How WA State lawmakers should address the anesthesia “staffing crisis.” | Opinion
As practicing Certified Anesthesiologist Assistants (CAA) we feel compelled to respond to the Jan. 23 opinion piece in the Tri-City Herald written by Joe Stover, CRNA. Mr. Stover rejects the possibility of allowing CAAs to practice in the state of Washington despite the severe need he thoroughly described for more anesthesia providers. As CAAs, we only work under the Anesthesia Care Team (ACT) model, which is led by physician anesthesiologists and is the most common, most cost effective, and safest anesthesia model in the U.S.
Citizens of Washington, as well as countless other states have overwhelmingly affirmed their desire to have physician-led anesthesia care. Both CAAs and CRNAs function as advanced practice providers who provide life-sustaining anesthesia. CAAs and CRNAs work as physician anesthesiologist extenders in the ACT. Both go through 24-30 months of higher education and anesthesia focused training. Both routes reach the end goal of providing life-sustaining and at times life-saving patient care through some of the most vulnerable parts of their patient’s lives: surgeries.
CAAs are trained to safely administer anesthesia through the ACT. By law, in the ACT anesthesiologists are required to be present and available at the crucial moments of care, when the patient is going under and emerging from anesthesia. We are working in one of the 20 states CAAs are licensed to practice in, with the option to work in all 50 states via the VA system due to recognition and support of CAAs by the Federal government.
We are strong proponents for the care team model because it is led by physicians. Physicians-led care in the ACT is proven to be the safest, with the most lives spared, and the most cost effective way to provide anesthesia. Physicians are uniquely trained through medical school and residency to know when additional testing is needed to proceed with anesthesia care, resulting in reduced costs when compared to other models. Every patient deserves the right to the ACT model, and bringing CAAs into Washington would help provide that.
We believe Stover’s worry about “a severe staffing crisis in health care” is tied to the fact that there are limited physician anesthesiologists entering the workforce to compete with the growing demand for anesthesia. As physician extenders under the ACT model, both CAAs and CRNAs can staff up to four rooms while being overseen by one anesthesiologist. This allows for each and every patient to have an anesthesiologist involved in their care without increasing costs for the patient. The safety outcomes between CAAs and CRNAs vary by 0.1%. We can attest that board certified AAs and certified registered nurse anesthetists (CRNAs) are used interchangeably in this physician anesthesiologist-led care team model.
Allowing CAAs practice in Washington state would allow more competent providers to be available while maintaining the highest standard of care that has come to be expected from the ACT model. This would ensure each patient has a physician anesthesiologist and a qualified anesthetist (CAA or CRNA) for each surgical encounter. We can say with certainty that CAAs are more than happy and willing to enter the state of WA, work as a team under the ACT, and help address the staffing crisis brought to light by Stover.
Taylor Friendt was born and raised in Minnesota and Chabely Rodriguez was born and raised in New York – both states that do not offer CAA licensure. They both went to graduate school in Florida and now practice there.
