The Anesthesia Dilemma
There is no single topic in health care that involves as much emotion as who should do anesthesia. It is the probably the only profession in healthcare where there are two licensed providers, with different educational backgrounds who can perform exactly the same functions. Medical Anesthesiologists and Certified Registered Nurse Anesthetists (CRNA) both can do exactly the same functions in the operating rooms. Anesthesia Assistants are also another group of providers, but unlike CRNAs must work in a practice that is supervised by anesthesiologists.
In the current health care economic environment, looking for a provider that provides a similiar service as a physician at a lower cost is very attractive option. Besides the econocmic issue, quality of care delivery is an equal component of the equation. In anesthesia services, cheaper must not be the prime motivator, if there are quality issues.
The purpose of my blog is to examine the history of both professions, the legal issues and ecomomic components that will be a guiding force in the future of health care in America. I will be upfront and admit my biases are towards CRNAs and their indpendent practice. While it is interesting to review history, to hear the stories, to read the studies, the story is being told every day in the surgical and diagnostic suites around the country. I have worked in those facilities for many years and have seen first hand the actual practices, how CRNAs are considered inferior practitioners until late evening and night, where they all of the sudden become intelligent enough to administer anesthesia for major trauma cases, difficult obstetrical cases and assist in the Emergency Department and Critical Care Units.
Operating rooms are inner sanctums, rarely seen in other settings. This blog with open those doors with a reality most hospital administrators, surgeons and hands on clinicians don't want the public to see or experience. If you think you know about surgery because you have watched it on TV or the movies, you have been fooled. Stay with me, ask questions, listen to the answers and be prepared to be enlightened.