Thirty years ago, I got my first OR job. I was 17, hired as summer help at Mount Sinai Hospital in Cleveland. That's when I knew I wanted to attend nursing school and become a nurse anesthetist. I graduated from the Mount Sinai School of Nurse Anesthesia in 1988, taught by physicians and an equally talented group of CRNAs to work independently and as part of the anesthesia care team.

Anesthesia looked like magic in the hands of my mentors. They rendered patients senseless during surgery and then reanimated them at the procedure's conclusion. These physicians and CRNAs were not only highly competent and professional, but they always carried themselves with class.

Fast forward to today. Our ability to treat patients is threatened by a medical malpractice crisis, increasingly costly medications, difficulty finding common anesthesia drugs and reports of thousands of medical errors. HMOs seemingly dictate allowable medical care. Large numbers of Americans are uninsured. Reimbursements have dropped. Mount Sinai, which had been providing healthcare to the insured and uninsured alike since the early 1900s, closed its doors amid the downsizing of hospitals in an increasingly competitive healthcare environment.

At the same time, the roles of nurses and other non-physician healthcare personnel have been expanding into what traditionally had been the exclusive domain of physicians. In 1986, Congress passed legislation that made CRNAs the first nursing group to be able to bill and collect professional fees from Medicare. As is often the case when the reimbursement landscape changes, tensions soon grew between the two camps - in this case, the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA).

PACs, lobbyists and legislative agendas have become staples of the two organizations, which have spent unbelievable amounts of money on efforts to sway legislators, regulators and the public in a futile conflict. Say-anything tactics and pseudo-science masquerading as scholarly studies have become acceptable. My mentors would be embarrassed as we denigrate and demean each other.

The huge irony here is that the groups have so much common ground. Roughly 70 percent of anesthesiologists and CRNAs work together, everyday, in the care-team setting. Yet, on the political front, since 1996, ASA has refused any meaningful dialogue with CRNAs unless our national organization, AANA, agrees first to the concept that "anesthesia is the practice of medicine" - an obvious non-starter.

Most of my colleagues, CRNAs and anesthesiologists alike, would like nothing better than to return to a kinder, gentler workplace. They have little interest in demeaning each other or themselves by virtue of mean-spirited tactics. Further, they have little interest in restricting the practice rights of their co-workers. Together, we could be a powerful voice for patient safety, designers of unique and cost-effective model practices, advocates for responsible and fair malpractice reform, watchdogs of the pharmaceutical companies, and collaborators for the scientific advancement of this unique and wonderful profession.

Anesthesia is the practice of medicine, but it is also the practice of nursing. From that starting point we can accomplish great things. Let's bring a little class back to the anesthesia world and make our mentors proud.