Circulation 34,475 • Volume 16, No. 1 • Spring 2001

Accusation on OBA Motives Brings Plea for Cooperation with Other Specialities

Steven R. Feldman, MD, PhD; Phillip M. Williford, MD; Alan B. Fleischer, Jr., MD; Marc Allan Feldman, MD, MHS

To the Editor

We endorse working together to promote patient safety with office-based anesthesia.

Several articles in the Spring 2000 APSF Newsletter called for anesthesiologists to work together with surgical colleagues to improve patient safety. We applaud these sentiments.

Other articles presented an adversarial approach, not recognizing other physicians’ commitment to their patients’ health and well-being: “As much as some surgeons may talk about patient convenience regarding access and surgeon convenience regarding scheduling, the real driving force behind the increase in office-based anesthesia is largely economic.”1 Dr. Moss writes, “Patient safety and the saving of lives and prevention of injury does not impress those powerful self-interest groups.”2

We recognize financial pressures exist for both surgeons and patients. We also recognize the financial concerns of some anesthesiologists in providing office-based anesthesia. Dr. Siker referred to the “potentially great cost, the equipment, monitors, and drugs.”3 We feel that these financial concerns should be recognized but should not be paramount in the discussion of improving patient safety.

Belittling other specialties does not promote patient safety. It invites other physicians to overlook the deep commitment of anesthesiologists to patients. Such conflict between specialties is likely to paralyze safety efforts. In contrast, working with other physician groups and reaffirming our mutual interest in our patients’ safety are far more likely to result in successful collaborative efforts. As stated by Dr. Trombly4, the specialties most involved in the surgical care of patients would be deeply supportive of rational strategies to protect our patients.

Steven R. Feldman, MD, PhD
Phillip M. Williford, MD
Alan B. Fleischer, Jr., MD
Department of Dermatology
Wake Forest University School of Medicine
Winston-Salem, NC

Marc Allan Feldman, MD, MHS
Department of General Anesthesiology
The Cleveland Clinic Foundation
Cleveland, OH


  1. Morell RC. OBA questions, problems just now recognized, being defined. Anesthesia Patient Safety Foundation Newsletter 2000;15(1):1-3.
  2. Moss E. Implementing OBA regulations a complex, difficult process: New Jersey example illustrates what it can take to make office anesthesia safer. Anesthesia Patient Safety Foundation Newsletter 2000;15(1):9.
  3. Siker ES. OBA Workshop Targets Huge Interest in Office Anesthesia. Anesthesia Patient Safety Foundation Newsletter 2000;15(1):
  4. Trombly ST. Office-based anesthesia increases potential liability concern. Anesthesia Patient Safety Foundation Newsletter 2000;15(1):10.