Anesthesiology issue is a real sleeper

6/3/2001

Luke Shockman has written about the shortage of anesthesia drugs and anesthesiologists and I concur on both accounts. At hospitals and ambulatory surgical centers around Toledo, we have dealt with shortages of common anesthetic drugs such as fentanyl, succinylcholine, and decadron since the end of 2000. It appears that the production of these drugs, which all happen to be generic, has been limited in favor of drugs that would bring a greater profit margin to the manufacturer.

There is nothing that an individual physician or hospital can do about this; the FDA cannot intervene in a “business decision.” There are other drugs that can be substituted to make up for the shortages, but in all instances, the substitute either costs more directly or indirectly through additional side effects that need to be treated. The drug shortages are currently abating, but I have no doubt they will recur when market forces dictate.

The shortage of anesthesiologists is a real problem that is nationwide, as is a shortage of the nurse anesthetists that often work with anesthesiologists. The problem is simply that of supply and demand. The supply of physicians and nurse anesthetists is static; the demand is accelerating as surgical volume grows.

The early 1990s thinking that managed care would control the need for surgical services was faulty. What was then perceived to be adequate numbers of anesthesiologists and nurse anesthetists has now been overwhelmed by the aging demographics of our country. There is no easy way out of this shortage.

The public will need to be aware that there may be some curtailment of services (as in Cincinnati and Cleveland). Any curtailment in service is done to maintain the patient safety that is a hallmark of anesthesiology.

TODD J. COOPERIDER, MD

President, Ohio Society of Anesthesiologists

Sylvania

While the interest in honoring America's veterans on Memorial Day appears to be on the decline, there was at least one bright spot. On May 25 more than 300 students met with more than 50 veterans at Southwyck Shopping Center for the third annual “Memorial Day: Don't Forget to Remember.”

These young people demonstrated a real enthusiasm to hear about America's history from the men and women who experienced it first-hand. Many veterans were truly moved by this interest and by the sincerity shown by the children during the special memorial ceremony held at noon.

The patriotic coloring contest and essay contest received more than 150 entries, with the winning students earning American Flags and the opportunity to ride in Toledo's Memorial Day Parade. Four 8-foot-long “Thank You, Veterans!” banners were filled with hundreds of greetings to be sent to the Ohio Veterans Home in Sandusky and the Toledo Veterans' Outpatient Clinic on Glendale.

While schools are often chastised for not teaching enough about our veterans, Richard Jackson of the Toledo Public School system should be recognized for his support. The teachers who brought their classes set a wonderfully positive example. Judging by the students' genuine interest, they enjoyed learning more about our veterans.

This event indicates that the problem may not be that young people don't care. They just don't know. Once they have learned about the battles fought for their freedom, they begin to appreciate the sacrifice. When this happens, it is a victory for all Americans.

JAMES M. NOWAK

Cheltenham Road

Editor's note: Mr. Nowak was chairman of the event.

Until recently, I assumed that letters to the editor enabled citizens to express their viewpoints on current social issues. How narrow-minded of me not to consider the potential for authorities to deter those who conspire to violate Ohio's seat belt law. So moved by the warning, I envisioned my fate if I were apprehended:

Parked on the roadside awaiting the inevitable citation, I questioned the spirit of the law - an omniscient, disembodied entity that rules us all - about the philosophy of freedom. “Why have I been detained?” I asked. “I have not harmed or victimized anyone.”

“You have risked your own safety and therefore threatened others with the potential loss of tax dollars.”

“But, where is it written that they must pay for medical attention if it is I who decide which safety devices to employ? I have not heard of the right to bear expenses.”

“Most laws are created not for your protection, but to give solace to the self-righteous, whose very existence requires imposing their beliefs on others.”

“So, their beliefs impel them to mandate safety equipment which is not utterly effective. If I die because of the seat belt I must wear by order of the state, are the authorities not responsible for my death?”

“Your thinking is deviant. Instead you should take comfort in the fact that, statistically, the state will recoup the cost of a few lives lost at the hands of the seat belts designed to save them.”

“Has law been reduced to a calculation of costs versus freedom? I must know, and soon.”

“That you must decide. I must leave you now, for they are coming to impose your penalty, And remember, it must be done because the wealth of the few outweighs the good of the many.”

SCOTT McKIMMY

Sylvania

If smoke does not go up, then does it follow that tobacco tax revenue should go down? If you can't smoke in Toledo then don't sell tobacco in Toledo. Smokers could boycott, and purchase tobacco and other goods outside Lucas County. For every action here is a reaction.

JOHN T. KLEEBERGER

Metamora

The Bush administration has announced a long-term energy plan that includes conservation and many measures to increase domestic energy and reduce our dependency on foreign suppliers. This is something the Clinton administration failed to do in eight years in office.

The predictable response by the Democrats is to relentlessly attack the new administration as soft on conservation and strong on the oil industry. This requires blatantly misrepresenting the facts.

Thus we see the Democrats saying that the Bush plan ignores conservation. This is just not true. They say that drilling in a tiny part of the Arctic National Wildlife Refuge, proportionately about the size of a football field in the city of Toledo, will decimate the caribou. We know that the caribou herds grew after the Alaska pipeline was built, and the pipeline had no negative effect on the environment.

Both the President and vice president have vast experience in the energy industry. Incredibly, the media and the Democrats treat this as a liability rather than an asset. They spin every action as benefiting the energy industry, but fail to mention that the administration endorsed regulations to reduce lead in gasoline, over the objections of their “friends” in the energy industry, which will require huge amounts of investment. Acknowledging this fact would get in the way of the agenda.

The energy crisis was created precisely because the Clinton administration placed political hacks like Hazel O'Leary and Bill Richardson in charge of the Department of Energy. They had no idea what they were doing.

Now that Tom Daschle leads the Senate the energy plan is in danger and the entire country will pay the price in terms of higher energy prices and inadequate supplies.

MARIO GOVEIA

West Bancroft Street

Democrats should speak up for life

What a welcome letter to the editor May 22. The sacredness and value of life is not a partisan issue. It's a shame that the Democratic Party has let the leadership ignore this most critical issue of our time. I say to all Democrats, “Speak up for life!” Make more noise and I'm sure more support will be forthcoming. May we again become a country that welcomes all life. I would surely welcome the opportunity to be able to vote for the Democratic Party if its platform would more openly support pro-life issues.

JOSEPH GANZEL

Dorr Street