Podcast: What Does It Mean To 'Clear' A Patient?

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Clearing a patient for surgery is a clinician's attempt to mitigate any side effects from occurring as a result of a surgical procedure.
Clearing a patient for surgery is a clinician's attempt to mitigate any side effects from occurring as a result of a surgical procedure.

Clearing a patient for surgery is a clinician's attempt to mitigate any side effects from occurring as a result of a surgical procedure. Using the word “clearing” to describe a preoperative evaluation of a patient might not be the most accurate representation of what a physician actually assesses when physically evaluating a patient and reviewing the records of a patient. A patient isn't “cleared” of anything; instead, a patient undergoes some level of risk assessment by a team of clinicians. 

This week I had cardiologist Ron Shnitzer, MD, on my podcast to discuss QT prolongation, tricyclic medication side effects, cardiac clearance and interventional procedures in the anticoagulated patient.

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The majority of our discussion, however, revolved around how and why patients are evaluated before going into surgery. There's always a level of risk when operating on a patient, and it's the team's job to correctly assess those risks.

“We don't 'clear' patients,” Schnitzer said during the podcast. “We define risk and try to mitigate risk.”

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The two of us agreed on using the term "optimization," since there's always a level of risk when operating on a patient. The term "clearance" implies that there's no risk to the patient or the physician.

"The idea that somehow the internist or cardiologist for that matter is going to be able to 'clear' the patient is really a falsehood," he said.

For our full discussion, listen to the podcast above.

DISCLAIMER: Dr. Rosenblum is here solely to educate, and you are solely responsible for all your decisions and and actions in response to any information contained herein. This blog and related podcast is not intended as a substitute for the medical advice of a physician to a particular patient or specific ailment.

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