6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 6
T
he Department
of Veterans
Affairs thinks it
has the answer to cut-
ting wait times for vet-
erans who need surgery
and other medical care:
Let nurse anesthetists
work without a doctor's
supervision. The coun-
try's largest healthcare
system wants to give CRNAs the authority to administer anesthesia and pre-
scribe medications, among other things, on their own. The VA's recent proposal
picked at the scab of a decades-old turf war waged by the American Society of
Anesthesiologists and the American Association of Nurse Anesthetists. The bat-
tle is playing out on a national and very public stage, but the debate centers on a
familiar argument that has been discussed for years in surgery centers and com-
munity hospitals: How much is patient safety worth?
The bottom line
It shouldn't come as a shock that both organizations are touting the clinical
expertise of their members. The ASA makes the argument that CRNA-only anes-
thesia is unsafe, and produced a position paper to back its claim
(osmag.net/JBTc7t). Of course, the AANA has similar research to cite, and
makes the argument that CRNAs are perfectly capable of providing safe anes-
thesia, that they do so in areas in which doctors are not available and that such
services are vital to the functioning of underserved areas.
Studies funded on
both sides of this particular argument have not conclusively convinced anyone
Who Should Administer Anesthesia?
The turf war between MDs and CRNAs heats up.
On Point
Shirie
Leng, MD
• BEHIND THE MASK Physician anesthesiologists and nurse anesthetists both lay claim to
safe patient care.
Pamela
Bevelhymer,
RN,
BSN
