Double Duty Docs


A new guideline, from health insurer Anthem, could force some eye surgeons to perform double duty in the operating room. And some believe this move may threaten the safety of patients.

From Kaiser Health News:

If you need cataract surgery, your eye surgeon may have to do double duty as your anesthetist under a new policy by health insurer Anthem. In a clinical guideline released this month, the company said it’s not medically necessary to have an anesthesiologist or nurse anesthetist on hand to administer and monitor sedation in most cases.

Some ophthalmologists and anesthesiologists say the policy jeopardizes patient safety, and they are calling on Anthem to rescind it.

National Public Radio (NPR) quoted Dr. David Glasser, an ophthalmologist in Columbia, Md., who is secretary for federal affairs at the American Academy of Ophthalmology, as saying – “The presence of anesthesia personnel is one of the key ingredients in the patient safety and effectiveness of cataract surgery today.  An ophthalmologist cannot administer conscious sedation and monitor the patient and do cataract surgery at the same time.”

Anthem’s new policy isn’t sitting well with many doctors in California, according to a story in

The California providers say they’ve sent letters to Anthem asking the insurer to rescind the policy and filed complaints with the California Department of Managed Health Care and the California Department of Insurance.

“Anthem’s newest policy change falls below the standard of care, and it follows a disturbing pattern of putting patients at risk to make a profit,” David H. Aizuss, M.D., an ophthalmologist and president-elect of the California Medical Association, said in the release.

A story on included a statement from Anthem that read:

“Medical Policy and Technology Assessment Committee, a majority of whom are external physicians, reviewed the available evidence addressing the use of general anesthesia and monitored anesthesia care for cataract surgery. According to the literature reviewed, there is no one definitive approach regarding the use of anesthesia for cataract surgery and patient-specific needs should be taken into consideration as well as potential risk of harm to individuals who are sedated during surgical procedures.”

We would love to hear from you regarding Anthem’s claim that it’s not medically necessary for anesthesiologists to assist in many cataract surgeries. Do you believe splitting the attention of eye surgeons could jeopardize the safety of patients as some medical groups are claiming? Share your thoughts with us. Generating meaningful dialogue around the health stories making headlines is another way we are working toward our long-term goal of one day making Arizona the Healthiest State in the Nation!

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