Statement on Anesthesiologist Assistant Practice

November 3, 2023

The Florida Society of Anesthesiologists would like to clarify several misconceptions concerning the practice of Certified Anesthesiologist Assistants (CAAs) in the state of Florida:

1. Declaratory Statements (DS) from the Florida Board of Medicine (BOM) apply only to the petitioner asking the question and their unique fact set and do not reset, supersede, or create new state law.
2. The DS from 2017 (In Re Richard L. Henry, M.D., 2017, Florida Board of Medicine) states that the petitioner, Richard Henry, MD, could supervise a CAA performing a regional anesthetic if Dr. Henry was in the same room. The DS is not necessarily applicable to every anesthesia practice in the state, others of which may have a different fact set.
3. Each anesthesia practice can (and should) interpret the statute independently of the 2017 DS, to determine if the anesthesiologist need not be in the same room as the CAA performing the spinal, epidural, or regional anesthetic. 
4. The CAA statute(F.S. 458.3475) states that an acceptable standard for the supervising anesthesiologist is that they must be “immediately available”.  The law is clear in that there is no statutory “same room” requirement.
5. Per the American Society of Anesthesiologists¹, “a medically directing anesthesiologist is immediately available if s/he is in physical proximity that allows the anesthesiologist to return to re-establish direct contact with the patient to meet medical needs and address any urgent or emergent clinical problems.”
6. The BOM never ruled, let alone rejected or voted down, a definition of a “suite”.  A 2015 proposal to clarify the term “suite” was never placed before the BOM for its consideration.
7. The individual facility and anesthesia group can (and should) define what constitutes a “suite” around their unique fact set and practice circumstances. “Suite” should not be interpreted as a solitary operating, procedural, or labor room.
8. CAAs (Rule 64B8-31.005) may personally perform – not passively stand by or merely assist – every clinical act delegated to them under their Protocol submitted to the BOM and must do so under the supervision of an anesthesiologist.

Christopher L. Nuland, Esq

General Counsel

Florida Society of Anesthesiologists

References            

  ¹ American Society of Anesthesiology 2019; American Society of Anesthesiology Statement on Definition of ʺImmediately Availableʺ When Medically Directing, accessed Oct.18, 2023; https://www.asahq.org/standards-and-practice-parameters/statement-on-definition-of-immediately-available-when-medically-directing