Few aspects of healthcare involve as much simultaneous interaction by different physicians as the management of the patient undergoing surgery. At a minimum, the primary care provider, surgeon and anesthesiologist form a team of three physicians, all of whom bring a different perspective and expertise to the care of the patient. As the medical intensity of patients increases, there is also an increasing number of specialty physicians actively involved in this process.

The intersection of the primary care provider and the anesthesiologist first occurs when the surgeon schedules a patient for surgery. At that point the series of events that culminates in medical evaluation, anesthetic assessment, and perioperative management starts. This chapter will begin with that aspect of preparation of the patient for elective surgery. The greatest detail is spent in this area as this is where, by far, the greatest overlap of expertise and communication occurs. The remainder of the chapter will then briefly cover the standard issues involved in perioperative management. These comments are not so much geared to make the primary care provider an expert in the field but are more designed to provide some familiarity with the environment into which the patient is going. It is assumed that detailed information about anesthesia care is provided directly to the patient by the anesthesia provider and/or preoperative systems.

Preoperative evaluation: preparation for surgery

The importance of this phase of clinical management is indicated by its global nature.