Reject costly pain-management bill

Health care in the United States is rapidly evolving in a way that has nothing to do with the Affordable Care Act. As patients have grown increasingly concerned about having access to safe, cost-effective health care provided by qualified professionals, they have become increasingly comfortable with the wide variety of credentials qualified professionals may have behind their names. Tennesseans are no different.


And yet, a bill proposed in the Tennessee legislature (SB 1935/HB 1896) would actually prevent many Tennesseans from having access to safe, cost-effective pain management services provided by qualified health-care professionals, namely certified registered nurse anesthetists (CRNAs). How? By requiring a limited group of physicians to provide on-site supervision of pain-management services, a burdensome, expensive and unmanageable restriction that could shut down pain management services in many facilities across the state, especially those in rural and other medically underserved areas.

The Federal Trade Commission has expressed strong concerns over the Tennessee bill, as it has over similar pain management rules and legislation proposed in Alabama and Missouri. The FTC was equally pointed in stating its concerns over the medical community’s attempt to use legislation to monopolize pain management in Tennessee. In the strongly worded letter and accompanying press release dated Oct. 5, 2011, the FTC stated that “Access to pain management services in Tennessee is likely to be compromised by unnecessary limits on the abilities of APNs (advanced practice nurses), CRNAs, doctors, and other health-care professionals to provide those services, with no demonstrable safety benefits.”


The FTC further stated that “Access problems may be especially acute for elderly patients with chronic pain, as well as rural and low-income Tennesseans.” The agency recommended that “Absent evidence of specific safety issues ... the bill be rejected, because it is likely to raise costs and limit access.”


CRNAs are highly qualified anesthesia professionals who safely provide more than 32 million anesthetics to patients each year in the U.S., including for pain management. In Tennessee, nurse anesthetists have been a fixture for more than 100 years. Today, more than 1,800 CRNAs ensure safety and comfort for pain management as well as surgical, obstetrical and trauma stabilization patients across the state, and in rural Tennessee CRNAs are the sole anesthesia providers in 39 of 95 counties.


The Tennessee Association of Nurse Anesthetists (TANA), like the Federal Trade Commission, encourages our state legislators to defeat SB 1935/HB 1896, a bill that would surely be detrimental to hundreds of thousands of pain patients across the state.


The message and the evidence are clear: Tennesseans deserve access to safe, cost-effective health care, and qualified professionals such as CRNAs are part of the solution to meeting the demand.


Mark J. Haffey, CRNA, MSN, APN, chairs the public relations committee for the Tennessee Association of Nurse Anesthetists.