The biggest change in anesthesiology today is that anesthesiologists are being groomed to become perioperative directors, says Dr. Pease, an anesthesiologist herself. From their vantage point working with physicians and nurses of multiple specialties at all stages of surgery and recovery, she says anesthesiologists can coordinate episodes of care for patients in the pre-, post- and intraoperative phases, helping to lessen patients' risk factors and improve their outcomes.
"What we're really good at is recognizing risk factors," she says. "If you want your kidney taken out, you want to make sure you're optimized prior to surgery. There are things we can do in the preoperative setting that will help, and it's a known fact that medical care becomes more expensive if a patient has a complication during surgery. If you're diabetic and your blood sugar is running high, then we know your chances of having a complication after surgery are higher." Predicting and preventing or lessening those complications can also help to keep ORs running on schedule and prevent last-minute cancelations and delays.
Half of many hospitals' revenue comes from surgery, she says, and surgery makes up 60 to 70 percent of most hospital budgets. With such a large chunk of a hospital's budget at stake, excellent perioperative leadership is a must. If anesthesiologists can help reduce risks of readmittance, longer hospital stays or less satisfied patients, then they can protect millions in hospitals' already threatened revenue streams and even boost income through raising value-based purchasing multipliers thanks to satisfied patients.