On August 28th, the NEMDJ published a letter to the editor in response to Governor Phil Bryant’s consideration of relieving Mississippi hospitals from an old federal regulation for physician supervision of Certified Registered Nurse Anesthetists (CRNAs) that is not consistent with Mississippi law. I would like to clarify and correct some of the assertions and opinions in that letter to the editor.
Currently, 40 states in the country, Mississippi included, do not have a physician “supervision” requirement for CRNAs. Instead, Mississippi law requires “collaboration” with a physician. The collaborating physician does not have to be an anesthesiologist or have any type of anesthesia training. In fact, many hospitals and surgery centers all around our state employ only CRNAs, and no physician anesthesiologists, to provide anesthesia services.
Scientific, clinical research has confirmed repeatedly that the administration of anesthesia is equally safe regardless of whether it is provided by a CRNA working alone, a physician anesthesiologistworking alone, or a CRNA and physician anesthesiologist working together (see https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2008.0966). CRNA care is safe for patients whether supervised by a physician or not.
If Governor Bryant chooses to opt-out of the old federal requirement, that decision will not lessen physician involvement in anesthesia care. State law will still require collaborative relationships between CRNAs and physicians. But hospitals and other healthcare facilities in Mississippi would be freed up to staff their anesthesia departments to function as efficiently, cost-effectively, and safely as possible. The supervision requirement places unnecessary burdens on a hospital’s ability to receive reimbursement from the federal government for anesthesia care provided to Medicare patients.
Mississippians deserve the best healthcare at a cost-effective price. Our hospitals deserve to be able to staff their anesthesia departments in cost-efficient ways that include physicians and CRNAs providing high-quality care and also keep costs of care under control.
Robert K. Rogers, MS, MSHA, CRNA
President Mississippi Association of Nurse Anesthetists