2010 AANA Annual Meeting- President’s Report

Greetings VANA members, I am writing this report as your new president and I am honored to be able to serve all VANA members during this interesting and exciting time for CRNAs. First, I would like to congratulate all of you as Vermont came in second place in the AANA Foundation State Challenge.  The funds donated by you were instrumental in funding education and research by the AANA Foundation.  Without those funds, we would not have the new evidence that CRNAs are high quality, cost efficient anesthesia providers.  So, thank you very much for your contributions and perhaps we can come reach first place next year. The AANA 2010 Annual Meeting in Seattle was one of the best AANA meetings I have attended.  Besides the usual pomp and circumstance, CEU lectures and networking, the recent peer reviewed articles that are now circulating in various national publications are electrifying the anesthesia community.  By now all of you should be aware of the articles titled: “No Harm When Nurse Anesthetists Work Without Supervision By Physicians” and “Cost Effectiveness Analysis of Anesthesia Providers”. These two articles are causing quite a stir in that we finally have documentation of what we already knew as practicing CRNAs; that CRNAs give high quality, safe anesthesia care in the most cost efficient manner and are important players in today’s effort to reform health care delivery. I realize that many of you may be thinking that this has no bearing on your current practice, however in the vast majority of rural areas of the United States, this has a major impact on access to anesthesia care. The “No Harm” study analyzed Medicare data from 1999-2005 in the 14 states that underwent the opt-out process (there are now 15 states) and found no evidence that opting out of physician supervision resulted in any increase in inpatient deaths or complications.  This evidence reinforces the long held notion by CRNAs that physician supervision of our practice in unnecessary and contrary to good public policy.  Based on the current findings, the authors recommend that CMS allow CRNAs in every state to practice without supervision of a surgeon or anesthesiologist. The “Cost Effectiveness Analysis of Anesthesia Providers” published in Nursing Economics in the May-June issue, indicated that CRNAS are, not only less costly to train than anesthesiologists, but provide anesthesia more cost efficiently.  This includes providing anesthesia for complicated procedures such as open heart, organ transplant and pediatric procedures.  This comes as no surprise to me since I, and I’m sure many of you, were involved in training anesthesiology residents rotating through these specialties.  This is especially true for military educated CRNAs serving in our large military training hospitals. While these research articles do not make policy, they will be instrumental in forming future policy at the federal level.  Without a doubt, there will be heated debate by those who desire to control our practice, however those who oppose will argue with emotions and not with scientific evidence. As I begin my term of two years, I am also hoping that VANA will continue to become a strong state association.  The fact that so many of you have donated to the AANA Foundation demonstrates the commitment of Vermont’s CRNAs.  However, we should not forget that the AANA, as our national organization, is only as good as the members who make up the organization.  While some national policies have been very controversial in past administrations, I have witnessed a significant improvement in our national leaders.  Now, more than ever, it is important for each and every VANA member to commit their time and money to support the organization that is responsible for CRNAs being able to practice in the manner we are accustomed to.  I urge every member to get involved in learning about the issues that face our colleagues in other states that could, depending on outcome, affect our practice here in Vermont.  And I urge those of you who have decided not to remain members of AANA to take another look and the work being done to preserve our profession and renew your membership. I welcome comments and suggestions on any issue that may affect your practice.  As a member of the AANA Anesthesia Policy and Payment Advisory Panel, I will continue to work hard for all of our members and especially for us in Vermont. I hope to see many new faces at our upcoming meetings over the next two years.  I am convinced that a strong association is key to preserving the profession we have all chosen. Mark Green, CRNA, MSN President Vermont Association of Nurse Anesthetists

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