Opportunities Beyond the Anesthesiology Department: Broader Impact Through Broader Thinking

Abstract

Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with clear and significant public health relevance. Within anesthesiology, the traditional perspective of the field's health impact has focused on providing safe and effective intraoperative care, managing critical illness, and treating acute and chronic pain. However, there are limitations to such a framework for anesthesiology's public health impact, including the transient nature of acute care episodes such as the intraoperative period and critical illness, and a historical focus on analgesia alone-rather than the complex psychosocial milieu-for pain management. Due to the often episodic nature of anesthesiologists' interactions with patients, it remains challenging for anesthesiologists to achieve their full potential for broad impact and leadership within increasingly integrated health systems. To unlock this potential, anesthesiologists should cultivate new clinical, research, and administrative roles within the health system-transcending traditional missions, seeking interdepartmental collaborations, and taking measures to elevate anesthesiologists as dynamic and trusted leaders.This special article examines 3 core themes for how anesthesiologists can enhance their impact within the health care system and pursue new collaborative health missions with nonanesthesiologist clinicians, researchers, and administrative leaders. These themes include (1) reframing of traditional anesthesiologist missions toward a broader health system-wide context;(2) leveraging departmental and institutional support for professional career development; and(3) strategically prioritizing leadership attributes to enhance system-wide anesthesiologist contributions to improving overall patient health.

Estimating the prevalence of anemia and its association with perioperative blood transfusion in patients who have no haemoglobin measurement using multiple imputation and inverse probability of treatment weighting

“…The recently concluded prospective observational ALICE trial [35] seeks to better estimate the prevalence and type of anemia in surgical patients but is limited to major surgery and will exclude the majority of the surgical population. Given the potential frequency of anemia all surgical patients, and that anemia is associated with worse health outcomes not in just transfusion as we measured here, there is a potential public health utility to screening these patients [36,37]. An approach that may offer a compromise to advocates of PBM and those of limited testing is to use of point-of-care hemoglobin screening with formal laboratory testing only in those who screen as anemic [38].…”

The anesthesiologist thoughts on medical residency in anesthesiology in Brazil

“…In fact, the low-profile perception towards anesthesiology practice may result on one hand from the massive advance of the specialty observed in recent decades, leading to an extremely low incidence of anesthetic complications, 3 and, on the other, from the almost exclusive dedication of anesthesiologists to perioperative medicine.…”

Roles for Anesthesiologists in the Future of Medicine in the United States

“…The first, “Anesthesiologists as Health System Leaders: Why It Works,” 1 discusses why anesthesiologists are uniquely well suited to leadership positions and how the anesthesiology mindset and skills can contribute to efficient integrated health care delivery. The second, “Opportunities Beyond the Anesthesiology Department: Broader Impact Through Broader Thinking,” 2 advocates that anesthesiology adjust its traditional missions to broader and more longitudinal aspects of population health, focusing less on episodes of care and prioritizing professional development of leaders in multiple aspects of health care. Both articles cite many valuable aspects of anesthesiology culture and practice that could be of great value to population health: team orientation; operational organization and reliability; intolerance for error; rapid response and problem solving; flexibility.…”

“…Needless to say, physicians in other specialties also have leadership and technical skills, sometimes overlapping with those of anesthesiologists. As Mathis et al 2 suggest, cooperation rather than competition with these other specialties will integrate health care and improve outcomes. Future health care systems directed at improved population health are likely to blur specialty boundaries, and deemphasize specialty hegemony (turf) and competition.…”