We thank Dr. Frost for sharing her personal experience with founding a preoperative evaluation clinic, and we wish to acknowledge her contributions to the field of preoperative medicine.1  Her story highlights that the concept of anesthesiologists as leaders of successful healthcare redesign projects is not new. Moreover, efforts to improve important determinants of perioperative outcomes such as patient engagement, interdepartmental collaboration, and value-based care have always been an integral part of our specialty. While Dr. Frost and others1–3  have demonstrated an improvement in perioperative efficiency through the use of an outpatient preoperative evaluation clinic, Rathmell and Sandberg4  suggest in their recent editorial view that there is new opportunity for anesthesiologists to welcome process engineers and other systems experts to our collaborative perioperative care redesign teams to maximize our impact on patient outcomes. Our study was motivated by the desire to better understand the impact that our preoperative evaluation clinic was having on the perioperative outcomes of patients at our institution.5  We believe that the value of the preoperative evaluation clinic lies in its ability to improve the quality of the preoperative preparation process. We appreciate Dr. Frost’s account because it emphasizes the power of patient engagement and that recognition of the preoperative evaluation clinic’s value by senior administration can be a potentially powerful force for change.

Dr. Jain served as an expert case reviewer for Dopf, P.C. (New York, New York) and Schiavetti, Corgan, DiEdwards, Weinberg and Nicholson, LLP (New York, New York). The other authors declare no competing interests.

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