LETTERS: CONCERN OVER ANESTHESIOLOGY CARE

To the editor:

A recent proposal by the Health Care Financing Administration could mean that senior citizens and the poor will not have an anesthesiologist available during surgery. This proposed rule change for Medicare and Medicaid recipients would eliminate the long-standing requirement that nurse anesthetists be supervised by a physician. At issue is the safety of our elderly and poor patients.

Anesthesiology is the practice of medicine, not nursing. The medical specialty of anesthesiology had achieved remarkable advances in safety for surgical patients and in scientific knowledge concerning anesthetic management. Many of the best and brightest young physicians over several decades have devoted their careers to patient safety and comfort. Please contrast this happy state with the risk, uncertainty and fear attending surgery before highly educated doctors specialized in caring for patients during surgery and the perioperative period.

To sanction the independent practice of nurse anesthetists would be a lamentable and shortsighted step backward. Certainly almost any appropriately trained person could use the advances of anesthesiology and administer a routine anesthetic much of the time. But when the unexpected happens and I, the anesthesiologist, truly mean the difference between a patient's life and death, my many years of formal education become very important to that patient.

Please, for the sake of that patient, understand that anesthesiology is the practice of medicine, not nursing. And please, for his sake, realize that an HCFA decision to sanction independent practice of nurse anesthetists could keep me from helping that patient when his life hangs in the balance.

There is still time to contact U.S. Sen. John Ashcroft, U.S. Sen. Christopher Bond and U.S. Rep. Jo Ann Emerson to speak out against HCFA's proposal.

DR. STEPHEN W. STIGERS, Diplomate

American Board of Anesthesiology

Cape Girardeau