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The New Hampshire Association of Nurse Anesthetists is now asking the state’s high court to throw out that decision to clear the way for CRNAs to use the term “nurse anesthesiologists.”

“While there is no question about the level of service and professionalism CRNAs bring to anesthesia care, they are not anesthesiologists, in the same way nurses are not physicians,” the brief informs the court in the case, In re Appeal of New Hampshire Association of Nurse Anesthetists. “Allowing the proposed title of ‘nurse anesthesiologist’ would confuse patients and the public about the education and role of CRNAs as well as place an unnecessary burden on patients to decipher whether their health care professionals are physicians or nurses.”

Find out more about the cases in which the AMA Litigation Center is providing assistance and learn about the Litigation Center’s case-selection criteria.

A CRNA’s education and training spans four to six years after high school and includes an average of about 2,000 hours of patient care in their curriculum, the AMA Litigation Center brief tells the court.

An MD or DO anesthesiologist has education and training that spans at least 12 to 14 years after high school and includes 12,000 to 16,000 hours of patient care training in the curriculum—twice the educational years and five times the clinical hours of a CRNA.

And there is a significant difference in the depth of the curricula. As physicians, anesthesiologists complete all courses relevant to practicing medicine, including laboratory courses and courses that give them comprehensive medical knowledge. Anesthesiologists are the professionals expected to medically manage patient care and prevent or respond to complications and complex situations for patients receiving anesthesia.

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“An anesthesiologist has been educated, trained, tested and retested countless times, with years and years of classroom and clinical experience to ensure the development and maintenance of the medical expertise and split-second critical decision-making skills required to address immediate and long-term patient care needs,” the brief says. “CRNAs, on the other hand, are trained to work within the physician-led care team, under physician supervision. … Through an amicus AANA [American Association of Nurse Anesthetists] argues the CRNAs should be viewed as an ‘independent anesthesiology practitioner,’ …. That is simply false.”

Letting CRNAs call themselves “nurse anesthesiologists” would make New Hampshire an outlier in how these professionals can refer to themselves, would confuse patients who are increasingly expected to play a greater role in their health care decision-making and could lead to negative health outcomes, the brief tells the court.

According to a recent AMA Truth in Advertising survey, 70% of patients recognized an anesthesiologist as a physician and 71% responded that a nurse anesthetist was not a physician. Allowing CRNAs to call themselves “nurse anesthesiologists” “muddies the waters” and will further confuse patients the AMA Litigation Center and ASA brief says.

“It is vital that all health care providers use only the titles and descriptors that align with their license, education, training and board certification,” the brief says in it urging the court to find the BOM’s ruling to restrict who can identify themselves as an anesthesiologist proper and lawful.

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