APSF comments on criminalization of medical errors
In June, MedPage Today reported on the Anesthesia Patient Safety Foundation (APSF) statement opposing the criminalization of medical errors in response to the conviction of a Tennessee nurse after a patient died as the result of a medication error and failure to monitor. The article quoted Daniel Cole, MD, FASA, APSF President and ASA Past President (2016). “We should celebrate error reporting rather than have retribution when someone discloses errors they make,” he said. “That’s the kind of culture that we’re trying to improve.”
Media turn to anesthesiologists for expertise on opioid use during and after surgery
In June, Healio.com quoted Mark Neuman, MD, about his research published in the Annals of Internal Medicine that found patients who had spinal anesthesia for hip fracture surgery had more pain in the first 24 hours and more prescription analgesia at 60 days compared to those who had received general anesthesia. “In our study, patients who got spinal anesthesia did get fewer opioids in the operating room, but they ended up having more pain and more prescription pain medication use after surgery,” he said. The study also was covered by Medscape later in the month, quoting Dr. Neuman, as well as Alexander Arriaga, MD, MPH, and Angela Bader, MD, MPH, on their editorial commentary.
Medscape also covered a meta-analysis in June that suggested prescribing opioids after minor to moderate surgeries did not reduce pain after patients were discharged, but increased the risk of adverse events. Karim Ladha, MD, offered insight on the research, noting that while the study provides data that suggests using opioids after surgery doesn’t affect the patients’ experience with pain or satisfaction, “this should not be taken as evidence to deny patients appropriate pain care after surgery.”
Media continue to cover latest COVID-19 developments, including research and guidance
In early June, Becker’s ASC Review, Crain’s Chicago Business, and HealthDay, among other outlets, featured a study published in Vaccine that found Americans are more likely to have surgery during a pandemic if they and the hospital staff are vaccinated. The HealthDay article was picked up by 103 outlets, including U.S. News & World Report, Buffalo News, Arizona Daily Star, and the Wisconsin State Journal. Study co-author Keith Ruskin, MD, FASA, was quoted in the article saying, “It’s critical to understand what factors affect a patient’s decision to have surgery during an infectious pandemic if we want to help reduce deaths and illness.”
The study continued to receive coverage in mid-July when it was featured in OR Management News. “Making the choice to not have surgery for an actual health problem could increase the risk of potential illness and disease attributable to pandemic-related fears,” said study co-author Anna Clebone Ruskin, MD. “This suggests a potential opportunity for public education.”
Later in June, Becker’s Hospital Review, Crain’s Chicago Business, and HealthDay featured an updated statement from ASA and the Anesthesia Patient Safety Foundation that recommended health care facilities in areas with low-to-moderate COVID-19 spread may consider a more permissive approach to testing for patients who are up to date on their vaccinations, are asymptomatic, and are having lower-risk procedures. The HealthDay article was picked up by 154 outlets, including the Arizona Daily Star, Clinical Pain Advisor, and St. Louis Post Dispatch.
Latest research highlights advances and key discoveries from the specialty
In June, Medical Xpress and HealthDay covered a study published in Anesthesiology that found 27.8% of drugs with high abuse potential make it through the development process compared to only 4.7% of drugs with low abuse potential. The HealthDay article was picked up by 58 outlets, including the Lincoln Journal Star (Lincoln, Nebraska), Neurology Advisor, and Physician’s Weekly. “Despite the prevalence and societal costs of pain in the United States, investment in pain medication development is low, due in part to poor understanding of the probability of successful development of such medications,” the authors of the study noted.
In July, Medscape featured new guidance, published in Anaesthesia, which provides actionable steps to mitigate greenhouse gas emissions from inhaled anesthetics without compromising patient care. Some of the evidence-based recommendations included: avoiding inhaled anesthetics with disproportionately high climate impacts, such as desflurane and nitrous oxide; selecting the lowest possible fresh gas flow when using inhaled anesthetics; and prioritizing and using regional and intravenous anesthesia when appropriate. “First, there has to be a very simple recognition that climate change is a problem, and second, that health care is part of the problem,” said Jodi Sherman, MD, co-author of the guidance and chair of the ASA Committee on Environmental Health. “And third, that there are very simple things that we can and ought to do to minimize our impact.” Harriet Hopf, MD, FASA, and Brian Chesebro, MD, were also quoted.
Also in July, United Press International published a story on a study noting how the number of overlapping procedures managed by an anesthesiologist can increase the risk of death or complications after major surgery by as much as 14%. The article quoted ASA President Randall M. Clark, MD, FASA, and study co-author Sachin Kheterpal, MD. “We know anesthesiologists in the OR make a difference,” said Dr. Clark. “This study shows it, and we need to do more studies like them.”
Medscape also covered the study in August, quoting the study’s lead author, Michael Burns, MD, as well as Meena Bhatia, MD, FASA. “In this cohort study, increasing overlapping anesthesiologist coverage was associated with increased surgical patient morbidity and mortality, despite treatment bias for healthier patients and lower-risk operations,” said Dr. Burns.
