There have been huge advances in patient safety, but that doesn’t mean there is no risk when it comes to having surgery and anesthesia. Each year there are more than 100 million operations and procedures performed with anesthesia. Doctors who specialize in anesthesia — we’re known as physician anesthesiologists — play a critical role in keeping patients safe and comfortable before, during, and after surgery.
Before surgery, a physician anesthesiologist checks out each patient’s medical conditions and determines whether the patient is able to safely undergo surgery. We determine the right type of anesthesia for the procedure. We provide pain control and manage each patient’s breathing. Leading anesthesia care teams, we maintain vital functions with life support, and treat emergencies or complications that might arise. After the procedure, we provide pain management for a faster, less painful recovery.
This comprehensive approach is known as the perioperative surgical home (PSH) model of care — a term coined by the American Society of Anesthesiologists to define a patient-centered, physician-led system of coordinated care. The aim is to achieve better health outcomes, better patient satisfaction, and lower costs.
Physician anesthesiologists put patients first. Our commitment not only keeps patients comfortable — it keeps them alive. We treat pain with “multimodal” therapy — nerve blocks, physical therapy, and non-addictive medications. With this approach, California patients don’t need as many dangerous narcotic prescriptions. In fact, they need narcotic prescriptions less often than patients in 48 other states. That’s important in the national effort to fight abuse of painkillers and lethal overdoses.
We encourage better access and communication between patients and their physician anesthesiologists. When patients talk to us before surgery, they work with us to prevent complications and pave the way toward a faster and more comfortable recovery.
We don’t work alone. Other important practitioners such as nurse anesthetists and, in some states, anesthesiologist assistants (AAs) are part of the anesthesia care team. Although AAs don’t yet have licensure in California, they could help increase access to care and improve efficiency. Within this team approach, it’s critical to have a doctor as the quarterback. Physician anesthesiologists have the training and experience needed to lead the team.
In fact, research has shown that patients strongly prefer a physician to lead their health care team. According to an American Medical Association survey, 70 percent of people want only a physician to administer and monitor anesthesia levels, and 78 percent want only a physician to perform pain medicine procedures like spinal injections. Furthermore, the Institute of Medicine found that anesthesiologists are the only physician specialty to significantly reduce patient mortality. There are 50 times fewer deaths under anesthesia than there were years ago, due to physician anesthesiologist efforts to develop new technologies and better standards of care.
The California Legislature just approved a joint resolution (SCR4) by Senator Richard Pan, MD, to commemorate Physician Anesthesiologists Week each year. This provides a perfect time to help patients and the public understand the key role we play in their care before, during, and after surgery. As our state and national health care landscape continues to evolve, it’s critical for California to guarantee each patient a safe system of anesthesia care led by physician anesthesiologists.
Paul Yost is president, California Society of Anesthesiologists.
