Anesthesia Deconstructed: Science. Policy. Realities.

On this episode we talk about Covid 19, what anesthesia professionals need to know about N95 Masks and PPE, testing, epidemiology and symptomatology, as well as utilizing 2 ventilators, expanding CRNA role into the ICU as "force multiplier" as opposed to limiting their positive impact as an ICU RN, what resources are out there and more.

We also provide a Covid19 resource document now circulating all over the globe with daily updates at this link: https://tinyurl.com/rt9xxja

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Summary

The conversation discusses the topic of out-of-hospital cesarean sections and the potential risks and implications. Dr. Matt Mazurek, a physician anesthesiologist and assistant professor of anesthesiology at Yale School of Medicine, provides insights and raises concerns about the definition of low-risk cesarean deliveries, the dangers of complications during and after the procedure, and the lack of resources and training in outpatient settings. The conversation also touches on the financial incentives and potential cherry-picking of patients by private equity-owned medical facilities. The need for increased access to obstetrical care and support for OBs in rural areas is highlighted as a more effective solution to address maternal morbidity and mortality rates.

Keywords
out-of-hospital cesarean sections, risks, complications, low-risk deliveries, resources, training, financial incentives, private equity, access to care, maternal morbidity, maternal mortality

Takeaways

• Defining low-risk cesarean deliveries is challenging and depends on various factors.
• Complications during and after cesarean sections can be life-threatening, especially in outpatient settings.
• The financial incentives of performing cesarean sections may lead to an increase in unnecessary procedures.
• Investing in more OBs and supporting them financially is crucial to improve access to obstetrical care in rural areas and reduce maternal morbidity and mortality rates.

Key Quotes

• "OB is still very dangerous, both in the OR and postoperatively"
• "It's much more common and more likely to happen in this particular group. So do we really want to gamble with people's lives in this setting?"
• "It has happened and it's happened to younger, healthier patients out of the blue."

Chapters

00:00
Introduction and Background

01:23
The Challenges of Defining Low-Risk Cesarean Deliveries

06:01
The Financial Incentives and Potential Risks of Outpatient C-Sections

08:20
Improving Access to Obstetrical Care in Rural Areas

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Meet the former AANA CEO and now Chief Anesthetist Officer of Northstar Anesthesia Dr. Randall Moore DNP, MBA, CRNA. We talk about ALL the things in this 3 part interview! Topics range from anesthesia reimbursement, the impact of the pandemic, the difficulty recruiting, why he left the AANA, culture, what his new role entails at Northstar, and what it takes to build a functional anesthesia team!
There is an incredible amount of information packed into this 3 part interview from a leader in one of the leading companies in anesthesia services in the United States.
https://northstaranesthesia.com/our-culture/leadership.html

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Meet Mr. Silberman JD from the BENESCH law firm! We talk about the New Hampshire ruling and Nurse Anesthesiologist, Qui Tam lawsuits and anti-trust, The risk of medicare fraud with medical direction and TEFRA, if Extubation is part of emergence as it related to TEFRA based on the Donegan v. Anesthesia Associates of Kansas City, PC, Liability of surgeons with CRNAs in the ACT or independently and MUCH more!
A little about Mark:
Mark is an experienced trial lawyer, health care attorney and litigator. His practice focuses on helping health care professionals and businesses navigate the complex and changing landscape of health care with an emphasis on achieving governmental and regulatory compliance.

Mark concentrates on managing internal and external health care investigations, False Claims Act cases, white collar criminal defense, all forms of health care litigation, and all aspects of the Illinois Certificate of Need program.

Mark handles audit, compliance, investigations and enforcement actions involving HHS-OIG, the Medicare/Medicaid programs, the Illinois Department of Public Health, and Illinois Health Facilities and Services Review Board (Certificate of Need). He advises clients regarding managing and avoiding allegations of health care fraud and health care-related criminal conduct, addressing concerns related to the Anti-Kickback Statute, and pharmacy and pharmaceutical related litigation. He provides counsel and litigation services for physicians, facilities and pharmacies engaged with any federal agency, along with handling Medicare/Medicaid reimbursement issues, False Claims Act/Qui Tam defense, and various health care transactional matters. Mark also served as the outside General Counsel to the American Association of Nurse Anesthetists.
More about Mark can be found here

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In an attempt to control the freedom of what other professions call themselves and limit titles in Wisconsin, the medical society introduced SB 143.
On May 24, Wisconsin Association of Nurse Anesthetists President Jenna Palzkill—as well as Dr. Joe Rodriguez, who was representing the AANA—helped inform and educate the Wisconsin Senate Committee on Health on why proposed SB 143 does NOT help Wisconsinites.

If passed, this bill would preclude the use of the title Nurse Anesthesiologist in the state. An attempt of one competitor trying to control another. This is the audio of that testimony that ended this attempt.

You can learn more about the genesis of Nurse Anesthesiologist here: https://www.nurseanesthesiologistinfo.com/

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