American Society of Anesthesiologists Urges Medicare to Keep Physician-led Anesthesia Care to Protect Older Patients and Patients with Disabilities

The U.S. Department of Health and Human Services (HHS) recently issued a request for information regarding waivers declared during the COVID-19 pandemic, including one that removed physician anesthesiologists from anesthesia care and replaced them with nurses. The American Society of Anesthesiologists (ASA) urges Americans to protect older patients and those with disabilities by posting a comment to the Federal Register asking the Centers for Medicare and Medicaid Services (CMS) to rescind the temporary policy that lowers the standard of care and risks patients’ lives.

The proposed Medicare policy was developed as a temporary waiver during the pandemic to prepare for potential shortages of physician providers, which fortunately has not occurred in anesthesia and is not needed to improve access to care. HHS is now requesting information on which of these waivers should become permanent and which should expire after the public health emergency has concluded.

“Even more so during COVID-19, Medicare needs to keep policies in the best interest of patient safety, and that does not include replacing physicians with nurses for anesthesia care,” said ASA President Beverly K. Philip, M.D., FACA, FASA. “We’re proud to be on the front lines combating the pandemic and working collaboratively in a team-based model with nurse anesthetists and other health care professionals. Older patients who have had or are infected with COVID-19 are some of the most complex and challenging cases a physician will see in their career.  Now is not the time to take the physician away from patients.”

Surgery and anesthesia are inherently dangerous and require physician involvement, especially for older patients and patients with disabilities who have underlying medical conditions that put them at greater risk for complications. When those complications occur, a physician anesthesiologist’s education and training can mean the difference between life and death, which is why an ASA survey found 9 in 10 surgeons prefer a physician anesthesiologist for their patients over a nurse.

Laws in 45 states and the District of Columbia require physician involvement for anesthesia care to ensure patient safety. This supervision is supported by independent research that shows elimination of physician involvement does not improve access to care or save medical costs. It also is a national standard and the care that is provided in the nation’s top hospitals.

Physician anesthesiologists receive 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care and pain control, with the necessary knowledge to understand and treat the entire human body. By comparison, nurse anesthetists have about half the education after high school and about 2,500 hours of clinical training. 

“Don’t let Medicare risk the lives of older patients and patients with disabilities,” said Dr. Philip. “Post a comment on the Federal Register urging CMS to keep physician-led anesthesia care for Medicare patients.”

The request for information was posted on Nov. 25. The Federal Register is open for public comment on the issue of HHS waivers for 30 days. ASA urges every American who cares about older patients or patients with disabilities to visit ProtectMedicarepatients.org and post a comment to rescind the temporary waiver of physician-led anesthesia care for Medicare patients. 

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 54,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/madeforthismoment. Like ASA on Facebook, follow ASALifeline on Twitter.