Need an anesthesiologist's input on this.....

[Beau Geste]

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I'm participating in a PA to MD/DO thread over in the clinician's forum in SDN and wanted an opinion and info on the role of the PA (physician assistant) in anesthesia...

could anyone shed light on physician supervision required, what states this is legit in, etc.

Or maybe point me to some links that are not provided by the AAPA?

This link is a little concerning to me:
http://forums.studentdoctor.net/showpost.php?p=4651196&postcount=19

 

[VolatileAgent]

well, the article is quick to point out that they need more training. that is, they'd have to get the anesthesiology assistant (AA) training.

aside from that, the article offers the often touted, and much refuted and debated, statistics from the AANA party line. for example, they say crna's "provide 65% of the anesthetics" in the U.S. well, not only is this disputed, this is also not factually true because looking at it as this way as a percentage of involvement anesthesiologists (MD/DO) provide or direct more than 90% of anesthetics delivered in the U.S. this is a far cry of from the "independent practice" picture the AANA tries to paint.

as the article alludes to, we also at our institution have "regular" PA's and CRNP's doing the bulk of the pre-op evaluation in our anesthesia clinic. they do not discuss or develop the plan for the anesthetic. they do and dictate the H&P, and order what tests they think need to be done based on algorithms. we then either cancel unnecessary tests or order additional ones based on their initial evaluation.

so, is this providing anesthesia care? i don't think so. and, certainly their involvement in the OR is nil.

ASA has never resorted to personal attacks on their profession or their leadership. We have never used anecdotal cases to prove our point. We know that access (rural or urban) is not the issue, and we know that anesthesia nurses do not, as AANA claims, deliver 65 percent of the nation's anesthetics alone. They do participate in anesthesia care. We know they are not better trained than anesthesiologists and we know they are not safer anesthesia providers. Anesthesiology is the practice of medicine — not the practice of nursing. Almost all of the nation's physicians and the nation's seniors want physicians involved in their anesthesia care, and they support the new proposed rule. The "bottom line" is no excuse to diminish the quality of health care. There is no alternative to patient safety. Patient safety is our oath and our motto.

http://www.asahq.org/Newsletters/2002/1_02/swissman.htm

 

[jwk]

I'm participating in a PA to MD/DO thread over in the clinician's forum in SDN and wanted an opinion and info on the role of the PA (physician assistant) in anesthesia...

could anyone shed light on physician supervision required, what states this is legit in, etc.

Or maybe point me to some links that are not provided by the AAPA?

This link is a little concerning to me:
http://forums.studentdoctor.net/showpost.php?p=4651196&postcount=19

For all practical purposes, PA's are not able to practice anesthesiology. MD's, CRNA's, and AA's are the only three recognized by CMS and private insurors to be eligible for reimbursement. In addition, hospitals and/or malpractice insurors will not credential or provide coverage to practitioners who have not undergone formal training in anesthesia, and such training is only available in an anesthesiology residency or a CRNA or AA training program. There is no such thing as an anesthesiology residency for PA's, nor is there any type of specialty certification in anesthesiology for PA's.

PA's and NP's are used in pre-op clinics in a number of departments, but they do H&P's, order labs and other pre-op tests, etc. They do not formulate the anesthesia plan.

The ASA has addressed this issue as well, and does not and will not support the idea of an "anesthesia PA".

There are a number of PA's that have gone through the AA programs at Case and Emory, and Emory now has a PA to AA bridge program that gives credit for some coursework by masters-prepared PA's and shortens the AA program by a semester (one semester out of the six usually required). PA's graduating from bachelor's programs would still have to go through the full program, as bachelor's degree credit does not transfer to a master's program, just like college biochem wouldn't get you off the hook for biochem in medical school.

 

[Beau Geste]

Thanks for the responses. I wanted to get opinion from outside the PA posters on that subject.

 

[pillowhead]

I'm participating in a PA to MD/DO thread over in the clinician's forum in SDN and wanted an opinion and info on the role of the PA (physician assistant) in anesthesia...

could anyone shed light on physician supervision required, what states this is legit in, etc.

Or maybe point me to some links that are not provided by the AAPA?

This link is a little concerning to me:
http://forums.studentdoctor.net/showpost.php?p=4651196&postcount=19

Actually, there are some PA's that work in the anesthesiology department at my school who do exclusively critical care. So PA's can work with anesthesiologists, but generally not in the OR.