Arizonans Overwhelmingly Want Physicians to Supervise Nurse Anesthetists and Respond to Anesthesia Emergencies

The Arizona Society of Anesthesiologists (AzSA) and the American Society of Anesthesiologists (ASA) strongly oppose Governor Doug Ducey’s decision to “opt-out” of the Centers for Medicare & Medicaid Services’ physician supervision requirement, which dismantles the anesthesia care team model in Arizona by allowing nurse anesthetists to administer anesthesia without physician supervision. Only 28% of Arizona voters support the governor’s exemption to this federal regulation that requires nurse anesthetists to administer anesthesia under the supervision of a physician.

A survey of 600 registered voters in Arizona conducted May, 2019, clearly found voters in Arizona want a physician to supervise nurse anesthetists and handle medical complications in an anesthesia emergency.  

• An overwhelming 80% of Arizona voters want a physician handling medical complications or anesthesia emergencies during surgery.
• When provided with the education and training associated with a physician anesthesiologist and a nurse anesthetist, 74% of voters want to have a physician anesthesiologist administer anesthesia.
• 76% noted that it is extremely or very important that a nurse administering anesthesia or responding to an emergency during surgery work under the supervision of a physician.
• Only 28% support Gov. Ducey’s opt-out decision, which was made without input from the public, medical boards, or the state’s medical community.

Gov. Ducey has refused five separate requests to meet with his physician constituents on this patient safety concern. His office neither consulted the medical community while the decision was being made, nor notified the physician community before the decision was made public.

AzSA and ASA urge Arizonans to call the governor’s office and demand that the opt-out only temporarily suspends physician supervision requirements while the state tackles the COVID-19 pandemic.

Every other governor who has authorized similar changes during this time has done so on a temporary basis. Governor Ducey is the only governor to issue such a drastic, permanent measure. To protect Arizona patients and to better align with other states and the federal government, he must clarify that this opt-out is temporary. Otherwise, this permanent change directly opposes what Arizona voters want from their health care system, lowering the standard of care and jeopardizing the lives of Arizonans.

“Physician involvement in surgical anesthesia ensures patients receive safe, high-quality care.  The people of Arizona deserve no less. More importantly, it is what the people of Arizona want for their health care,” said AzSA Immediate Past President Courtney Koshar, M.D.

“Despite advances in medicine and patient safety, surgery and anesthesia are inherently dangerous,” said ASA President Mary Dale Peterson, M.D., MSHCA, FACHE, FASA. “Physician anesthesiologists are highly skilled medical experts who have the education and training to make critical decisions in an emergency. People want a physician to administer their anesthesia or respond in an emergency.”

Physician anesthesiologists have up to 14 years of postgraduate medical education and residency training, which includes 12,000 -16,000 hours of clinical training, nearly seven times more training than nurse anesthetists.

The United States Department of Veterans Affairs’ (VA) Quality Enhancement Research Initiative (QUERI) could not discern “whether more complex surgeries can be safely managed by CRNAs.”

Additionally, there are no cost savings for patients in Arizona to receive anesthesia care solely by a nurse anesthetist. Physician supervision of anesthesia ensures patients receive safe, high-quality care. AzSA and ASA urge the governor not to lower the standard of care in Arizona. It provides no benefit and can mean the difference between life and death.

The survey was conducted by TelOpinion Research. The individuals interviewed were randomly selected from the latest list of registered voters in Arizona and the results represent a cross-section of voters across the state. The margin of error associated with a study of this size is +-3.9%.

About the Arizona Society of Anesthesiologists

The Arizona Society of Anesthesiologists is a source of educational, social, and ethical exchange for member anesthesiologists of the state of Arizona. The purpose of the society is “to raise the quality of the practice of anesthesiology, to improve patient care and safety through education, research and advocacy, and to disseminate current information about scientific progress in anesthesiology.”

About the American Society of Anesthesiologists

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 54,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Like ASA on Facebook; follow ASALifeline on Twitter.

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