The governor's action significantly impacts "the practice of medicine, [the doctors'] ability to protect their patients and their physician/patient relationships," according to the complaint.
The complaint asks the court to order the governor to withdraw his letter, declare that Schwarzenegger had no authority to submit it, and to "declare that, under California law, a CRNA is not authorized to administer anesthesia, except under the supervision of a physician."
It's unclear whether hospitals are already letting nurse anesthetists work independent of physician supervision. But the lawsuit alleged some hospitals have "already begun to take (that) position."
Hertzka says he would be surprised if nurse anesthetists are working without physician supervision because he doesn't think a medical malpractice company "would insure an unsupervised nurse for medical mishaps in any setting."
The lawsuit added that anesthesiologists and other doctors "are placed in particular peril, and suffer special damage and injury under present circumstances, because physicians have traditionally provided the supervision required by law in most facilities. Relationships between physicians, including but not limited to anesthesiologists, and CRNAs have been jeopardized and made uncertain by the Governor's actions."
Silva speculated that Schwarzenegger may have received pressure to opt out from the California Hospital Association and the California Association of Nurse Anesthetists successfully lobbied him to do so. The nursing group could not be reached for comment.
The California Medical Association represents about 35,000 of approximately 125,000 licensed physicians in the state. The anesthesia physician group has about 4,000 members, according to the lawsuit.