Florida opens loophole in office surgery rule

Nurse anesthetists may sedate patients if doctors win a waiver from state regulation requiring presence of an anesthesiologist.

By Myrle Croasdale, AMNews staff. Aug. 12, 2002.

Plastic surgeons in the Sunshine State could soon be back to doing tummy tucks and face lifts in their offices.

Many had to move their surgeries to hospitals or hire an anesthesiologist as of April 15 when a Florida Board of Medicine regulation took effect, requiring the presence of an anesthesiologist for complicated office surgeries.

However in late July, nurse anesthetists and several physician groups fighting against the restriction were given a reprieve when the board released a set of criteria physicians and their offices need to meet to be considered for a waiver from the anesthesiologist requirement.

Chris Nuland, legal counsel for the Florida Society of Plastic Surgeons, said the guidelines would uphold patient safety while restoring the use of physicians' private operating suites.

"I think the board's action this past weekend strikes a good balance in accessibility [to office surgery] and optimum patient safety. The anesthetists think it's too loose, and the CRNAs think it's too tight, so it may just be right," Nuland said.

Until April, any medical doctor could supervise a certified registered nurse anesthetist during surgery.

"Since April 15, physicians have had two choices," Nuland said. "First, they can move their level IIIs to more expensive hospitals or ambulatory surgical centers or use more expensive anesthesiologists in their offices. Second, they can try to do the procedures under a level II anesthetic, increasing patient discomfort. None is an ideal option." [...]