“All the liability falls to the doctor.” — How physicians, CRNAs, and PAs can join forces to protect
Key Takeaways
Industry Insights
“There is a movement by physicians to push back. When you are not a physician, you simply don’t know what you don’t know.” - Sulagna Misra MD, BCMAS
Patient safety can be a concern as more non-physicians provide care. Taking patient safety and professional responsibility into account is key when working with non-physician providers.
A Texas family has sued an area wellness center after one of their loved ones died during a rhizotomy procedure.[] Kimberlya Ray, 42, received anesthesia during her procedure and never regained consciousness. Scott Houghton, a CRNA, administered the fatal anesthesia. Raising the thought, how can PAs, CRNAs, and physicians work together more effectively?
PAs and CRNAs needed in many settings
Over the past decade, providers such as APRNs and Physician Assistants have taken on an increased role in healthcare facilities. For instance, CRNAs provide over 50 million anesthetics annually across the United States.[] This major change in the healthcare landscape brings specific challenges to physicians.
There are major benefits associated with the increased use of APRNs and Physician Assistants in healthcare settings. Increased healthcare access in rural areas is an often-discussed benefit. In some states, CRNAs provide all or nearly all of the anesthesia care in rural communities.[] The National Rural Health Association advocates for the increased presence of Physician Assistants in rural areas, emphasizing cost-effectiveness and care access.[]
Liability and safety
Today, APRNs and Physician Assistants practice with increased independence and scope of care. However, physicians are typically still liable for care provided by non-physician practitioners. In some instances, physicians aren’t aware of this care until after procedures or treatments have occurred. Sulagna Misra MD, BCMAS, Founding Physician at Misra Wellness says, “All the liability falls under the doctor. Sometimes the license is used or signed without the doctor’s knowledge. They can be fired or lose their license.”[]
“There is a movement by physicians to push back. When you are not a physician, you simply don’t know what you don’t know.” Dr. Misra says.
While many non-physician providers deliver excellent patient care, some physician groups have expressed concerns about safety risks associated with non-physician providers’ increasing scopes of practice. For instance, the AMA considers “scope creep” to be a primary advocacy issue and has stated that the expansion of Physician Assistant and APRN scope of practice presents a risk to patients.[]
"All the liability falls to the doctor. "
— Sulagna Misra MD, BCMAS
Current data on the effects of non-physician providers on patients is inconclusive. The number of malpractice claims filed against APRNs and Physician Assistants has increased in recent years, but the number of practitioners in these roles has also increased. []
What is clear is that CRNAs, PAs, and physicians must collaborate across various environments to ensure the best possible outcomes for patients.