The president of the American Society of Anesthesiologists (ASA), Mary Dale Peterson, MD, issued a brief response on the federal government’s decision to waive scope of practice rules this week during the weekly ASA town hall, on Thursday, April 2.
In the broadcasted statement, Dr. Peterson expressed her disappointment over the White House’s decision, but also offered a measured perspective on the benefits it could offer health care institutions faced with increasing caseloads of patients with COVID-19 as the pandemic continues.
“Many of you are wondering why President Trump eliminated all scope of practice rules in hospitals, essentially stating that no doctors are needed,” Dr. Peterson said. “My understanding is that the federal government does not want to impede any flexibility that states may need to handle this crisis.”
On Monday, March 30, the Centers for Medicare & Medicaid Services (CMS) issued a sweeping array of regulatory waivers and new rules for the American health care system at President Trump’s direction. One of those changes was to remove the requirement that certified registered nurse anesthetists be supervised by a physician.
Dr. Peterson said that one should not believe there is a workforce shortage of physician anesthesiologists that would necessitate this change, as there are many reports of anesthesiologists being “out of work” due to mass cancellations of elective surgeries. She emphasized that state laws and hospital bylaws on scope of practice can still overrule those changes in the CMS rules. She also urged that the focus should remain on the crisis at hand, and that these changes would not last past the current situation.
“We should not be discouraged. This is an unprecedented period of time that we must all work through,” she said, adding that “once the emergency declaration expires, so too does the waiver.”
The remainder of the town hall focused on organizing anesthesia teams in both academic anesthesiology departments and private practices.
Andrew D. Rosenberg, MD, FASA, the ASA vice president of scientific affairs, gave a presentation on reorganizing academic departments. Dr. Rosenberg is also the chair of the Department of Anesthesiology, Perioperative Care and Pain Medicine at NYU School of Medicine, in New York City.
Steven Schulman MD, MHA, FASA, the associate medical director at St. Francis Hospital, the Heart Center, in Roslyn, N.Y., delivered a presentation on preparing for the pandemic in private practices. He is also the president of New York Cardiovascular Anesthesiologists, P.C.
The presentations will be available along with past town hall webinars on the ASA website for CME credit.
This was the ASA’s third town hall webinar aimed at providing updates on how anesthesiologists should prepare for treating patients with COVID-19.
—Michael DePeau-Wilson
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The sky is NOT falling. CRNAs have been capable of administering anesthetics without supervision by a physician (including dentists & podiatrists) for over 100 years. Opt out is a fact in at least 17 states and counting.
i agree with Dr. Peterson that the crisis at hand needs to be the focus. May i remind you that CRNAs have been providing safe,unsupervised anesthetics for decades and anesthesiologists have had jobs. Ive had the pleasure of working side by side not supervised byanesthesiologists. With utmost respect to all, i hope to work side by side in the future without battles. Lets keep patients as the focus not our egos. Everyone be Safe.
having been a practicing anesthesiologist for 41 years I jave seen the slow demise of mdas surgeons dont care who is at yhe hesd of the table as long as the pstient doesnt move and wakes up st the end of the case I have seen crnas with mo training whatsoever start stickkng needles into patients saying they are ultrasound experts Anesthesia companies would rather hire crnas because of bottom line issues only Even physician trsined anestjesia assistants sre using the same ploy as crnas ie going to the govt and saying they do the same thing as mdas and need to be paid the same
Nurses are wannabes. Anesthesiology is the practice of medicine. Medicine is practiced by doctors.
Too bad our own society doesn't support us.
@JMS You stated " CRNAs have been capable of administering anesthetics without supervision by a physician (including dentists & podiatrists) for over 100 years." I'm not sure what you mean. CRNAs were supervised by the Physician Surgeon a hundred years ago. CRNAs are capable administrators of anesthetics. They are NOT physicians. Full Stop.
@armencv CRNAs are not physicians, but in the history of legal challenges, anesthesia has been deemed a practice of medicine when administered by a physician and a practice of nursing when administered by a CRNA. The “supervision” only requires a written order requesting anesthesia by a MD, dentist, or podiatrist. That is the extent of the “supervision”. No one is claimimg that CRNAs are physicians, but they are safe and competent administrators of anesthesia.