Florida shouldn’t gamble with patient safety on false promises

Florida lawmakers are once again being asked to expand unsupervised anesthesia practice, this time under the familiar banner of “access,” “cost savings,” and “modernization.” We are told this is inevitable — that “48 states already have similar laws,” and Florida is simply behind the curve.

That claim collapses under even minimal scrutiny.

Let’s be clear about what is being proposed: allowing Certified Registered Nurse Anesthetists to practice independently, without physician anesthesiologist supervision, in all settings. This is not a minor regulatory tweak. It is a fundamental change in how anesthesia care — one of the riskiest aspects of modern medicine — is delivered.

If lawmakers want to make policy based on evidence rather than talking points, three facts matter most.

Physician-led anesthesia care is the safest model.

Anesthesia is not just about “putting patients to sleep.” It involves managing complex physiology, responding to sudden, life-threatening emergencies, and caring for patients with multiple comorbidities — often when things go wrong quickly. Physicians who practice anesthesiology complete four years of medical school, four years of residency, and often additional fellowship training. That depth of training matters when seconds count.

The safest anesthesia outcomes consistently occur in physician-led teams, where anesthesiologists work alongside Certified Registered Nurse Anesthetists. Team-based care maximizes patient safety by matching expertise to the complexity of each patient’s care. Eliminating physician oversight does not improve safety; it removes a critical layer of protection.

Florida should be strengthening team-based care — not dismantling it.

Unsupervised anesthesia is not more cost-effective.

Proponents often claim that removing physician supervision lowers costs. The data do not support this. Medicare pays the same for anesthesia services regardless of whether a physician anesthesiologist is involved. Further, having an anesthesiologist present to manage complications helps control costs by reducing hospital stays and downstream medical expenses.

The cheapest anesthesia is the one that goes right the first time — and the safest model is also the most cost-effective in the long run.

These laws do not help rural communities.

This is where rhetoric diverges most sharply from reality. State “opt-out” laws allowing unsupervised anesthesia have been studied for more than a decade. The conclusion is consistent: they do not increase access to anesthesia services in rural or underserved areas.

Certified Registered Nurse Anesthetists, like all health care professionals, tend to practice where hospitals are well-resourced and professionally supportive. Opt-out states did not see a meaningful expansion of anesthesia services in rural hospitals. Workforce shortages remained unchanged.

If unsupervised practice were the solution, rural access problems would already be solved. They are not.

Supporters now claim that nearly every state has “similar” laws — a creative redefinition that lumps together wildly different regulatory frameworks. Supervised practice, delegated authority, limited opt-outs, and emergency exceptions are being counted as “unsupervised care.” Florida should not make major patient-safety decisions based on inflated numbers and fuzzy definitions.

This proposal is not about modernization. It is not about rural access. And it is not about saving money. It is about replacing the safest, most cost-effective anesthesia model with one that offers no proven benefit — and real risk.

Florida’s patients deserve policies grounded in evidence, not exaggeration. Lawmakers should reject unsupervised anesthesia and instead invest in physician-led, team-based care that puts safety first — every time.

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Rebekah Bernard, M.D., is a family physician in Fort Myers and a Board member of Physicians for Patient Protection.