CRNAs are essential for safe and timely anesthesia care in California

OPINION – Certified Registered Nurse Anesthetists (CRNAs) play an indispensable role in California’s health care system, particularly for underserved and rural communities where anesthesia access is critical, yet limited. For decades, California CRNAs have independently provided safe, cost-effective, and patient-centered anesthesia care—a policy reinforced by state statute and upheld by court rulings and regulatory guidance.

California’s independent, collaborative anesthesia model allows physician anesthesiologists and CRNAs to function in an identical capacity in the surgery suite. Both physician anesthesiologists and CRNAs are allowed to independently administer anesthesia care and services in the same way. In practice, this independent model ensures all Californians have access to high-quality anesthesia care no matter the zip code in which they live.

Even though countless studies show CRNAs provide safe and cost-effective anesthesia services comparable to those of physician anesthesiologists, special interests including the California Society of Anesthesiologists continue to push a political agenda to line their pockets and revert California back to a physician supervision model.

Not only is physician supervision an outdated and duplicative staffing model, but it also reduces the amount of anesthesia care available in California. Unfounded allegations about care provided by CRNAs have already led to significant disruptions. In one instance, a Modesto hospital was forced to cancel more than 1,000 surgeries, disproportionately impacting Medi-Cal and Medicare beneficiaries. These cancellations were driven by deliberate misinterpretations of CRNA scope, leaving patients in limbo and creating financial strain on hospitals.

Deliberate misinterpretations at the expense of patients are not only unethical, but short-sighted. California’s population of nearly 40 million is served by more than 5,000 practicing anesthesiologists and 3,000 practicing CRNAs. The only way for California to address a looming staffing crisis is by implementing efficiency-driven practice models that allow CRNAs and physician anesthesiologists to practice independently as their scope supports. Trying to claw back physician supervision – to the financial interest of physician anesthesiologists – will only sideline experienced providers, increase costs, and decrease access to care for Californians in need.

Beyond their technical skills, national board certification, and more than 8 years of training, CRNAs are compassionate advanced practice nurses specialized in anesthesia who consistently deliver patient-centered care that meets rigorous clinical and safety standards. In addition, many CRNAs form long-standing relationships with their patients to foster trust and improve outcomes, highlighted by the fact that, for the 22^nd year in a row, nurses are the most trusted professionals in America. Their 130-year track record and commitment to patients ensures that even Californians in remote areas have timely access to essential procedures and pain management, eliminating the need for long-distance travel. In fact, in four California counties, CRNAs are the sole anesthesia providers.

I must make this abundantly clear – there is no “turf war” between CRNAs and physician anesthesiologists and contrary to CSA’s claims, CRNAs are not on a crusade to “replace” physician anesthesiologists. We call on our physician colleagues to put their patients first, provide anesthesia, and stop the unfounded attacks on our profession.

CRNAs are committed to working alongside physicians to deliver excellent, accessible, and affordable care for all Californians. Effective collaboration between CRNAs and physicians will help address our state’s health care affordability and access challenges while improving patient outcomes. We must foster, support, and expand this collaborative model to allow all providers to practice to their fullest scope; otherwise, we’ll just continue to create barriers to care for vulnerable Californians.

As health care evolves, CRNAs continue to bridge essential gaps by supporting rural hospitals and ensuring safe, timely, and compassionate care statewide. Now is the time to support and strengthen a model that already works – not revert the State back to an unsuccessful, duplicative, and expensive model that was unnecessarily reliant on physician supervision.

Emily Francke CRNA is president of the California Association of Nurse Anesthesiology (CANA).