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Michigan Physicians Speak Out to Protect Patients at House Health Policy Committee

Michigan Physicians Speak Out to Protect Patients at House Health Policy Committee

Physicians are Standing Up to Oppose House Bill 4359, Legislation to Take Doctors Out of Operating Rooms, Away from Patients

Wednesday, March 3, 2021
Physicians with the Michigan State Medical Society and the Michigan Society of Anesthesiologists today are testifying before the Michigan House Health Policy Committee about the importance of putting patients first, and opposed dangerous legislation that would end physician supervision of high-risk medical procedures in operating rooms across the state.

House Bill 4359 would remove physician supervision from doctors’ offices and operating rooms across the state, eliminating the requirement that a physician participate in every anesthetic. Instead, nurse anesthetists would be solely responsible for the entire plan and administration of anesthesia care, including responding to serious problems which may arise during a procedure or when a patient is awakening from the drug induced coma of anesthesia.

“The safest, highest quality anesthesia care is delivered in Michigan through a physician-led anesthesia care team model,” said Doctor Roy Soto, a practicing physician in metro Detroit and the President of the Michigan Society of Anesthesiologists. “It’s a patient-focused approach that’s used in most states across the county. It is a model implemented with a central goal – delivering the highest quality care for patients.”

House Bill 4359 would end the state rule that a physician supervise anesthesia care, eliminate the requirement that physicians participate in high-risk anesthesia procedures, and newly grant opioid prescribing authority to roughly 3,000 mid-level providers without physician supervision. “A physicians’ training and experience enable them to make split-second medical decisions to provide life-saving assistance and treat any number of catastrophic complications which may occur when a patient is under anesthesia,” said Doctor Bobby Mukkamala, President of the Michigan State Medical Society. “Assuring the safety of patients before, during, and after anesthesia requires the broad understanding of medical diagnosis and treatment acquired over many years of training and education. Less training and less experience place our patient’s lives’ in danger.”

Physicians have well over a decade of education and specialized training to evaluate patients before they receive anesthesia or undergo treatments for chronic pain, while nurse anesthetists have as little as 2 years of postgraduate training in anesthetics.

According to a study conducted by the University of Pennsylvania for the Agency for Healthcare Research and Quality, anesthesiologists prevent more than six avoidable deaths for every 1,000 patients who encounter a complication. The study concluded that removing physician supervision from operating rooms threatens patients and could literally cost lives.

House Bill 4359 would force patients, including children, to receive high-risk care from health care professionals with significantly less training, despite the fact that under Medicare and Medicaid and most insurance plans, the fees for nurse anesthetist-provided anesthesia and physician anesthesia care are the same, eliminating any potential for cost savings.

Only 5 states in the nation have enacted similar legislation.

Anesthesia carries significant risks. Every anesthetic, from “light sedation” through general anesthesia – actually a drug-induced coma – requires careful planning and proper administration to see a patient safely through what would otherwise be a painful procedure.

With an aging population and increasingly complex surgical interventions, patient safety means physician supervision of this care is more important than ever.
A physicians’ training and experience enable them to make split-second medical decisions to provide life-saving assistance and treat a number of catastrophic complications which may occur during anesthesia.

Assuring the safety of patients before, during and after anesthesia requires the broad understanding of medical diagnosis and treatment acquired over many years of training and education. Less training and less experience means less safety for patients when emergencies occur.

HB 4359 would also grant opioid prescribing authority to roughly 3,000 new individuals while simultaneously removing physician oversight of that opioid prescribing.
A recent study found nurse practitioners practicing in states with independent prescription authority were 20 times more likely to overprescribe opioids than nurse practitioners practicing under the supervision of a physician.

The House Health Policy Committee was not expected to vote today on the legislation.