Akst is delusional on many levels. One delusion I can address specifically – the value of using certified registered nurse anesthetists (CRNAs) for anesthetic care. There are very real differences between anesthesiologists (medical doctors) and CRNAs. Does Akst know about the longer training, routine care for more challenging cases and thus greater skill in safer delivery of anesthesia given by physicians?
A recent report even suggests differences in outcome for perioperative care given by anesthesiologists. Will cost savings be realized given CRNAs routinely work in shifts?
The great strides in safety and efficacy in anesthesia care made over the last two decades have come from the research and practice efforts of anesthesiologists. The practice is more challenging than ever, but is the safest it has ever been. Can Akst put a dollar value on this?
About salaries: A doctor’s charges represent about 20 to 25 percent of a hospital bill. Medicare pays anesthesiologists 33 percent of private insurance charges. I greatly doubt this specialty is a serious driver in our health care costs.
Akst should ask himself who he would feel more comfortable with caring for himself or his family. And if he’s truly interested in decreasing costs, I’d suggest he support tort reform and a serious conversation with Americans about decisions in end-of-life care.
(Forte is a Tacoma anesthesiologist.)