CRNAs being supervised by drs who are not anesthesiologists

Specialties CRNA

Published

Why do some states as Oklahoma have laws that say a dr, which could be dentist, podiatrist, surgeon etc have to sign off on a CRNA at end of procedure. Could any of these drs step in and take over the crna role if something happened to him/her? I would think at min. It would need to be anesthesiologists who would know what to do. What's your thoughts?

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Hmmm...I know in IL our practice owns a surgi-center where we occasionally employe a CRNA for pt care and they do not have an MDA on site.

Bluebolt

1 Article; 560 Posts

Those regulations are in order to bill for Medicare and Medicaid (CMS). It has nothing to do with your license to practice anesthesia. CMS requests that in 33 of the 50 states you need a physician/dentist/podiatrist to have a signature on the chart. It does not make them responsible for your anesthetic but CMS wants it in order to pay you for your services. It's an archaic request and has already been removed from 17 states and growing. Not to mention the very obvious point you make that none of these healthcare professionals are trained in anesthesia and are not "supervising" you in any way. They are also not responsible for your anesthetic because they are not trained or knowledgeable in anesthesia. You will be responsible for whatever anesthesia services you provide because you are the trained and licensed anesthesia provider, not them.

Ultimately, it's an artificial barrier to practice encouraged by a group of competing anesthesia providers who want more of the market share for themselves. Walmart can't eliminate Target but they can try to block the entryways with a bunch of shopping carts.

I believe New Jersey is the only state that does require a physician anesthesiologist to sign the chart. In all the other 33 states that do want signatures, CRNA only practices are alive and well and simply have the surgeon/podiatrist/dentist put their name on the chart so everybody gets paid.

Oklahoma 1

36 Posts

Thank you BlueBolt that makes sense and answered my questions. Thanks again.

Oldmahubbard

1,487 Posts

Hilarious or aggravating that a podiatrist can sign, depending on one's point of view.

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