Let’s have smarter anesthesia delivery in Michigan
The state House of Representatives on Nov. 29 will begin debate on a bill already passed by the Senate with strong bipartisan support — and backed by nearly two decades of medical science — to improve access to anesthesia services in Michigan.
The House Health Policy Committee will begin hearings on Senate Bill (SB) 1019, which would do three things if passed:
■End another meaningless government mandate in Michigan,
■Improve access to anesthesia services in Michigan while protecting patient safety and reducing costs, and
■Align Michigan’s anesthesia regulations with the vast majority — and growing number — of states that allow Certified Registered Nurse Anesthetists (CRNAs) to practice independent of mandatory physician supervision.
Michigan remains one of the few states to mandate physician supervision of CRNAs. Nine medical studies since 2000 demonstrate these types of regulations appear to do nothing to improve patient safety and medical outcomes, and they can limit access to anesthesia services, driving costs higher.
Under Michigan’s current supervision mandate, the state’s 2,600 CRNAs who are licensed and educated to manage all types of anesthetics can be supervised by any physician — even one with absolutely no skills or training in anesthesia. Most other states view this as a ridiculous and meaningless mandate and have more flexible anesthesia delivery models than Michigan. Most other states understand CRNAs are educated and licensed to administer anesthetics with or without a physician standing by to “supervise.” CRNAs this year will safely, efficiently and competently administer more than 43 million anesthetics in the United States.
A growing number of states — 40 now — have more flexible anesthesia models than Michigan, because extensive peer-reviewed medical research (nine studies since 2000), including a study by the prestigious National Institutes of Health, has found no difference in patient safety and medical outcomes in states with and without the old model of mandatory supervision of CRNAs. Studies have also found that access to anesthesia can improve and costs can be lower in the growing number of states without mandatory supervision of CRNAs.
Opponents of SB 1019 site no peer-reviewed medical research or medical evidence for their position. However, they are shopping to Michigan lawmakers one political poll — entirely paid for by these opponents — alleging to show voters are against the bill. We all saw how accurate polling is in the recent presidential election.
In addition, we would urge lawmakers to base Michigan’s healthcare policies on medical research, not political polling. And the medical research overwhelmingly concludes that SB 1019 is good for patient safety and good for healthcare access in Michigan.
We strongly urge the state House to concur with the Senate, base our healthcare laws on medical research, and pass SB 1019 to create a new flexible anesthesia model that allows Michigan hospitals to choose what works best for their communities and patients.
Howie Drews is a certified registered nurse anesthetist and president of the Michigan Association of Nurse Anesthetists. Timothy Johnson is CEO of Eaton Rapids Medical Center.