Catherine Gillis' op-ed, "Anesthesia's unneeded duplication" (Sept. 20) is really about efforts to eliminate the best trained providers in the interests of finances. One can only wonder if Ms. Gillis would truly wish for herself or a family member to undergo anesthesia in the absence of a physician to manage unexpected complications.

There are many dimensions to the drive to reduce health care costs. Can she really be advocating that we drive down the level of training and skill of health care providers? Can we no longer afford medical school and residency training for those in whose hands we put our lives? Would she also eliminate psychiatry and substitute social work? Nurse's aides for nurses? Teacher's aides for teachers?

Your readers should be alarmed by the proposition that Americans can't afford doctors and must rely on individuals with less than a third of the education for their medical care.

Dr. Alexander Hannenberg, Washington

The writer is president of the American Society of Anesthesiologists.