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\"Newly minted chief resident at Boston Memorial Hospital Noah Rothauser is swamped in his new position, from managing the surgical schedules to dealing with the fallouts from patient deaths. Known for its medical advances, the famed teaching hospital has fitted several ORs as \"hybrid operating rooms of the future\"--an improvement that seems positive until an anesthesia error during a routine procedure results in the death of an otherwise healthy man. Noah suspects Dr. William Mason, an egotistical, world-class surgeon, of an error during the operation and of tampering with the patient's record afterward. But Mason is quick to blame anesthesiologist, Dr. Ava London. When more anesthesia-related deaths start to occur, Noah is forced to question all of the residents on his staff, including Ava, and he quickly realizes there's more to her than what he sees. A social-media junkie, Ava has created multiple alternate personas for herself on the Internet. With his own job and credibility now in jeopardy, Noah must decide which doctor is at fault and who he can believe--before any more lives are lost\"-- Provided by publisher.

ObjectivesTo evaluate anesthesiologists’ preparedness and training needs during a mass casualty event in a resource-limited setting, focusing on hospital disaster planning and response effectiveness.MethodsThis study utilized an exploratory mixed-methods design, combining qualitative and quantitative approaches to assess the experiences of anesthesiologists during a catastrophic disaster. Data were collected through interviews and a survey of anesthesiologists who were directly involved in emergency response.ResultsThe findings highlight significant gaps in disaster preparedness among hospitals, influenced by factors such as physical infrastructure damage, resource shortages, and limited personnel involvement in disaster planning. Anesthesiologists demonstrated adaptability and commitment despite inadequate training and limited disaster management frameworks. The study underscores the urgent need for standardized disaster preparedness plans, multidisciplinary training, and enhanced psychological support for health care professionals.ConclusionsThis study reveals critical deficiencies in hospital disaster preparedness and anesthesiologists’ training in emergency response. Addressing these gaps through robust disaster planning, simulation-based education, and institutional support is essential to enhance health care systems’ resilience in resource-limited and conflict-affected regions.

Annual professional practice evaluations (i.e., peer review) are mandatory for anesthesiologists in many practice settings. The de Oliveira Filho clinical anesthesia supervision instrument is a valid and psychometrically reliable tool suitable for these high-stakes assessments. We studied item-specific feedback to anesthesiologists to increase their scores. The retrospective cohort study used all 11 academic years for which the studied department used the supervision instrument, July 2013 through June 2024. There were 55,195 evaluations of 715 combinations of anesthesiologist and year by 242 rating trainees (e.g., anesthesia residents), each evaluation with 9-items scored 4=always, 3=frequently, 2=rarely, or 1=never. The 9-item supervision instrument had Cronbach alpha 0.96 and functioned as a binary (4 vs ≤3) multivariate array. Consequently, the 87% (47,859/55,195) of evaluations with all 9 items 4=always, or all 9 items ≤3, provided information about the quality of performance of the anesthesiologists, but no potentially useful item-specific information for feedback to anesthesiologists. Cochran Q tests were performed for each of the 715 combinations of anesthesiologist and year using the remaining 7336 evaluations. There were 17% (124/715) of the combinations of anesthesiologist and year with adjusted P < 0.05, showing one or more of the items' scores differed significantly from the other items' scores. The 17% of combinations represented 6.0% (3311/55,195) of evaluations. For each of those 124 combinations of anesthesiologist and year, 36 McNemar tests were performed, comparing the 1st item to the 2nd, …, 8th item to 9th. Among those pairwise comparisons that were statistically significant, the directions of odds ratios were examined. The items about teaching quality accounted for 19% and 26% of the odds ratios <1 (i.e., low scores), respectively, while the other seven items each accounted for ≤5%. Earlier it was known that anesthesiologists' annual professional practice evaluations can be provided along with education regarding good teaching attributes associated with high quality intraoperative supervision and greater supervision scores. Our results show that also providing analyses of individual item scores could benefit, at most, <20% of the faculty anesthesiologists. •Faculty anesthesiologist evaluation is mandatory, and feedback is desirable. Combine?•No true information from mean (standard deviation) or median [range] of items' scores.•Fewer than 20% of ratees would gain actual information from associations among items.•Implications: provide evaluations and teach results of earlier studies of how to do better.

Background In modern healthcare systems, the scope of practice for anesthesiologists is expanding within and beyond the traditional perioperative care continuum. This study was conducted to assess the knowledge and perceptions of perioperative patients of the roles of anesthesiologists as providers of healthcare services in different Palestinian hospitals. The study also assessed associations between the patients' different demographic and clinical variables and their knowledge and perceptions about the roles of anesthesiologists. Method This study was conducted using a cross-sectional design and a questionnaire among perioperative patients admitted for elective surgeries in five major public and private hospitals in the Nablus, Tulkarm, Jenin, and Salfit governorates of the West Bank of Palestine. The data were collected between September 2023 and December 2023. Results Of the 500 patients invited, 411 patients completed the questionnaire, giving a response rate of 82.2%. The overall knowledge score of the patients about the roles of anesthesiologists was 59.4% (18.8%). The majority of the patients lacked awareness about the roles of anesthesiologists outside the operating room. There was a low positive correlation between the self-rated general health and overall knowledge score (Pearson's r = 0.17, p -value < 0.001). Similarly, knowledge scores were significantly higher for the patients who had a university education ( p -value =  < 0.001) and had a degree in one of the medical/health fields ( p -value =  < 0.001). On the other hand, the patients who lived in refugee camps ( p -value = 0.048), had a blue-collar job (p-value = 0.005), and were scheduled to receive orthopedic surgeries ( p -value = 0.035) had significantly lower knowledge scores. Conclusion The findings of this study showed that perioperative patients in Palestine had inadequate knowledge about anesthesia and the roles of anesthesiologists, especially outside the operating room. Efforts should be made to improve the knowledge and perception of perioperative patients about anesthesia and the roles of anesthesiologists as providers of healthcare services. These efforts should be tailored to target uneducated patients, who have blue-collar jobs, live in refugee camps, and are scheduled to receive orthopedic surgeries.

