Years ago I was at a dinner for some Oklahoma State legislators. I was new to the political scene. The fellow that set up the dinner was aware of my libertarian philosophy and sat me next to the most conservative legislator in the State senate. He told the legislator, “ok…here is someone that makes you look liberal!” The senator accepted the challenge. He said, “where do you stand on ‘scope of practice?’”
Without hesitating, I said, “Let God sort them out.”
He turned to the dinner host that arranged the seating and said,”O.K. You are right. He is a libertarian.”
I have always marveled at the anesthesiologists and ophthalmologists that fight with nurse anesthetists and optometrists. Nurse anesthetists want autonomy. The anesthesiologists don’t want them to have it….they want to supervise the nurses. Yet, in rural Oklahoma, nurse anesthetists are all that’s available when an emergency C-section is needed…or an emergency appendectomy. Maybe they only need this “all-knowing” supervision when they are in the “big city.”
Optometrists want to do laser surgery. Ophthalmologists don’t want them to do this. Why? Because patients are in jeopardy? Or because they want protection from this group?
Money flows into the state capitol from both sides. Statements are made. Facts and figures are produced. Statistics and studies are cited. Year after year, the same result. Nothing. Why? What kind of idiot would a legislator have to be to solve this? Once it is solved, the game (money) is over.
Why not let the market work? As anesthesiologists, our training should provide us with skills that place us in a position to compete with nurses that have not attended medical school and therefore lack the rigor of our training. As ophthalmologists, the training necessary to complete this difficult path dwarfs the path taken by their optometry counterparts. So why fear competition? Why ask the legislator to get involved? Why not embrace the discipline the free market provides for those unable to complete the task/service advertised on their shingle?
I know anesthesiologists that I would not let touch me. I know nurse anesthetists that I would feel completely comfortable anesthetizing me. Why not leave the government out of it.
I stand by my original statement: ”..let God sort them out.”
G. Keith Smith, M.D.
