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August 13, 1982

An Anesthesiologist's Plea

JAMA. 1982;248(6):648-649. doi:10.1001/jama.1982.03330060016020

To the Editor.—  "An Anesthesiologist's Plea" by T. Cameron MacCaughelty, MD (1981;246:2692), illustrates the unfortunate growing controversy among anesthesiologists, internal medicine subspecialists, surgeons, and general internists as to who is most qualified to provide primary care in the rapidly developing field of critical care medicine.As Dr MacCaughelty states, the anesthesiologist is unquestionably the most qualified physician to care for the surgical patient during surgery and the immediate postoperative period. However, expertise in this area does not necessarily extend to the general care of the critically ill patient, as Dr MacCaughelty implies. While programs may vary from institution to institution, no anesthesiology residency can provide adequate training in (1) evaluation and treatment of acute renal failure; (2) treatment of acute gastrointestinal (GI) tract bleeding; (3) use of antibiotics in a broad spectrum of respiratory tract, GI tract, and urogenital infection; (4) interpretation and treatment of complex ECG changes and arrhythmias;