Why Credentials?

Today, the ongoing turf war between nurse anesthetists and anesthesiologists was reported in the Wall Street Journal:

Gov. Arnold Schwarzenegger decided last year to allow nurse anesthetists in California to work without a supervising physician. Now two doctors’ groups are challenging the move in court, according to HealthLeaders Media.

The fight centers over 2001 Medicare rules that usually require a doctor to supervise when nurses administer anesthesia, but allow states to op out of the requirement if a governor sends a letter to the feds. California did that in June.

Needless to say, the anesthesiology community was not too happy and filed suit to block the decree.

But we must ask ourselves, where are the credentialling bodies in this debate?

On an recurring basis, doctors must obtain continuing medical education credits and pay large sums to state regulators to remain licensed to practice medicine in a state. The process involves validation of license to practice, education/training, malpractice coverage and claims history, DEA/CDS certificates, hospital privileges and whether or not the physician or healthcare professional has been sanctioned.

So when states want to replace doctors with nurse anesthetists, where are the credentialling bodies in this discussion? Don't such moves by politicians in the name of cost savings make the whole physician credentialling immaterial?

We already know that very few states legally protect the term "board certified" as having relevance to creditialling physicians, and the current efforts by a state governor to permit others not subject to similar review and standards to provide medical care makes a mockery of the entire physician credentialling process.

Hey, but at least not having to have all pay those licensing fees and education course fees would save everyone money.

-Wes