CRNAs and anesthesiologists: A closer Look at Scope-of-Practice Debates
Table of Contents
- 1. CRNAs and anesthesiologists: A closer Look at Scope-of-Practice Debates
- 2. Study Finds No Link Between Expanded Nurse Anesthetist Scope and Improved rural Healthcare Access
- 3. HCA Florida ocala Hospital Feeds Needy Families Across Marion County
- 4. New Head and Neck Specialist Joins HCA Florida Memorial Hospital
- 5. New Faces in Jacksonville Healthcare: Dr. Smith Joins HCA florida Memorial and Amit Parmar Appointed COO at HCA Florida Woodmont
- 6. Rural Florida Faces Health Crisis as medicaid Cuts Loom
- 7. • How do proposed Medicaid cuts threaten the well-being of children in rural Florida?
- 8. Florida’s Healthcare Crossroads: A Conversation with Erica Li
- 9. The Importance of Medicaid in rural Florida
- 10. The Impact of Proposed Medicaid Cuts
- 11. Addressing Staffing Shortages
The debate over scope of practice for Certified Registered Nurse Anesthetists (CRNAs) and physician anesthesiologists is a recurring theme in healthcare policy. At the heart of the issue is the question of whether CRNAs, who are highly trained nurses specializing in anesthesia governance, should have greater autonomy in their practice.
Currently, Florida law mandates that CRNAs practice under the supervision of a physician anesthesiologist.This requirement, argued by some, limits access to anesthesia care, notably in rural areas where physician anesthesiologists may be scarce.CRNAs, represented by organizations like the Florida Association of Nurse Anesthetists (FANA), consistently advocate for changes in scope-of-practice laws, striving for increased autonomy and broader access to anesthesia services.
However, a recent study by Florida Atlantic University researchers challenges the claim that expanding CRNAs’ scope of practice through “opt-out” provisions necessarily improves access.
Lead author Dr.Scott Feyereisen analyzed hospital data from 2010 to 2021, finding no significant increase in anesthesia care access in states with these opt-out provisions. As Dr. Feyereisen’s research states, “We discovered that adopting opt-out provisions does not universally result in increased CRNA service provision in U.S. hospitals. Notably, opt-out provisions do not improve access in rural counties.”
While acknowledging the ongoing surgical access limitations in rural areas,the study suggests that “opt-out” provisions have failed to effectively address these shortages. This finding adds a layer of complexity to the ongoing debate, highlighting the need for nuanced solutions that go beyond simply expanding scope of practice.
Study Finds No Link Between Expanded Nurse Anesthetist Scope and Improved rural Healthcare Access
A recent study conducted by Florida Atlantic University researchers, funded by the Florida Society of Anesthesiologists, sheds light on the impact of expanded scope-of-practice provisions for Certified Registered Nurse Anesthetists (CRNAs) on healthcare access, particularly in rural areas. The findings, published in a peer-reviewed journal, challenge the notion that allowing crnas to practice independently improves access to anesthesia services, especially in underserved communities.
“We have long suspected — based on our direct field experiences — that when states dangerously expand the scope-of-practice for CRNAs, allowing them to perform anesthesia services without the supervision of a physician, areas with nurse shortages do not benefit. This detailed analysis by three respected FAU professors clearly bears this out,” stated Asha Padmanabhan, president of the Florida society of Anesthesiologists.
The study, wich analyzed extensive data, concluded that expanding CRNA scope-of-practice does not lead to increased nurse anesthetist presence in rural areas. padmanabhan emphasized the potential dangers associated with unsupervised anesthesia practice, stating, “not only is the practice of allowing nurses to independently practice anesthesia medicine without physician supervision costly and potentially dangerous, but this paper also demonstrates that it does not yield more nurses working in underserved areas.”
Padmanabhan underscored the study’s definitive findings, concluding, “the data unequivocally showed that taking the costly and potentially dangerous steps of expanding scope in anesthesia medicine does not improve access to care — especially in rural communities.”
Meanwhile, GuideWell, the parent company of Florida Blue, announced a 3% workforce reduction across 29 states. While the exact number of employees affected in Jacksonville remains undisclosed, the layoffs, first reported by the Jacksonville Business Journal, signal a belt-tightening measure amidst broader economic challenges.
HCA Florida ocala Hospital Feeds Needy Families Across Marion County
In a heartwarming display of community spirit, HCA Florida Ocala Hospital has donated $10,000 to interfaith Emergency Services, a crucial step in the fight against hunger in Marion County, Florida. The donation was the result of HCA Healthcare’s “Healthy Food for Healthier Tomorrows” campaign, where HCA florida ocala Hospital emerged as the North Florida Division winner.
