Colorodo CRNA's win right to administer anestetics without Dr supervision

That reporter was mistaken, Colorado will be the EIGHTH state to opt out.

Don't forget Nebraska, Kansas, New Mexico, New Hampshire, Minnesota, Idaho, and Iowa.

So, is that 42 left to go then?

Only problem is, that of the remaining 42 states, only

10 more (JAMA estimate),
22 more (AANA estimate), if hospital licensing is not taken into account, this was a major issue in Colorado.
12 more (Dept. of Health and human Services) if hospital licensing is taken into account.
no more states (ASA estimate) the one they capitulated on was New Hampshire. Even then they ran FUD (fear uncertainty and doubt campaigns on the radio, and actively tried to oust the governor).

Have state laws and licensing requirements compatible with an opt out.

It should also be noted, that Oregon already has independent practice legislation in place. Why they have not opted out is a wonder. they aslo have a CRNA charter.
(note the above figures have the eight opt outs accounted for, i.e. 22 = 30)


Gee, can you tell I am doing a presentation on this in less than a week?

BTW, I think that this newspaper jumped the gun. I have not been able to find any references corraborating Colorado as an opted out state.

If any of you know of any, i would appreciate hearing about it.

nilepoc,

Gov. Owens of Colorado has requested the opt out. It is not in effect yet, because the Colorado ASA has filed a lawsuit trying to prevent the opt out. The court case is still pending.

BTW, have you heard the latest consequence of the supervision issue? JCAHO has always categorized CRNAs as "licensed independent practitioners". I'm not sure what all that means, but apparantly it grants us authority to do certain things under JCAHO guidelines that would otherwise require a physician. Anyway, JCAHO has now decided CRNAs may only be LIPs in opt out states. This may have pretty significant implications for hospital policies in non-opt out states. AANA is just beginning to tackle this latest development.

loisane crna

Thank you Loisane, I figured that was the case, as the lawsuit between the ASA and the Governor of Colorado has yet to be decided. I would imagine that the ASA will be able to drag this out in the courts for quite a while.

I have read quite a few things about the recent JCAHO decision.

I have reflected on it a bit, and I feel that if this was a physician backed decision, they may have cut their nose off to spite their face.

I think that while immediately, this will cause problems with small hospitals in rural areas. There are not enough MDAs currently practicing to cover the anesthesia need of these areas. As such, It will have the longterm effect, of forcing the hospitals in these areas to fight for the independant practice of CRNAs. So, I see more states being forced to consider opting out, in order to provide care for their citizens. If JCAHO really enforces this, I think there are going to be a large number of governors considering CRNA practice in the near future.

Regarding AA practice, I am a bit baffled. If this was backed by the ASA, it is not going to help them get AAs more recognition. In fact, in the short term, it is going to drive CRNAs into the city, to directly compete with AAs in urban areas.

I am not sure how this new JCAHO change will pan out, but I am hopeful.

craig

nilepoc,

I think (hope) you may be right about the change in JCAHO policy actually encouraging more opt outs. It is a case of those "unintended consequences" they tell us about in health policies class.

Personally, I don't think this is a direct ASA strategy. More likely a logical outgrowth of the overall "physician bias" held by the entire JCAHO operation.

loisane crna

Interesting comments Nilepoc. However, will JCAHO not simply revert to the old standby, ie. the surgeon is supervising the CRNA, or is this no longer possible?