KEY POINTS

1. Anesthesiology's scope of practice encompasses the entire perioperative experience from preoperative evaluation to intraoperative anesthesia care (in almost any clinical setting, including hospital OR, obstetric suite, ambulatory surgery clinic, procedure room, freestanding ambulatory surgery center, and surgeon's office), to recovery in the postanesthesia care unit or ICU, and even the patient's home. Additional venues for nonsurgical anesthesia care include the obstetrics suite, chronic pain clinic, and intensive care unit. Anesthesiologists also teach resuscitative skills and conduct research to advance future practice.
2. The anesthesiologist's preoperative assessment has multiple objectives, including evaluation of health status, identification of opportunities to enhance health status with the hope of improving patient outcomes, discussion of an anesthetic plan, patient education, and encouragement of greater family involvement in care.
3. Because of their broad medical knowledge and scope of professional activity, anesthesiologists are increasingly involved in management of the OR, to improve efficiency, control costs, enhance institutional performance, and improve quality of care.
4. Anesthesia care is now given throughout the modern hospital in an increasing array of non-OR, alternate site settings: interventional radiology suite, cardiac electrophysiology laboratory, lithotripsy suite, and settings in which cardioversion and electroshock therapy are administered. Patient safety is maintained by adhering to the same clinical practice standards observed in the OR.
5. Among the most significant trends in surgical care since the 1980s is the shift of about 75% of surgery procedures from the inpatient hospital setting to a variety of ambulatory venues, including the hospital outpatient unit, freestanding ambulatory surgery center, and surgeon's office. Maintenance of the specialty's widely recognized success in achieving markedly improved patient safety requires meeting the same high standards of care, regardless of setting.
6. Anesthesiologists were among the pioneers in establishing critical care medicine; the specialty trains substantial numbers of future critical care specialists, and recent research documents that the presence of dedicated critical care specialists is associated with better patient outcomes.
7. Anesthesiologists have been leaders in developing pain management as a subspecialty that improves patient comfort postoperatively and quality of life for those with chronic pain.
8. Anesthesia care is subject to dynamic clinical, social, economic, and political forces that preclude accurate workforce requirement projections beyond a short-term horizon. Workforce needs must be reevaluated periodically as circumstances and assumptions change and evolve.

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9. Like other health care practitioners, anesthesiologists face myriad opportunities to improve quality of care and enhance institutional performance through objective evaluation of care practices and patient outcomes and by implementing data-driven quality improvement projects.