Pro-Con Debate

Anesthesiologist- Versus Hospitalist- Run Preoperative Clinics and Perioperative Care

David Hepner, MD, MPH, FASA; Catriona M. Harrop, MD, SFHM, FACP; Christopher Whinney, MD; Padma Gulur, MD

Disclosures

Anesth Analg. 2022;134(3):466-474. 

In This Article

Abstract and Introduction

Abstract

In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care. The medical and anesthesia evaluation before surgery has pivoted from the model of "clearance" to the model of risk assessment, preparation, and optimization of medical and psychosocial risk factors. Assessment of these risk factors, optimization, and care coordination in the preoperative period has expanded the roles of anesthesiologists and hospitalists as members of the perioperative care team. There is ongoing debate regarding which model of preoperative assessment provides the most optimal preparation for the patient undergoing surgery. This article hopes to shed light on this debate with the data and perspectives on these care models.

Introduction

In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care.

An important point to note in regards to many preoperative clinics is that these are primarily care team models with advanced practice providers and even registered nurses performing a significant number of these evaluations under the supervision of anesthesiologists or hospitalists for preoperative assessment and optimization.

For a true discussion of the perioperative continuum including preoperative assessment, optimization, and postoperative care, it is important to understand the phases of care and roles played by specialists in each phase. We elaborate on key distinctions and regulatory requirements in the background below before debating the Pros and Cons.

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