State Lawmaker Takes Aim At Health Care Titles

Oct 10, 2019

A Republican lawmaker wants to crack down on the titles that health care providers use when they identify themselves to the public.

Rep. Ralph Massullo, a dermatologist from Lecanto, has filed a bill for the 2020 legislative session that would change state law and allow health-care licensing boards to take disciplinary action against providers who are not physicians but use monikers that could imply they are, such as “anesthesiologist.” 

The bill (HB 309) comes on the heels of a unanimous decision by the Florida Board of Nursing in August to allow John McDonough, an advanced practice registered nurse, to identify himself as a “nurse anesthesiologist” without facing repercussions.

The News Service of Florida obtained a copy of the Board of Nursing’s Sept. 13 final order, which notes that nothing in law indicates that the term anesthesiologist is “protected and requires licensure from either of the two medical boards,” referring to the Board of Medicine and the Board of Osteopathic Medicine.

Massullo’s bill, however, would amend health-care professional licensure laws to define anesthesiologists as allopathic or osteopathic physicians who have completed anesthesiology training programs.

McDonough told the News Service of Florida in August that he is moving, in part, to describe himself as a nurse anesthesiologist as a reaction to anesthesiologist assistants using the term “anesthetists,”  which he contends has long been associated with advanced practice nurses who specialize in the administration of anesthesia. The American Academy of Anesthesiologist Assistants refers to its providers as “anesthetists” in its 2019 mission statement.

McDonough noted that anesthesiologist assistants must work under the direct supervision of anesthesiologists, while certified registered nurse anesthetists, like him, are only required to work under the direct supervision of doctors.

Moreover, McDonough said dentists, who are not medical doctors, have been identifying themselves as dental anesthesiologists. Even some anesthesiologists, he said, now identify themselves as physician anesthesiologists.

In a time when providers are trying to distinguish their identity, he said, it “doesn’t make any sense” not to identify his profession as “nurse anesthesiologists.”

While the final order from the Board of Nursing would only apply to McDonough, who also is a professor and director of the nurse anesthesiology program at the University of North Florida, other certified registered nurse anesthetists will follow suit, said Jacksonville health-care attorney Chris Nuland.

Nuland represents the Florida Society of Anesthesiologists, which tried to speak against McDonough’s request at the August Board of Nursing meeting but was denied standing.

Nuland said in a statement to the News Service that the anesthesiologist group is considering its legal options.

“But HB 309 is certainly a legislative response to the McDonough decision. It is imperative that patients have confidence in and understand the credentials of their health care providers," Nuland said.

In addition to banning them from using the term anesthesiologist, the bill also would make clear that non-physicians are not allowed to identify themselves as a physician, surgeon, medical doctor, doctor of osteopathy, M.D, cardiologist, dermatologist, endocrinologist, and many other doctor monikers.

The bill also would amend the law to make clear non-physicians are banned from using “any other words, letters, abbreviations, or insignia indicating or implying” that they are licensed allopathic or osteopathic physicians.