Anesthesiology Practice Issues

There are two competing email campaigns going on right now — one waged by a group of nurse anesthetists and the other by a group of physician anesthesiologists. Samples of the emails appear further below. A pair of bills are pending which would allow trained nurses to administer anesthesia without the supervision of a physician. The nurse group supports the bills, while the physician group opposes them.

Every year there are many bills of this type filed — bills which would expand the practice scope of health care professionals. The elements of the dialog are generally the same — cost/access arguments by the proponents and safety/quality arguments by the opponents. In general, I have a bias in support of expanding practice scope — I mistrust laws which artificially limit competition.

I have not heard debate on these particular bills, so I don’t have a firm position yet, but I do have an incoming view. I think these bills are different from the other practice scope bills. I believe that the administration of anethesia is a very dangerous and delicate procedure which should occur only with the involvement of the most highly trained professionals available. I tend to favor the consistent use of nurse/physician teams for anesthesia.

These bills are not before me in my committee roles, so I don’t have the occasion to delve further into the issue, but if one of them reaches me on the Senate floor, I will give the issue a careful look studying in more depth the available evidence offered by both sides.


Our state is facing new and ongoing challenges in meeting Massachusetts’s health care needs. As a nurse practitioner in your district, I understand the challenges that our community is facing. I also know of a solution, that when enacted, will make a tangible difference in the lives of our neighbors, improve access to care, and help curb healthcare costs. Senate Bill 1079 / House Bill 2009, An Act Improving the Quality of Health Care and Reducing Costs, is that solution. This bill does not change the scope of practice for nurse practitioners in the state. It right-sizes nursing regulations so that individuals who choose to see a nurse practitioner have full and direct access to all the expertise and services that nurse practitioners are prepared to provide. Please vote to move this legislation forward.

There is significant support for the policy changes in SB  1079/HB 2009:

Seventeen states and the District of Columbia already have similar regulatory models for nurse practitioners. Several of these states have used this model of regulation for over two decades with safe, quality care outcomes.

The model of regulation in SB 1079/HB 2009 has been projected to bring an $8.4 billion dollar savings in health care costs over the next 10 years in Massachusetts, according to the 2009 RAND report, “Controlling Health Care Spending in Massachusetts.”

SB 1079/ HB 2009 is consistent with the regulatory model endorsed by the National Council of State Boards of Nursing, and the evidence-based recommendations of the National Academy  of Science’s Institute of Medicine.

Thousands of research studies spanning over forty years have consistently demonstrated the safety, quality, and cost effectiveness of nurse practitioner practice.

Based on the research and financial data, both the National Governors Association and the National Conference of State Legislatures have issued reports encouraging state governments to adopt a regulatory model like SB 1079/HB 2009 as a means to provide safe, quality, and affordable care. Under this model of regulation, nurse practitioners will continue to hold national board certification; maintain ongoing continuing education; and consult, coordinate and refer with the health care  community as part of professional nursing practice.

SB 1079/HB 2009 promotes the flexibility to adopt and create new models of care delivery–such as the patient-centered health care home and integrated care.

Please help patients get full and direct access to care that nurse
practitioners provide. Pass SB 1079/HB 2009 to make health care delivery in Massachusetts more efficient, effective, and accessible. I look forward to hearing back from you. Thank you in advance for your support of this legislation and the 7,000 nurse practitioners across the state.


My name is name deleted I live in community deleted and I am a physician anesthesiologist in Massachusetts. I am emailing you today to encourage you to oppose bill H.2009 and S.1079. I believe these are dangerous bills that would eliminate the statutory provisions requiring nurse anesthetists to practice under the supervision of a physician.

I believe the safe administration of anesthesia requires a collaborative team approach between a nurse anesthetist and a supervising physician. When seconds count, having an anesthesiologist or qualified physician immediately available, working with and overseeing the nurse anesthetist reduces risk and ensures the safe delivery of quality anesthesia care.

I urge you to oppose bill H.2009 and S.1079.

Published by Will Brownsberger

Will Brownsberger is State Senator from the Second Suffolk and Middlesex District.