Physician anesthesiologists on Wednesday established their opposition to a U.S. Department of Veterans Affairs proposed policy that replaces physician anesthesiologists with advanced practice registered nurses in surgery, and urged the public to tell the VA to reject this policy.
The urging came during a press briefing in Washington, D.C.
Daniel J. Cole, MD, president of the American Society of Anesthesiologists, argued that the policy change, designed to help expand the pool of providers for the VA Health Care System, "would abandon a proven model of quality healthcare where physician anesthesiologists and nurse anesthetists work together as a team to assure veterans get high-quality, veteran-centered care."
Jane C.K. Fitch, MD, former president of the American Society of Anesthesiologists and a former certified registered nurse anesthetist, echoed Dr. Cole, saying she believes the policy change "lowers the standard of care and endangers the lives of those who have served our country."
Given her background, she also discussed the role of nurses. She believes the physician anesthesiologist she worked with as a certified registered nurse anesthetist respected her and relied on her. However, she knew she didn't have the same breadth or depth of her physician, and she needed physician supervision.
"When we have a veteran on the operating room table with multiple medical conditions, seconds count. And all those [additional] years of education and training [physician anesthesiologists receive] can make the difference between the life and death of that veteran or brain damage or no brain damage for that veteran," she said.
However, the policy is supported by various other healthcare and veterans' organizations, including the American Association of Nurse Anesthetists, the Military Officers Association of America and the Air Force Sergeants Association. ANA President Juan Quintana, who is a certified registered nurse anesthetist and Air Force veteran, said in a statement, "Veterans are waiting entirely too long to receive the quality healthcare they deserve and have earned in service to our country. The AANA strongly supports the VHA's plan to solve this problem by utilizing readily available healthcare resources — such as CRNAs, nurse practitioners and other APRNs — to the full extent of their practice authority."
The AANA also pointed to a new study published in the June issue of Medical Care, which found scope of practice restrictions and physician supervision requirements for nurse anesthetists have no impact on anesthesia patient safety.
The proposed rule, which was published in the Federal Register, is open for comment until July 25.
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