthesiologist is a physician and anesthetist is a nurse.

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An anesthetist has an R.N. degree and went to nursing school and did a usually two-year nursing anesthetist program. An M.D. physician anesthesiologist went to four years of medical school then completed four or five years of residency specializing just in anesthesia. Both anesthetists and anesthesiologists are very well qualified to perform anesthesia. Physician anesthesiologists are able to perform more complicated anesthetics when multiple medical complications present themselves with complex physiology. Nurse anesthetists do a very nice job of taking care of helping patients for routine anesthetics.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Anesthetist is a nurse; anesthesiologist a doctor. Be cautious about general anesthesia in office

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Nurse anesthetists typically work under the supervision of an anesthesiologist (MD) in a hospital.

The problem with general anesthesia outside of a hospital operating room is the lack of emergency support when something goes wrong (e.g. Michael Jackson).

Although nurse anesthetists typically give anesthesia throughout the case, the MD anesthesiologist is always present during induction and emergence, the two critical phases of general anesthesia.

The limitations of office surgey are many, but most importantly are the lack of adequate back up during an emergency. If I were to consider general anesthesia in any but a hospital OR, I would insist on an Anesthesiologist present. The only reason to substitute an anesthetist is cost and when it comes to your life, cost should not be a consideration

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.