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Difficult Identification
hank you for presenting my comments
in the April 2006 NEWSLETTER
on the need to re-examine and improve the technical
aspects of routine oral tracheal intubation. Over
the years, advances in anesthesiology have led to
the incorporation of this technique into many fields
of medicine. In keeping with its past, the specialty
of anesthesiology, as the major contributor in its
development, should continue to be the leader in innovative
thinking and remain the source of expertly trained
individuals with superior skills.
Unfortunately the fundamentals on which intubation
is founded remain unchallenged in our literature.
To the contrary, constructive inquiry has vanished,
replaced by the literature’s nearly absolute
focus on technology as the solution to “difficult
intubation.” In reality many perceived problems
are avoidable by substituting a more scientifically
based system of intubation that can be tailored to
each individual and one structured on patient anatomy
and controlled delivery of the endotracheal tube.
Hopefully this topic will eventually be revisited
as it presents an opportunity to significantly improve
patient outcome and safety.
The purpose of this note, however, is to indicate
a printing error in the author acknowledgment for
the following letter in the ASA NEWSLETTER,
April 2006, page 43: “Critical Analysis of the
Trauma ASA Difficult Airway Algorithm.'
The author was incorrectly stated as “Jan
M. Stasiuk, M.D., Yakima, Washington.”
The author should have been listed as: Russell B.
Stasiuk, M.D., Vancouver, British Columbia, Canada.
Russell B. Stasiuk, M.D.
Vancouver, British Columbia, Canada.
Editor’s Note: We deeply
regret the confusion and apologize for the error.
— D.R.B.
Want
to Be a Doc? Do the Work
fter reading your article “Perpetual
Motion” in the May 2006 NEWSLETTER,
I would like to comment on the American Association
of Colleges of Nursing’s proposed conversion
to “Doctor of Nursing Practice” by 2015.
I agree that this proposal will cause further patient
confusion and threaten patient care. I view the change
as a worsening of the overall climate of health care
delivery.
From personal experience, nonphysician providers can
be “liabilities” to my practice on a daily
basis. When things go wrong, it is the physician who
is ultimately responsible for the care of the patient
in the end. Why do we want to rely on individuals
who may represent a “weak link” in the
chain when a sick patient is at stake? This is why
I am in a physician practice with no “advanced
care” nurses.
It is not about whether those of lesser training can
do what M.D.s can do. It is about obtaining a certain
level of understanding, training, experience and making
that the standard of care.
For those that want to be called “doctor,”
go to medical school, do a residency, collect debt,
read until you need glasses and take call on nights,
weekends and holidays.
Amen.
Brett M. Sprtel, M.D.
Grayling, Michigan
Doctored
Names Cause Confusion
The May 2006 article by Russell C. Brockwell, M.D.,
“The
Anesthesia Machine: What’s New Besides the Name?”
contains the following:
“The importance of using an appropriate pre-use
workstation check list has been taught to anesthesia
care providers (A.C.P.s) for many years … Unfortunately,
despite the availability of such check lists, some
A.C.P.s do not always perform a complete and appropriate
daily pre-use workstation checkout procedure.”1
I thought we were called “M.D.A.s”?2
I have just discovered that we are now called “A.C.P.s.”3
Thank goodness there will be no more confusion.
“Assuming that the quality of care rendered
by individuals with a nurse doctoral degree is not
equivalent to that of a physician and that these health
care providers would identify themselves to patients
as “doctors” — thus creating confusion
… ”4[emphasis added].
David Breznick, M.D., M.D.A., A.C.P.
Fond du Lac, Wisconsin
References:
1. Brockwell RC. The anesthesia machine:
What’s new besides the name? ASA Newsl.
2006; 70(5):34-35.
2. Medical Doctor Anesthesiologist.
3. Anesthesia Care Provider.
4. Bacon DR. Perpetual motion. ASA Newsl.
2006; 70(5):1-2.
The views and opinions expressed in the “Letters
to the Editor” are those of the authors and do
not necessarily reflect the views of ASA or the NEWSLETTER
Editorial Board. Letters submitted for consideration
should not exceed 300 words in length. The Editor has
the authority to accept or reject any letter submitted
for publication. Personal correspondence to the Editor
by letter or e-mail must be clearly indicated as “Not
for Publication” by the sender. Letters must be
signed (although name may be withheld on request) and
are subject to editing and abridgment. |