Pending law could allow anesthesiologist assistants to work in Va., bolster health care workforce

Ricky Miller would like to come home to Virginia. 

He’s been in Indiana practicing as a Certified Anesthesiologist Assistant and finished his schooling to do so there because he couldn’t in Virginia. This type of medical worker is involved in placing patients under anesthesia for surgeries. 

The Virginia Beach native’s passion for the work first formed when he was earning his bachelor’s degree at Radford University in Southwest Virginia because it fused his interest in physiology and chemistry. 

Though he’s enjoyed his time in the Midwest, he said he misses his home state with its mountains and beaches. When his grandfather became ill and needed surgery, he longed to be closer to home and more easily able to see family. A bill now under review by Gov. Glenn Youngkin could make it possible for Miller, and other health care professionals like him, to live and work in Virginia.

When hospitals conduct surgery, two key positions other than anesthesiologist doctors can be involved: CAAs — like Miller — or Certified Registered Nurse Anesthetists. 

Both workers have medical knowledge and training specific to anesthesiology; VCU Health’s program for CRNAs, for instance, touts its decade of ranking high in the U.S. World and Report. While CRNAs need doctoral degrees to practice, CAAs can practice in other states with masters degrees, but they are not able to practice in Virginia due to a lack of licensure. 

Senate Bill 882 by Sen. Mamie Locke, D-Hampton, would establish criteria for professionals like Miller to be licensed in Virginia and would direct the Board of Medicine to adopt regulations to govern the practice. 

The workforce is in demand and bolstering it was a recommendation from Virginia’s Joint Commission on Health Care. Locke’s bill cleared the legislature with bipartisan support and now awaits action from Youngkin. 

Between the governor’s expressed support of bringing jobs into the state and his history of supporting licensure bills, advocates for Locke’s bill are hopeful he might sign it. 

“I’m just happy and just really grateful that, you know, it seems to be something I can go back to,” Miller said of Youngkin’s potential to sign the law. 

The Medical Society of Virginia threw their support behind the bill and wrote a letter to Youngkin recently to explain how CAAs operate under the supervision of anesthesiologists to monitor patients before, during and after surgery. 

“By handling routine but critical tasks, including preoperative evaluations, patient monitoring, and postoperative care, anesthesiologist assistants allow physician anesthesiologists to serve more patients, and dedicate more time to high-risk patients, ensuring expert attention is available where it is most needed,” MSV president Joel Bundy wrote in the letter. 

Bundy noted that 20 states, Washington D.C. and Guam license anesthesiologist assistants and that the Joint Commission on Healthcare found the supply of anesthesia providers is not keeping pace with demand. Some factors to increasing demand include aging populations that could require more surgeries, increasing numbers of elective outpatient procedures and more non-operating room procedures that still require someone to be placed under anesthesia.

Virginia Society of Anesthesiologists director Dr. Jeffrey Green concurs. 

“Anesthesiologists are the only medical physician group that doesn’t have multiple choices of advanced practice providers,” he said. “CRNAs are the only ones, and so this would essentially be a second group of advanced practice providers for us to have so that we can extend our reach.” 

For Miller, he said he would come back to Virginia eventually if he would be able to do his job here. While he’s enjoyed Indiana, it’s “a little cold” for him in the winters and he’s appreciated his home state more since leaving it. 

“I just think it’s a great opportunity, not only for people who want to come home to Virginia,” Miller said, “but people who are not even from here to be like ‘this is a good place to practice and good place to live.’”