From the front lines: a qualitative study of anesthesiologists' work and professional values.

PURPOSE: Despite significant contributions to medicine, anesthesiology is poorly recognized and faces the threat of "deprofessionalization". Clear articulation of its work and professional values plays an integral role in maintaining the viability of a profession. The purpose of this qualitative study is to explore anesthesiologists' perspectives in order to define the distinct elements of their work and their professional values.
METHODS: A qualitative research approach was used for this study. Sixteen Canadian faculty anesthesiologists were interviewed regarding their choice of anesthesiology as a career, the characteristics of a good anesthesiologist and good anesthetic care, and the sources of work-related stress. The interviews were taped and transcribed. The qualitative analysis of the interviews included primary coding, which separated the data into units of meaning. Next, similar codes were clustered into pattern codes to identify common themes and subthemes. The relationships between the themes and subthemes were analyzed and interpreted to identify core values.
RESULTS: The anesthesiologists were motivated to choose their career path by the academic, technical, and practice aspects of the profession, influential role models, and an interest in human consciousness. Five themes characterized a good anesthesiologist: clinical competence, personality traits, physician-patient relationship, approach to anesthetic care, and outcomes. The major sources of stress were: balancing clinical care and teaching, unexpected critical events, and administrative issues. Four core professional values were identified: goal-directed care, responsibility, control, and humility.
CONCLUSIONS: Anesthesiology is characterized by its distinct work and core professional values. Under the threat of deprofessionalization, the practice of anesthesiology should be guided by its professional values in defining and envisioning its future.