From;http://www.journaltimes.com/news/local/article_c012729e-1b57-11df-8428-001cc4c03286.html
More nurses, fewer doctors for anesthesia worries Wheaton surgeons even though its common nationally
LINDSAY FIORI
[email protected] | Posted: Tuesday, February 16, 2010 5:55 pm |
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One of several issues
The change in anesthesiologists is one of several issues that have All Saints doctors upset and fed up with Wheaton administrators. Doctors met to discuss their concerns with administrators last Wednesday and they were meeting again Tuesday. To read more about the issues doctors have, click
here.
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RACINE - A change at Wheaton Franciscan-All Saints hospital to using more nurses and fewer doctors for anesthesiology has some surgeons concerned even though anesthesiologists and Wheaton officials say having more nurses is common practice nationally.
Some surgeons have said they will not work with the new nurse anesthetists, who are trained but lack medical degrees, but Wheaton officials said the practice is safe.
"This model is used throughout the state of Wisconsin and the country. It's very prevalent in Milwaukee," said Steven Gottlieb, CEO,
(President and CEO of Anesthetix) of All Saints' current anesthesiologist group, Racine Anesthesia Services which took over anesthesia services Jan. 11 from Southeastern Anesthesia Consultants, a local group that had worked with All Saints for more than 20 years.
This change is one of several issues that have All Saints doctors upset with hospital administration and meeting in attempts to reconcile differences.
Events leading to the change in anesthesia providers - and in models of care - began in August. At that time, All Saints officials thought the hospital's needs had grown beyond what Southeastern Anesthesia Consultants could provide,
so they brought in Florida-based anesthesia consulting group Anesthetix Management, said Mary Ouimet, vice president of patient care and chief nursing officer for All Saints, 3807 Spring St.
Ouimet said All Saints wanted to have an anesthesiologist at the hospital 24/7 instead of just having them on-call.
Southeastern Anesthesia Consultants wanted to meet that need but wanted doctors paid for their on-call time, said former Wheaton anesthesiologists who spoke with The Journal Times under condition of anonymity because of fear for their professional reputations.
The former anesthesiologists said All Saints would not agree to paying them for on-call work. The group gave their 30-days notice at the end of October and later agreed to stay until Dec. 31, according to Ouimet.
Ouimet said All Saints then began talks with
Anesthetix Management to provide services for the hospital. All Saints and the company finalized a contract Nov. 16 and talked with the hospital's current anesthesiologists about staying on with the new company, which is operating locally through the new Racine Anesthesia Services group. Only two of the hospital's 12 anesthesiologists decided to do stay on, she said.
The former Wheaton anesthesiologists said they did not want to stay because that would have meant operating under a new management system, taking a cut in pay and using the nurse-based model, something tried in the past and deemed unsuccessful.
With the nurse-based model implemented at Wheaton, the 12 anesthesiologist positions previously held became about eight anesthesiologist positions and about 12 nurse anesthetist positions, Gottlieb said, adding that the nurses are qualified and that an anesthesiologist is with them during an entire procedure.
Wheaton said Monday that an anesthesiologist is in the operating room with the nurse anesthetist for the entire procedure but Tuesday said they meant the anesthesiologist is in the operating suite the whole time. The operating suite is the area containing operating rooms.
"Each anesthesiologist works closely with two nurse anesthetists," said All Saints anesthesiologist Jacqueline Peters, who worked for the hospital before and after the provider switch. "The rooms we supervise them in are next door. I am immediately available between two rooms."
Wheaton officials and doctors said anesthesiologists are present during the start and end of procedures but may rotate among rooms during operations. Despite their close proximity, some doctors still worry that, if something were to go wrong when the actual anesthesiologist was not in the room, the nurse anesthetist would not know what to do, said several doctors who spoke to The Journal Times under condition of anonymity because they feared retaliation.
"I do surgery and part of it is patients ask if I trust the anesthesiologists," said one doctor. "Now I have to tell them some nurse is going to give you your anesthesia."
But Wheaton officials maintained the nurse-based model is common and does not put patients in jeopardy in any way.
"This is not something unusual that All Saints has done," said Barbara Harris, director of perioperative services for All Saints. "It's not a matter of a lesser model or any model you put in place in any effort to save money."
Harris said she prefers the nurse-based model because it allows doctors to focus more on patient needs instead of paperwork.
"I am very comfortable with the quality of anesthetic care now," said Wheaton surgeon Tim LeSage. "I don't think our patients are getting lower quality care then before."
