VOLUME 26, ISSUE 2
THE ARMY OF ANESTHESIOLOGISTS
Across the nation and here in Texas, the practice of anesthesiology is battling regulatory changes driven by political forces. Nurse Anesthetists are fighting for independent practice in state legislatures and in federal programs while combating the expanding use of Anesthesiologist Assistants. Their strategy is legislative, political and media-driven but the TSA has confronted these assaults and built up our defenses.
This year the TSA defended a proposed rule by the Department of State Health Services which would have allowed Medicaid payments to Anesthesiologist Assistants, having approved them as a Medicaid provider in October of last year. The Nurse Anesthetists vigorously attacked this rule by testifying that Anesthesiologist Assistants were less educated, not recognized by the Texas Medical Board, and so few in number as to not warrant this rule. Through this misrepresentation of facts, the Nurse Anesthetists were successful in delaying adoption of the rule. However, the TSA joined forces with the Texas Academy of Anesthesiologist Assistants to educate the members of the Council and to successfully advocate for the passage of this rule.
Winning this battle allows for a greater market for Anesthesiologist Assistants who believe in and support the physician-led team. But, the Nurse Anesthetists’ strategic plan to achieve independent practice has multiple fronts, including propaganda meant to sway legislators to their cause.
In May, the Texas Tribune, an online political news source, published a very nurse-friendly article titled “Nurse Practitioners Looking to Ease Physician Supervision” which was really about how advanced nurse practitioners want to eliminate physician supervision in Medicaid.
Three days later, the Texas Public Policy Foundation hosted a policy forum at the Texas Capitol. Entitled “Let the People In!”, it had an extremely biased panel of three advocates for eliminating all practice restrictions for advanced nurses against our own Rep. John Zerwas, M.D. These propaganda pushes are clearly to gain support and votes from legislators in an upcoming legislative affront.
In order to be successful in the legislative theatre, alliances must already be in place to provide tactical success and both the TSAPAC and the Nurse Anesthetists are trying to gain the advantage during the election cycle. Exactly one year ago, the Texas Association of Nurse Anesthetists started a political action committee of their own and has given donations to legislators, from Representative Donna Howard, R.N. to Representative Sarah Davis, the House champion of both our legislative initiatives last session. They have been block walking for candidates and have even run one of their own for a State Representative seat. But, the TSAPAC has been early, consistent and generous supporters of key legislators and statewide office holders. Receiving advice from in-house and contract lobbyists, the TSAPAC has been able to build these critical relationships to last into the future session.
The practice of Anesthesiology and Physician Led Care in Texas is under imminent attack and the work of the TSA and the TSAPAC to defend Patient Safety is already underway. Make sure to get involved and gear up for the coming battle.
