American Society of Anesthesiologists Strongly Opposes Legislation to Replace Anesthesiologists with Nurses for Veterans’ Care

CHICAGO – The American Society of Anesthesiologists (ASA) strongly opposes legislation introduced recently — the Ensuring Veterans Timely Access to Anesthesia Care Act of 2025 — that would dismantle the U.S. Department of Veteran Affairs’ (VA) proven and well-established physician-led, team-based model of anesthesia care and move VA hospitals and clinics nationwide to a rarely used nurse-only model that would lower the standard and quality of care for America’s Veterans.

“ASA, including our members who work in the VA, is committed to serving Veterans and ensuring they receive the highest-quality care,” said ASA President Donald E. Arnold, M.D., FACHE, FASA. “Physician-led anesthesia care is best for the health and well-being of our nation’s Veterans. VA has the right policy in place right now and there is absolutely no rationale to change it. We will continue to work with Veterans, Veterans’ families and other stakeholders to oppose any effort to replace our expert VA anesthesiologists with nurses.”

“As a physician, I know that Veterans are a patient population with unique health care needs. Many Veterans have underlying diseases and conditions, including some with serious health issues related to exposure to toxic substances from agent orange and burn pits. These conditions can increase the risks of anesthesia and surgery. The involvement of a medically educated and trained anesthesiologist in the care of these patients is absolutely critical,” Dr. Arnold noted.    

The current VA anesthesia policy is the physician-led, team-based model of anesthesia care. This issue is one of VA's most thoroughly researched, studied and reviewed policies. The physician-led, team-based model is the same model of care practiced in every top hospital in the country, and it is a model that aligns with the state licensure and practice laws of the vast majority of states.

“We continue to support physician-led anesthesia care at VA facilities that recognize well-established state law and licensure,” Dr. Arnold said. “Veterans deserve access to the best possible care in this country — the exact same standard of care that civilians receive — not a different standard and not a lower one.”

The VA employs over 1,000 anesthesiologists nationwide. An ongoing review of VA’s vacancy data demonstrates no systemic shortage of anesthesiologists in the VA health care system. In fact, nurse anesthetist vacancies consistently outpace anesthesiologist vacancies.

Independent research supports the importance of physician involvement in Veterans’ anesthesia care, including VA's own research. VA’s Quality Enhancement Research Initiative (QUERI) specifically raised questions about the safety of replacing anesthesiologists with certified registered nurse anesthetists (CRNAs), noting it could not discern “whether more complex surgeries can be safely managed by CRNAs, particularly in small or isolated VA hospitals where preoperative and postoperative health system factors may be less than optimal.”

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 59,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

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