Physician Anesthesiologists Urge VA to Reverse Directive Jeopardizing Veterans' Lives

CHICAGO – The American Society of Anesthesiologists (ASA) urges Americans to protect our nation’s Veterans by asking the U.S. Department of Veterans Affairs (VA) to reverse its memorandum that dismantles the successful anesthesia care team, removes physician anesthesiologists from surgery and replaces them with nurses, lowering the standard of care for Veterans and jeopardizing their lives.

The VA decision, which was recently outlined in an April 21, 2020 memo by VA Under Secretary for Health Richard Stone, M.D., puts the health and lives of our Veterans at risk and also ignores two record-setting public rule-making processes in 2017 that reaffirmed the importance of safe, physician-led anesthesia care for VA patients.

“COVID-19 has created an unprecedented time but that does not change the fact that surgery and anesthesia are inherently dangerous, requiring physician involvement, especially for VA patients who have complex medical conditions that put them at greater risk for complications,” said ASA President Mary Dale Peterson, M.D., MSHCA, FACHE, FASA. “When those complications occur, a physician anesthesiologist’s education and training can mean the difference between life and death. “

Throughout the pandemic, ASA has closely tracked anesthesia services. There is no shortage of anesthesia providers that necessitates this change in the current anesthesia care team model where physician anesthesiologists and nurse anesthetists work together to provide Veterans high-quality and safe anesthesia. The October 2019 National Anesthesia Directive also provides flexibility to meet the demands of patient care during this public health emergency.

Research supports maintaining physician-led anesthesia care and the VA’s own internal evaluation of the relevant studies regarding health outcomes of patients receiving care from nurse anesthetists practicing independently concluded that the evidence was biased and insufficient to support making any policy changes. VA’s Quality Enhancement Research Initiative (QUERI) could not discern “whether more complex surgeries can be safely managed by CRNAs, particularly in small or isolated VA hospitals where preoperative and postoperative health system factors may be less than optimal.”

Physician anesthesiologists receive 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care and pain control, with the necessary knowledge to understand and treat the entire human body. By comparison, nurse anesthetists have about half the education and almost 2,500 hours of clinical training.

“Every patient wants and deserves a physician anesthesiologist in charge of their care,” said Dr. Peterson. “Our nation’s Veterans earned and deserve nothing less.”

Visit here to take action and submit a letter to your lawmakers urging them to have the VA rescind this dangerous policy and keep Veterans safe with physician-led anesthesia care.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 54,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Like ASA on Facebook, follow ASALifeline on Twitter.

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