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Michael F. Roizen, MD
JAMA. 1990;263(19):2625-2627. doi:10.1001/jama.1990.03440190081042.
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Many, if not most, anesthesiologists consider themselves primary care specialists—the internist in the operating room, the primary physician in the chronic pain setting, the physician without conflict of interest in the preoperative assessment of patients, and the physician interested in pain control and functional status recovery in the critical care and outpatient environments. Changes in each of these areas were introduced during the past year. "Smart" new technologies, such as the use of computers to turn one form of data (hemoglobin absorbance) into a clinically useful number (oxygen saturation), have been made part of practice guidelines. These new technologies and guidelines have improved the quality of anesthesia care, reduced its cost, and reduced malpractice premiums.

As we enter a new decade, changing practice and research patterns in anesthesiology are evident. Injection of local anesthetics through interpleural catheters can be repeated to provide pain relief over long periods in patients with


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