20 years? Can you do the day to day work for your chosen speciality? If not it may not be for you.
As you’ve pointed out, it’s a buzzword, as far as I know within this current medical system, it will be difficult to implement. As an internist, I would want to see my own patients before surgery. As an anesthesiologist, I don’t want to see my patient for three months (certainly don’t want to be responsible for any medical problems for three months after surgery). Not sure if you can see where this is going....
But in short, within the current system, Anesthesiologists see their patient on the day of surgery, for more complicated case, maybe preop clinic. Right after patient leave the pacu the patient is no longer “mine.” Sure I can implement ERAS or do a little more before to prep the patient for surgery and a little more after for speedier recovery. But those effect will be hard to measure, and as far as I know, most institutions will not pay me extra to do that work.
So set patient up for preop clinic, cardiology work up, ERAS pathway implementation, prevention of N/V, prevent prolong PACU/hospital stay, adequate pain control to shorten hospital stay. More esoteric things, blood product utilization, OR resources management, even testing for rare genetic susceptibility for drugs, diseases.
I am jaded.