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The American Society of Anesthesiologists is an educational, research and scientific association of physicians organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

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N. Martin Giesecke, M.D., Chair

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June 1, 2013 Volume 77, Number 7
CEO Report: Golden Age for Patient Education Paul Pomerantz


Will you still need me, will you still feed me, when I’m 64?
– “When I’m 64,” The Beatles (1967)

The character intoning that line in Paul McCartney’s famous song about growing old must have been confident in his longevity: According to the U.S. Census, the average lifespan for a male in 1967 was 67 years and for a woman 74 years. From a strictly Census data-standpoint, there might not have been many years left to “rent a cottage in the Isle of Wight” or spend with the grandkids, “Vera, Chuck and Dave.”

Incidentally, McCartney turns 71 this month and still performs on stage with a vigor that would have been rare for a man his age 45 years ago. Sixty-four isn’t considered “old” anymore, and each year our definition of “old” continues to change. Currently, the Census Bureau’s projected lifespan in 2015 is 76 years for men and 81 years for women. You’re probably familiar with some of the statistics about baby boomers below. These numbers validate the oft-noted observation that in the very near future, geriatrics will become an increasing focus of anesthesiology practice.

  • By 2030, an estimated 20 percent of the U.S. populace will be 65 or older.
  • Almost 2 million people in the U.S. are over 90 – three times more than 30 years ago.
  • Approximately 80 percent of Americans 65 and older have at least one chronic disease requiring ongoing care.

  • You wouldn’t think there’d be a silver lining in this “gray tsunami,” but I believe there is. There will be an unprecedented demand for health services, which cannot be addressed by manpower alone. According to the Health Resources and Services Administration, the supply of orthopedic surgeons will increase by 2 percent while demand for their services will increase by 23 percent between 2000 and 2020. How will we keep up with that demand? A new paradigm of efficiency and improved coordination of care will be of the utmost importance.

    This is where anesthesiologists have the opportunity to dramatically expand their roles in perioperative care and further enhance patient safety initiatives. A central tenet of the Perioperative Surgical Home model of care is that anesthesiologists are uniquely suited to improve coordination and quality of care because of their comprehensive knowledge of care from well before surgery, during surgery, and through discharge.

    In addition to the perioperative space, the practice of anesthesiology is growing in areas that will be increasingly valuable to an aging population and their families. This includes pain medicine, critical care and hospice. I recently had the opportunity to observe a pain practice and was fascinated by the range of problems, the complexity of diagnoses and range of treatment. Moreover, it was clear how effective treatment can have a dramatic impact on the patient’s quality of life.

    The baby boomer generation tends to be much more physically active than their parents and, therefore, more likely to be proactive in their medical care. After a procedure they want to get back to skiing, playing tennis with their grandkids or performing in front of sell-out crowds at music venues. Earlier contact with these patients not only will empower them to make informed decisions about their care, but also help doctors to carefully plan that care, thereby improving efficiency, reducing unnecessary tests and lessening the risk of surgical delays, complications and errors.

    The so-called “gray tsunami” certainly presents challenges to health care, but the worst-case “perfect storm” may never come to pass if we prepare for it. Anesthesiologists, in particular, are poised to lead coordination of care across all specialties and professions to improve efficiency, cost-effectiveness and safety.

    We also must not neglect our roles as educators and communicators. A well-informed and proactive patient population is perhaps the best defense against the coming storm. No other medical specialty has the training and experience to serve so well in such a broad perioperative role.

    The tsunami is coming, but it’s not unnavigable. The good health of an entire generation depends on our preparation. I believe we’ll be ready. And in a few years, we’ll have the generations to come wondering what they’ll be doing in the summer when they’re 94.



    Paul Pomerantz is ASA’s Chief Executive Officer.


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