Wednesday, February 3, 2010

Doctor's Vs. Schwarzenegger In California Court? Yep.

Some call it a "turf war", others say Gov. Arnold Schwarzenegger ignored the law when he decided to allow nurse anesthetists in California to work without a supervising physician last year. Whatever is being said, it's a mess. Several doctor's groups are now challenging the procedures used by the Governor in a lawsuit recently filed in the San Francisco Superior Court.

Those of you who are familiar with my practice know that I insist on one of two nurse anesthetists to do ALL of my cases. If you've watched us on Big Medicineon Discovery Health lately, you'll see why. Candy, the petite Asian lady behind the ether screen, is always there. And if you watch, you'll see that her eyes are always either on the monitor or on the patient. She defines the word vigilance.

You see, nurse anesthetists must have 2 years of critical care nursing before moving ahead with their nurse anesthetist training. Critical care nursing is hour after hour of bedside care. And I mean total care. I was once an orderly, and know what that means. We doctors waltz in and out of the room, but it's the nurses who truly care for the patient.

In the O.R., I appreciate and demand that the same approach be followed. Now, I'm not knocking my M.D. colleagues, and plenty of them are great. But for me, a nurse anesthetist is the way to go for cases.

But there are instances where the input of a crusty old physician is really welcomed. And it can even be lifesaving. Anesthesia can result in the need for one of several an emergency surgical procedures. A nurse would not be the best qualified to do that. And review of patients with complex medical problems is also something I feel is best left to an experienced physician.

It's painfully easy to see why they are going this route in California, and that is because there will be a cost savings. Sadly, it will come at the expense of patient safety.

To suggest that this is some kind of "turf war" where greedy nurses want their cut, and doctor's are defending their fiscal territory is naive and unfair.

After all, doctor's have been working alongside nurses for a long time without any problems. I say we keep it that way.

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