Background As enhanced recovery after surgery (ERAS) protocols evolve and become increasingly important in anesthesia management, anesthesiologists must update and improve their knowledge and skills. To investigate knowledge, attitude, and practice (KAP) of anesthesiologists towards ERAS and day surgery anesthesia management. Methods This cross-sectional study was conducted among anesthesiologists from tertiary hospitals of China, using a self-designed questionnaire. Results 303 valid questionnaires [aged 37.61 ± 8.77 years, 155 (51.16%) males] were collected. The mean KAP scores were 21.04 ± 6.03 (possible range: 0–32), 31.59 ± 3.14 (possible range: 8–40), and 19.68 ± 4.09 (possible range: 6–30), respectively. Structural equation modeling showed that surgical cases (β = 0.53, P  = 0.017) and ERAS-related training (β = 5.22, P  = 0) directly affected knowledge. Further, knowledge (β = 0.16, P  = 0) and hospital grade (β = 0.81, P  = 0.044) directly affected attitude. Moreover, knowledge (β = 0.28, P  = 0), attitude (β = 0.21, P  = 0), gender (β = -0.96, P  = 0.005), ERAS-related training (β = 2.05, P  = 0), hospital grade (β = 0.89, P  = 0.027), and surgical cases (β = 0.28, P  = 0.025) directly affected practice. Conclusion Anesthesiologists demonstrated insufficient knowledge, positive attitude, and inactive practice towards ERAS and day surgery anesthesia management. It is recommended that efforts be made to enhance anesthesiologists’ knowledge and foster proactive practice in the domains of ERAS and day surgery anesthesia management. Clinical trial number Not applicable.

This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States. This is a cross-sectional analysis of general payments by pharmaceutical and medical device industry to all anesthesiologists (2014–2023) and NPAPs (2021−2023) for non-research purposes using the Open Payments Database, a federal transparency database under the Physician Payments Sunshine Act between 2014 and 2023. The United States. All active practicing anesthesiologists and NPAPs, including certified registered nurse anesthetists and anesthesiologist assistants, in the United States. Fraction of providers receiving non-research payments; total payment amounts; median payment amounts per provider; relative annual average percentage change from 2014 to 2023. A total of $297.8 million general payments were made by industry to 75.4 % of all active anesthesiologists from 2014 to 2023, while $7.2 million was made to 46.8 % of NPAPs from 2021 to 2023. Median annual payments ranged from $59–$120 for anesthesiologists and $37–$38 for NPAPs. The proportion of anesthesiologists receiving payments declined at a relative annual average percentage change (RAAPC) of −2.9 % from 2014 to 2019, followed by a substantial decrease in 2020. Subsequently, the number of payment recipients increased at an RAAPC of 15.4 % (2020−2023) for anesthesiologists and 9.0 % (2021–2023) for NPAPs. Payment distribution was highly concentrated, with the top 1 % of anesthesiologists and NPAPs receiving 78.2 % and 52.5 % of total payments in 2023, respectively. Among anesthesiology subspecialties, pain medicine physicians consistently received the highest median payments ($332–$767) throughout the study period. This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers. •Financial relationships with healthcare industry can be conflicts of interest.•Three-quarters (75.4 %) of all anesthesiologists received non-research payments totaling $297.8 million from 2014 to 2023.•46.8 % of non-physician anesthesia providers received $7.2 million from 2021 to 2023.•Payments were highly concentrated, with the top 1 % of anesthesiologists receiving 78.2 % of total payments.

Relates the life and career contributions of NZ's first specialist anaesthetist, Director of Anaesthesia to the Auckland Hospitals from late 1945 until 1957, and first President of the New Zealand Society of Anaesthetists (NZSA). Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Background Adverse patient events are an inevitable part of an anesthesiologist’s work. When such incidents occur, they may lead to significant emotional and psychological distress in healthcare providers—a phenomenon known as the Second Victim Phenomenon (SVP). While international evidence of SVP exists, data from German anesthesiologists remain scarce. Objective This study aimed to determine the prevalence, symptom severity, recovery time, and available support structures for second victims among German anesthesiologists and to identify individual and workplace-related risk and protective factors. Methods A cross-sectional survey was conducted using the validated SeViD questionnaire. The survey assessed five domains: demographics, SVP experience and symptoms, support structures, and personality traits (Big Five Inventory-10). Data were collected both online and on paper at three national anesthesiology symposia in Germany. Results Of the 408 respondents (mean age: 50.8 years), 76.9% identified as second victims, with 27% having experienced a related incident in the previous 12 months. Common triggers included patient harm or death, near misses, and critical events. The most frequently reported symptoms were self-doubt (69%), feelings of guilt (66%), reliving the event (59%), and sleep disturbances (59%). 16% of the respondents had not recovered at the time of the survey, and 14% had not recovered even after more than a year. Legal consultation, debriefing, and preventive feedback mechanisms were rated as the most helpful support strategies. A lack of support was significantly associated with increased symptom burden and prolonged recovery. A higher level of neuroticism and a lower level of openness were associated with increased symptom load. Conclusions SVP is highly prevalent among German anesthesiologists, with a significant psychological burden in many cases. These findings highlight the urgent need for systematic interventions, including peer support and organizational frameworks, to address and mitigate the effects of SVP in clinical practice.