Currently, in NC, the law and Nurse Practice Act states that CRNAs must work in "collaboration" with a physician (which can be a surgeon, dentist, podiatrist, anesthesiologist). The bill currently in committee in the state legislature will change the law to say that CRNAs should be "supervised" by a physician, if it passes. The biggest difference in practical terms is that if the physician is "supervising" the CRNA, then the physician will be held as liable, if not more so, legaly for the anesthetics provided. In NC, the bill could have a truly negative effect on rural health care. NC has 35 counties without any access to MDAs. All anesthetics in those areas are provided by CRNAs. Surgeons (or other physician) will have to claim "supervision" thus liability, for CRNAs to continue practice in those areas.