I am not affiliated with or have even heard of Watertown Regional Medical Center having lived in Wisconsin myself (that alone should tell you something) if you couldn’t already tell from looking at the credentials of their hospital CEO with an undergraduate sociology degree and likely an online masters who has no business being in charge of a daycare center, much less a hospital.
That said, the situation is alarming and very clear. This CEO thinks he’s being smart by cutting physicians, a more expensive commodity, and replacing them with CRNAs. He probably thinks he’s a visionary for doing this and is probably selectively googling CRNA talking points (they provide more access to care, etc.) just like he probably did when he had to write papers to get his sociology degree. Meanwhile, the militant CRNA leadership doesn’t give a damn about patient safety and would love any attempt to nuke institutional standards to make the medical system more unsafe than it already is to gain his profession more prestige he likely missed out on. He lies in his statement saying that CRNA led anesthesia has been going on for a while when in reality , like the physician’s spokesperson has said, it’s actually only even theoretically possible (legal) in 5 US states. His motives are clear and align with why he chose to become a CRNA instead of a physician (to take shortcuts).
I’m also currently in Wisconsin and have never heard of this place. Like RP says, that should give you some idea of the size of facility and complexity of their patients. Highly unlikely those CRNAs are putting ASA 3+ people to sleep for anything more than medium sized procedures and likely everything else is getting transferred.
That doesn’t at all reflect my opinion on whether there should or shouldn’t be an anesthesia MD doc there, but that context in these anecdotal stories is really key. I’ve done locums at some small town Wisconsin hospitals for general surgery and the threshold to transfer is like age >50, BMI >30, on more than one home Med, expected nights in hospital after procedure >1. That is not an exaggeration.
Anyway, context. There may or may not be places in the country where doctors are not necessary because the place isn’t doing anything that isn’t extremely simple. I would ask if this is one of those places. I don’t know. If they’re going to transfer 75% of stuff an hour down the road anyway, indignant rage at replacing docs is probably misplaced.
Edit: A quick google search tells me this is a tiny AF town exactly one hour away from either Milwaukee or Madison so I'm 97% sure what I described above is almost certainly what happens in reality. They probably have a single general surgeon on staff (at best) and send everyone left or right as an hour is not an unreasonable distance to receive invasive medical care. This is pretty common in smaller Wisconsin hospitals I have found that are even more remote.
I think this conversation really needs to really include the role of rural hospitals, their finances, and what their capacity should be and in some cases, whether they should exist at all. I read a really interesting article from r/medicine on Reddit about a place that couldn't afford its EMS services or its local hospital which were all closing and shutting down, and when they quoted citizens from the town they are all pissed and indignant in one breath and in the next breath absolutely refuse to raise local taxes and feel that it should be the federal government stepping in to deal with this (or the State, or whatever). Not to turn the flamethrower onto the political spectrum, but in a place like Watertown, if you want an anesthesia doc and don't want to drive an hour for your medical services, you have to pay for it somehow. Watertown does not seem like a pretty hip place to live, so its going to be damned expensive I bet to recruit someone to stay there who has no family ties. This is reality. If you want nice things you have to pay for them, usually with taxes. I don't agree with just indiscriminately blasting whoever is running that hospital for CoRpOrAtE gReEd. Its definitely, definitely more complicated than that in rural America.
Now when we start getting articles about hospitals in the heart of Chicago firing all their anesthesia docs, we gonna have something juicy to have a conversation about... I'm sure it'll happen. But we aren't quite there yet.
