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Caroline Palmer and the History of Operating Room Management

Dexter, Franklin MD, PhD

doi: 10.1213/ANE.0000000000001224
Letters to the Editor: Letter to the Editor

Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa,

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To the Editor

I was pleased to read the fine article by Drs. Brodsky and Saidman1 describing Dr. Palmer’s leadership as the first chief of anesthesia at Stanford Medical School. Citing my brief article on Dr. Palmer’s contributions to operating room management,2 Drs. Brodsky and Saidman write:

Her recommendations {for operating room management}, published in 1923, were clearly ahead of their time and are nearly indistinguishable from those currently practiced by anesthesia departments in university hospitals.

That statement was true before the 1990s, but things changed.2 Same-day admission transformed hospital management, requiring a new science for perioperative management. As I noted in my description of Dr. Palmer’s contributions2:

Same day admit surgery and outpatient surgery have had profound implications for the managerial responsibilities of anesthesiologists… Modern anesthesia departments are different… {requiring} overutilized time [as] a conceptual model.

This in no way diminishes the contributions of Dr. Palmer but emphasizes that every aspect of anesthesiology practice necessarily adapts to the endless stream of innovations in perioperative care.

Franklin Dexter, MD, PhDDivision of Management ConsultingDepartment of AnesthesiaUniversity of IowaIowa City,

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1. Brodsky JB, Saidman LJCaroline B. Palmer: pioneer physician anesthetist and first Chair of Anesthesia at Stanford.Anesth Analg201512116236
2. Dexter FA brief history of evidence-based operating room management: then and now.Anesth Analg2012115101
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