The VA still needs your comments in support of physician-led anesthesia care!

  • CSA Board of Directors
| Dec 19, 2016

CSA_LogoSeal_ColorRGBMany CSA members wonder if an individual letter or phone call to a policymaker really makes a difference. The answer is YES! One letter or email by itself may not tip the scales, but when you and thousands of your peers actively engage, you help amplify the voices of physician anesthesiologists, and you truly make a difference.

We saw the results of your efforts with last week’s ruling by the Department of Veterans Affairs (VA) that preserved physician-led anesthesia care for patients throughout the VA system. In May, the VA proposed a new policy that would have removed physician anesthesiologists from the anesthesia care team, lowering the standard of care for veterans and compromising patient safety.

While the VA’s final rule does not grant full practice authority to nurse anesthetists, we wish we could say that the fight is over. The VA is currently soliciting additional public comments “on whether advanced practice authority for CRNAs would bring further improvements.”                                                                                                     

safevaWe need you and your colleagues to continue communicating the importance of preserving physician-led anesthesia care in the VA system, and emphasizing how removing physician anesthesiologists from the patient care team would jeopardize the lives of our veterans.

We urge you once again to engage in this critical effort.  Please log on to to submit a comment before January 13, 2017. To date, there have been 7,308 comments submitted to the VA on this issue – we need to make sure that your voice, and the voices of CSA’s 3200 members, are heard.

vaWhile there is not a current or anticipated shortage of physician anesthesiologists in the VA system, the VA ruling states, “If we learn of access problems in the area of anesthesia care in specific facilities or more generally that would benefit from advanced practice authority, now or in the future, or if other relevant circumstances change, we will consider a follow-up rulemaking to address granting full practice authority to CRNAs.”

Thanks to the efforts of you and other CSA and ASA members, and physician anesthesiologists across the country, over 104,000 comments were submitted to the Federal Register in support of maintaining the VA’s current physician-led, team-based anesthesia policy. More than 7,000 of the comments submitted were from California and CSA members alone!

In its decision announced on December 14, the VA granted full practice authority to three categories of Advanced Practice Registered Nurses: Certified Nurse Practitioners (CNP), Clinical Nurse Specialists (CNS), and Certified Nurse-Midwives (CNM). The exclusion of nurse anesthetists assures the VA’s alignment with current laws in 46 states and the District of Columbia, which all require physician involvement in anesthesia care.

If you and other CSA members had not mobilized and engaged your colleagues, patients, friends and families to weigh in on this important issue, the outcome could have been starkly different. Grassroots advocacy matters, not just from CSA’s leaders and lobbyists, but advocacy and engagement on the part of each and every member.

On behalf of the CSA Board of Directors, thank you for making such a huge difference in the outcome of this struggle on behalf of our nation’s veterans, preserving physician-led anesthesia in VA facilities.

And please, raise your voice once again by submitting a comment before January 13 at  We all must continue advocating for physician-led anesthesia care – that’s what our nation’s veterans deserve!

Below is a sample comment you may use when submitting your comments to the VA. 

I want to commend the VA Administration for recognizing the critical role that physician anesthesiologists play in the operating room. Surgery and anesthesia are inherently dangerous, requiring physician involvement, especially for VA patients who often are sicker and have multiple medical conditions that put them at greater risk for complications.

The reality is there is not a current or anticipated shortage of physician anesthesiologists in the VA system. The best approach is a team-based care model in which physician anesthesiologists and nurses work together. Nurse anesthetists are important members of an anesthesia care team. However, they cannot replace a physician. 

Our nation’s veterans deserve to have a physician anesthesiologist involved in their care. I urge the VA to carefully consider any future changes to anesthesia care which would jeopardize care for our Veterans.

Thank you for your consideration.




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