“The [existing] platform and the mechanisms by which anesthesia groups contract for services is a little bit uncertain going forward,” he says. “When there is uncertainty, it causes apprehension.”

Stiefel says that recently, talk centers on how anesthesia systems can become more integrated and believes incentives will play a key role.


“The world of anesthesia has evolved in an interesting way in the last decade as the compensation has increased dramatically. If you look at studies from a variety of industries, people respond to incentives and physicians are no different,” he says. “In order to achieve a given outcome, you need to make sure that all integrated physicians are shopping toward the same goals and get rewarded.”

Training on these digital solutions has been a hot topic in the industry. As hospitals transition from traditional numeric delivery systems to digital solutions, it’s critical that they invest the time to have personnel train appropriately before they’re live in the operating room.

The great debate
In 2001, CMS enacted a rule allowing states to determine which professionals could administer anesthesia and the level of supervision required. This ruling started a heated debate among those in the field as to whether certified registered nurse anesthetists need supervision when performing their jobs.

When it comes to the actual administration of anesthesia and monitoring of the patient, there is no difference between a nurse anesthetist and an anesthesiologist. Both use the same techniques, the same equipment, the same drugs, adhere to the same standards of care, and put the patient’s comfort and safety before all else.

Still, there are differences of opinions over the amount of supervision nurse anesthetists should have as they do their job.

“As we move into uncharted waters churned by health reform and other factors, there are far more pressing issues than whether one group of qualified health care professionals should hold sway over another group of qualified health care professionals simply on the basis of degrees or credentials,” says Paul Santoro, president of the American Association of Nurse Anesthetists. “In anesthesia, recent research by highly respected companies published in leading journals clearly shows that nurse anesthetists working collaboratively with non-anesthesiologist physicians are safe, cost-effective and a big part of the answer to the nation’s ongoing issues concerning access to health care.”

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