Patients

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.

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“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.

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Anesthesiologists

  • PSA Member Advocates for Controlled Substances Database

    6/16/2011 Michael Ashburn, MD, MPH, a PSA member, provided information to the Pennsylvania House Human Services Committee on June 16 regarding the possible creation of a controlled substances database.

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  • Court Decision Affirms Colorado’s Opt-Out From Medicare’s CRNA Rule

    4/21/2011 Most recently, Colorado’s Governor requested an “opt-out” and the Colorado Society of Anesthesiology (CSA) filed a lawsuit challenging that decision. A Colorado Court has now decided that case, in favor of the opt-out and against the CSA. The court found that both Colorado statutes and regulations authorized the delivery of anesthesia by a CRNA without physician supervision. The important point for PSA members is that the decision is based on several parts of Colorado law that differ substantially from Pennsylvania law.

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  • FTC contests Alabama’s restrictions on CRNAs

    11/19/2010 The proposed rule (rightly) restricts the “interventional treatment of pain to qualified, licensed medical doctors and doctors of osteopathy, who may not delegate to non-physician personnel the authority to utilize such procedures to diagnosis, manage or treat chronic pain patients.” See why the FTC opposes it and why we should care in Pennsylvania.

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  • Don’t let half-truths determine patient care!

    10/8/2010 The motto of the PSA is “Physicians Protecting Patients.” In addition to the clinical care that anesthesiologists provide daily in the OR, the ICU and the Pain Clinic, we must advocate and provide for patient protection in the legislative arena.

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Physicians

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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