Search

This special article briefly discusses the role of women as the new journal Current Researches in Anesthesia and Analgesia (now Anesthesia & Analgesia [A&A]) began in 1922. It was a time of a few women physicians, and they were usually isolated from the world of mainstream medicine and its predominantly male practitioners The journal's founders, Frank McMechan and his wife Laurette of Cincinnati, were committed to developing an organization for everyone, and women physicians were welcomed early on. Three women physicians even served as the presidents of various anesthesia organizations early in the formation of the present national organization. This acceptance of women was to change as medical education and practice evolved to embrace scientific medicine, after the Flexner Report of 1910 documented the deficiencies of American medicine. Mrs McMechan made the most important contributions by a woman because she cared totally for Dr McMechan, after he experienced disabling and very severe arthritis. He became dependent on his wife for most activities, including the simple act of eating. He could not function without her; she kept him going physically for another 27 years after the onset of his very debilitating illness. After her husband's death in 1939, Mrs McMechan served an executive function, keeping the organization going and maintaining production of the journal. This article also briefly discusses the life of the first woman physician to publish an article in A&A, Frances Edith Haines, MD, of Chicago. Haines published several articles in the journal; the first was in 1922, in the second journal issue. She was the president of the Mid-Western Association of Anesthetists, an affiliated organization, in 1926. She also served in World War I as a contract physician anesthetist for the US Army; she was the first woman contract surgeon to go overseas, to Limoges, France. Her adventure-filled and bold life changed as she aged and developed financial problems. She tried, but failed, to get financial help from the government and the military for her war service, and she died in 1966. These women are examples of women physicians involved with the journal, as it began in 1922. As the number of women physicians has increased recently, some past problems, such as difficulty with getting admitted to medical schools, for example, have improved. However, there are still many issues for women in medicine, including in our specialty., Competing Interests: The author declares no conflicts of interest., (Copyright © 2022 International Anesthesia Research Society.)

Laurette van Varseveld McMechan (1878-1970) was married to Francis Hoeffer McMechan (1879-1939), who organized the International Anesthesia Research Society and was the editor of the first journal for physician and dentist anesthetists. Although she was not a physician, she made vital contributions to the development of worldwide organized anesthesia and its journals. These were most evident after her husband became severely disabled in 1911, when Laurette McMechan worked closely with him on his efforts to organize the practice of anesthesiology and create a scholarly journal for the specialty. After his death, she continued to serve our profession for another 17 years, serving as assistant executive secretary-editor of the International Anesthesia Research Society and its journal, Current Researches in Anesthesia and Analgesia. Her life was dedicated to the profession of anesthesia. A memorial tribute labeled her "the mother of anesthetists," a title she deserved.

A 1992 General Accounting Office (GAO) study on costs of anesthesia found that anesthetics administered by anesthesia care teams (ACTs) were more costly than those administered by Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists practicing alone. In 1994, Medicare implemented a single payment system in response to the GAO report and recommendations by the Physician Payment Review Commission. Restructuring of many anesthesia departments has followed. A study was conducted in a 370-bed public teaching hospital to: 1. Examine how one ACT functionally provided services. 2. Identify roles of CRNAs and anesthesiologists within this team practice. 3. Determine if medical direction was perceived as equally beneficial in all cases. 4. Identify practice modifications which could possibly lower costs. All anesthetics (n = 358), excluding obstetrics, were studied over a 4-week period. Sixty-four variables were collected on each case including patient demographics, case characteristics, provider functions, and outcome data. Most patients were healthy and had low complexity operations. Systat statistical software was used for data analysis. There were clear functional variations in the roles of anesthesiologists and nurse anesthetists within the anesthesia care team. Anesthesiologists provided most preoperative and postoperative care, while nurse anesthetists administered the majority of anesthetics. Anesthesiologists and nurse anesthetists in this study agreed in their perceptions that more than 70% of these cases did not need medical direction. Logistical regression of variables was used to construct a predictive equation for cases where providers perceived that medical direction was beneficial.(ABSTRACT TRUNCATED AT 250 WORDS)