Rebrand of Nurse Anesthetists Met With Criticism From Physician Group

The professional group representing nurse anesthetists announced that it will be known as the American Association of Nurse Anesthesiology (AANA) going forward. But the name change wasn’t met with approval from all sectors of the medical community.

The AANA — which represents nearly 60,000 certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists — said that its new name is part of a yearlong rebranding effort aimed at advancing the science of nurse anesthesiology and advocating for CRNAs.

“Since its very beginning 150 years ago, the administration of anesthesia by nurses has been essential in caring for patients safely, comfortably, and compassionately,” said AANA President Steven Sertich, CRNA, MAE, JD, Esq, in a statement. “When anesthesia is administered by a nurse, it is recognized as the practice of nursing.”

“Our new name tells the story of who we are, what we do, and what we stand for,” Sertich added. “We have now unified this understanding behind a clear, revitalized brand.”

However, the American Society of Anesthesiologists (ASA) was quick to condemn the rebranding, issuing its own statement that called the name change “misleading.”

Medical title misappropriation remains an ongoing concern in healthcare, and the AANA’s “encouragement of its members’ use of the term ‘nurse anesthesiologist’ [will] confuse patients and create discord in the care setting, ultimately risking patient safety,” they stated.

There is “an unchallenged ethical principle that every patient must have full knowledge and understanding of the education, training, skills and experience of the health care professionals who provide their care. Throughout the medical and nursing communities and certifying boards, ‘anesthesiology’ and ‘anesthesiologist’ are accepted as the terms for a medical specialty and a medical physician,” they continued.

“AANA’s title misappropriation is a deceptive use of established medical terms and is part of their continuing push for nurse-only practice, which can jeopardize our patients’ safety and well-being,” said ASA President Beverly Philip, MD, in the statement. “It also misleads the public and engages in the pretense that nurse anesthetists’ education and training are equivalent to that of physicians.”

Regarding the use of the phrase “nurse-only practice,” the ASA told MedPage Today in an email that it is a reference to an attempt to have nurses fill positions that would normally be held by physician anesthesiologists.

“ASA physician anesthesiologists work every day with nurse anesthetist colleagues,” and our organization’s members “have nothing against nurse anesthetists,” they added. However, “allowing nurses to administer anesthesia without physician supervision does not save patients or taxpayers money.”

“Medicare, Medicaid, and most third-party insurers pay the same fees for anesthesia whether it is administered by a nurse anesthetist or physician anesthesiologist,” they continued. “Independent studies show that eliminating physician anesthesiologists can actually cost more. Other physicians may be needed to consult or provide the services a physician anesthesiologist would, such as assessing pre-existing conditions or handling emergencies and other medical issues before, during, and after medical procedures that could jeopardize a patient’s life and safety.”

In its rebranding announcement, the AANA said, “CRNAs practice in every setting in which anesthesia is delivered,” including serving as the primary providers of anesthesia in rural and medically underserved areas, as well as on battlefields.

“As expert clinicians with specialized skills in advanced airway and ventilator management, advanced hemodynamic monitoring, and advanced patient assessment, CRNAs have expanded the nation’s critical care workforce, particularly during the COVID-19 pandemic,” they added.

In response to the ASA’s condemnation of its name change, the AANA told MedPage Today in an email, “The notion being pushed by the ASA that rebranding and changing the name of the AANA will somehow mislead or harm patients or create discord among providers is absurd at best and false and inflammatory fearmongering at worst. As advanced practice nurses, CRNAs are proud to be part of America’s most trusted profession — they do not equate or present themselves as physicians.”

The association’s new name “accurately and strongly communicates that the AANA represents members of the nursing profession who provide anesthesia and are experts in anesthesiology,” they continued. “Coming at a time when the COVID-19 pandemic is far from over and all hands continue to be needed on deck, the ASA’s fearmongering and baseless accusations are particularly unfortunate.”

The advanced practice group isn’t the only one to undergo a rebrand recently. Earlier this year, the American Academy of PAs (AAPA) voted to change the name of their profession from physician assistant to physician associate.

“The title ‘physician associate’ will position PAs to successfully compete in the ever-changing healthcare marketplace by boosting the profession’s relevance and impact among stakeholder groups, especially patients,” Lisa Gables, CEO of the AAPA, told MedPage Today at the time.