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MSMS Testifies in Opposition of SB 4359, Scope of Practice

MSMS Testifies in Opposition of SB 4359, Scope of Practice

Thursday, May 20, 2021

On Thursday, May 20, the Senate Health Policy and Human Services Committee heard testimony on House Bill 4359, dangerous legislation which would expand the scope of practice for Certified Registered Nurse Anesthetists (CRNAs). Under the bill, in addition to duties within the scope of practice of nursing, a CRNA would be responsible for the development of a plan of care; performance of all patient assessments, procedures, and monitoring to implement the plan of care or to address patient emergencies that arise; and the selection, ordering, or prescribing and the administration of anesthesia and analgesic agents, including prescription drugs or controlled substances.


S. Bobby Mukkamala, MD provided testimony in opposition of House Bill 4359 on behalf of the Michigan State Medical Society (MSMS).  Doctor Mukkamala shared his personal experiences in the operating room as an otolaryngologist, emphasizing the importance of patient safety.  In his opposing arguments, Doctor Mukkamala also discussed the importance of physician supervision and team-based care, and highlighted the distinct differences in education and training between physicians and CRNAs. The additional training and education that a physician receives is imperative given the many complications that may arise during a procedure.


Doctor Mukkamala also discussed the many peer-reviewed studies that found access to care did not improve, costs of care increased, and quality of care declined in states that expanded the scope of practice for CRNAs.  Proponents of House Bill 4359 have frequently made the claim that 42 states do not have supervision requirements for CRNAs when in fact, only five states, by statute or regulation, authorize nurse anesthetists to practice outside the relationship of a physician.

Rather than taking a one-size-fits-all approach to this issue, MSMS urges the Michigan Senate to instead assess the needs of the small population of underserved areas and consider solutions that do not jeopardize the health and safety of patients across the entire state.