Patients Deserve Honesty About Who Is Providing Their Anesthesia Care

Patients deserve truth and transparency in health care so they can make the best choices for themselves and their loved ones. That’s why it is so alarming that the American Association of Nurse Anesthetists (AANA) is engaged in activities that will mislead patients about which professionals are best-equipped to provide anesthesia care.

Graphic that says AANA is misrepresenting nurse anesthetists as medical doctors.

AANA’s Misrepresentations Will Mislead Patients

AANA plans to change its name in August 2021 to the American Association of Nurse “Anesthesiology” and is pushing for its members to adopt the title “nurse anesthesiologist.” This title misappropriation is blatantly misleading.

A physician anesthesiologist is a medical doctor. A nurse “anesthesiologist” is not. This is not a new distinction. Since its first use in 1922, “anesthesiologist” has always referred to a physician trained in the medical science of anesthesiology.

The American Medical Association, the American Board of Anesthesiology, and the American Board of Medical Specialties affirm that anesthesiology is a medical specialty and that professionals who refer to themselves as “anesthesiologists” must hold a license to practice medicine.

“To use the term ‘anesthesiologist’ incorrectly will confuse patients and violate the universally accepted ethical principle in health care that patients must have full knowledge and understanding of who the professionals are that are providing their care.”
—Dr. Beverly K. Philip, President of the American Society of Anesthesiologists

AANA’s Actions May Deceive Policymakers

Why is AANA forging ahead with its misleading title changes despite widespread objections from the medical community? The answer lies in AANA’s campaign to win policymakers’ approval for nurse anesthetists to expand their scope of practice to provide anesthesia care without a physician anesthesiologist’s supervision or involvement.

AANA’s change in terminology is just its latest misrepresentation, which fits into a pattern of deception. AANA artificially inflates nurse anesthetists’ education, licensure, certification, and expertise and distorts data about patient safety, health care costs, and health care access.

Get the facts about AANA’s misrepresentations.

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AANA’s Misrepresentations - Facts and Deceptions

The deception:

AANA distorts and embellishes nurse anesthetists’ number of clinical training hours to position their education and training as equivalent to that of physician anesthesiologists.

The facts:

Physician anesthesiologists are medical doctors who specialize in anesthesia care, pain management, and critical care medicine, bringing the knowledge required to treat the entire body. They complete 12 to 14 years of higher education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care, pain control, and responses to complications and emergencies in surgery.
Nurse anesthetists are qualified members of the physician-led Anesthesia Care Team, but they can’t replace a physician. They have about half the education of an anesthesiologist and only 2,500 hours of clinical training. This training also is more narrowly focused on anesthesia administration.

The deception:

AANA consistently misrepresents data to support claims that there is no difference in patient outcomes in surgery when physician-led anesthesia care is replaced with nurse-only practice.

The facts:

AANA’s data on patient safety comes only from self-funded studies. These studies also typically evaluate nurse-only practices that are treating low-risk patients undergoing low-risk procedures.
An independent study showed that the presence of a physician anesthesiologist in surgery prevented 6.9 excess deaths per 1,000 cases in which an anesthesia-related or surgical complication occurred.
Independent research reviewing over 2.4 million surgeries over 10 years found that patients having outpatient surgery were far more likely to be admitted to the hospital if their anesthesia was provided solely by a nurse anesthetist.

The deception:

AANA uses misleading statements and self-funded advocacy studies to position nurse anesthetists as the most cost-effective anesthesia care providers.

The facts:

A 2017 study of “opt-out” states, which allow nurse-only anesthesia care for Medicare patients, found a consistent pattern of increased costs when compared with states that did not opt out of the physician-led anesthesia requirement.
Independent studies showed that eliminating physician anesthesiologists from the care team can increase costs: Other physicians may be needed to consult on or provide the critical patient protection services that an anesthesiologist provides before, during, and after a medical procedure.
Medicare, Medicaid, and most third-party insurers pay the same fees for anesthesia care whether it is administered by a nurse anesthetist or a physician anesthesiologist.

The deception:

AANA repeatedly cites nonexistent workforce shortages and barriers to care to assert a false need for nurse-only practice.

The facts:

Studies of states that opted out of the Medicare requirement for physician-led anesthesia care have found no evidence that opting out of the safety standard increases access to care. For example, an analysis of more than 1.1 million Medicare patients who underwent one of five common elective procedures found that patients in opt-out states traveled the same distance for care as patients who were not in opt-out states.
Throughout the COVID-19 pandemic, there have been no anesthesia provider shortages that necessitated the elimination of physician-led care.

Fact: Anesthesia Care Teams Provide the Best Care

The American Society of Anesthesiologists is pro-patient, not anti-nurse. We value nurse anesthetists and their contributions as important members of the physician-led Anesthesia Care Team. We recognize their service to our patients, our anesthesia groups and departments, and the hospitals and surgery centers where they practice. Most nurse anesthetists also value working alongside their physician colleagues to provide patients the safest, highest-quality care.

Reject AANA’s deceptions. Protect physician-led anesthesia care and preserve honesty in health care.