Joshua Smith, MD Board certified in both Anesthesiology and Pain Medicine, Practicing in Greenville, SC

INDEPENDENT PRACTICE FOR NURSE ANESTHETISTS  -  PLEASE OPPOSE

 

Session 123 - (2019-2020)
S 0563 General Bill, By Davis, Scott, M.B. Matthews, Harpootlian
Similar (H 4278)
A BILL TO AMEND SECTION 40-33-20 OF THE 1976 CODE, RELATING TO DEFINITIONS UNDER THE NURSE
PRACTICE ACT, TO PROVIDE THAT ADVANCED PRACTICE REGISTERED NURSES MAY PERFORM SPECIFIC
MEDICAL ACTS PURSUANT TO APPROVED WRITTEN GUIDELINES, TO REMOVE THE SUPERVISION REQUIREMENT
FROM THE DEFINITION OF "APPROVED WRITTEN GUIDELINES" AND CRNA PRACTICE, AND TO PROVIDE THAT A
CRNA MUST HAVE COMPLETED AT LEAST A MASTER'S LEVEL ACCREDITED PROGRAM; TO AMEND SECTION
40-33-34 OF THE 1976 CODE, RELATING TO QUALIFICATIONS FOR THE PERFORMANCE OF MEDICAL ACTS, TO SET
MINIMAL QUALIFICATIONS, TO PROVIDE GUIDELINES FOR ANESTHESIA CARE, AND TO PROVIDE NOTICE
REQUIREMENTS; AND TO REPEAL SECTION 40-47-197 OF THE 1976 CODE, RELATING TO THE SUPERVISION OF
CRNAS.
02/26/19 Senate Introduced and read first time (Senate Journal-page 12)
02/26/19 Senate Referred to Committee on Medical Affairs (Senate Journal-page 12)

Link to the Full Bill

Dr. Kevin Walker, President of the SCSA submitted the following letter to the Members of the General Assembly:
The Honorable Jay Lucas, Speaker of the House

ORGANIZATIONS SUPPORTING MAINTAINING PHYSICIAN SUPERVISION OF NURSE ANESTHETISTS

South Carolina Society of Anesthesiologists                                          
South Carolina Medical Association
South Carolina Chapter of the American College of Surgeons
South Carolina Society of Gastroenterologists
South Carolina Society of Ophthalmologists
South Carolina College of Emergency Physicians                         

South Carolina Academy of Family Physicians
South Carolina Obstetrical & Gynecological Society
South Carolina Society of Plastic Surgeons
South Carolina Orthopaedics Association

South Carolina Association of Anesthesiologist Assistants
Allergy, Asthma and Immunology Society of South Carolina
South Carolina Chapter of the American Academy of Pediatrics
South Carolina Society of Emergency Medicine Physicians
South Carolina Society of Otolaryngology
South Carolina Society of Pathologists
Majority of South Carolinians (Based on survey results conducted by The USC Research Center)

SUPPORT LETTERS

15 South Carolina Physician Specialty Organizations Oppose CRNA Independent Practice
South Carolina Medical Association, Todd Schlesinger, MD, President
March Seabrook, MD, Gastroenterologist and Immediate Past President, SCMA

SC Chapter of the American College of Surgeons, Stephen A. Fann, MD, FACS, President
I was a CRNA and Now I am a Physician Anesthesiologist, Robert Wilson, MD
We Are Anesthesiologists, Sasha Shillcut, MD
Laura Roberts MD, Nurse and then a Physician in the U.S. Navy, President of the SCSA
Former CRNA Recognizes Training Limits, Jane Fitch, MD
The Anesthesia Care Team is Best Model for Both Groups of Anesthetists, Koty Price, CAA, President of the SC-AAA
South Carolina Gastroenterology Society, Gary A. Vukov, MD, President of the SCGA
Linda Mason, M.D., FASA, Past President, American Society of Anesthesiologists
SC Obstetrical & Gynecological Society, Amy Crocket, MD, President
SC Opthalmology Society, C. Blake Myers,MD
Post&Courier Editorial

STATUS IN OTHER STATES WHERE NURSE ANESTHETISTS HAD LEGISLATION INTRODUCED IN 2019 (as of 1/22/2020)

Alabama - DEAD                                                                       
Arkansas - DEAD
Florida - 2 bills - DEAD
New Mexico - DEAD
West Virginia - DEAD

CARRY-OVER STATES WHERE LEGISLATION STILL IN PROCESS

Illinois
New York
North Carolina
Oklahoma
South Carolina*

  • Forty (40) states do NOT allow independent practice for nurse anesthetists. Each state uses terms in statute that are defined by the General Assembly of each state. For example, some states that do not use 'supervision' to describe the relationship between the physician and the nurse anesthetist, use the term 'medical direction' which is defined more narrowly than 'supervision.' Other states that do not use 'supervision' use the term 'physician oversight' and define that substantially similar or more narrowly than 'supervision.'  South Carolina is among 46 states, plus the District of Columbia, that requires a supervisory or oversight relationship with a physician.

STATISTICAL DATA AND SUPPORTING FACTS

PATIENT SAFETY RESEARCH

PATIENT SAFETY POLICY STATEMENTS

Wherever and whenever possible, anesthesia should be provided, led, or overseen by an anesthesiologist (HIGHLY RECOMMENDED). When anesthesia is provided by non-anesthesiologists, these providers should be directed and supervised by anesthesiologists, in accordance with their level of training and skill. World Health Organization

The final rule preserves safe, physician-led anesthesia care in the U.S. Department of Veterans Affairs.  Our Veterans deserve nothing but the safest, highest quality of care – a level of care consistent with the nation’s top hospitals.