Image Credit: @SenatorBriggs / X, @MasseyForSenate / X & Canva
Submitted by a Concerned Tennessee Patient –
The same Corporations and Physician groups that encouraged the mandate for the COVID vaccine and refused to let you visit grandma while she was hospitalized during the COVID crisis are the same corporations who came dangerously close to allowing you to be knocked unconscious for surgery by an anesthesia assistant who is not a nurse or a Doctor.
Anesthesia Assistants (AA’s) are not required to have clinical experience prior to their inferior two years of training versus a Certified Registered Nurse Anesthetist (CRNA) or Physician anesthesiologist. But it’s okay, as the hospital can save a buck and the physician anesthesiologists can make several extra bucks while overseeing AA’s .
You get to lay unconscious while being monitored by someone who has an undergrad in anything. These assistants, add in a few science classes and a quick two years of surface anesthesia training, and poof..they are ready to administer some of the most dangerous drugs known to man. Right?
To top it off, you get charged the same as if the anesthetic was provided by a CRNA who has an average of 7 years of clinical experience prior to entering a 3 year anesthesia program. That’s 10 years of experience prior to passing boards and receiving a doctorate in anesthesia. Physician anesthesiologists have even more training and experience.
Furthermore, CRNA can work autonomously while the AA must be supervised during the beginning and ending of the case.
Let me share a metaphor with you.
You board a plane to Miami only to discover the pilot will only be in the cockpit for take off and landing. You inquire as to who will be in the plane during the majority of the flight. A Pilot Assistant. Well, what happens if a door flies off and the pilot is still chilling somewhere outside of the cockpit? A Pilot Assistant will be flying the plane? What kind of training does this assistant have? Oh a Bachelor’s Degree in anything and two years of surface flight school? What? Who would choose that? Do passengers know? Do they not deserve a say? Would they book a flight knowing this?
This is exactly what State Senate Bill 0453 was and is. Medical professionals across the state had to fight SB0453. By informing the public of things like this, talking plainly to the people, people like you and me who will certainly have to be put under anesthesia at some point.
Thankfully, the bill was defeated, this time. That is how we beat this bill back but rest assured, it will return.
The hospitals and a lot of physician anesthesiologists want that extra buck, nevermind the fact that surgeons, nurses, and many anesthesiologists of all types have spoken out against it. The days of ignoring state politics because we live in a red state are dead.
My Republican representative Senator Becky Massey and Senator Richard Briggs of Knox County, the sponsor of SB0453, showed they valued a dollar more than me. Hospital representatives and physician anesthesiologists will go to fancy luncheons and talk to your rep in an attempt to persuade them to vote in alignment with these powerful corporations and lobby groups and against your quality of care. These same corporations will place your representative on their hospital boards and “donate” to their campaign.
Tennessee is evolving and changing and sure we have many needs in healthcare but resorting to a lesser quality provider when we could easily raise pay for our current providers, open more anesthesia schools and clinical sites as a means to retain and grow the high quality providers we already have in Tennessee.
We should stop the bleeding of providers going to states that pay more. We could also make more Doctors of anesthesia, pay for their medical school and contract them so they have to stay in Tennessee for an amount of years until they pay a portion of that back in service. The same thing for CRNA’s. We have excellent schools in this state, and excellent nurses and doctors.
What do we have more of than all the doctors and all the nurses combined, patients? From the skyline of Memphis to the Appalachian mountains of east Tennessee, CRNAs and Physician Anesthesiologists are the only two options for the highest quality of anesthesia care.
15 Responses
I will not be voting for Dr Briggs!
You won’t be put to that task Jeanne during this primary season because Briggs (TLRC-78/C) is in an odd numbered district (7) and even numbered senate districts are up this year. On the other hand, next door in District 6 Beckey Massey (TLRC-76/D-) has her hands full fending off the challenge from conservative stalwart Monica Irvine https://monicairvine.com/. The only question is how many conservatives will send their support to Monica before the August 1 primary.
I am curious what Tennessee conservative is publishing nonsense from a “concerned Tennessee patient” about the attempt by the Tennessee Society of Anesthesiologists to allow AAs to practice in the state of Tennessee. Why a conservative news organization would support attempts to maintain a bottleneck or stranglehold on a service in desperate need of more providers is beyond me. By allowing AAs to practice in Tennessee, there would be more rural access to surgery, not less. AAs work under the direction of physician anesthesiologists, highly trained medical doctors. There’s not a shred of evidence using AAs has any effect on outcomes. The AANA uses fear and straight up lies to prevent any expansion of anesthesia providers in order to maintain their tight grip on the market. Many practices are struggling to pay the exorbitant costs of a “locum” CRNA because of the inflated costs with using a “traveler” CRNA. The AANA only exacerbates the healthcare shortage and offers no meaningful solution, only obstruction. I urge the Tennessee conservative to reconsider publishing continued factually wrong information. While I do not support Becky Massie or Richard Briggs, there are better ways to point out their flaws.
Seth,
Do not misunderstand that just because we publish an opinion piece from a fellow Tennessean, that we necessarily agree with their stance. However, the writer’s op-ed does represent their own beliefs and points out that their elected officials failed in listening to their concerns. And the fact that many of them are more beholden to lobbyist dollars than the desires of their own constituents.
