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- Aug 10, 2010
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Hypothetical elective oupatient surgery Total Knee Replacement Cardiac stent 7 years ago, diabetic, HTN couple of outpatient surgeries in the past prior to stent placement. No known cardiac problems per patient since stents placed. Preop clearance by Family Practice or Internal med no cardiology consult. EKG- normal, Labs normal, no cardiology workup since stents. Here is my question. At what point is the anesthesiologist responsible for this patient as far as work-ups prior to surgery. If something happened during surgery cardiac wise is the anesthesiologist responsible for this patient because an echo wasn't ordered on this patient by the clearing physician? Or is this go back on the physician that cleared the patient (or medically optimized) this patient to begin with? If you didn't know about the pulmonary hyperstension or the aortic stenosis prior to surgery are you then responisble for the bad outcome if something untoward happens? Do you find yourself having to play defensive medicine at times because of the "lack of specialist training" of the family practice physicians? I don't want to sound like I'm bashing family practice docs they seem like they have a lot of knowledge but not a great depth of knowledge. I know in a sue happy society everyne would get named initially in a lawsuit but are you responisble for ensuring that this patient was properly cleared?