The anesthesiologist lobby is pushing back this week against a New York Times editorial hinting that nurse anesthetists are as qualified as physicians to deliver anesthesia care.
Alexander A. Hannenberg, president of the American Society of Anesthesiologists (ASA), said a shift to certified registered nurse anesthetists (CRNAs) — and away from the better-trained doctors — "is both dangerous and ironic and condemns Americans to the end of improvement in anesthesia."
Current Medicare rules dictate that CRNAs can't administer anesthesia services without a physician present — unless states choose to opt out of that requirement (15 have done so in the past decade). Some medical experts say the quality of care is the same in either case, and they're pushing Medicare to eliminate the physician-supervision requirement.
The Times's editorialists on Tuesday hinted that they support that plan.
"From a patient’s point of view, it would seem preferable to have a broadly trained anesthesiologist perform or supervise anesthesia services, but, in truth, the risk is minuscule either way," the Times wrote on Tuesday. "As health reformers seek ways to curb medical spending, they need to consider whether this is a safe place to do it."
But the anesthesiologists are quick to argue that the reduction of risk surrounding anesthesia treatments didn't happen by accident.
"Anesthesia safety has improved so dramatically in the past 20 years precisely because physicians are developing and testing the drugs, techniques and monitors leading to those improvements," Hannenberg said in an e-mail. "When The New York Times proposes to drop physicians from anesthesia because of those advances, it is both dangerous and ironic and condemns Americans to the end of improvement in anesthesia."
This debate, it would seem, is far from over.