As an independent nurse anesthesiologist (CRNA) who proudly serves three rural hospitals with anesthesia and chronic pain services, I recognize that surgical services are the lifeblood of any rural facility. It is often the greatest revenue generator and the fine line between closing and continuing to offer and expand service lines.

When I read that Gunnison Valley Health (GVH) has recently added a physician anesthesiologist to its staff , I was confused and bewildered. Just as nearly all rural hospital anesthesia departments across the country, the GVH anesthesia department has been successfully run by CRNAs for decades.

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