August 1999
Volume 63 |
Number 8
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| Nonphysician Providers,
Office-Based Surgery Probed by Media |
John B. Neeld, Jr., M.D., President
National broadcast and cable television news organizations are
beginning to take note of some of the major health care issues
that directly affect patients and the delivery of their safe anesthesia
care. News reports on the issues of office-based surgery as well
as supervision of nonphysician providers are being prepared by
at least two national news outlets.
During a two-day period in early June, the television
news programs "Dateline NBC" and the CNN health program, "Weekend
Health," came to Atlanta to interview me at my facility, Northside
Hospital.
"Dateline NBC" is preparing to air a segment about office-based
surgery. A number of deaths across the country prompted the segment,
which is expected to take a critical look at the events and mistakes
that led to the death of a child during an in-office ENT procedure
while being attended to by an ENT physician and a nurse anesthetist.
My interview concerned a number of patient safety issues
as they related directly to this case as well as the overall issue
of safe anesthesia care during office-based surgery. In preparation
for the interview, "Dateline NBC" producers asked that I review
several official documents. These mostly included portions of
the deposition from the nurse anesthetist involved in the case,
the attending physician and other health care professionals who
reviewed the medical records of this case. There is no mistake;
the death of this child was not only tragic but could have been
prevented if the physician and nurse anesthetist would have followed
accepted safety procedures and protocols.
During the interview with "Dateline" correspondent Chris
Hansen, I was very candid in my assessment of the case. I told
him that the child's death was directly related to the absence
of proper patient care on the part of the nurse anesthetist and
the ENT physician's failure to properly supervise the nurse anesthetist.
I am not alone in this evaluation. Several official statements
and depositions by physicians and a nurse anesthetist all came
to similar conclusions.
CNN Examination of Proposed Rule Change
For several months, CNN health reporter Rhonda Rowland
has been preparing a report on the Health Care Financing Administration's
proposed rule change to eliminate physician supervision of nurse
anesthetists. As expected, CNN interviewed representatives of
the American Association of Nurse Anesthetists for their opinions.
The day after my interview with "Dateline NBC," Ms. Rowland interviewed
me about ASA concerns over the compromise of patient safety if
nonphysician providers are allowed to practice without proper
supervision.
CNN has also taken an interesting approach to their story.
They spent some time with Carolyn F. Bannister, M.D., at Egleston
Children's Hospital in Atlanta. She is a pediatric anesthesiologist
and a former nurse anesthetist. CNN recognized that Dr. Bannister's
experiences, education, nurse and physician training give her
a unique perspective that other nurse anesthetists and most anesthesiologists
will never gain.
At the writing of this article, NBC and CNN were still
preparing their reports for broadcast.
Update on Herbal Video News Release
I want to update an article in the July
1999 ASA NEWSLETTER about the extremely successful
video news release produced by ASA and distributed to media outlets
nationwide last March.
A fortuitous combination of an article in The New York
Times about herbal products along with the proactive public
relations efforts on the part of the Georgia Society of Anesthesiologists
and New York State Society of Anesthesiologists has generated
another wave of media coverage.
The New York Times article prompted "ABC News" to produce
and distribute a consumer health report to its hundreds of affiliates
nationwide. That report has aired on television and radio in New
York City, San Francisco and Raleigh, to name a few.
This type of positive image for anesthesiology, ASA and
its members is possible with proactive involvement on the part
of component societies. We appreciate their efforts and encourage
other states to become involved in public education locally.
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