Pre-Op Clinic

Now that I'm back in pre-operative clinic, I think of how it's evolved for me over time. I started as an intern, prior to doing actual anesthesia. Although this may seem strange, pre-anesthesia evaluations are more medicine than anything else. I had a lot of questions for my preceptor and I did really thorough medicine evaluations. I remember examining for lower extremity edema and JVP, trying to palpate the liver and spleen, and discussing exercise and behavior changes with most patients.

Now well into residency, I have a much firmer sense of what's directly relevant to anesthesia. I still try to be a good citizen and physician, encouraging patients to stop smoking, discussing side effects of medications, and probing psychiatric overlay. But I can see a patient so much faster because I know the types of medical problems that worry anesthesiologists, the tests I would want to see for a particular surgery, and the common questions that come up about going under. I know specific surgeon preferences and I often give heads-up pages to anesthesiologists to prepare them for cases. I understand the ins-and-outs of the system, and as a result, pre-op clinic is smoother and more straightforward now than a few years ago.