Supervision Debate Intensifies Between Anesthesiologists and Nurse Anesthetists

Colorado is among the most recent states debating the rights of certified nurse anesthetists to administer anesthesia without a physician's supervision, according to a New York Times report.

The conflict stems from a 2001 Medicare and Medicaid regulation change that allows states to "opt out" of a requirement that nurse anesthetists be supervised. So far, 17 states have chosen to waive the requirement.

Proponents of the opt-out say that it will allow patients in rural and medically underserved areas to receive medical care. Some of Colorado's rural hospitals, for example, began allowing nurses to administer anesthesia in 2010 and have since been able to attract other specialists to the region due to the assurance that someone will be able to administer anesthesia, the report said.

Critics argue that the opt-out can be harmful to patients because nurses and anesthesiologists receive distinctly different medical training. "There is a very different background between nurses and physicians in both education and training," said Randall Clark, MD, a spokesman for the Colorado Society of Anesthesiologists. "Anesthesia is a very complex and technically demanding area of medicine that, at its core, needs to be either performed by a physician or supervised by one."

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