Anesthesiology Assistants (AA)

The newest of the three types of anesthesia providers recognized in the United States, AAs have been around for more than 30 years. By comparison, nurse anesthetists have been providing anesthesia care in the United States since the late 1800s; anesthesiologists since the early 1900s.

Despite the fact that they have been in existence for more than a quarter of a century, there are approximately 700 AAs in the country today. More than 36,000 anesthesiologists and 30,000 CRNAs provide more than 99 percent of the nation’s anesthesia care, while AAs provide less than 1 percent and only under the direct supervision of an anesthesiologist. However, anesthesiologists are not required to remain in the operating room with the AA for the duration of a patient’s surgery.

Currently, 11 states and the District of Columbia have adopted medical practice act laws or board of medicine regulations explicitly authorizing AA or PA/AA practice: The states are Alabama, Florida, Georgia, Kentucky, Missouri, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, and Vermont.

There are significant differences in the education, experience, and scope of practice of AAs versus CRNAs and anesthesiologists. AAs are not required to have a healthcare education or background prior to beginning their anesthesia training. CRNAs and anesthesiologists receive a minimum of seven and eight years of education and clinical experience respectively, all directly related to healthcare and anesthesia. In addition, unlike CRNAs, AAs cannot practice unless directly supervised by an anesthesiologist.

CRNAs and anesthesiologists are qualified to provide every type of anesthesia care, including general, regional, and local, while AAs are not. For example, AAs who graduate from the Emory University program in Georgia do not receive clinical instruction in the administration of regional anesthesia.