An Anesthesiologist's Philosophy on Medical Clearance for Surgical Patients

Simon Gelman, MD, PhD; John Ebert, DO
Arch Intern Med. 1988;148(6):1468. doi:10.1001/archinte.1988.00380060232043.
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To the Editor:  —From our viewpoint, Dr Choi's editorial1 concerning the role of the internist in the preoperative evaluation of the surgical patient was not only timely, but insightful as well. We are sure that most anesthesiologists wholeheartedly agree with his thoughts.Certain points deserve emphasis, others may be modified. First, the motivation for requesting a medical consultation is all too often confused, thereby precipitating misunderstanding. For instance, if the consultation request is initiated in order to provide a buffer against legal liability or to derive suggestions for intraoperative anesthetic management, then both the patient and medical consultant have been done a disservice. The end result would not be even potentially therapeutic, which should be the primary goal of the requestor. Moreover, in the circumstance where the medical consultant recommends an anesthetic technique and this course is not followed by the anesthesiologist for appropriate and defined reasons, but complications


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