The entire country except So Carolina and Virginia have permits to practice sedation and/or general anesthesia. So Carolina is in the process of developing its permit which would leave Va the ONLY state that does not have a permitting system. If Virginia would at least talk with the other states and find out why they have decided to institute a permit, it would certainly be a plus for our state, and the public,  in knowing what practitioner, has what training. The reasons to have a permit system have already been hashed out by the other 48 states and it probably would be best if the Board did the inquires rather than I go into the reasons in this short comment session.

Secondly, the use of a "blue ribbon" panel of anesthesia experts to help the Board sift through the difficulties of investigating a morbidity or mortality HELPS the Board and the public both. California does it and although not perfect, it does help the Board get an indepth insite into the intricacies of some of these cases. Va has had 17 deaths since 1972 about one every two to three years and who knows how many reported or unreported morbidities.

The costs of developing an ad hoc blue ribbon panel would more than be offset by the fees generated by the permits issued and would help defray the costs of "targeted" office inspections that might be needed and experts' fees to review cases for the Board.