Talk:Anesthesia provision in the United States

message: Just tidying up a bit
deepzCRNA 04:36, 11 February 2007 (UTC)
thread_title: Just

message: Mmm, I guess as I suggested this article might be a possibility, I shouldn't be surprised it has been created. This article offers the opportunity to go into a lot more detail about how anesthesia is delivered in the US. For one thing, I suspect a separate discussion of ACTs is appropriate here. Please note the following:
# This article needs to offer more detailed content than that provided at Anesthesia or is likely to be deleted.
# The article must provide balanced, neutral discussion of how anesthesia is provided in the US.
# However, here it may be possible to have a section about Controversies in US anesthesia provision. Please baer in mind that such a section would need to present all sides of the debate equally. Also, given its controversial nature, all content would have to be reliably sourced.
Lets see where this takes us... WjBscribe 02:12, 12 February 2007 (UTC)
replies: text: As I have said on your talkpage, the article was not vandalised. I agree that the addition in question could have been more neutrally written and have now changed it. But blanket deletions of content are not the way to resolve a content deletion. Please work with others to improve this article. WjBscribe 23:38, 13 February 2007 (UTC)
thread_title: Thoughts on article

message: It would help move things forwards if sources were found for the following:
*Proportion of anesthesia administrations in the US each year done by nurses vs. physicians
*Proportion of anesthesia administrations by nurses that are supervised by physicians
Thanks, WjBscribe 23:50, 13 February 2007 (UTC)
thread_title: Sources for statistics

message: There wont be any reference for this statement "90% of all anesthetics administered in the US are either provided solely by physician anesthesiologists or supervised by anesthesiologists." because none exists.Mmackinnon 03:56, 14 February 2007 (UTC)
thread_title:  Where is the evidence? 

message: Again more opinion without references. Please add them or have it removed. Also this "As the methods of altering and monitoring physiology became more advanced, so did the interest amongst American physicians in the field." is blatantly untrue. Physicians became interested in anesthesia  ONLY after there was significant reimbursement NOT due to "altruistic" or "scientific" interests.Mmackinnon 20:40, 17 February 2007 (UTC)
thread_title:  add the references  

message: Please, discuss it here first.Mmackinnon 14:59, 18 February 2007 (UTC)
thread_title:  If your making changes..... 

message: The phrase "Despite intensive, selfish lobbying by the AANA..." makes me think this section has lost a neutral POV.  Since I'm no expert in this area, I will have to leave it to others to work this out. —The preceding unsigned comment was added by 69.111.57.173 (talk) 22:44, 19 February 2007 (UTC)
thread_title:  "selfish lobbying" 

message: Mmm, I've taken a break from looking at these articles because (a) various issues elsewhere needed attention and (b) I wondered if you might be able to work out your difficulties between you. Evidently I was mistaken about (b). So that I don't have to review about 50 edits to this page, could people indicate what they feel is wrong with the present version, how it can be improved etc. Hopefully we can have some discussion and move forwards. Oh, and were any of the illusive sources discovered in my absence? WjBscribe 07:37, 20 February 2007 (UTC)
thread_title:  Where were we? 

message: Anesthesiologist Assistants are another group who participate in anesthesthetic care. They earn a masters degree and practice under physican supervision in sixteen states through licensing, certification or physician delegation. Despite intensive, selfish lobbying by the AANA to, AAs are able to practice in an ever increasing number of locations. Anesthesiologist assistant's responsibilities in the ACT settings are identical to CRNAs under the direct supervision of a board certified anesthesia doctor. Anesthesiologist Assistants are happy with their position providing anesthesia under physician supervision, and unlike CRNAs, do not lobby to try to become doctors without attending medical school. As opposed to training ICU nurses to be CRNAs, training AAs does not worsen the shortage of qualified nurses and is altogether positive for heathcare provision in the US.
:(Emphasis mine)
This is one of the worse examples of POV-pushing I have seen on Wikipedia outside of articles on the validity of same-sex marriage. I have warned the user responsible and further such edits will likely lead to blocks. This article is not a forum for anyone to express their opinion about the standards of care provided by other bodies. It should convery neutrally informations about who DOES provide anesthesia and when. Not who should, who is. I've added a controversy section. Sourced statements about issues between various groups belong there.
While we're at it, though not nearly as bad, this is problematic from the other side of this debate:
 It is estimated by many, but the facts have repeatedly neither been confirmed nor denied by the ASA, that approximately 40 percent of the physician membership of the ASA are neither board eligible nor board certified in anesthesia. 
Allegations should not be in this article, especially not if unsupported by a reliable citation (which would include a citation for the 'many' bit of it). 
It should not necessary for me (or any other editor) to have to baby-sit the writing of this article. So please, write neutrally and include references. Thank you. WjBscribe 07:51, 20 February 2007 (UTC)
thread_title: Unacceptable POV

message: "There are studies which suggest that physician and nurse anesthesia may not be substitutable services because anesthesia delivered by physicians results in fewer adverse events than undirected nurse anesthesia."
The study, Silber et al, has been debunked by its own authors are mere conjecture and not science. Even MDAs admit that. The pine study we have added however, parallels 4 others actual studies suggesting the same thing, there is no difference. Sibler is flawed and the author admits it therefore it does not count as evidence.
Here is the evidence against the study. 
http://www.anesthesia-analgesia.org/cgi/reprint/99/5/1578.pdf (Study Regarding Anesthesia Outcomes Cites Outdated Studies)
http://bja.oxfordjournals.org/cgi/content/full/93/4/540
Comparative effectiveness and safety of physician and nurse anaesthetists: a narrative systematic review
http://www.aana.com/news.aspx?ucNavMenu_TSMenuTargetID=171&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=1606
Surgical mortality and type of anesthesia provider
Mmackinnon 14:48, 20 February 2007 (UTC)
replies: text: Sorry but I can't seem to find the number 90 anywhere in the article, where should I be looking? WjBscribe 15:42, 27 February 2007 (UTC)
thread_title:  I suggest removing this part 

message: Please, dont change this entry as an anonymous person, be a man and have the balls to sign your name so that I can identify who is making up crap. Thanks.Mmackinnon 20:22, 10 April 2007 (UTC)
thread_title:  Yes im still watching 

message: An ordinary person coming to read this article would expect to find a broad spectrum of info about anesthesia in the US.  But it seems to be meant as simply a enclosure to fight battles about WHO provides anesthesia services in the US. (See Talk:Anesthesia for the tedious main battle.)  I won't bother trying to intrude by suggesting other appropriate content, such as US safety statistics.  But it is absurd that the article doesn't include a comprehensive discussion of the major organizations and websites related to the turf battle that it reflects, with links to articles about each of the organizations.  Again, I won't try to intrude by adding content that is sure to offend some faction.  But anyone interested can find such info by googling <anesthesia safety>. -69.87.200.24 21:44, 28 August 2007 (UTC)
thread_title:  Turf battle enclosure 

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thread_title:  External links modified 

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