Thus far there methods have been:
1. State level attempts to regulate office based surgery, usually with language that requires an anesthesilogist to supervise if a CRNA is administering the anesthesia. (this is a back door route, if they can get that in it will be easier to argue that CRNA's should never work unsupervised by an anesthesiologist.)
2. Expansion of the AA programs, I think three or four new programs are set to open, and they are working state by state to institute a practice act for AA's as they are not in every state yet. AA's are under the supervision of an anesthesiologist only therefore they appear to be the better choice from a monetary perspective for anesthesiologists.
3. State by state efforts to stop governors from opting out of the supervision requirement. Again, this has little to do with the practice of most CRNA's but, just the implication that supervision is required in one type of practice spills over to others.
4. Increasing the number of anesthesiology graduates
Those are just the ones off the top of my head, I am sure there are plenty more. One of the greatest advantages CRNA's have is a VERY strong organization and PAC. The AANA is very proactive, and unlike the ANA they do not roll over to political pressure, they stand up and fight it. I think something like 97% of CRNA's are members which is a strong statement to the value of the organiztion.
