Perioperative medicine as the core identity of anesthesiology: From service delivery to clinical decision-making approach

This is the authors' abstract. We don't add key points for this paper.

The discipline of anesthesiology has undergone profound transformation over time and is still progressing. However, anesthesiologists still lack ample space in the clinical decision-making process of patient management. Surgeons, hospital owners, and at times primary care physicians dominate their role in preoperative clinics and during recovery. At some places they continue to serve as service providers. This limits their professional autonomy and risks marginalizing their active role within multidisciplinary teams. This perspective argues that anesthesiologists must proactively embrace their identity as clinical decision-makers and central coordinators of the entire surgical continuum. This extends from preoperative risk stratification and physiological optimization through intraoperative homeostasis and postoperative recovery. This transformation is not merely a professional satisfaction but a prerequisite for advancing patient safety, improving perioperative outcomes, and ensuring the specialty’s leadership role in modern healthcare systems.