Reader response
From Nancy L. Glass MD
Today's PAAD is terrific--Dr. Agarwal and Dr. Reece-Nguyen have done a wonderful job of introducing the comprehensive article just published by Dr. Reece-Nguyen and his colleagues. As someone who lives in the state of Texas, which seems hell-bent on making life miserable (and unsafe) for trans individuals and their families, it's hard for me to understand the hate-filled hearts of Gov. Greg Abbott and Lt. Gov. Dan Patrick. Much advocacy work remains to be done to protect the rights and safety of trans-gender and gender-diverse individuals.
I have shared this PAAD and the referenced article with one of the AAP speakers who will be on the podium at our upcoming meeting.
From Robert M. Ricketts MD Pediatric Anesthesiologists Are Not Pediatricians
I have been an avid reader of PAAD since its inception by the late and great Ron Littman. I have learned much from this publication’s succinct but important distillation of pertinent literature. I applaud your collective hard work on this important publication.
However, I have become increasingly concerned by a practice by your editorial board. In a few publications, PAAD has advanced the notion that pediatric anesthesiologists are or can be in some ways pediatricians. This idea has been put forward in different ways. Once the notion was advanced that pediatric anesthesiologists should consider themselves ‘perioperative pediatricians.’1 More recently, one of your editors directly said that readers should consider themselves both pediatric anesthesiologists and pediatricians by proclaiming to readers “yes, you are pediatricians as well as anesthesiologists!”2 (emphasis to the author).
I respectfully disagree. Pediatricians are physicians who are diplomates of the American Board of Pediatrics (ABP). They have trained in a ACGME accredited residency and have successfully sat for and past the ABP board certification test. The ABP further stipulates ongoing continuing education and maintenance of medical licensure of its diplomates to continue to call themselves pediatricians. While many pediatric anesthesiologists in this country also happen to be pediatricians, the vast majority are not.
There is danger in pediatric anesthesiologists embracing the notion that they are pediatricians even in a tongue in cheek manner. “Misappropriating medical titles confuses patients and risks safety. . . . It is an unchallenged ethical principle that every patient must have full knowledge and understanding of the education, training, skills and experience of the health care professionals who provide their care.” These are not my words. Rather they are the words of the American Society of Anesthesiologists regarding the American Association of Nurse Anesthesiology’s (AANA) recent name change.3
How can the field of Anesthesiology be aghast at the AANA cooptation of the term anesthesiologist but then itself permit members to coopt the term pediatrician? How can anesthesiologists vigorously advocate for the sanctity of the term anesthesiologist but assert that by only will and good intentions they are ‘perioperative pediatricians?’ Respectfully, these two notions are entirely mutually exclusive. And their simultaneous existence undermines the ASAs efforts to protect the field of anesthesiology.
Much like the ASA has reminded nurse anesthetists when using the term nurse anesthesiologist, the PAAD board should remind its readership that inappropriately identifying yourself as a pediatrician likely risks admonishment by state medical boards and your institution. Unless you are indeed a diplomate of the ABP in good standing, I would strongly advise any physician or medical professional to not apply the term pediatrician to themselves in a professional setting in any capacity.
I do concede that PAAD’s editorial board advancing this notion of pediatric anesthesiologists being pediatricians has a noble if not quixotic goal. Much of this has been put forward when PAAD articles discuss the scope of practice of a pediatric anesthesiologist. Should pediatric anesthesiologists administer influenza vaccines? Should pediatric anesthesiologists screen for suicidality in adolescent patients? These are all interesting and stimulating discussions. But they can be held and discussed without the simultaneous notion that pediatric anesthesiologists should consider themselves pediatricians.
It is my hope that the PAAD editorial board follows the overall guidance and advocacy expulsed by the ASA toward the misappropriation of medical titles. Because should a day come when pediatric anesthesiologists freely call themselves pediatricians, it will undoubtedly mean that the term anesthesiologist has long been usurped.
1- Yaster, M. Nichols, D. Suicide Risk in the Emergency Department: Should we be doing this in Pre-Op? Pediatric Anesthesia Article of the Day. August 11, 2022. Accessed January 10, 2023.
2- Yaster, M. Influenza vaccination in the perioperative period: A teachable moment. Pediatric Anesthesia Article of the Day. January 3, 2023. Accessed January 10, 2023.
3- American Society of Anesthesiologists. American Society of Anesthesiologists Condemns the American Association of Nurse Anesthetists’ Misleading Name Change. American Society of Anesthesiologists Website. August 15, 2021. Accessed January 10, 2023https://www.asahq.org/about-asa/newsroom/news-releases/2021/08/asa-news-release-on-aanas-misleading-name-change