In anesthesiology, leadership by physicians is a necessity
Now more than ever, our communities have a heightened focus on health and a strong desire for modern medicine to overcome the devastation of this coronavirus pandemic. As we move through this crisis, physicians have been on the front lines caring for patients, saving lives, conducting research, and advancing the practice of medicine.
However, there are some interest groups that are unfortunately trying to take advantage of COVID-19 to push their own political agenda aimed at expanding the scope of practice for nurses.
There is no doubt that nurses, including advanced practice nurses like certified registered nurse anesthetists, play a critical role in patient care. But some nursing advocates are trying to represent themselves as interchangeable with doctors. A recent opinion piece in The Californian, “Common sense approach to health care now and in the future,” (Sept. 16), called physician supervision “burdensome” and unnecessary. That couldn’t be further from the truth.
Patient safety, and the safe practice of medicine, depends on physician leadership and supervision. Nurses are welltrained in nursing, and highly qualified to fulfill nursing duties. But they do not have the same education, training, research capability, responsibilities, expectations, or liability that doctors do.
Physician training includes 12 to 14 years of postsecondary education, including medical school, 12,000 to 16,000 hours of clinical training, and at least four months of concentrated work in intensive care units. There is subspecialty training to develop focused expertise, such as pediatric anesthesia, obstetric anesthesia, acute and chronic pain management, critical care, neurosurgical anesthesia, and cardiac anesthesia.
Physician training is necessary and can mean the difference between life or death in complex cases. Everyone wants their case to be “an easy one,” but expected or unexpected complications do arise, when physician leadership is required to avoid adverse outcomes or save the patient’s life. Having a physician leading the care team is essential for patient safety.
This isn’t a “holier than thou” statement, and it is not meant to minimize the essential role of our nursing colleagues who we work beside day and night. Their contributions to patient care are valuable. But for the sake of public education, public health and public safety, it’s important to be clear that nurses are not doctors. Any attempt to blur that line, or for a nurse to try to portray themselves differently through the use of misleading titles, is disingenuous and disrespectful to patients and dangerous for patient care.
A survey conducted recently by the American Society of Anesthesiologists found that 8 in 10 patients want physician anesthesiologists (medical doctors) to lead anesthesia care during their surgery. Physicians have the most advanced diagnostic abilities, knowledge on how to treat emergencies, and commitment to research and discovery. Based on their expertise, physician anesthesiologists are able to safely determine if patients are ready to undergo surgery, reduce hospital re-admittance, improve recovery times, facilitate alternative pain management techniques and develop personalized pain management plans.
I am a physician anesthesiologist. I would never argue that nurses are unnecessary or that my job is the same as theirs. Likewise, I am dismayed the APRN community is spreading misleading information about their role — and implore them to stop trying to adopt new titles like “Doctor of Nursing” that intentionally mislead their patients regarding their qualifications.
When your child, your parent, your sibling or your best friend needs care — you want to know they will undergo the safest possible procedure by the best-qualified team. For that reason, physicians will always be needed to continue to advance the practice of medicine, drive discoveries in anesthesia science, and manage the complex cases.
I invite our nursing colleagues to join us in delivering the highest quality patient care possible, and urge them to stop the misinformation campaign that is attempting to use this global pandemic to push their political message on scope of practice.
When it comes to saving lives — physician leadership is a necessity, not a burden.
Jeff Poage, M.D., is president for the California Society of Anesthesiologists.