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State Rep. Gus Blackwell released a video and press release yesterday saying he was “appalled” by a legislative measure sponsored by fellow Republican John Trebilcock that is primarily designed to reduce the number of pain-management treatment providers in rural Oklahoma. His reaction comes two days after conservative blogger Christopher Arps’ post in the Examiner.com titled, “Dear patients: I’m from the government, and I’m here to hurt you!”
It’s hard to imagine a bill worse than the one that killed Sen. Brian Bingman’s chances to succeed Glenn Coffee as senate leader. But the chatter (and laughter) is starting to build about SB 1133, a bill that rolls back the scope of practice for Certified Registered Nurse Anesthetists.
CRNA’s provide the bulk of pain management to rural Oklahomans. CRNA’s are supervised by doctors, and are primarily responsible for pain relief and anesthesia delivery in the 57 counties where no anesthesiologists practice. So is there a problem with CRNA’s? Patient advocates say no: in fact, they point to the fact that no CRNA’s are in trouble with their boards. They don’t want to practice medicine or expand their scope of practice the way optometrists and chiropractors have been doing for the past decade. Read more…
Blackwell further states in the release that he believes the legislation is designed to fix a problem that doesn’t exist.
“For much of the past decade, organized medicine has been telling us the greatest threat to Oklahoma’s patients is expansion of surgical privileges by non-surgeons. They’ve bought ads, issued press releases, raised campaign funds and sounded the alarm bell. Now they suddenly whirl and attack medical providers, CRNAs that legally and safely operate entirely within their scope of practice. This is madness, and I suspect it’s organized and orchestrated for profit or payback.”
Rep. Blackwell says the bill’s hypocrisy is evident with only a cursory examination.
“Not one patient advocate group has come forward asking for this bill. In fact, the patient advocates I’ve talked to are puzzled about why organized medicine has walked away from what they’ve been saying for years is the central threat to patient safety: dangerous expansion of scope of practice by untrained medical professionals.”
Blackwell’s last line is priceless and should be a wake up call for all Oklahomans:
“Now they attack CRNAs: Does that mean they’ve been lying to us for much of the past decade about the primary threat to patients on Oklahoma? Are they lying now? Regardless, this laughable bill and the rogue’s gallery of characters pushing for it guarantee one thing: Jay Leno, David Letterman and Jon Stewart won’t soon run out of material with which to mock Oklahoma anytime soon I’m sad to say.”
Related:
NewsOK.com: Pain management bill draws debate in Oklahoma House
Your Vote Counts: “Debating Health Care in Oklahoma”
7 Comments
1. Tired replies at 7th March 2010, 6:35 pm :
It is really growing wearying watching this sort of thing get introduced at the Capitol year after year — power grabs by one influential group trying to kill or hurt the livelihoods of others.
The OK GOP is no better than the Dems were in doing this sort of thing. How many fatcat anesthesiologists are contributing to fatcat Sen. Clark Jolley’s campaign slush fund? What a disgusting joke Jolley is.
Any true conservative should be absolutely disgusted by this loathsome legislation.
Follow the money.
2. Tired replies at 8th March 2010, 9:25 pm :
Here’s a short summation of why anesthesiologists are worried, feel threatened and have resorted to shady political tricks like SB 1133:
“Looking to the future, an ASA task force anticipates more changes in the next two decades (Miller 2005; Miller and Hannenberg 2005). These include: (1) innovations that will reduce the invasiveness and duration of many surgical procedures and eliminate others; (2) genetic medicine that will identify individual drug responsiveness and anesthetic needs; and (3) information technology and robotics that will transform surgery and make anesthesia equipment self-functioning. The task force raises questions about whether such advanced technology and pharmacology will push anesthesiologists out of operating rooms, given the anticipated greater delegation of procedures to allied health workers. The Chair of the task force warns his peers that, “close examination of current economics and scope of practice indicates that this scene of rapid change is already taking place.””
3. Tired replies at 8th March 2010, 9:26 pm :
Medicare, that wonderful legacy of LBJ’s statist “Great Society,” created the anesthesiologist monster:
“Although Medicare’s rules stipulated that an anesthesiologist did not have to be involved when a CRNA administered anesthesia, they established lucrative compensation if they were (Cromwell 1999). Anesthesiologists could bill directly for their services, but unlike other physicians, their formula factored in their time to protect them from variations in the duration of surgery. If an anesthesiologist “directed” a hospital-employed CRNA, he also could bill Medicare for that case, although he had to reduce the time component of his fee in half. Anesthesiologists who employed CRNAs could bill for their nurses’ work as if they personally administered each procedure. These structural arrangements allowed anesthesiologists to earn far more than they could as solo practitioners. Their average earnings jumped from $39,400 in 1970 (American Medical Association 1977), which was at the low end of physicians’ earnings, to $131,900 in 1982, which was about the same as general surgeons’ earnings, and then to $228,500 in 1992 (Anders 1995). Medicare lifted anesthesiologists to the ranks of the most highly compensated physicians.”
4. Tired replies at 8th March 2010, 9:32 pm :
This has been a decade-long nationwide fight between CRNAs and the ASA:
“All pretense of détente between anesthesiologists and CRNAs ended in December, 1997. As part of a larger initiative to make health care standards evidence-based and outcome-oriented, the government agency that oversees Medicare proposed eliminating the requirement that CRNAs be supervised by a physician to qualify for reimbursement (Centers for Medicare and Medicaid Services 2001a). There were no other federal requirements mandating that physicians overseehe practice of any other state-licensed practitioners. Such decisions have always been left to the states as part of their control of professional licensure and scope-of-practice laws. By changing the supervision requirement from federal to state regulation, CRNAs would be regulated like other advanced practice nurses. In states with no specific regulations requiring supervision or medical direction, CRNAs, who already won the right to bill Medicare directly, would become independent practitioners. The ASA rushed to Washington, D.C. intent on killing the proposal. The degree of the anesthesiologists’ resolve was evident in the size of their war chest. The ASA, whose 35,000 members made up only 5.4 percent of all physicians (American Medical Association 2005), ranked 30 th on Fortune’s list of the most powerful lobbying groups in the capital in 1998 and 92 nd in 1999 (Bettin 1999).Unlike in the first half of the twentieth century, the ASA had the full support of the AMA. The AMA, facing an increasing number of nonphysician health care providers trying to enlarge their scope of practice, viewed the proposal as a bellwether and adopted an official policy to stem such developments (Butler 2000).”
5. Tired replies at 8th March 2010, 9:33 pm :
Priceless:
“When asked to define supervision by American Medical News, a publication of the AMA, the President of AANA said, “We have a range of supervision when it comes to anesthesiologists. Are they in the room? Are they in the hospital? Are they five minutes away? Are they on the golf course?” (Greene 1999). The President of ASA responded, “We are working on a definition of supervision… Immediately available doesn’t mean in the building—it means within five minutes or so. Frequently involved in a case will at a minimum mean being in the operating room every 60 minutes or less. We aren’t going to allow members to say they are on a golf course.””
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7. Tanisha Mills replies at 24th December 2010, 12:15 am :
It is really growing wearying watching this sort of thing get introduced at the Capitol year after year — power grabs by one influential group trying to kill or hurt the livelihoods of others. The OK GOP is no better than the Dems were in doing this sort of thing. How many fatcat anesthesiologists are contributing to fatcat Sen. Clark Jolley’s campaign slush fund? What a disgusting joke Jolley is. Any true conservative should be absolutely disgusted by this loathsome legislation. Follow the money.
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