His comments are similar to comments from Lawrence Beck, president of the Wisconsin Association of Nurse Anesthetists, we reported on Jan. 4 when it was first revealed publicly that Wheaton had cut ties with its anesthesiologists and was replacing them with a private contractor from Florida. (The JT picked up on the story this week - over a month later.)
Local surgeons are concerned about the switch, saying it reduces the quality of service provided to surgical patients.
Here's Dr. Koebert's letter:
There has been a recent change in the delivery of anesthesiology services at Wheaton Franciscan-All Saints Hospital in Racine. Questions have been raised as to whether or not these changes compromise the quality and safety of patient care in that institution. As President of the Wisconsin Society of Anesthesiologists I wanted to take this opportunity to address these concerns.
Though the Milwaukee area tends to be dominated by a model of anesthesia care being delivered entirely by physician anesthesiologists, the most common method of care across the state and, indeed, the country utilizes what is known as the “anesthesia care team”. This model utilizes physician anesthesiologists in conjunction with non-physician anesthesia providers such as Certified Registered Nurse Anesthetists (CRNA’s) and Anesthesiologist Assistants (AA’s).
The anesthesia care team is directed by a physician anesthesiologist. The anesthesiologist is responsible for managing anesthesia care team personnel, pre-anesthetic evaluation of patients, prescribing the anesthesia plan, managing the anesthetic and participating in critical parts of the anesthetic and post-anesthesia care. The anesthesiologist remains immediately available to assist with management at any point in the anesthesia care. Medicare standards would allow one anesthesiologist to direct up to four procedures simultaneously. The Wheaton model being utilized allows for a single anesthesiologist to direct no more than two anesthetics at a time.
Surgery is a complex endeavor and the relationships between all members of the team are very important to the care of the patient. An abrupt change in the dynamics of the surgical team may well be disconcerting but the model of care outlined for Wheaton Franciscan-All Saints is one that is associated with high quality patient care and is fully supported by the American Society of Anesthesiologists as well as the Wisconsin Society of Anesthesiologists.
Robert F. Koebert, M.D.