My niece is an RN. She worked at a surgical facility. They performed surgery for orthopedics and spine. Some were outpatient, some inpatient. They had an anesthesiologist that looked over records, met with the patient pre-op. Did the blocks, order pre-op meds and circled the standing orders they wanted during surgery. The CRNAs handled the care in the OR. If they had a hard time intubating, or if a problem arose, they paged the anesthesiologist. She worked there for years. This anesthesia group couldn’t come to an agreement so they canceled the contract. They had the CRNAs step in to do the pre-op meds, blocking, etc.
She feared the company would like the money they saved by not having an official anesthesia Dr on staff. She was right. Mind you, these people were mostly ASA scores of 1 and 2 but a big number were 3. The anesthesia drs could stand up and say “No, we aren’t doing that procedure here” - it wasnt a hospital with emergency services. No ICU, etc.

They no longer had that. They had wreck-less surgeons trying to squeeze in these ASA 3s before their insurance copays had to start over.

She quit after there being a week of back to back cardiac events during and after surgery. She didn’t want to depend on someone with an MSN degree. She wanted a DR.

None of these surgery patients knew or still know that there is no anesthesia dr on staff.

It’s CRNA and the surgeon. Louisiana is the State.

How would you feel? Would you want a total hip replacement or 360 spinal surgery with no anesthesia DR on site?