Your anesthesiologist takes several factors into account when recommending the type of anesthesia. Some of those factors include the type of surgery or non-operative procedure being performed and your medical history. These types of anesthesia are not always clearly defined, and patients may progress from one level of sedation/anesthesia to a lighter or deeper level during the procedure. For this reason, the American Society of Anesthesiologists (ASA) considers anesthesia a continuum, from light sedation to general anesthesia.


“Anesthesia Care Team”
Most anesthetics administered in Pennsylvania are provided using an “Anesthesia Care Team” model, with the anesthesiologist serving as the “director” of the anesthesia care team. Prior to surgery the anesthesiologist evaluates the patients’ current state of health and is responsible for designing the anesthesia plan taking into account the patient’s condition and the nature of the surgery.



  • Breaking News! Governor Proclaims Physician Anesthesiologists Week 2015

    1/8/2015 1/8/15: January 11-17 is the inaugural celebration of "Physician Anesthesiologists Week." Gov. Tom Corbett has issued a proclamation setting the week aside in Pennsylvania; PSA has drafted a press release; and ASA has designed a poster. PSA members are encouraged to remind patients, colleagues, and policymakers of the importance of patient-centered, physician-led care.

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  • Breaking News! Read Pittsburgh Tribune-Review Article on Highmark Decision

    12/24/2014 12/24/14: The Pittsburgh Tribune-Review interviewed PSA President Robert Campbell, MD, for its article on Highmark's decision to back away from a proposal to stop paying for full anesthesia for some patients undergoing colonoscopies. Click on READ MORE below for the link to the article.

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  • Breaking News! Highmark Shelves Controversial Proposed MAC Policy

    12/22/2014 12/22/14: Highmark recently notified PSA that it will abandon its controversial proposed monitored anesthesia care (MAC) policy. Instead it will align its MAC policy with Medicare, which will implement a national policy change effective January 1, 2015. (See page 3 of the Winter 2014 Sentinel for details on the CMS change.) CMS has recognized that the prevailing practice for endoscopies in general and screening colonoscopies in particular is undergoing a transition, and that anesthesia separately provided by an anesthesia professional is becoming the prevalent practice. We understand that physician advocacy to keep the current policy in place was a big part of Highmark’s decision – thanks to PSA, PAMED, the Hospital Association of Pennsylvania, the Pennsylvania Ambulatory Surgery Association, and the Pennsylvania Society of Gastroenterologists. This is a big win for patient safety and public health.

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  • PSA Members: Please Review Reports Before 10/11 Annual Business Meeting

    9/5/2014 UPDATED 9/23/14: Bylaws changes and election of leadership positions will be voted on at the PSA's Annual Business Meeting in New Orleans on October 11. Please review the proposed bylaws changes and Nominating Committee report as well as minutes from the 2013 Annual Business Meeting in advance of the 2014 Annual Business Meeting on October 11. The meeting will be in the Melrose Room of the Hilton Riverside Hotel from noon to 1:15 p.m.

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The choice of anesthetic or sedation is made by a physician taking into account various factors, including but not limited to the procedure being performed and the general medical condition of the patient. General anesthesia may be administered by an anesthesiologist, a nurse anesthetist under the direct supervision of a physician, preferably an anesthesiologist, or in some states by an anesthesiologist’s assistant under the direct supervision of an anesthesiologist. 

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The Anesthesiologist’s Expanding Role
The Centers for Medicare and Medicaid Services (CMS) released a January 2011 update to their Interpretive Guidelines for the Anesthesia Services Condition of Participation for Hospitals. As a result anesthesiologists have assumed a leadership role in developing and implementing medical staff rules and regulations (bylaws) that define the qualifications and supervision requirements for many “categories of practitioners”, such as those providers performing “Moderate Sedation”, “Deep Sedation” or obstetrical “analgesia” services. 

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