Doc supervision for nurse anesthetists not required in states

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Like 16 other states, certified registered nurse anesthetists (CRNA) can work without physician supervision in Colorado, where the state appeals court upheld a 2009 decision to opt-out of the federal supervision requirement.

The court ruling follows a lawsuit filed by the Colorado Society of Anesthesiologists (CSA) and the Colorado Medical Society (CMS) challenging the opt-out.

Hospitals praised the decision in light of the physician shortage, which is expected to grow with millions of new patients under health reform, the Associated Press reported.

However, the CSA maintained its support of the federal supervision requirement for CRNAs. Not only does the opt-out end surgeons' role as "captain of the ship" in the operating room, but it makes them legally accountable practitioners that they don't control, the group said today in a statement.

Meanwhile, the American Society of Anesthesiologists (ASA) and the American Medical Association (AMA) disputed the theoretical cost savings behind letting nurse anesthetists practice without physician supervision. "Anesthesiologists deliver anesthesia services to patients more safely and at a cost equivalent to, if not less than, the cost of a CRNA performing the same services," they said in an amici curiae submitted the court.

The decision in Colorado comes only weeks after a California court reaffirmed its decision to allow certified registered nurse anesthetists (CRNA) to work without physician supervision, stirring opposition from the California Society of Anesthesiologists and California Medical Association who claimed nurses don't have the necessary training to handle anesthesia-related complications.

For more:
- here's the ruling (.pdf)
- check out the AP article
- read the CSA statement
- here's the ASA and AMA amici curiae brief (.pdf)

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