- Dear Jeff,
- A letter of mine was read on your show several weeks
ago regarding the Anthrax vaccination. I have since read a news item that
should shock any active duty and dependent military member in the US Navy
that is not a VIP or dignitary. Here it is.
- Why should are active duty personnel get sub-standard
care? Why should VIP s get better treatment? Who made this decision?
I was a former active duty Navy Physician who resigned because I saw this
unethical and immoral policy implemented on a daily basis. In fact, I
resigned my commission three months ago and have yet to hear a response.
- This story exemplifies the state of Navy Medicine in
ways I could never articulate. This story is appalling and it should to
any active duty man or woman. I hope you have the honor, courage and commitment
to pursue this with all its implications regarding the state of Navy Medicine.
- Craig Michael Uhl, MD, CPA, P.O. Box 3961 Monarch Beach,
- Navy Fires Doctor
- By Jeff Nesmith COX NEWS SERVICE 11-18-99
- WASHINGTON--The chief anesthesiologist at the National
Naval Medical Center was relieved of his command last week for refusing
to place specially trained nurses in charge of administering anesthesia
to some patients.
- The hospital's policy of administering sleep-inducing
drugs only under the supervision of an anesthesiologist will remain in
effect for VIP patients, staff members were told. Members of Congress and
other high-ranking government officials, including the president, receive
medical care at the Bethesda, Md., hospital.
- However, other active duty personnel, retirees and their
dependents will receive the drugs from nurse-anesthetists without the supervision
of physicians specializing in anesthesiology.
- Physicians and other professional staff members at the
hospital were told Nov. 11 that Dr. Alvin Manalaysay, a Navy captain, was
being relieved of his command.
- Officials of the American Society of Anesthesiologists
said the staff was told the action was because Manalaysay refused to carry
out an order that he institute the change.
- The new policy will apply only to treatment of healthy
or mildly ill patients, physicians were told at a staff meeting.
- Dr. Manalaysay declined comment late Wednesday, saying
that questions about his being relieved of his command must be addressed
to the hospital's public affairs office.
- The hospital did not respond to questions about the policy
change Wednesday. A spokesman said that the hospital commander, Rear Adm.
Bonnie Potter, was in a meeting and was not available to answer questions.
- Dr. John Beauregard, a civilian anesthesiologist in Washington
who left the Navy two years ago, said he was told by hospital staff members
that Potter was specifically asked at a staff meeting what the policy would
be when dignitaries are treated. She replied that their care would continue
to be supervised by an anesthesiologist, he said.
- "I was told by current active-duty anesthesiologists
that that's what the policy will be for high government officials, high-ranking
officers and physicians who are treated at Bethesda," Beauregard said.
He said he left the Navy two years ago without accepting promotion to commander,
partly out of frustration at being constantly pressured to expand the role
of nurse-anesthetists. He was chief cardiac anesthesiologist at Bethesda
when he left the Navy and remains in close contact with his former colleagues
there, he said.
- "This means that Bethesda has a lower standard of
care than any other hospital in the Washington area," Beauregard said.
"It's unethical and immoral."
- "They have decided they can't justify spending the
money on anesthesiologists just to avoid a few complications."
- One of the findings of a 1997 Dayton Daily News investigation
of problems in military hospitals was that in some cases, nurses and physician's
assistants provide medical care that Defense Department regulations require
a doctor to perform.
- Among these were the administration of anesthesia by
unsupervised nurse-anesthetists and even student nurses.
- In denouncing the Bethesda change as "something
that could not legally happen in 49 of the 50 states," Dr. Ronald
Mackenzie, president of the American Society of Anesthesiologists, warned
that problems involving the use of anesthesia can happen to healthy patients
"right out of the blue." But Jan Stewart, president of the American
Association of Nurse-Anesthetists, said members of her profession "are
highly qualified and educated people" who have been delivering anesthesia
on battlefields for decades without a doctor's supervision.
- Certified registered nurse-anesthetists (CRNAs) handle
all phases of administration of anesthesia in 75 percent of the cases in
rural civilian hospitals in America, she said.
- "CRNAs plan what kind of anesthesia to deliver,
administer the drug, maintain the patient during surgery and oversee the
recovery," said Stewart, a Chicago nurse-anesthetist.
- She added that CRNAs administered anesthesia on battlefields
in Korea, Vietnam, the Persian Gulf war and in Bosnia, "and there's
no demonstrable difference in outcome between their care and that of anesthesiologists."
Mackenzie said the change "means that the finest young men and women
in the United States, the ones who are serving their country in the Navy,
are going to receive substandard care."
- "We did a careful survey of state laws governing
medical and nursing practice, and in only one state, New Hampshire, would
this be legal," said Mackenzie, an anesthesiologist at the Mayo Clinic
in Rochester, Minn. He added that "there is no scientific data that
this (change) is safe." Bethesda, across the street from the campus
of National Institutes of Health, has been called the "crown jewel"
of Navy medicine.