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The Malpractice Crisis

The wide variety of anesthesia practitioners was a major factor in the explosive rise in anesthesia medical malpractice insurance rates in the late 1970s and early 1980s. Medical malpractice insurance companies rate insurance on the procedures that the physician performs, not the physician's training. Board-certified anesthesiologists pay the same rates as untrained practitioners who hold themselves out as anesthesiologists. These unqualified practitioners increased the losses in the pool, which raised the rates for every insured in the pool.

The diversity in anesthesia practice styles and training made it impossible for any accrediting body to establish basic standards for anesthesia practice. The absence of such basic standards allowed marginal practices to continue, greatly increasing the risks to patients. Perhaps the best example of such practices was the debate over whether the person delivering anesthesia needed to stay in the operating room with the patient. In a number of cases in which the patient suffered a sudden anesthesia death, there was an indication that the patient did not die suddenly but was discovered to be dead only when the anesthesiologist returned to the room. Even if the death in such a case might have been unpreventable, the case becomes impossible to defend as soon as the plaintiff's attorney finds out that the anesthesiologist was not in the room.

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