Nurse anesthetists have been proven to deliver about as safe and high quality care as physician anesthesiologists, but there’s still a key question every patient should ask before being put to sleep by a nurse anesthetist.
“Is there a doctor anesthesiologist nearby in case there’s an emergency during my surgery?”
That’s the question you need to get answered. In most hospitals and many free-standing surgery centers, the answer will be, “Of course, we wouldn’t dream of putting patients to sleep without an anesthesiologist supervising the anesthetists.” But in other facilities, particularly same-day surgery centers, the answer will be, “No, we don’t think it’s necessary.”
And that “no” should give you pause.
Anesthesiologists have MD degrees and broad training in medicine. They also spend a lot more years learning anesthesia than nurses who come up through a “CRNA” program (Certified Registered Nurse Anesthetist). It costs about six times as much to train an anesthesiologist as an anesthetist, and the anesthesiologists are paid about double what nurse anesthetists get paid.
If something goes terribly wrong during surgery — and luckily that’s a rare event nowadays, thanks to improvements in anesthesia technology over the last thirty years — I know who I want nearby. That’s an anesthesiologist.
You can read more about this in a series of letters to the editor in the New York Times debating the merits of state governments passing laws that opt their state out of the Medicare requirement that surgery centers have an anesthesiologist supervisor.
I discuss anesthesia and other issues about safe surgery in my book, “The Life You Save.”