title: The future of anesthesiology: implications of the changing healthcare environment.
abstract: OBJECTIVE
  Anesthesiology is at a crossroad, particularly in the USA. We explore the changing and future roles for anesthesiologists, including the implication of new models of care such as the perioperative surgical home, changes in payment methodology, and the impact other refinements in healthcare delivery will have on practice opportunities and training requirements for anesthesiologists.
  
  
  RESULTS
  The advances in the practice of anesthesiology are having a significant impact on patient care, allowing a more diverse and complex patient population to benefit from the knowledge, skills and expertise of anesthesiologists. Expanded clinical opportunities, increased utilization of technology and expansion in telemedicine will provide the foundation to care for more patients in diverse settings and to better monitor patients remotely while ensuring immediate intervention as needed. Although the roles of anesthesiologists have been diverse, the scope of practice varies from one country to another. The changing healthcare needs in the USA in particular are creating new opportunities for American anesthesiologists to define expanded roles in healthcare delivery. To fulfill these evolving needs of patients and health systems, resident training, ongoing education and methods to ensure continued competency must incorporate new approaches of education and continued certification to ensure that each anesthesiologist has the full breadth and depth of clinical skills needed to support patient and health system needs.
  
  
  CONCLUSIONS
  The scope of anesthesia practice has expanded globally, providing anesthesiologists, particularly those in the USA, with unique new opportunities to assume a broader role in perioperative care of surgical patients.
authors.affiliation: aDepartment of Anesthesiology, University of Minnesota School of Medicine, Minneapolis, Minnesota bDepartment of Anesthesia and Perioperative Care and Medicine, UCSF School of Medicine, San Francisco, California, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Prielipp
authors.forename: Neal H
authors.initials: NH
authors.lastname: Cohen
mesh_terms: D000072080:Anesthesiologists / Q000639:trends*; D000776:Anesthesiology / Q000191:economics / Q000193:education / Q000639:trends*; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000191:economics / Q000639:trends*; D004501:Education, Medical; D006301:Health Services Needs and Demand; D006801:Humans; D009719:Nurse Anesthetists / Q000639:trends*; D019990:Perioperative Care / Q000191:economics / Q000193:education / Q000639:trends*; D017216:Telemedicine; D014481:United States