Improving access to anesthesia health care

Certified Anesthesiologist Assistants (CAAs) are superbly trained anesthesia caregivers, loyal supporters of physician anesthesiologists, and eager to come to work in every state if we can just get state legislatures to grant them licenses to practice!

That was the message I heard clearly in Denver this past weekend, as a guest faculty member at the 40th annual meeting of the American Academy of Anesthesiologist Assistants (AAAA). More than 600 CAAs and student AAs from across the country made the journey to Colorado, one of the 18 states where CAAs are currently able to practice their profession, to hear lectures, promote advocacy, and attend workshops.

Anyone who still doubts that CAAs are champions of our profession should have been there! The ASA cosponsored the meeting, and ASA President-Elect Jeff Plagenhoef, MD, delivered this year’s Gravenstein Memorial Lecture, a powerful talk on “Professional Citizenship” in anesthesiology.

Ready to relocate!

“Many experienced CAAs are telling me they are ready to drop everything and relocate to California whenever we can work there,” said Megan Varellas, CAA, the immediate past president of the Academy. Her viewpoint was echoed by other CAAs I spoke with, including Maria Williamson, CAA, and her fiancé, Jeff Carroll, CAA, who currently practice in Florida. Ms. Williamson’s parents live in southern California, and the couple would be eager to move here if they could work.

The ASA strongly supports CAAs as members of the physician-led anesthesia care team. Their master’s level educational programs are located at medical schools, not nursing schools, and physician anesthesiologists direct their training. CAAs work exclusively within the anesthesia care team, under physician anesthesiologist supervision. Their services are attractive to many physician-only practices that want to move toward a care team model.

At present, though, despite a shortage of qualified anesthesia practitioners in California, CAAs can’t yet work here. Last year, CSA sponsored AB 890, a bill championed by Assembly Member Sebastian Ridley-Thomas (D-Los Angeles), which would have recognized CAA practice in California. The bill stalled in the Appropriations Committee, but CSA hasn’t given up. We plan to introduce a new bill to authorize full CAA licensure, and realize that it’s typical for these legislative efforts to take more than one attempt to pass.

Close ties between AAAA and ASA

The exhibit hall outside the main meeting room included a table for the ASA Political Action Committee, hosted by Jason Hansen, MS, JD, who is ASA Director of State Affairs. CAAs have donated generously to the ASAPAC, and their advocates are working closely with Mr. Hansen toward achieving licensure for CAAs in more states including California. CAAs are supporting the “Safe VA Care” initiative to preserve physician-led care for all patients in our VA hospitals.

Terri Howard, CAE, the ASA’s Director of Member Services, was a welcome guest at the meeting too, and stayed busy signing CAAs up for membership in the ASA. CAAs are eligible for their own category of membership in the ASA for the first time this year, since the ASA modified its bylaws last fall. The CSA’s Board of Directors has approved a similar bylaws change to offer membership to CAAs, and looks forward to ratification by the full House of Delegates in June.

Samantha Yakey, CAA, the 2016 Annual Meeting Chair, organized several of the visiting faculty’s presentations around this year’s focus, thoracic anesthesiology. The faculty members included the Mayo Clinic’s David Warner, MD, who gave an entertaining presentation on 10 common misconceptions about respiratory management during anesthesia, and Javier Campos, MD, from the University of Iowa, speaking on hypoxia during one-lung ventilation. My talk offered tips and tricks for making thoracic anesthesia smooth and even pleasant.

Dr. Plagenhoef presented the AAAA’s annual Distinguished Service Award to William Paulsen, PhD, CAA, who is Professor of Medical Sciences at the Frank Netter, MD, School of Medicine of Quinnipiac University in Connecticut, and Director of the Anesthesiologist Assistant Program there. Dr. Paulsen serves on the Executive Committee of the Anesthesia Patient Safety Foundation, and chairs the Foundation’s Committee on Technology.

Just like physician assistants (PAs), Certified Anesthesiologist Assistants can extend the reach of physician expertise and make physician-led care available to more patients. It’s high time to let them work in every state.

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