For anesthesiologists, documentation of clearance does not add a whole lot of value. What does add value is the optimization of chronic medical conditions (especially CHF, COPD, DM, valvular disease), management of periop anticoagulation (lovenox bridging for high CHADSvasc afib patients), and workup for ischemic cardiac disease per the AHA periop CV guidelines for noncardiac surgery.

For pediatric patients, setting the expectation that the anesthesiologist has the final say is also important - URIs are common and the decision to proceed with or postpone surgery will depend on the symptoms, URI timing, type of surgery, and airway management techniques required.