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Anesthesiology led in establishing standards of care, now plans practice parameter strategies.

ABSTRACT THEORIES ABOUND as to why the grateful patients of Dr Crawford Long's day gave way to the many litigious recipients of medical care more than a century later. Whatever the reason, by the mid 1980s in the United States, anesthesiologists and other physicians found themselves practicing in an adversarial climate.To mitigate the "malpractice crisis," in which an increasing number of legal claims by patients who suffered less than optimal outcomes was driving insurance premiums sky high, efforts were begun to improve patient care.Establishing Standards In 1986, anesthesiologists affiliated with nine teaching hospital departments that made up the Department of Anesthesia of Harvard Medical School, Boston, Mass, took the lead in establishing standards of care (JAMA. 1986;256:1017-1020). According to Burton S. Epstein, MD, chair of the American Society of Anesthesiologists' (ASA's) Committee on Standards of Care since 1985, such clearly stated standards had not existed before in any specialty.