In April 2000, the Ohio Attorney General issued an opinion stating that the administration of anesthesia was considered to be the practice of medicine and could not be delegated to a person who was not authorized by law to administer anesthesia. AAs then approached the Ohio Legislature to codify their scope of practice and certification. The legislature subsequently did so. The new law permits AAs to "assist the supervising anesthesiologist with the implementation of medically accepted monitoring techniques" and also permits AAs to "assist the supervising anesthesiologist with the performance of epidural anesthetic procedures and spinal anesthetic procedures." On May 14, 2003, the Ohio State Medical Board voted to enact an Administrative Code. The regulation appeared to prohibit what the state statue provided.
Arguing that the rule was in direct conflict with the statute, an AA practicing in Cleveland, filed suit against the Ohio State Medical Board demanding a declaration that the rule conflicted with the statute and was therefore invalid. On June 11, 2003, Judge Fais granted a temporary restraining order prohibiting the Medical Board from enforcing the rule until a hearing on the merits could be held. On November 11, 2003, the parties each submitted motions. On July 26, 2004, the Ohio Court of Common Pleas invalidated a regulation prohibiting anesthesiologist assistants ("AAs") from performing epidural and spinal anesthetic procedures and implementing medically accepted monitoring techniques. In his decision, Judge David Fais held that such regulation was in clear conflict with the permissible practices granted to AAs by the Ohio Legislature. On Aug. 18, 2004 the Medical Board filed its Notice of Appeal stating that the trial court erroneously ruled that the rule conflicted with the statute. Briefings will proceed over the next several months. See the Sept/Oct. issue of the Cleveland Physician for more specific information on this case and issue. The AMC/NOMA actively supports the supervised practice of anesthesiologist assistants (AA's). We have worked with both AA's and physicians in our area of the state to assure that AA's are licensed and brought under the jurisdiction of the Ohio State Medical Board. The AMC/NOMA leadership provided testimony at both the Ohio legislature and the State Medical Board referable to this matter.