By Ed Sutton, MD
Throughout my anesthesia career, “Blame it on Anesthesia” has been a tongue-in-cheek, longstanding joke. The room\’s running late… “Blame it on Anesthesia,” the case is cancelled… “Blame it on Anesthesia,” the patient is bleeding… “Blame it on Anesthesia.” Unfortunately, and sadly, multiple studies reveal that anesthesia is the number one specialty in terms of harassment, incivility, and disrespect (HID). (Anesth. Analg. 2025;141:856-67) (https://journals.lww.com/monitor/fulltext/2025/11000/silent_threat__the_impact_of_hid_on_patient_safety.4.aspx). A study by the Association of American Medical Colleges reported that 52.6% of female anesthesia providers and 21.3% of male anesthesia providers experience harassment, which often goes unreported. This sexual disparity should not be ignored, and proudly, the issue seems to be trumpeted by female anesthesia providers. HID can be present as verbal abuse, intimidation, microaggressions, disregard for our professional opinions, or even disregard for physical needs, such as breaks to eat lunch. Outpatient facilities with established hierarchies and a lack of “patient ownership” by anesthesia are particularly prone to HID from multiple layers of administration, where anesthesia is seen as “support staff” or “vendors” instead of patient safety professionals. In high-volume centers, our preassessment time is literally condensed to a few minutes for high acuity ill patients, where room turnover is the priority rather than safety.
Patient safety can be affected by HID when decision-making, judgement, and performance are eroded by microaggressions and microinvalidations from team members and administrators. Overt microaggressions such as verbal abuse, reduced helpfulness, impaired teamwork, and covert actions such as withholding information or constraining creativity all adversely affect patient safety. Normalized HID directed at anesthesia providers also adversely affects provider burnout and retention.
I applaud this national effort to highlight this issue in our profession and encourage dialogue. Please feel free to reach out with your feedback at [email protected].
