Editors Note: There’s a battle playing out in the halls of the Florida Capitol right now over who should be allowed to administer anesthesia during surgery – physician anesthesiologists or Certified Registered Nurse Anesthetists (CRNAs). Doctors argue that CRNAs need physician oversight to ensure patient safety, while CRNAs say they are just as qualified to work independently—and that restrictive rules only drive up costs and limit access to care. The following rebuttal makes the case for more CRNA autonomy, and is published in direct response to an opinion column that appeared last month in The Capitolist.

Grant Van Meter

Last month, medical special interest groups working to protect the current status quo drafted and published a piece under the byline of Dr. Asha Padmanabhan, which cast Certified Registered Nurse Anesthetists (CRNAs) as “velociraptors”—the ingenious yet terrifying dinosaurs made famous in the movie Jurassic Park, arguing that their human counterparts require the cage of physician oversight to safeguard patients.

In her view, expanding their scope of practice is a sequel destined for disaster, jeopardizing safety and rural access without cutting costs. But this narrative twists the truth. CRNAs aren’t the threat—they’re the breakthrough, ready to escape outdated restraints and prove their value, while the real “bad guys” cling to a system that profits from CRNA containment.

Who are the real villains? Look to the physician lobby—like the Florida Society of Anesthesiologists (FSA) and American Society of Anesthesiologists, who funded the FAU study Dr. Padmanabhan leans on. Their stake isn’t patient welfare; it’s preserving a model where physician anesthesiologists, costing hospitals twice as much to employ as CRNAs, maintain control. She dodges the real cost issue, noting billing rates don’t shift regardless of provider.

That’s a smokescreen. CRNAs don’t just save on salaries—they generate revenue by actively performing cases, not idly “supervising” from the sidelines. Every case a CRNA handles is money in the bank for hospitals, unlike oversight that drains resources without adding value. That’s not a risk; it’s a financial lifeline.

These so-called “velociraptors” – CRNAs – don’t need cages; they’ve earned their freedom. The most rigorous studies shred the FSA’s claims. The 2010 Health Affairs Medicare study analyzed nearly 500,000 cases and found no difference in patient safety or mortality rates between CRNAs and physician anesthesiologists. The 2014 Cochrane Review, pitting physician-led against CRNA-led anesthesia, found the same: no significant outcome gaps. Dr. Padmanabhan’s uncited fears of complications? Baseless. Rural access? The 2019 RAND Corporation study showed that states with less restrictive CRNA rules and Medicare opt-out policies—25 as of now, like Montana and Iowa—have more CRNAs, especially in rural areas, enhancing anesthesia access without compromising safety. Florida’s nurse shortage doesn’t sink the idea of CRNA independence; it begs for it.

Dr. Padmanabhan props her argument on one physician-funded study, ignoring the robust data from 25 opt-out states where CRNA autonomy thrives. She warns of costly chaos, but the facts say otherwise: CRNAs deliver equal quality while driving revenue. The real waste is the status quo—paying double for physicians to supervise instead of perform. I say let the “velociraptors” run free. They’re not here to ravage; they’re here to boost hospital bottom lines and patient care. The only thing threatened is the profit of those holding the leash.

Grant Van Meter is a Certified Registered Nurse Anesthetist with a Master of Science in Nurse Anesthesia from Southern Illinois University Edwardsville in 2008. He has deep family ties to Florida and is working on his doctoral thesis at SIUE. He is board certified in Non-Surgical Pain Management and has extensive experience providing anesthesia and pain management services to rural communities.