ASA members highlight brain health, patient safety, and women in leadership on KevinMD.com
During Alzheimer’s & Brain Awareness Month in June, Katie Schenning, MD, MPH, and Stacie Deiner, MD, wrote about how health care professionals can bring awareness to brain health before, during, and after surgery by educating the surgical care team on perioperative cognitive disorders and communicating effectively with patients. “It is essential for health care professionals to have conversations about perioperative brain health with at-risk patients and their loved ones and caregivers,” they said.
In July, R. Christopher Call, MD, Michael O’Connor, MD, FASA, and Keith Ruskin, MD, wrote about how the nation’s health care system can be improved by understanding the quality and patient safety model it has embraced, and viewing health care workers as the solution and not the problem. “In a culture where systemic vulnerabilities are the primary culprit, system corrections become the primary intervention, rather than human correction,” the authors wrote.
On National Women’s Equality Day (August 26), Asha Padmanabhan, MD, FASA, shared why she did not want to be a leader in her early career and why accidentally becoming one was the best thing that happened to her. “The one thing most women physicians don’t realize is that they’ve been leaders for years, just without formal titles,” she wrote.
ASA members provide expert commentary on medical supply shortages
David Dickerson, MD, chair of the ASA Committee on Pain Medicine, spoke to Medscape and HealthLeaders in June about the contrast media shortage being experienced and how it could impact pain management and affect patient care. He noted on Medscape that while some procedures require contrast to ensure safety, “we have many different forms of image guidance and approaches to deliver targeted treatment to inflamed or dysfunctional parts of the nervous or musculoskeletal system.”
In August, Mark Zakowski, MD, FASA, chair of the ASA Committee on Obstetric Anesthesia, and Krishna Shah, MD, were quoted on WhatToExpect.com regarding potential epidural shortages in the U.S. In the article, they stressed that patients should not expect a widespread shortage of epidurals in the U.S., and they discussed other pain management options pregnant women have during labor. “We put patient safety first, and we have the skills and tools to adapt and do what we need to keep our patients comfortable and safe,” said Dr. Zakowski.
ASA members share their expertise in pain management
On July 1, U.S. News & World Report quoted David Dickerson, MD, chair of the ASA Committee on Pain Medicine, on a study about a dissolvable device that “cools down” the nerves and blocks pain signals from reaching the brain, noting “unlike the sprouting that occurs when a nerve is heated, cooling allows the nerves to stay intact.” Originally published by HealthDay, the article also was picked up by more than 80 other outlets, including the St. Louis Post-Dispatch, Drugs.com, and Omaha World-Herald (Omaha, Nebraska).
ASA’s opposition to Medicare physician fee schedule makes news
Becker’s ASC Review quoted ASA President Randall M. Clark, MD, FASA, in July after ASA announced its opposition to additional Medicare payment cuts proposed in the Centers for Medicare & Medicaid Services’ 2023 Physician Fee Schedule. “Anesthesiologists, who play a critical and unique role on surgical teams, are facing an unacceptable cut under the proposed schedule,” he said.
Anesthesiologist jumps into action to help treat mass shooting victims
In July, CNN, ABC World News Tonight with David Muir, and the Associated Press were among the outlets that quoted Wendy Binstock Rush, MD, after she stepped up to treat victims on the scene of a mass shooting during a Fourth of July parade in Highland Park, Illinois. “Anybody who had any medical background, from first aid to physicians, all jumped into the action to do whatever they could to help the situation,” she told CNN.
Specialty provides thought leadership on pre-procedure pregnancy testing post-Dobbs
In August, STAT interviewed ASA President Randall M. Clark, MD, FASA, about ASA’s guidelines on pre-procedure pregnancy testing for elective or urgent procedures after the Supreme Court’s Dobb’s v. Jackson Women’s Health Organization decision. “ASA has looked at this extensively over the years,” he said. “The reason we do pregnancy testing is for procedures where it may affect fetal development.” No currently used anesthetic agents have been shown to have any teratogenic effects in humans of any age when using standard clinical doses and duration.
Media continue to cover ASA’s efforts to advocate for fairness with No Surprises Act
In August, HealthLeaders reported on a study conducted by Avalere Health for ASA, the American College of Emergency Physicians, and the American College of Radiology that found insurers’ calculations of Qualifying Payment Amounts (QPAs) for out-of-network care may violate the No Surprises Act. The article quoted ASA President Randall M. Clark, MD, FASA. “We have received reports of extremely low QPAs that bear absolutely no resemblance to actual in-network rates in the geographic area; yet these same rates are being used by insurers as their initial payment,” he said.
Later that month, Modern Healthcare covered the final rule on the No Surprises Act independent dispute resolution process and ASA’s concerns. Manuel Bonilla, ASA Chief Advocacy Officer, was quoted. “The median rate, called the qualifying payment amount, is often so low that providers feel forced to enter the independent dispute resolution process,” he said. Dr. Clark also was quoted in the article on how insurers manipulated QPAs for specialists by using ghost rates for primary care services that were never negotiated, may never be provided by specialists, and may never be paid, which can artificially reduce the rates submitted to arbiters. “We really need to have the federal government put in place a robust audit system to make sure that these calculations are done appropriately,” he said.