June 1997

Preoperative Anxiety in Children Predictors and Outcomes-Reply

Author Affiliations

Departments of Anesthesiology and Pediatrics Yale University School of Medicine 333 Cedar St New Haven, CT 06510-8051

Arch Pediatr Adolesc Med. 1997;151(6):637. doi:10.1001/archpedi.1997.02170430102030

It is surprising in this era when improved communication between physicians is being fostered that Dr Agre feels that pediatricians should be divorced from the perioperative care of the pediatric surgical patient.

Numerous organizations have emphasized the paramount importance of communication between the primary care physician and the consulting specialist(s). As both a board-certified pediatrician and pediatric anesthesiologist, I have a comprehensive understanding of the complex forces at work to foster a good outcome for the pediatric surgical patient and their family. I believe, as do most pediatric anesthesiologists, that time must be spent both preoperatively and postoperatively with the patient and family. Dr Agre's comment is quite pejorative in assaulting the motives of my specialty (and that of our surgical colleagues). A significant portion of the time spent in the perioperative period is devoted to "unremunerated activities," because we believe it is appropriate.

Although Dr Agre denigrates the knowledge

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