The HCA Florida Ocala Hospital team went above and beyond, creating a unique food sculpture of a smiling turkey to highlight the importance of supporting their neighbors during the holiday season. “HCA Florida Ocala Hospital is proud to assist Interfaith Emergency services in the fight against food insecurity and to help our less fortunate neighbors achieve a healthier tomorrow,” said CEO Alan Keesee. “I am incredibly proud of our hospital team whose creativity and commitment made this donation possible,”
The impact of this generous donation will be felt deeply within the community. ”This $10,000 will sustain our truck and driver for five months, enabling us to collect approximately 365,000 pounds of food, including fresh produce, dairy, meats, and nonperishable items, which will be delivered to households within 48 hours,” explained Karla Greenway, CEO of Interfaith Emergency Services.
New Head and Neck Specialist Joins HCA Florida Memorial Hospital
In another exciting development for healthcare in Jacksonville, HCA Florida Memorial hospital has welcomed a new head and neck specialist to its team. Russell B. Smith, a highly skilled physician, brings extensive experience in advanced surgical care for conditions affecting the head and neck regions.
Dr. Smith’s expertise extends to a wide range of head and neck issues, encompassing cancers of the head and neck, as well as conditions affecting the mouth, throat, voice box, sinonasal cavities, and skin. This addition to the medical staff underscores HCA Florida Memorial Hospital’s commitment to providing remarkable and specialized care to its patients.
New Faces in Jacksonville Healthcare: Dr. Smith Joins HCA florida Memorial and Amit Parmar Appointed COO at HCA Florida Woodmont
The Jacksonville healthcare scene is welcoming two new key figures: Dr. Russell Burton Smith and Amit Parmar. Dr. Smith, a specialist in head and neck surgical care, has joined the team at HCA Florida Memorial Hospital, while Amit Parmar takes on the role of chief Operating Officer at HCA Florida Woodmont Hospital.
“We understand that being diagnosed with cancer is life changing. We are committed to taking a personalized approach to provide multidisciplinary care for each of our patients, making sure they understand all options to therapy,” said Dr. Smith.“At all times, our patient’s care and comfort is our highest priority, and our entire team works diligently to ensure that each patient and their entire family are supported throughout the process.”
Dr. Smith’s practice will be located in the Head & Neck Specialists wing of HCA Florida Memorial Hospital, conveniently situated at university and Beach Boulevards in Jacksonville.
Meanwhile, Amit Parmar brings eight years of experience at HCA Healthcare to his new role. Hailing from Tristar Skyline Medical Center, a Level I Trauma Center in Nashville, Parmar previously served as Vice President of Operations, where he oversaw several impactful projects, including establishing the HCA Healthcare TriStar Division’s first helicopter Fuel Depot, planning and implementing a $128 million tower expansion, and spearheading an East Nashville FSER expansion.
Rural Florida Faces Health Crisis as medicaid Cuts Loom
A new report throws a spotlight on the precarious health situation in rural Florida, highlighting the vital role Medicaid plays in providing healthcare access to these vulnerable communities.The report, produced by the Georgetown University Center for Children and families, unveils the unique challenges faced by rural Floridians, including a shortage of healthcare providers, long travel distances, and limited connectivity, all of which significantly hinder their access to essential medical services.
Erica li, a health policy analyst with the Florida Policy Institute, underscores the immense importance of Medicaid for the state, emphasizing that over 52% of children in rural Florida depend on Medicaid or the Children’s Health Insurance Program (CHIP) for their health coverage.
“Medicaid is a critical lifeline for families who need it,” Li explains. “And the longer that children go without coverage in health care, the more risk they are at for poor outcomes and othre aspects of their life, such as educational attainment and overall quality of life measures.”
The report’s findings serve as a stark warning about the potential devastating consequences of proposed Medicaid cuts. These cuts, if implemented, could plunge rural Florida into a healthcare crisis, leaving countless families without access to life-saving medical care and jeopardizing the well-being of countless children.
Florida continues to lead the nation in Obamacare enrollment, with a record-breaking 4,633,650 residents signing up for coverage through the Marketplace by the end of 2024.This impressive figure surpasses the national average,where 23.6 million people enrolled for 2025 coverage, including 3.2 million new consumers. The Florida marketplace boasts participation from four insurance companies and 12 health maintenance organizations (HMOs), offering residents a range of options to meet their healthcare needs. It’s crucial to note that HMO coverage is regional, requiring individuals to reside within the HMO’s authorized operating area to enroll.
