Anesthesiologist viewpoint: Arizona's opt-out puts patients at risk

Heidi Tavel, MD, is an anesthesiologist practicing in Tucson, Ariz. She wrote about her concerns about Gov. Doug Ducey's decision to opt out of CMS' requirement for physician supervision of CRNAs in a column for the Arizona Capitol Times.

She wrote about her work as a physician anesthesiologist and making sure patients don't feel pain and survive procedures safely. Compared to CRNAs, anesthesiologists have about twice as many years of education and about five times the clinical training hours, according to Dr. Tavel.

"During a procedure, I monitor every heartbeat, the patient's blood pressure, breathing and other vital signs," Dr. Tavel wrote. "But even in routine procedures, complications occur and those vital signs can change instantly — threatening the patient's life."

In her column, Dr. Tavel recounted one instance when a man undergoing an outpatient hernia procedure had a heart attack during surgery. The team was able to get his heart back to normal, and he survived.

About 80 percent of voters in Arizona said they would want a physician managing medical complications or emergencies during surgery, her column said. 

Proponents of the governor's decision argue that CRNAs receive about 10,000 hours of clinical training and that research shows there's no difference in outcomes between patients treated by a CRNA and those treated by a physician anesthesiologist.

Dr. Tavel argued Gov. Ducey's decision was made without feedback from the public or medical community, and eliminating physician oversight wouldn't save patients any extra costs.

"Just as you would not remove the surgeon (a physician) from the operating room during a surgical procedure and allow a physician assistant to operate alone, what sense does it make to remove physician involvement from the patient’s anesthesia care and allow a nurse to perform alone?" Dr. Tavel wrote.

Read her full column here.

More articles on surgery centers:
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CRNA viewpoint: How freeing CRNAs from doctor supervision helps patients, hospitals

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