Pay for Epidural Anesthesia

I feel compelled to respond to Dorothy McEwan’s letter [“Epidural Critic’s Anger Is Misplaced,” Letters, July 11]: Although attempts to obtain cash payments from Medi-Cal patients for epidural services is improper, this practice was certainly the exception rather than widespread, and it is unfair to characterize anesthesiologists as “greedy” for expecting fair and reasonable compensation for professional services rendered.

The placement of an epidural catheter and management of epidural anesthesia require fundamental medical knowledge and considerable skill and training. It is a procedure that entails risk and may be fraught with complications. It may take minutes to place the catheter, but the best anesthesiologists make it look easy. Nurses may report vital signs and patient reports of analgesia, but the ultimate monitoring of the procedure is done by the physician, who remains immediately available; removal of the catheter is always done by the anesthesiologist.

As far as the tax returns of the physicians involved, these are no more a matter of public record than are your own tax returns.

LES WYNNE, M.D.

San Marino

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