Bringing Anesthesiologist Assistants Into the OR in California and off the Sidelines

  • Zakowski, Mark, MD
| Mar 30, 2015

In 1971 an important class of healthcare providers - anesthesiologist assistants (AAs) - was created. AAs were considered necessary to address the need for additional healthcare professionals who work with physicians to safely care for patients undergoing the increasingly complex and technologic practice of anesthesia. Fast forward 44 years and these needs still exist.

Annually in the U.S., more than 100 million operations and procedures are performed with anesthesia. But according to a 2010 RAND report, the U.S. is experiencing a shortage of providers of anesthesia care as many physician anesthesiologists and nurse anesthetists are reaching retirement age and leaving the workforce. This is coupled with an increasing number of people entering the healthcare system and an aging baby boomer population that requires more surgical procedures. In fact, according the American Society of Anesthesiologists Anesthesia Workforce Summary, California has the lowest ratio of anesthesia providers to the general population.

Despite all of this, AAs cannot practice in California today.

Fortunately, Assembly Member Sebastian Ridley-Thomas (D-54) authored Assembly Bill 890 that would permit AAs to practice in California.  AB 890 – the Anesthesiologist Assistant Practice Act – would recognize AAs and allow them to become part of the physician-led, patient-centered Anesthesia Care Team. For updated information on this bill, search for Bill Number '890'.

​AAs currently work safely and effectively alongside nurses and physician anesthesiologists in 17 other states and the District of Columbia. AAs are trained by physician anesthesiologists for the specific purpose of practicing under the direction of a physician anesthesiologist, performing support and monitoring functions that extend the capabilities of a physician. Their role as a member of the anesthesia care team ensures a physician anesthesiologist is directing overall care and is immediately accessible when emergencies arise.

While AAs and nurse anesthetists can be assigned the same care duties, the training and certification process for AAs differs.  In order to become an anesthesiologist assistant, students with a pre-medical undergraduate background and Bachelor’s degree must complete a Master’s-level program which includes a minimum of 2,000 clinical hours.

The American Medical Association, private health insurance companies, and the U.S. federal government all recognize AAs as part of the anesthesia care team. It’s time for California to catch up and allow AAs to assist physician anesthesiologists in meeting patient needs and the growing demand for anesthesia services in our state.

The introduction of AB 890 is a huge milestone for California as AA practice guarantees the patient-centered physician-led care that all patients deserve and expect. AAs promote efficiency and safety in care as the healthcare system works to meet growing demand, and will increase access to and options for providing anesthesia care to California patients. I encourage you to learn more about AAs and the importance of AB 890 on the advocacy page of CSA’s website

Dr. Zakowski is Chair of CSA’s Legislative and Practice Affairs Division.

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