Perioperative Medicine: What the Future Can Hold for Anesthesiology

The scope of anesthesiology and POM practice has expanded in recent years. Anesthesiologists have tremendous opportunities to make major clinical contributions and to fulfill leadership roles in the care of surgical patients during the entire perioperative continuum, thereby contributing to improving the population health and health care economics in the United States. These opportunities will stem from anesthesiologists' active engagement in the entire continuum of a patient's perioperative journey from assessing and improving the SDOHs in the surgical patient population, undertaking preoperative risk stratification and optimization, introducing prehabilitation programs, implementing patient and procedure specific enhanced recovery programs, participating in value-based care delivery models and quality payment programs, influencing population health through transitional care management, managing chronic pain conditions, and helping with opioid stewardship. These varied responsibilities and contributions by anesthesiologists as POM specialists to deliver high-value, patient-centered, recovery-focused perioperative care are vital for bridging the chasm between and thus meeting surgeons' and patients' expectations, as well as helping control the upwardly spiraling costs of health care in the United States. Moving forward, as a specialty, anesthesiology must achieve 4 primary objectives: (1) focus clinical efforts on the medical needs and life goals of patients; (2) prepare the current and future generation of anesthesiologists to deliver high-quality, patient centered, recovery-focused care through education and training in POM and population health; (3) build collaborative approaches with all stakeholder groups in providing timely, efficient, and effective perioperative care for our patients; and (4) help anesthesiologists in developing fair and transparent comanagement agreements with hospitals and payers. Our future clinical care and business models as well as educational, research, and advocacy effort must ultimately add value for patients and payers.