The practice of anaesthesia--a stressor for the middle-aged?

Surveys conducted in the United Kingdom over the last few years have revealed decreased job satisfaction and increased anxiety and depression in both hospital specialists and general practitioners. Anaesthesia is perceived to be a stressful specialty and there is evidence, albeit patchy, that certain stress-associated conditions are more common in anaesthetists. The 'middle years' seem to be a danger period. The analogy between the work of anaesthetists and airline pilots is often drawn and the principles underlying the assessment and maintenance of pilot competence could be adopted in anaesthesia. While outcome studies are numerous much less attention has been paid to the structure and process of anaesthetic practice. Models for studying these aspects have been developed for investigating stress in general practitioners and doctors in training. Even minor degrees of professional impairment may place patients at risk and an investigation into the effects of the specialty on those who practise it is justified.