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Doctors say "backdoor maneuvers" revived bill on nurse anesthetists

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The state’s doctors accused a nursing group on Wednesday of using “backdoor maneuvers” to revive legislation granting more autonomy to nurse anesthetists in Oklahoma.

“Though we can’t say we were surprised, we were definitely disappointed to see the Oklahoma Association of Nurse Anesthetists opted for backdoor maneuvers instead of coming to the table to discuss this issue,” said Dr. Larry Bookman, president of the Oklahoma State Medical Association.

Bookman’s statement came a day after a state House committee approved legislation by a vote of 7-3 that would allow nurse anesthetists to work in collaboration with doctors, rather than under their supervision, and to administer anesthesia without a doctor on site.

Jennifer Schmitt, a certified registered nurse anesthetist and president of the Oklahoma Association of Nurse Anesthetists, said she had met with doctors multiple times about the issue. She called the bill a “necessary piece of legislation that 40 other states nationwide and the U.S. military already utilize.”

The next stop for the bill would be the full House.

Rep. Sean Roberts, R-Hominy, who agreed to move the bill through the House committee, said Wednesday there is a chance it won’t be heard by the full House.

However, he thinks House members are open to it “because it's going to help access in rural Oklahoma and there's a lot of doctors who don't want to be a supervisor for a (nurse anesthetist) when it's not their area of specialty."

The legislation easily cleared a Senate committee in February but stalled on the way to the full Senate amid an advertising campaign financed by the state medical association opposing the expansion of nurse autonomy.

Sen. Jason Smalley, R-Stroud, the author of the Senate bill, said last month that Senate GOP leaders wouldn’t give the bill a hearing this year, and he blamed lobbying and “the almighty dollar.”

Smalley persuaded Roberts, the chairman of the House Public Health Committee, to insert the language approved by the Senate committee into an unrelated bill. A provision was added requiring nurse anesthetists to be responsible for their actions and carry the same level of malpractice insurance as physicians.

Roberts said the bill, which is backed by the Oklahoma Farm Bureau and the AARP, would allow hospitals to choose whether they want nurse anesthetists under the supervision of doctors.

“We’re trying to improve access to health care,” Roberts told the committee on Tuesday. “That’s what this bill’s trying to accomplish.”

Bookman, with the state medical association, said Wednesday that “the fact remains that Oklahoma’s patients deserve to have the best care available, which is a team-based approach with a highly trained physician on site.”

Schmitt, with the nurse anesthetist association, said the bill “does not change or remove the physician from the surgery team. Rather it allows for hospitals to choose a collaborative model between surgeons and CRNAs for the best delivery of health care in individual communities.”

Chris Casteel

Chris Casteel began working for The Oklahoman's Norman bureau in 1982 while a student at the University of Oklahoma. Casteel covered the police beat, federal courts and the state Legislature in Oklahoma City. From 1990 through 2016, he was the... Read more ›

Carmen Forman

Carmen Forman covers the state Capitol and governor's office for The Oklahoman. A Norman native and graduate of the University of Oklahoma, she previously covered state politics in Virginia and Arizona before returning to Oklahoma. Read more ›

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