Anesthesiologist title protection bill advances to final Senate committee

A Senate bill that would reserve the title “anesthesiologist” to medical doctors and specified assistants cleared its second committee Thursday.

The Appropriations Subcommittee on Health and Human Services passed the proposal (SB 1142), brought by Lee County Republican Sen. Ray Rodrigues, with a unanimous vote. 

The bill would prohibit health care practitioners from making “misleading, deceptive or fraudulent representations” regarding their specialty designation. Specifically, the bill prohibits a health care practitioner from using the designated titles “dermatologist” unless they are a licensed physician or the title “anesthesiologist” unless they are a licensed physician or an anesthesiologist assistant, who works under the direction of a licensed anesthesiologist.

Under the bill, an unlicensed individual may be subject to administrative action or criminal penalties if they imply they’re a licensed medical professional, as enforced by the Florida Department of Health. 

The measure seeks to address the growing trend of certified registered nurse anesthetist (CRNAs) calling themselves “nurse anesthesiologists,” which physicians believe is misleading and confusing for patients. In Florida, CRNAs are allowed to administer anesthesia under the supervision of a physician or a dentist, not necessarily an anesthesiologist. 

But, under the bill, CRNAs would not be allowed to refer to themselves as “nurse anesthesiologists.”

The Florida Osteopathic Medical Association, the Florida Academy of Anesthesiologist Assistants, the Florida Dental Association and the Florida Society of Anesthesiologists expressed support for the bill. The Florida Association of Nurse Anesthetists opposed it. 

“This bill is not a scope of practice bill. What this bill is, is a patient education bill, so that the patient can make an informed decision knowing who they are seeing,” said Chris Nuland, representing the Florida Society of Plastic Surgeons and the Florida Society of Dermatology. “This is about empowering the patient, and we ask for your support on this fine bill.”

The Senate bill has had a lot more support than its House counterpart, having cleared its first two committees by unanimous votes and without much debate. The House proposal (HB 721), brought by Beverly Hills Republican Rep. Ralph Massullo, has not had the same luxury, receiving criticism from a handful of Democrats and sparking debate in its first committee meeting.

Those who oppose the measure say is does not address the issue it was drafted to solve. Orange County Democratic Rep. Carlos Guillermo Smith, attempted to rectify this criticism by bringing forth an amendment in the bill’s first House committee, which sought to provide a similar protection for the title of CRNAs.

The amendment, which ultimately failed in a 5-10 vote, would require the title “anesthetist” be reserved for CRNAs. Smith said this amendment would rectify the problem that originally brought the bill forward by allocating a clear title for CRNAs, since they can no longer be called “nurse anesthesiologists” under the legislation. 

Massullo countered Smith’s amendment, arguing that it was not within the scope of the bill, which was crafted to address physician titles.

After the failure of the amendment, more questions were brought up about the bill’s constitutionality, which is discussed in the legislation’s analysis.

According to the analysis, the bill’s requirement for DOH to enter an order imposing penalties if a person does not immediately comply with an emergency cease and desist order may interfere with due process — an issue highlighted by Pinellas County Democratic Rep. Michele Rayner, who ultimately voted in favor of the bill in the House committee.

Both the Senate and House bills have one remaining committee before they can be heard on the floor.