Colorado Opts Out of the Federal Physician Supervision Requirement

Governor Ritter Replaces Physicians with Nurses

(September 28, 2010) 

Today, the American Society of Anesthesiologists (ASA) expressed its grave disappointment with the election-year decision of Colorado Governor Bill Ritter to exempt his state from Medicare’s longstanding patient safety standard providing for physician oversight of anesthesia services. This decision replaces physicians with nurses. In taking this action, the Governor ignored scientific evidence regarding patient safety and Colorado citizens’ overwhelming preference for physician involvement in the delivery of anesthesia to needlessly put Colorado patients at risk. The Governor’s decision comes despite tremendous opposition from Colorado and national physician and patient organizations including the ASA, its State Component Colorado Society of Anesthesiologists (CSA) , the Colorado Chapter of the American College of Surgeons, and the Scope of Practice Partnership which includes the ASA and other national medical groups such as the American Medical Association, American Osteopathic Association, American College of Surgeons, among many other state medical societies and medical specialties. These organizations rallied together to oppose the governor’s short-sighted decision.

Reflecting its longstanding commitment to anesthesia patient safety, ASA partnered with the CSA to organize an aggressive grassroots campaign in Colorado to oppose Governor Ritter’s effort to weaken the state’s patient safety standards. The ASA and CSA worked closely with the other organizations to explain to the Governor the level of patient safety risk assumed in an opt-out state. An important component of ASA’s outreach included a well-received patient-centered radio and print ad campaign that encouraged concerned patients to speak out. The campaign garnered the attention of a number of  media outlets across the state of Colorado.

Governor Ritter,  a “lame duck” governor,  issued a letter last month to the medical and nursing communities stating that he was “of the opinion that opting- out of the federal supervision rules for anesthesia services in rural areas could help ensure their affordability and accessibility, without sacrificing the quality of care patients receive.” Despite compelling evidence to the contrary as well as strong patient opposition, the Governor still acted to eliminate the over 40 year old Medicare patient safety standard needlessly putting thousands of Coloradans at risk.

The ASA and CSA remain strongly committed to ensuring patient access to safe physician-led anesthesia and they are currently considering other alternatives to reverse the governor’s ill-advised decision. ASA will keep members apprised of future developments in this issue.


Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at To learn more about the role physician anesthesiologists play in ensuring patient safety, visit Join the ANESTHESIOLOGYTM 2014 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES2014.



American Society of Anesthesiologists