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sively qualified to do the hard stuff; to handle the difficult cases, the sick
patients, the severely overweight patients, the ones teetering on the brink
between life and death. The value of the expert physician is in this realm.
In order to be eligible for outpatient surgery, a patient generally must be in
good health and without conditions that would make anesthesia more compli-
cated or dangerous. Or at least that's how it used to be. Current market forces
have sent more surgical cases to outpatient centers, and the definition of
"healthy" has been stretched more than a little.
It falls to anesthesia personnel, who generally have the last say in who goes to
the OR and who doesn't, to determine which patients are truly eligible to under-
go surgery in the outpatient setting. And here's the rub: The decision isn't
always clear. A patient who looks good on paper might not pass "the look test"
in the perioperative holding area. A broad knowledge of medicine and an exten-
sive experiential base are required to integrate medicine and the technical
aspects of anesthesia administration so that every patient remains safe.
OSM
Dr. Leng (shiriegale@yahoo.com) is an anesthesiologist at
Beth Israel Deaconess Medical Center in Boston, Mass., and a
healthcare blogger.
