SUMMARY
Our primary goal has to be efficient delivery of quality care.
Patients undergoing surgery move through a continuum of medical care to which the
primary care physician, internist, anesthesiologist, and surgeon contribute in a
partnership that ensures the best outcome possible. No aspects of medicine require
greater cooperation than the performance of surgery and the perioperative care of
a patient. For the anesthesiologist, this responsibility starts in a preoperative
and preprocedure assessment. The importance of integrating practice is even greater
because of the increasing life span of our population. As the number of elderly
patients increases, so does the need for preoperative consultation to plan for comorbidities
and multiple drug regimens, knowledge of which is crucial to successful patient management.
At a time when medical information is encyclopedic, it is difficult
for even the most conscientious anesthesiologist to keep abreast of medical issues
relevant to perioperative patient management. Thus, the proposed PPAC facilitates
those most sought-after goals: improved quality of care and reduced costs. We physicians
can demonstrate to our constituency—the patients—and to their watchdog—the
government—that the present system of preoperative evaluation can be changed
to increase efficiency, to
reduce costs substantially, and to improve the quality of care. At the same time,
anesthesiologists can lessen their own anxiety about performing the very best evaluation
possible.
