Proposal looks into changing model of care for veterans
AUSTIN (KXAN) — There is a proposed change over how veterans get anesthesia if they need surgery.
The Department of Veterans Affairs current system includes a doctor working with an anesthetist nurse to provide anesthesia care. It’s been like that for decades, but it varies by state and VA officials want to know if a National Standard of Care would better care for veterans.
“What’s being proposed is to remove the physician from that team. So, that it would be a nurse anesthetist practicing independent of any physician oversight. That is a model that’s rarely used in this country and we feel puts our veterans at unnecessary risk,” said Dr. Ronald L. Harter – president of the American Society of Anesthesiologists.
The group is one of several asking lawmakers to not make any changes to the current model of care.
“Veterans want that level of care,” said Dr. Harter.
“Nine out of 10 veterans surveyed by the American Legion said that they want to have the same care within the VA that they would receive within any other hospital system.”
During a subcommittee on health, the Department of Veterans Affairs said, “in regard to the certified registered nurse anesthetist (CRNA) national standard of practice, VA will only include independent practice if VA determines that it is appropriate, safe, and in the best interest of Veterans.”
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In a letter to lawmakers, some anesthesiologists argue the proposal would put veterans at risk.
“Our veterans are a special patient population. They have been exposed to things like Agent Orange and the burden pit and have a higher propensity for mental health issues, which requires different medications. All of these things contribute to greater risk during surgery,” said Dr. Bridget Bush a practicing anesthesiologist and combat veteran.
“They (veterans) deserve to have the full team-based care with a physician and anesthesiologist supervising or directing a nurse anesthetist in their care.”
VA officials cite “no evidence from impartial, independent studies, to indicate that full practice authority for CRNAs leads to either improved or adverse outcomes,” and has enlisted Temple University School of Law to conduct an independent third-party comprehensive review of each State’s practice.
The data is being used to develop the CRNA national standard of practice.
For Dr. Bush, the move is unnecessary.
“There really is no reason for this risky initiative,” Bush said. “The cost of Anesthesia Care is the same whether an anesthesiologist or a nurse anesthetist provides it. And the VA zone data shows that there are no anesthesia workforce issues nor access issues within the VA.”
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