Ep 47: How Legal Cases Have Shaped the CRNA Industry

We were on location at the North Carolina Association of Nurse Anesthetists and wanted to get a historical perspective on CRNAs. With the help of past AANA presidents Sandy Ouellette and Nancy Maree, we take a look back at the important battles fought and won by nurse anesthetists through the years that help shape the way our industry operates today.

On This Episode:

As we often talk about on this podcast, CRNAs are standing on the shoulders of giants when it comes to our profession. Many people have put in hard work, effort, and time to get the field to where it is today. That includes a number of legal battles that have taken place over the last century.

As the years pass, the memories fade and we forget about those people and those battles. We’re going to take time on this episode of the Beyond the Mask Podcast to look back through the history of nurse anesthetists with Sandra Ouellette and Nancy Maree. The two former AANA presidents have seen the fights first-hand and understand the challenges that CRNAs still face.

Check it out at the top of the page and use the timestamps to help you navigate through the many topics we discussed.


Past Legal Cases

We begin the episode by taking a look back through the legal cases that have shaped nurse anesthesia. The Frank vs South decision dates back more than one hundred years ago but was the first time the practice was recognized as a nursing specialty.

Then there’s the case case involving Dagmar Nelson, where a group of physicians brought an injunction against her for illegally practicing medicine without a license.

The other important milestone came in 1986 when Congress passed legislation for direct reimbursement rights.

1:51 – Two popular guests, Nancy Marie and Sandy Ouellette, join the show.

2:37 – Sandy highlights some of the past challenges that will help CRNA’s unite and fight future issues.

3:12 – Background on Frank vs South and why that decision is still important today.

5:04 – The next important case involved Dagmar Nelson in the 1930s.

6:34 – The road to reimbursement was a 7-year process in the 1980s.  


ANA Plays a Strong Role in Growth

After the direct reimbursement decision, the industry was still struggling. More than 60 programs closed and student enrollment dropped significantly. But the American Nurses Association stepped in and helped rejuvenate the industry.  

7:50 – How the ANA helped turn around the industry when it began dying out in late 80s.

9:25 – The ongoing issue of federal supervision of nurse anesthetists in Medicare. Why we need to remove it and what role states are playing.  


Antitrust Fights

Antitrust issues are still a battle that we have to fight and the ANA knows that. They’ve a lot of support behind these fights to protect nurse anesthetists.

13:31 – ANA threw their support behind antitrust cases.

18:06 – Antitrust fights still go on today.

19:24 – Nancy explains the antitrust and fraud case against Twin City Hospitals in 2004 and what came from it.

23:42 – What role has the ASA played in all of the challenges and crises the industry has faced?

26:30 – The recent Anesthesia Care Team statement and why many believe it’s restrictive.


Membership is Vital

Despite the successes and progress we’ve made over time, there’s still a long way to go. Nurse anesthetists are vital to our health industry and the ANA will continue to fight for our best interests. To keep doing so, everyone needs to consider becoming a member and do their part. That’s a priority for Sandy and Nancy, but it’s also important to recognize the needs of members along the way.

29:13 – What can ANA members do today to help the association succeed and remain strong moving forward?

30:36 – Why membership is so important for ANA.

32:24 – New students and new graduates seem to be the biggest hole in membership.

36:20 – Can the ANA be listening to members better? Here are issues they have spoken out on.

40:24 – Jeremy’s perspective as an outside on the membership issue.

44:11 – Final thoughts from Sandy on why it’s such a great time to be a CRNA.  

Thanks for listening to another episode of Beyond the Mask Podcast. Join us on Facebook to continue the discussion.

“So why was ANA formed? Because individually we have no power. Without our big ANA family, we have no protection. We need strength in numbers and that’s why we formed.”

-Sandy Ouellette, Former AANA President







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J. Cross CRNA
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This podcast is very well put together. I love the hosts Sharon & Jeremy, they do a fantastic job at presenting topics as well as getting great speakers on the show! This is my morning commute podcast everyday! Thank you for all that you do!
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I enjoy listening every morning. Great content and always a pleasure to learn something new.
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I started listening to this podcast religiously early on in my CRNA journey, a year before applying to CRNA school. The content in this podcast was one of my most helpful resources for getting into my first choice school, Wake Forest! It has also been a huge motivator for getting involved with the AANA now and throughout my career. I highly recommend this podcast to every prospective CRNA I meet.
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I appreciate hearing the latest and greatest in the world of Nurse Anesthesiology while also getting Class B credits. Just listen on your commute for a win/win experience. I love the perspectives from Jeremy and Sharon who both ask varied and insightful questions!
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If you’re a CRNA or any medical professional, I highly recommend giving this podcast a listen. Hosts have a great rapport.