A California appeals court ruled last month that Certified Registered Nurse Anesthetists (CRNA’s) no longer need to be under the supervision of an M.D. This was a clear victory for CRNA’s, as well as rural hospitals in California that have complained that requiring physician supervision of CRNA’s added unneeded costs and limited the range of surgery services they could provide. This was also a further recognition of the fact that CRNA’s are so well-trained and that the current anesthesia delivery systems so “precise” that CRNA’s are able to deliver extremely safe and unsupervised anesthesia without input from a supervising M.D.
Just to make the difference between a CRNA and an anesthesiologist clear, a CRNA is a Registered Nurse who completes their nursing training and then does several years of additional training in anesthesia. On the other hand, an anesthesiologist is an M.D. who has graduated from medical school and who then does additional training in anesthesia.
I am very comfortable with the use of CRNA’s as anesthesia providers in my Los Angeles surgery center. For the past 26 years I have had a wonderful experience with the excellent group of CRNA’s who have provided anesthesia for my patients, including my own family members. From time to time patients request an anesthesiologist, and my experience with them has been equally excellent. If a patient has significant medical issues, I recommend that their surgery be done in a hospital and that an anesthesiologist provide the anesthesia. But for the patients in my office who, by my choice, are all in good to excellent health, I personally believe that either a CRNA or an M.D. anesthesiologist is an excellent choice.
It’s interesting to note that nationwide, studies have shown that the anesthesia complication rate is extremely low for either type of anesthesia provider. The bottom line is that the anesthetic agents currently available, the equipment used to deliver them, and the standardization of the method of delivery has made anesthesia an extremely safe venture. The overall death rate from anesthesia per year in the United States is only 1 in 5 million. That’s 10 times less than the risk of being struck by lightning!
So the Bottom Line is this: There is no such thing as a bad choice when it comes to the type of anesthesia caregiver used in an office surgery center. Of course some individuals are more skilled than others, and I make sure that our patients have only the best to choose from.
Should you have any further questions, please contact my office.
George Sanders, M.D.