For a decade, a debate has swirled around whether registered nurse anesthetists ought to be able to work without the supervision of a physician.

The issue is particularly acute at rural hospitals that don't have an anesthesiologist — a specialty doctor — on staff, yet are faced with patients who need surgery.

Gov. Bill Ritter is mulling whether Colorado should become the 16th state in the union to opt out of a federal Medicare rule that requires nurse anesthetists to work under the supervision of a doctor.

We think he should do it. The Ritter administration plans to consult with health officials in the states that have opted out of the rule, and we think that's wise.

However, we find it persuasive that the Colorado Board of Nursing and the Colorado Medical Board have signed off on the idea, despite the medical board vote being a close 7-6 tally.

Anesthesiologists are, by and large, opposed to the idea, and we do not dismiss their concerns out of hand.

They cite the potential for complications that nurse anesthetists might not be trained to handle and the overall higher levels of preparation that physicians undergo.

"It's hard to overstate how seriously we take patient safety," Dr. Randall Clark, head of anesthesiology at The Children's Hospital in Aurora and a spokesperson for the Colorado Society of Anesthesiologists, told The Post.

At the national level, the sentiment is much the same. A recent report urging a repeal of the physician supervision requirement drew loud objections from anesthesiologists, who said the underlying research asserting that patients fared just as well with nurse anesthetists was biased and flawed.

However, nurse anesthetists argue compellingly that in rural settings, the supervising physician is not an anesthesiologist, and in that situation a nurse anesthetist has more expertise in anesthesia.

The Post's Jennifer Brown interviewed certified registered nurse anesthetist Lawrence Shovelton, who said the surgeons performing operations are focused on their own work even though they are technically in charge of supervising the anesthetist's work.

"I am more qualified," said Shovelton, who has significant military medical experience in delivering anesthesia.

Part of the problem stems from the difficulty that rural hospitals have in hiring doctors who are willing to take responsibility for overseeing anesthesia.

In Colorado's 42 rural hospitals, 38 provide anesthesia services, but 24 of them don't have anesthesiologists on staff. Those two dozen facilities use nurse anesthetists, but only under the supervision of a doctor.

Allowing nurse anesthetists to work without the supervision of a doctor is an acknowledgement of the difficulties that rural hospitals face in providing access to care.

Such a move would give them the flexibility to deliver services without lowering the standard of care that is expected.