A gem sparkles because it is multifaceted. Anesthesiology is a gem as it is truly multifaceted, that is, our specialty includes individuals who are facile clinicians, inspiring educators, inquisitive scientists, and practice management experts. Today's reality and complexities of patient care, education, research, and administration make it virtually impossible to be all things that encompass our specialty. The fact that there are many anesthesiologists with great facility in each of these areas tells us to select our strengths and passions and sit on the anesthesiology four-legged stool on equitable and firm footing.1 

Dr. Serlin expresses disappointment about what he describes as being precluded from sitting at the table on a stable stool. He is, however, a rightful and important participant. He is a member of a group of private clinician practitioners. Their contribution to the strength and stability of the anesthesiology stool is quite reassuring as they provide anesthesia patient care and facilitate operating room and hospital clinical practice. Dr. Serlin laments what he perceives as research activity he would like private practitioners to be able to do were it not for lack of support from hospitals, the burdens of Investigational Review Board requirements, and discouragement from anesthesia journals. He calls on our specialty to support private practicing anesthesiologists to be more a part of the research component of our four-legged stool.

I agree with Dr. Serlin's assertion, “... it is [always] time for the encouragement and support of private practicing anesthesiologists to be a part of the four key activities encompassing anesthesia.” Anesthesiology is a specialty with options. Anesthesiologists are lucky to have choices for how they devote their professional time. Private practitioners are facile clinicians and practice management experts. They are also inspiring educators, able to teach patients and their families, physician peers, and the vast array of paraprofessional hospital staff about anesthesiology. As individuals who champion anesthesia patient care, clinician practitioners are astute observers of much that we do not understand. Dr. Serlin, sit on the anesthesiology stool by asking the questions about what we do not understand about anesthesiology and make the choice to investigate the answers by reallocating your time and resources.

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. schwartza@email.chop.edu

Schwartz AJ: Education: An essential leg for Anesthesiology's four-legged stool! Anesthesiology 2010; 112:3–5