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If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Clinical Practice:
L. C. Lemmens, H. E. Kerkkamp, W. A. van Klei, N. S. Klazinga, C. L. Rutten, R. H. van Linge, and K. G. Moons
Implementation of outpatient preoperative evaluation clinics: facilitating and limiting factors
Br. J. Anaesth. 2008; 100: 645-651 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Outpatient Preoperative Clinics : Our perspective
Somnath Bose   (23 April 2008)

Outpatient Preoperative Clinics : Our perspective 23 April 2008
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Somnath Bose,
Senior Resident
Department of Anaesthesiology , All India Institue of Medical Sciences, New Delhi, India

Send letter to journal:
Re: Outpatient Preoperative Clinics : Our perspective

I compliment Lemmens and colleagues (1) for their work portraying the Dutch perspective on the facilitating and limiting factors in outpatient preoperative evaluation clinics (OPE clinics). I wish to highlight a developing nations' perspective on the same issue.We have a partial OPE clinic functional in our tertiary care institute. The major problem facing the efficient functioning in such a setup is the lack of sufficient number of anaesthesists to deal with the overwhelming number of patients awaiting surgeries. The sheer volume of patients in a tertiary referral centre like ours makes the number of attending anaesthesists look miniscule. Contrary to the Dutch practice, internists or other specialists are never involved in the preliminary outpatient evaluation in our set up. They are involved in the second tier of referrals if required at all. The question of loss of income to anesthesists or internists is also irrelevant in our setup because all referral and consultations are covered by the single fee paid at the time of registration. Hence, in addition to issues like perceived benefits, the biggest problem in a developing country like ours remains one of logistics and resource management. Financial issues as obstacles do not appear to be that prominent.

Reference: 1. Lemmens LC,Kerkkamp HE,van Klei WA,Klazinga NS,Rutten CL,van Linge RH,Moons KG.Implementation of outpatient preoperative evaluation clinics: facilitating and limiting factors.Br J of Anaesth 2008 100:645-51.

Conflict of Interest:

None declared