8 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
It's pompous of the American Society of Anesthesiologists to
oppose the Department of Veterans Affairs' proposal to
expand the autonomy of nurse anesthetists, especially since
the idea is based on a very successful military model. The fact
that some anesthesiologists don't want CRNAs to function
independently is a simple case of restriction of practice.
The ASA's tired, unsupported argument centers on
patient safety and relies on outdated literature.
Contemporary research shows no difference in safe outcomes when anesthesi-
ologists or CRNAs administer anesthesia. Let's get serious: The current debate
centers on control and money. The ASA doesn't want to level the playing field,
because if you look at the cost of care, anesthesiologists simply can't compete
with CRNAs. If CRNAs do the same job with the same safety profile, why
wouldn't you want the less expensive option working in your facility?
Most anesthesiologists and CRNAs who work together in the trenches don't
care that their respective societies are locked in heated debate. I'd never take
away from what anesthesiologists bring to the table, but I also won't diminish
what seasoned CRNAs have to offer. Anesthesia requires knowledge and it's a
technical, hands-on specialty. Is an experienced CRNA who sedates hundreds
of patients a month really less qualified than an anesthesiologist simply
because of the letters after their names? There's no arguing that a medical
school education provides anesthesiologists with a greater expertise in gener-
al medicine but, when it comes to an understanding of anesthetics, I believe
CRNAs are equally capable.
— William Landess, CRNA, MS, JD
Mr. Landess (william.landess@palmettohealth.org) is corporate director of
anesthesia at Palmetto Health in Columbia, S.C.
William Landess,
CRNA, MS, JD
POINT TAKEN
CRNAs Are More Than Capable
