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Your rationales are laughable. As a CRNA, I take care of all the patients and more both in a Trauma center and a less intense setting. The facts are simple, after 4pm I become significantly more intelligent and capable. I can attend and run a trauma while my MDA is sleeping comfortably in his bed, I can triage the OB patient with Pre-ecclampsia and determine the best method of anesthesia for a safe delivery as long as I "call" my MDA, again in the call room, to clear it with him\her. I can teach the new residents because it's too tedious for the seasoned MDA. I have done the bowel resection on the 29 week 650gram neonate, as well as the same bowel resection on the 98 year old nursing home patient with free air in the stomach. I, as well as all CRNA's provide this care every day in every setting and do it extremely well, otherwise the MDA would not be able to "safely" supervise 4 rooms while talking on their cell phone and eating a bagel. Anesthesia is safer today than 20 years ago, because someone is supervising????? NO it's due to the superb care being given every day in every room that a CRNA as well as the MDA who sits on the stool, provides. Quality care is in the minute to minute details, not in the signature of supervision.

More importantly, its CRNAs on the FRONT LINE in our Military, in the WAR ZONES who provide all of the direct trauma care to our wounded soldiers. Where is the need for MDA supervision in Iraq or Afganistan??? There are NO MDAs sitting on the front line MASH units with our soldiers, and there are NONE demanding a supervision requirement. They are very content in the green zone hospitals. That shoudl send up the red flag for sure.

Lastly, NJ is the only state to require anesthesiologist supervision, or anesthesiologist job protection. If anesthesia was safer with an MDA, or if CRNAs where unqualified to practice the data would be clear and indisputable. Patients in NJ are not safer, the data is no better, and the care is no greater in NJ than it is in RI, NY, AZ, IL, or any other state. BUT, the availability of care, as the amount of insured patients grow will definitly decrease if there are not enough qualified providers available.

The bashing of providers is unacceptable and unprofessional. If you look around at all states in the nation, if you look in the ORs around this state as well as the country you will see patients receiving high quality care every day. You will see 1 provider at the head of the bed for 98% of the case and in a majority of the cases that person will be a CRNA. The numbers and data don't lie.