Meanwhile,the state agency responsible for administering Florida’s Medicaid program for 5 million residents is seeking a midyear budget increase of $6.7 million. The agency cites chronic staffing shortages as the primary reason for the request, arguing that these shortages prevent needy families from accessing necessary medical care. “Current salaries do not attract candidates with the desired skill sets, experience, and expertise,” Sonya smith, Chief of Finance and accounting for the Division of Health Care Finance at the Agency for Health Care Administration, stated in an email to legislators on December 27th. Studies have shown that at current staffing levels, some residents face lengthy wait times to connect with someone at Florida’s Medicaid call center.
In Key West, a historic building that houses vital public health services is set to reopen after a temporary closure due to lead concerns. The Gato building on Simonton Street, which housed administrative offices for several municipal agencies, including the Florida Department of Health in Monroe County, was shut down in November following the finding of trace amounts of lead in construction materials. Testing revealed the lead originated from a paint layer dating back to the 1970s or earlier. The county has since declared the building safe for occupancy, with officials anticipating full operational capacity within six months.
Mark your calendars for some key legislative happenings in the coming weeks.
The Florida Department of Health has finalized a rule concerning acupuncture program requirements. This rule, 65B1-4.001, takes effect on February 6, 2025. For more details,click here.
On january 28th,the House Human Services Subcommittee will convene at 3:30 p.m. in Room 314 of the House Office Building. The following day, January 29th, at 1 p.m., the House health Care Budget Subcommittee will meet in the same location. This meeting will feature a panel discussion on mental health and substance abuse, featuring reports from the Department of Children and families and the Agency for Health Care Administration.
And on February 1st,let’s extend birthday wishes to Rep. Chuck Brannan.
Health Policy Committee, Senate Appropriations Committee, Florida Chamber of Commerce, Legislative Fly-in">
February promises to be a busy month for Florida’s legislative scene, packed with crucial meetings, celebrations, and opportunities for engagement. Keep these key dates marked on your calendar:
February 4: The Senate Health Policy Committee convenes at 1:45 PM in Room 412 of the Knott building.
February 5: The Senate Appropriations Committee on Health and Human Services meets at 1:15 PM in Room 412 of the Knott Building.
February 6: happy birthday to Senator Clay Yarborough!
February 10: Mark your calendars for Day One of the Florida Chamber of Commerce’s 2025 Legislative Fly-in, taking place at 1:30 PM at the Donald L. Tucker Civic Center.
February 11: Day Two of the Florida Chamber of Commerce’s 2025 Legislative Fly-in continues at 1:30 PM at the Donald L. Tucker Civic Center.
• How do proposed Medicaid cuts threaten the well-being of children in rural Florida?
Florida’s Healthcare Crossroads: A Conversation with Erica Li
Florida’s rural communities face unique challenges when it comes to accessing healthcare.Erica Li,a health policy analyst with the Florida Policy Institute,sheds light on the critical role Medicaid plays in ensuring access to care for these vulnerable populations,particularly children.
The Importance of Medicaid in rural Florida
Q: Erica, why is Medicaid so crucial for rural Florida, especially for children?
A: Medicaid is a lifeline for many families in rural Florida. Over 52% of children in these areas rely on Medicaid or the children’s Health Insurance Program (CHIP) for their health coverage. Without it, many families would struggle to afford essential medical care, leading to delayed or forgone treatments and perhaps serious health consequences for children.
The Impact of Proposed Medicaid Cuts
Q: What are the potential consequences of proposed Medicaid cuts for rural Florida?
A: The impact could be devastating. Cuts would leave countless families without access to life-saving medical care, jeopardizing the well-being of countless children. These cuts would exacerbate existing healthcare disparities,further widening the gap in access to quality care for rural residents.
Addressing Staffing Shortages
Q: Beyond access, what other challenges are facing rural healthcare providers?
A: Rural areas often struggle with a shortage of healthcare providers, limited connectivity, and long travel distances. These factors make it difficult to attract and retain qualified medical professionals, leading to longer wait times and limited access to specialized care.
Q: What steps can be taken to address these challenges?
A: Investing in telehealth initiatives, expanding loan repayment programs for healthcare providers willing to practice in rural areas, and supporting community health centers are crucial steps. Additionally, addressing the root causes of healthcare disparities, such as poverty and lack of access to education, is essential.
Erica Li’s insights highlight the urgent need to protect Medicaid and invest in rural healthcare infrastructure. The future of healthcare access for countless Floridians depends on it.
