If the specialty of anesthesiology is to be truly focused on “Putting Patients First,” there will need to be difficult and significant shifts in many of the current paradigms that underline what we currently view as metrics of our success. We can’t achieve this with false sincerity; the changes will be hard. The first and most obvious question is how much we currently value this concept as part of our clinical, operational and educational frameworks. Unfortunately, there seems to be significant evidence that we do not. A quick review in PubMed of the search terms “anesthesiology” and “efficiency” reveals hundreds of articles devoted to how anesthesiologists can improve operating room efficiency and throughput. In contrast, a review of the search terms such as “anesthesiology,” “patient engagement,” “shared decision-making” and “appropriateness” reveals very few. Patients are likely to be far...

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