New legislation aims to improve patients' access to anesthesia in Michigan's hospitals.
A current mandate requires physician supervision when anesthesia is administered by certified registered nurse anesthetists — even if that physician has little or no training in anesthesia.
Senate Bill 550 would allow Michigan hospitals to choose the anesthesia model that best meets the needs of their patients and communities, and give them the option to either keep or eliminate that rule.
Howie Drews is a CRNA and president of the Michigan Association of Nurse Anesthetists. He says the mandate is a problem, particularly for small rural hospitals, because many exclusively rely on CRNAs since they are more affordable than anesthesiologists.
"It can mean the difference between a hospital staying open or closing," he said. "Small rural hospitals can’t afford to pay two, three times for one body when they could have two or three bodies at that same price."
He said it also makes it harder for hospitals to recruit physicians because of the added paperwork and responsibilities.
"If you’re looking at a job as a surgeon, you want to go to a place that has more paperwork? Probably not." Drews said.
We all know Michigan’s physician supervision mandate is a hollow mandate. We know that in the vast majority of cases, the surgeon relies on the CRNA to be the anesthesia expert, to manage the entire anesthetic process absent any supervision from the surgeon. As surgeons, we understand CRNAs are educated and trained to manage this process safely absent physician supervision, just like in most other states.
Drews says in addition to improving access to anesthesia and reducing red tape, it would also reduce healthcare costs for some patients. And he says that patient safety is still the top priority in the bill.
"Which is backed by over 10 years of medical research that has shown zero difference in outcomes whether your care is provided by a certified registered nurse anesthetist or an anesthesiologist," he said. "There is no difference in outcomes.”
In full disclosure, the Michigan Association of Nurse Anesthetists is a financial sponsor of Michigan Radio.