Federal rules allow states an exemption from the required physician supervision of Certified Registered Nurse Anesthetists (CRNAs), provided the governor of the state follows certain procedures for "opting out."
In 2009, Governor Schwarzenegger of California exercised that option, along with 15 other states that now have an opt-out status. The California Medical Association (CMA) and the California Society of Anesthesiologists (CSA) filed a lawsuit to block the decision.
The petition argued that the decision violated California law that requires physician supervision of nurse anesthetists who administer anesthesia during surgeries. The San Francisco Superior Court ruled in favor of the former governor, stating that the governor’s decision was consistent with California law.
The CMA represents more than 35,000 physicians. According to Anesthesiology News, California has the largest number of anesthesiologists in the United States with 5,400 with over 4,000 physician anesthesiologists in the CSA. The CMA and CSA are pursuing an appeal and a writ petition (a special request for immediate relief from the court order).