The ASA keeps touting AA’s as the solution to provider shortages, but the reality is AA’s just increase the provider shortage as they cannot work independently, and thus will not be able to increase access to care in places where physicians don’t want to live or work because they don’t get paid enough. The problem is that a physician working in an ACT (“Anesthesia Care Team”) model makes 2x+ what a physician who sits cases makes. So, physicians are lobbying and spending millions of dollars to bring in AA’s in order to protect their income and the ACT model, all so that they can be paid twice as much NOT to administer anesthesia. Thus these self-proclaimed “experts” are basically glorified secretaries who mainly just do pre-ops and watch other people do the anesthesia. The issue is not a shortage of providers, but rather a shortage of WILLING providers, AKA physician anesthesiologists – who have relegated themselves to a role that could be 80-90% done by a well trained MA (and I’m sure it’s only a matter of time until they push for that just so they can continue to get paid double the salary to sit in the doctor’s lounge). As much as they want to blame “traveler CRNA’s” for driving up healthcare costs, at least those CRNA’s are actually providing anesthesia. Locums MDa’s also drive up healthcare costs but without even actually administering the anesthetic and merely “supervising” – AKA adding cost without adding value. Not to mention the fact that physician anesthesiologists are retiring at almost the same rate that they are coming out of residency, which means that not only are AA’s not a good short-term solution, but they are not a good long-term solution either as they won’t have anybody to supervise them, then they will push for autonomy, physicians will create some new, even less qualified provider in order to tell case them and maintain their pitiful “ACT model” and paycheck, and the process continues… Follow the money and you will see that AA’s are not about patient care – they are about maintaining an outdated ACT model and physician ability to be paid to NOT provide anesthesia.
Me!
I will vote for Monica
Kent Morrell will likely be running against him again in 2026. Kent is a true conservative!!
You’d think that something as important as anesthesia would never be done by an assistant.
I will not be voting for Becky Massey in the primary. I need someone in office who is less of a bought and sold politician.
That would be Monica Irvine.
To be fair, the term “doctorate of anesthesia” is misleading here, as this term doesn’t exist.
I come from the old school and have been around a very long time. As CRNAs (nurse educated track), we get a DNP (Doctorate of Nursing Practice) not an MD (Medical Doctor) or DO (Doctor of Osteopathy) given to medical school graduates (Physicians).
The training, while involved and substantial is not equivalent, and should be recognized that MD/DOs have far more hours (years) than we do in Anesthesia training, hence the DNP title, which is purely academic in nature.
Accordingly, we do NOT get to use the title of “Doctor” when caring for patients as this is/would be deliberately confusing to the patient (Title Misappropriation) and completely unethical.
As for Anesthesiologist Assistants, I agree with the statement that we should be trying at all cost to keep our trainees (CRNA and Doctor alike) in the state of Tennessee, but until we do, all avenues for delivery of care should be explored, especially AAs, which require an MD to be involved in their care.
With more surgical case demand in Tennessee than there are anesthesia providers available (CRNA & Doctor COMBINED) to fulfill the demand, WHY ARE WE ARGUING THIS POINT?
Just my opinion here, but it seems like we’ve lost sight of what really matters here: the patient.
Briggs was allowed to run for office by the TNGOP despite not living in the district. This was to unseat incumbent Stacey Campfield. Then the TNGOP gerrymanded the district to capture Briggs’ residence on the lake. He should have never been on the ballot.
Both Briggs and Massey are part of the TNGOP Pfizer Contingent. They have already proven they are willing to kill you with the Deathvax recommended by their benefactors. They should never be voted for again. That is the least that should happen to them.
https://drive.google.com/file/d/1N0XJMDsOcSrPXrPkcZU_2svjZg4ZqhqQ/preview
What the author is actually worried about is driving down the salaries of Tennessee CRNAs. They care about the money going in their own pocket more than the Tennessee patients access to care. All this while hypocritically calling out politicians for simply going to a luncheon to learn about Certified Anesthesiologist Assistants. There is zero evidence of a difference in care whether a CRNA or CAA is in the room. It is also proven that the Anesthesia Care Team is the safest Anesthesia model which CAA must practice in through out the country. This is simply a slam piece in order to put fear into the people of Tennessee’s heads, which is a common tactic used in a certain red country, in an attempt to control the populous for their own bidding. You WILL be working side by side with a CAA soon and when you are I hope you have the courage to look them in the face Mr or Mrs Anonymous.
This article is unbelievable how insanely untruthful it is. I’m genuinely curious how you can write this kind of an argument while flat out making up details and “facts” with no actual information to back it up.
A simple googling search will discredit everything in this article. Search for a study done by Stanford University in 2018 that looked at surgical outcomes over the course of years and hundreds of thousands of surgeries and found there to be no clinical significant difference in patient care and outcomes between CRNAs and CAAs. Here is a little information from the research for your enjoyment:
“The investigators found that the mortality rate was 1.6% when the care team included anesthesiologist assistants versus 1.7% for care teams that included nurse anesthetists. Hospital length of stay was shorter and medical spending was slightly less for care teams that involved anesthesiologist assistants, with decreases in length of stay of 0.009 days and a reduction in spending of $56. These differences were not statistically significant.”
The fact of the matter is CRNAs are threatened by CAAs and are willing to do and say whatever lies the can to try and prevent truly helping expand patient care to an even higher level, even though there is a severe shortage of anesthesia care team members nationwide. Even to the point where they are now trying to call themselves Doctors to further confuse patients and eliminate the most effective form of anesthesia, an anesthesia care team model.