RMV->) Re: "Finding the Right Anesthesia Provider" (2007 Manager's Guide to New Surgical Construction, January supplement, page 92). Having set up three outpatient facilities myself (in Ohio and Florida), I can attest to the sensibility of most of what Paul Patane, MD, MBA, writes. However, I take issue when he says that, "at a minimum, you should have a board-certified anesthesiologist in your facility whenever a patient is receiving an anesthetic or recovering from one." There's no credible scientific evidence to support this advice. And you may have left the impression that not having an anesthesiologist is somehow dangerous or a lesser standard of care. As a CRNA with almost 20 years experience and thousands of cases performed without a single complication, none of my patients would have benefited from the presence of an anesthesiologist. As a member of Outpatient Surgery's editorial board, I didn't think it would be fair to my CRNA colleagues or to the magazine if I didn't write this note.

Jay Horowitz, CRNA
Sarasota, Fla.
writeMail("[email protected]")

Thumbs Down on ASCs That Bill as Hospitals
Re: "Under Arrangements Not Going Over Well" (November, page 8). This practice is giving the ASC industry a black eye. I appreciate that we all need to make money to keep our businesses running, but walking slightly below the ethical line isn't the right thing to do. This hurts taxpayers and makes ASCs look greedy. I've always appreciated working in an industry that prides itself on doing the best it can for its patients. As you say, "Just because there's a loophole, it doesn't mean you have to jump through it."

Cheryl Stanley, RN, CASC
Director
Elkhart Clinic Endoscopy & Surgery Center LLC
Elkhart, Ind.
writeMail("[email protected]")

Pols Should Stay Out
Re: "Happy or Sad Days for Doc-owned Hospitals?" (January, page 18). The politicians need to listen to providers. ASCs and specialty hospitals provide safe, clean, intimate patient care.

Stephanie T. York, CPC, CPC-H
Director Business Office Operations
OR Partners
writeMail("[email protected]")

Surgery's Ten Commandments
Re: "The Ten Commandments of Surgery" (December, page 88). I can't wait to share this with the staff. They will find it very amusing, especially calling the orthopod's mom.

Teresa Nosek, RN, BSN, CNOR, ONC
Indiana Surgery Center North
Greenfield, Ind.
writeMail("[email protected]")

Yes, you might step on some toes, but I believe that was not your intention. OR nursing staff need a laugh and you provided that! Thanks!

Janice Gadbaw, RN
Blake Woods Medical Park
Jackson, Miss.
writeMail("[email protected]")

Some humor, but hardly worth the space to print it or the time to read it.

Kathy Simmons, RN, MS
Perioperative supervisor
Clearfield Hospital
Clearfield, Pa.
writeMail("[email protected]")