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MEDICAL: ANESTHESIOLOGY :
MEDICAL: PROFESSIONAL ORGANIZATIONS :
MEDICAL: STANDARDS OF CARE :
COUNTRIES: UNITED STATES:
Doctor, Nurse Groups Spar Over Who Can Give Anesthesia
Doctor, Nurse Groups Spar Over Who Can Give Anesthesia
Posted: Tuesday, November 9, 2010 11:45 am
Tom Kisken
Scripps Howard News Service
East Valley Tribune
http://www.eastvalleytribune.com/nation_world/
article_02fae356-ec23-11df-a197-001cc4c002e0.html
A shorter URL for the above link:
http://tinyurl.com/2ucwr8u
Doctors and nurses are fighting over who delivers anesthesia in a conflict
over responsibility that is bleeding into other medical practices.
"There's always been a turf war, especially in California," said Dr.
Steven Bansbach, a Thousand Oaks anesthesiologist, referring to
professional organizations representing doctors and nurse anesthetists.
"It's a turf war set up more by the societies than the individuals."
The tug-of-war focuses on supervision. A Medicare billing rule says nurse
anesthetists must be monitored by anesthesiologists or other doctors. A
year ago, California became one of 16 states to opt out of the federal
provision. Gov. Arnold Schwarzenegger argued that allowing the specially
trained nurses with master's degrees to work unsupervised would improve
access to care while curbin costs in rural and some urban hospitals.
Dominoes went flying.
Two physician groups, the California Medical Association and the
California Society of Anesthesiologists, filed a lawsuit to block the
move. In October, San Francisco Superior Court Judge Peter Busch ruled in
favor of the nurses, saying they can deliver anesthesia without
supervision. Leaders of the doctors groups argue the ruling will
compromise patient safety, particularly in surgeries where complications
emerge.
"There's no question that the more training the provider has, the better
off the patient is," said Dr. James Hinsdale, president of the California
Medical Association.
The medical association has also opposed recommendations -- driven by the
growing shortage of primary care doctors -- to let nurse practitioners
perform more duties typical of doctors.
Nurses have delivered anesthesia with minimal supervision at many sites --
including rural hospitals and outpatient surgery centers -- even with the
Medicare rule.
The anesthetists are advance practice nurses who've worked at least one
year in critical-care units before earning master's degrees. The
profession is moving to eventually require more training and doctoral
degrees for all new nurse anesthetists.
==================================
The complete article may be read at the URL above.
There has been very lively discussion of this issue on the PED-EM-L
discussion group that can be found under this topic heading:
Guess who wants to regulate your deep sedation practice?
At this web address:
http://listserv.brown.edu/archives/cgi-bin/wa?A1=ind1011&L=PED-EM-L
Sincerely,
David Dillard
Temple University
(215) 204 - 4584
[log in to unmask]
http://daviddillard.businesscard2.com
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