Abstract and Introduction
In this issue of Anesthesia & Analgesia, 2 articles focus on future roles for anesthesiologists and the future of anesthesiology as a specialty. The first, "Anesthesiologists as Health System Leaders: Why It Works," discusses why anesthesiologists are uniquely well suited to leadership positions and how the anesthesiology mindset and skills can contribute to efficient integrated health care delivery. The second, "Opportunities Beyond the Anesthesiology Department: Broader Impact Through Broader Thinking," advocates that anesthesiology adjust its traditional missions to broader and more longitudinal aspects of population health, focusing less on episodes of care and prioritizing professional development of leaders in multiple aspects of health care. Both articles cite many valuable aspects of anesthesiology culture and practice that could be of great value to population health: team orientation; operational organization and reliability; intolerance for error; rapid response and problem solving; flexibility.
Needless to say, physicians in other specialties also have leadership and technical skills, sometimes overlapping with those of anesthesiologists. As Mathis et al suggest, cooperation rather than competition with these other specialties will integrate health care and improve outcomes. Future health care systems directed at improved population health are likely to blur specialty boundaries, and deemphasize specialty hegemony (turf) and competition. Clearly, the current era of guilds of superspecialists has produced amazing outcomes for select patients, but mediocre outcomes for the population at large. In considering the future of anesthesiology and health care writ large, we found the words of Prikel Avot (Ethics of our Fathers 1:14) to be particularly pertinent: "If I am not for myself, who is for me? And if I am only for myself, what am I? And if not now, when?"
Discussions about the future of anesthesiology are often overly focused on what would be best for anesthesiologists. The call for new and bigger leadership roles for anesthesiologists may not promote integration of health care and may not be well received by other specialties or the population at large. This call for a leadership role is understandable, but as suggested in the aphorism above, a contribution to a larger purpose has to be part of our mission. The critical question should be "What can anesthesiologists do to improve the health of our population?"
Anesthesiology. 2022;134(2):231-233. © 2022 American Society of Anesthesiologists | Lippincott Williams & Wilkins