Letters & Emails

By: Zzz Zzz

Published: 10/10/2007

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Anesthesiologists vs. CRNAs


RMV->)Anesthesiologists vs. CRNAs
Re: "Are You Prepared for the Anesthesiologist Shortage?" (September, page 28). Why, I wonder, was it not entitled "Are You Prepared for the Anesthesia Provider Shortage?"? Have you been fooled by the doctors' self-promoting line of propaganda? CRNAs do two-thirds of the 26 million anesthetics in the United States each year, and while I do appreciate the fact that you apparently talked to some AANA staffers, the article also quoted a number of anesthesiologists, all of them pushing the fallacious presupposition that MD anesthesia is superior. Where is their proof? If it were, British anesthesia (MD only) would be demonstrably better than American. It isn't. End of argument.

Wayne Johnston, CRNA
Twilight Anesthesia, Inc.
Durango, Colorado
writeMail("[email protected]")

Re: The ongoing shortage of qualified anesthesia practitioners and the increasing competition between anesthesiologists and CRNAs has led some physicians to place anesthesiologist assistants (AAs) in marginally supervised situations in order to increase profits. AAs are unlicensed assistive personnel and are trained to help the anesthesiologist in the "care team" setting. They were never trained to replace a qualified nurse or physician. CRNAs are licensed independent practitioners in most states and are reimbursed at the same rate as anesthesiologists (when not working in a "care team" setting). We come to our university-based residency program with a scientifically grounded patient care-centered education in nursing. Unlike AAs, CRNAs have a statutory accountability for their practice through licensure as an Advanced Practice Registered Nurse. The solution to the anesthesia practitioner shortage lies not in promoting unlicensed assistants but in increasing the training opportunities in anesthesia for both physicians and nurses.

Robert T. Laird, CRNA
Past President, Texas Association of Nurse Anesthetists
writeMail("[email protected]")

Corrections and Clarifications
- We used the term "custom packs" several times to generically describe sterile procedure packs in "A Review of Procedure Packs" (February, page 45). To prevent confusion, we should have used the latter term instead. While the term "custom packs" is not trademarked, the term "Custom Paks" is a trademark of Alcon Laboratories. We regret any confusion our use of the two terms may have caused.

- Spectrum Surgical Instruments manufactures the three rigid endoscopes shown in the photo that accompanied "What You Need to Know About Endoscope Reprocessing" (January, page 60). We failed to credit Spectrum in the photo caption.

- Due to an editing error in "What You Need to Know About Endoscope Reprocessing" (January, page 60), we may have caused some confusion regarding equal standard of care. Sterilizing endoscopes overnight and then disinfecting them between patients is approved by JCAHO and highly recommended as a processing procedure. It does not violate the "equal-standard-of-care" code.

- The words "deflectable tip" should not have appeared in the caption that accompanied the photo of the Visera EndoEye videoscope from Olympus in "The Laparoscope Revolution" (February, page 34). The deflectable tip is part of a different Olympus model.

- We failed to credit FASA as the source of the data that appeared in "Estimated Average Cuts for ASC Procedures," a chart that ran on page 49 of our February issue.