Are CRNA Only Practices Becoming More Common?

Published on June 16, 2021

There are many reasons why some find it beneficial to have CRNA only practices. Recently a facility in Wisconsin replaced all anesthesiologists with CRNAs. What are the benefits of a CRNA only practice, and do the benefits outweigh the risk?  Is this a turning point for the future of anesthesiologists?  Would CRNAs ever completely replace physician anesthesiologists?  While that scenario is highly unlikely, it is becoming very common, and in fact there are seventeen states that have opted out of the requirement for MD supervision of CRNA anesthetics.  

There are a many reasons CRNAs will play a signficant role in the future of healthcare.  Rural areas of the country are dependent on CRNAs to staff surgery. About one-quarter of the population reside in rural areas of the country.  Although there has been a rise in anesthesiologists it is hard to attact them to these rural parts of the country.  Mid-level providers are often considered a cheaper, cost saving alternative to MD anesthesia care, which is attractive to hospital administrators as well as health plans.  

Future trends will be to try and seek out the cheapest possible anesthesia staffing model to include both CRNAs as well as anesthesiologist.  An example would be a 4:1 ratio of four CRNAs supervised by one MD.  Cases on this model would be more simple in nature.  The more complex procedures, patients of extreme age, or medical comorbidities would be best served by MD anesthesia care.  Therefore while it appears there is a trend towards CRNA only practices, it is apparent in most cases that and MD income can be augmented by supervising multiple surgical suites with multiple CRNAs at the same time.  Physicians have no desire to be rid of CRNAs and personally do only one case at a time by themselves.

Both CRNAs and physician anesthesiologist play a privitol role in the future of healthcare and it is a role played best together.

Kelli Smith

Special Projects Manager