Guys & Gals,

We do not want to lower the safety of our most vulnerable surgery patients. Please see this important development, a letter from the Nevada Osteopathic Board, on SB181 not necessarily viewed or voiced to the Assembly Commerce & Labor at the hearing last Wednesday.  We must get this out to the public.  I would appreciate you spreading this far and wide.  Use it in your correspondence with the committee members listed below, they need to know there are huge wrinkles in passing this bill.

Attached are important exhibits submitted during the hearing which none of us were informed about.  ACI and the big group up north are the ones who want this bill for obvious reasons.

  • The behavior of crazy proceduralists will be able to browbeat Anesthesiologist Assistants (AAs) into endangering patients lives
  • Unfortunately for the rest of us, this proposed law will displace anesthesiologists 4 times more often than CRNAs.
  • In a state declared emergency, Anesthesiologist Assistants (AAs) can practice without ANY supervision on very challenging patients.
  • Board Certified and Board Eligible anesthesiologists can supervise 4 AAs in separate surgical rooms.

As you realize if SB181 passes the Assembly, Nevada will change it’s standard of quality care from the best to the worst and so will the entire western states.  These AAs have been trying for about 5 years to get into Utah but the surgeons and Utahans have effectively blocked them there.  Most surgeons I have spoken with have no idea this is even being considered, the proponents of this bill (the greedy anesthesiologists and corporate hospitals) have done this under the cloak of secrecy.  The surgeons can’t believe that after years of hearing us inform them how much safer it is to select your anesthesiologist instead of being stuck with hospital controlled anesthesia providers, that some rogue anesthesiologists would want to lower the standard of care to their patients by using lower trained assistant in their ORs!

They claim there is an anesthesiologists shortage (there isn’t), that no one wants to come to Nevada, but the job offers by these guys was below national average so of course they didn’t get any valid candidates. They say they are offering ACT model jobs to CRNAs up north but this is reported as false by CRNAs (one who’s husband testified last Wednesday) who have asked for possible positions and been told there are none available.  The American Society of Anesthesiologists (ASA) is unbelievable because they quote 52,000 members but don’t bother to differentiate between anesthesiologist members, residents, CRNAs, AAs, PhDs, or any other non-anesthesiologist members.  The endorsement of SB181 by the ASA is like the endorsement of Obamacare by the American Medical Association (AMA). 

The testimonies are very deceptive and we can clearly change the outcome if we expose the facts by our numerous outcries. The letter from the former NV Medicaid Administrator, Charles Duarte, who deceased reimbursement by 43% to anesthesiologists but only 5% to hospitals in 2010, and is now a bureaucrat somewhere else, is especially offensive since he helped create the problems he complains of today.

We had a very good showing in opposition at the hearing and you can still voice opposition by: 

  1. Going to the website at: Please see attached screen shots of website Home & Share Your Opinion page so that you click on the link and select or type in SB181 (highlighted in yellow) to share your opinion “Against” this bill.  Tell everyone you know to log on and select “Against” and leave a comment if they wish. Type in their name, home street address (in red marked areas) so the assembly member knows his/her constituents are against this bill.  Entering your Email and other information is optional.
  2. You can also call or email the committee members by clicking on the imbedded links for each member below:
Randy Kirner Chairman
Victoria Seaman Vice-Chairman   
Paul Anderson 
John Ellison
Michele Fiore
Ira Hansen
Erven T. Nelson
P.K. O’Neill

Stephen H. Silberkraus
Irene Bustamante Adams
Maggie Carlton
Marilyn K. Kirkpatrick
Dina Neal
James Ohrenschall  

Note Red names are Republican, Blue names are Democrat and the two bold names are co-sponsors of the bill who may have been deceived by the proponents.  We can stop this if everyone speaks up and opposes this bill.  This is not a partisan issue, this is a Nevada issue! If we remain silent the legislators will not understand the serious problems this law will create and none of the legislators know anesthesia or medical issues!  The legislators know one thing, they wish to either do the right thing or get re-elected and public outcry is the thing that works stronger than any lobbyist or campaign contributions. 

“All it takes for evil to triumph is good men to do nothing.” – Edmund Burke


One Response to Act TODAY!!! SB181 Very Important Development In Our Favor!

  1. William Pfau says:

    As a physician practicing in Reno for over 10 years, who relies daily on Anesthesia services, I strongly oppose Senate Bill 181 for the following reasons:
    – Anesthesia Assistants are not sufficiently trained to provide anesthesia safely, and they will be doing so under this bill in most cases under the indirect supervision of physician Anesthesiologists.
    – use of Anesthesia Assistants will not help those counties which do not already have physician Anesthesiologists
    – the ugly truth of the primary motivation of this bill is to enrich certain physician Anesthesiologists, who will bill for complete Anesthesia services, as well as supervisory services, which will actually increase the cost of delivering anesthesia, not reduce it.
    – Nevada has no problem with hiring competent Anesthesia professionals, both physician Anesthesiologists as well as CRNAs (Certified Registered Nurse Anesthetists) – there is no shortage of these providers.
    Again, I am strongly recommending you vote NO on SB 181.
    William Pfau, M.D.

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