ASA has moved aggressively to clarify misconceptions previously articulated by the Federal Trade Commission (FTC) concerning the role of anesthesiologists to treat chronic pain. In its strong letter to the FTC dated January 19, ASA articulates why it believes the Alabama State Board of Medical Examiners’ (“Alabama Medical Board”) proposed rule that would prohibit a qualified physician from delegating to a nonphysician the authority to utilize certain pain management procedures is necessary to protect chronic pain management patients. ASA details the special training that anesthesiologists must master to diagnose the pain processes, interpret the indications for various procedures, perform these invasive procedures, and treat potentially catastrophic complications. Such training and experience begins during medical school, which provides an essential foundation for anesthesiologists and other physicians who are specifically trained in interventional pain medicine to treat chronic pain. Conversely, nurse anesthetists complete nursing training, which does not adequately prepare them to practice pain medicine. Further elaboration of these points can be found by reading ASA’s letter to the FTC in its entirety (below).
Earlier, in its letter to the Alabama Medical Board, the FTC urged the medical board to “avoid adopting provisions that would limit the role of CRNAs in pain management more strictly than patient protection requires” and states that “absent evidence that the proposed restrictions are necessary to protect the public, there appears to be no reason to sacrifice the benefits of CRNA pain management services….” While there are no available data examining the outcomes associated with chronic pain care delivered by nurse anesthetists, safety studies demonstrate that anesthesiologists have a proven track record of improved outcomes when involved in the administration of anesthesia. ASA cautions the FTC, which heavily relied on the 2010 AANA-funded Health Affairs paper in its letter to the Alabama Medical Board, and other policymakers against adopting policy on pain medicine that is not based on data that are applicable to interventional pain practice. As additional state medical boards and legislatures address this issue, ASA believes it is essential to educate state and federal policymakers on the risks involved in performing interventional pain management procedures to treat chronic pain in order to protect patients from needless injuries from treatment by unqualified providers.
The Alabama proposed regulation is one of the most recent states to address this issue. For additional information concerning ASA’s efforts at the state level concerning interventional pain management, please contact Lisa Albany at firstname.lastname@example.org or 202-289-2222.
Click here to read the full letter.
ASA’s letter dated October 4 in support of the Alabama Medical Board’s proposal can be found here.