Dr. Daniel Janik, president of the Colorado Society of Anesthesiologists, told DOTmed News that the organization "felt compelled to take legal action" following the governor's decision to opt out the states' rural hospitals from the rule.

"I think we and the other physicians are the only people that have the depth of education and training to make medical decisions for patients in the operating room, which is a time when they're most vulnerable," said Janik. "Anesthesia is complex, it can be dangerous, but in the right situation it can be safe, and in the right situation means with a physician in charge."


The two groups also criticized the governor's decision to opt-out the hospitals he defined as rural in his letter to the Centers for Medicare and Medicaid Services.

"The governor's opt-out pertains not only to the critical access hospitals in the state but a host of other 'rural hospitals' that do indeed have significant numbers of anesthesiologists on staff," said Sonn.

Janik said nurse anesthetists are currently being supervised by physicians other than anesthesiologists, such as surgeons or family practitioners.

"While there may not be anesthesiologists in some of the rural hospitals, there still are physicians who we think have the appropriate scope of practice to make medical decisions," said Janik. "The administration of anesthesia is a practice of medicine, this is a delegated medical function."

Sonn said the medical society asked that the governor hold off on making the decision on the federal Medicare rule in order to bring all the stakeholders together to discuss an alternative.

"That didn't happen. We're very disappointed that it didn't," said Sonn.

In his letter to CMS, Ritter wrote that he "consulted with the Colorado Medical Board and Colorado Board of Nursing about issues related to access to, and the quality of, anesthesia services in Colorado."

In order to better explain what physician supervision entails, the two medical groups plan to work together on a comprehensive education and outreach plan for Colorado physicians.



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