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ABSTRACT: The field of anesthesiology championed patient safety, which has decreased death rates from 1:2,500 to 1:13,000 over 50 years. Anesthesiologists played an important role in the introduction of monitors, post-anesthesia care units, intensive care units, acute and chronic pain interventions, ethical advancements, and simulation into routine practice. Anesthesiology is now safer, but also more sophisticated. Current and future challenges will require creative new leaders in the clinical, political, and research arenas to keep the specialty moving forward. The authors examine the current literature and make recommendations for future anesthesia leadership structures.
anesthesiology, a leading medical specialty in patient safety, decreased mortality rates from 1:2,500 to 1:13,000 in 50 years.1-3 Anesthesiologists played an important role in the introduction of monitors, post-anesthesia care and intensive care units, acute and chronic pain interventions, ethical advancements, and simulation into routine practice. Current and future challenges require creative leaders in the clinical, po I itical, and research arenas to keep the specialty moving forward.
In this review, we examine the current literature and make recommendations for future anesthesia leadership structures. We performed a literature review using the search terms "anesthesia" and "leadership." References within manuscripts were reviewed for additional references. Searches were performed through PubMed, MEDLINE, PsycINFO, Google, personal requests to anesthesia chairs, and Cochrane databases. All articles that pertained to anesthesia leadership in United States practices were included. To our knowledge, such a review has not been published. Because most manuscripts on the topic are more than a decade old, we hope this review will incentivize further research.
ANESTHESIA CHAIR DEMOGRAPHICS
A 2006 survey indicated that 86 to 90 percent of U.S. anesthesia chairs were professors; 89 to 92 percent were men, with a median age of 54.4 The percentage of male chairs was similar in 2016.5 Eighteen percent of chairs had PhDs and 24 percent had master's degrees, with 10 percent graduating from the Massachusetts General Hospital (MGH) residency.4 A majority (57 percent) completed fellowships.
Most chairs had a goal early in their careers to become a chair: 31 percent as residents or fellows and 32 percent as assistant professors. Thirty percent had previously served as chair, although the experience of vice chair (24 percent) was deemed most beneficial in preparation for this new role. Furthermore,...