Separation of Surgical & Anesthetic Responsibilities

Carolina Anesthesia Associates, PA believes the administration of anesthesia or sedation should be provided by a professional who is educated in the specialty of anesthesia. The provision of general anesthesia, or conscious sedation requires constant monitoring and requires the sole attention of the anesthesia provider. Likewise, the operative or therapeutic intervention requires the committed attention of the operating physician. Conscious sedation can easily become unconscious sedation and should only be provided an individual who is capable of managing any anesthetic level, ort its complications, including airway management. Ideally, there should be two appropriately trained individuals involved in any procedure requiring anesthesia, or sedation: the operating physician and the anesthesia provider.

The Practice of Anesthesia

For more than 100 years, Nurse Anesthetists have been providing quality anesthesia care in the United States. CRNA's are responsible for administering more than 65 percent of the anesthetics given annually. The safety record CRNAs have compiled is enviable. To date no studies have shown a difference in anesthesia care outcomes based on whether the anesthesia provider is a CRNA or an anesthesiologist.

Anesthesia is administered by nurses, physicians, dentists, osteopaths and podiatrists and is considered the practice of nursing when administered by a CRNA, the practice of medicine when administered by a physician, and so on. It is not the exclusive right or privilege of either.

Liability on the surgeon's part is no different, regardless of whether the anesthesia provider is a CRNA, or anesthesiologist. No surgeon has ever been held liable for the negligence of a CRNA, because of a statutory obligation of supervision or collaboration. Only when a surgeon attempts to control or direct an anesthetic does liability become an issue, regardless who the provider is.

Anesthesia practice has become much safer in recent years due to pharmacological advancements and the introduction of more sophisticated technology. There has been a dramatic reduction in the anesthesia mortality rates. Beyond a certain level of education, anesthesia outcomes seem to be only minimally affected by further medical knowledge, however outcomes are affected by factors such as attention and organization.

Carolina Anesthesia Associates, PA provides each physician the opportunity to perform the surgical procedure, rather than the anesthetic.