Where do we fit in?
Anaesthetists all over the world are driving the development of perioperative medicine as both a healthcare model and a clinical specialty. Learn how we'll be leading the change here.
Although doctors from many specialities are starting to identify as "perioperative physicians", anaesthetists are by far the best placed practitioners to lead the development of this exciting new clinical field, due to their "ideal combination of training, skills, and experience." (Grocott and Pearse 2012)
As one of the largest specialist medical colleges in Australia and New Zealand, and the foremost authority on anaesthesia and pain medicine in each country, we're the logical leaders of perioperative medicine.
In 2016, we established a Perioperative Medicine Steering Committee composed of representatives from ANZCA, FPM, and other specialist medical colleges to reflect the diverse nature of the perioperative space.
In February 2018, ANZCA Council approved a vision for the perioperative medicine program which, together with our strategic plan, will guide and inform our approach.
Here are some of the other things we'll be working on between now and 2023.
Creating a clear economic case
We will define and collect standard measures of quality care, and conduct independent analysis into the value (outcome/cost) of a perioperative care model to demonstrate and defend the case for resource allocation.
Developing a new qualification
One of the key ways we're helping to provide patients in Australia and New Zealand with perioperative care is by creating a new qualification that will enable specialist doctors such as anaesthetists to train as perioperative specialists.
The steering group with membership from multiple colleges has recommended the development of a year-long, flexible competency-based diploma that must be completed within three years.
Advocating and lobbying
It's critical that clinicians work collaboratively to advance - and advocate for - perioperative medicine. A good example would be "working together to generate widespread support for appropriate remuneration. The Perioperative Medicine SIG is likely to play a leading role in this area.
Guiding and governance
Developing a perioperative care model involves the input of a diverse group of stakeholders. To reflect this, we invited representatives from a range of specialist medical colleges including the Royal Australasian College of Surgeons (RACS); the Royal Australasian College of Physicians (RACP); the Faculty of Pain Medicine (FPM); the Australian College of Rural and Remote Medicine (ACRRM); the Royal Australian College of General Practitioners (RACGP); the Royal New Zealand College of General Practitioners (RNZCGP); and the College of Intensive Care Medicine (CICM) to participate in our steering committee.
Since it was formed in 2017, the committee has established a number of cross-college working groups. In late 2019, in conjunction with the RACP, we surveyed geriatricians to better understand their interest and involvement in perioperative medicine. In 2021 we plan to survey other specialties.
Recognising other qualifications
We're exploring the possibility of working with universities and other providers that support aspects of perioperative medicine, such as: Echocardiography, regional anaesthesia, anaemia management, assessment of frailty and, perhaps, management courses.
Providing patient-centred education
We're developing a range of resources that explain and evidence the benefits of perioperative medicine to each of our key communities of interest, and establish the essential part anaesthetists have to play in perioperative medicine.
Producing professional documents
We will be developing a suite of guidelines around the minimum requirements for maintaining standards of perioperative medicine.
Accrediting training sites
We're identifying specific requirements to ensure perioperative medicine trainees get appropriate clinical exposure and teaching, particularly outside the operating theatre. We will adapt the Training Accreditation Committee (TAC) assessment tools to evaluate perioperative medicine.