Some anesthesiologists hope this is the year Tennessee passes legislation to allow Certified Anesthesiologist Assistants to practice in the state.

Assistants are authorized to work in 20 states but not in Tennessee.

Sasi Duggirala, certified anesthesiologist assistant and managing partner at Harmony Anesthesia in Atlanta, a former Tennessean, said the state's shortage of anesthesiologists as well as Certified Registered Nurse Anesthetists delays surgeries. He is advocating for licensure of certified assistants to increase the number of anesthesia providers, saying it would ultimately improve patient care.

"After coming out of COVID, there's been just a huge backlog on necessary procedures and surgeries that need to be done," Duggirala pointed out. "The mid-level anesthetist coming only from CRNA pool is just not enough to fill that gap."

Last year, Senate Bill 453 would have allowed certified assistants to practice in Tennessee but the bill stalled in the House. Some Tennessee Certified Registered Nurse Anesthetists opposed it, claiming the assistants lack the comprehensive training of nurse anesthetists. Backers want to see the bill reintroduced.

David Ryan Diehl, certified anesthesiologist assistant at Diehl Anesthesia in Atlanta, explained his son was born with a congenital disorder requiring prosthetics. The family receives support from the Jordan Thomas Foundation in Nashville. Diehl said new legislation would allow him to practice anesthesiology in Tennessee.

"Legislation needs to be passed that allows us to practice there, to bill insurance, Medicare, Medicaid, all those types of things, and for the groups to be reimbursed," Diehl outlined. "Also for us to be insured there as well, to practice."

Dr. Richard Duncan, orthopedic surgeon and medical director of the Center for Advanced Bone and Joint Surgery at Watauga Orthopedics in Johnson City, Tennessee, pointed out both Certified Registered Nurse Anesthetists and Certified Anesthesiologist Assistants can administer anesthesia during surgeries. He highlighted their extensive training, and suggested Tennessee institutions could offer such training as an additional educational benefit.

"A Certified Anesthesia Assistant is a person that has a bachelor's degree with some prerequisites that they have to have, and testing that they do," Duncan explained. "Once they're admitted into their training, it's 24 to 28 months of didactic training, and then clinical training."

Duncan added the critical shortage of anesthesia providers affects hospitals, surgery centers and patient care across the board.


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The Medicaid and CHIP programs are vital to rural Missouri, according to a report that says reliance on this safety-net health coverage is much higher in small towns than in cities - especially for children.

The Georgetown University report says proposed federal cuts threaten rural communities, where nearly 41% of children rely on Medicaid, compared to 38% in metro areas.

Dr. Shanon Luke, a pediatrician at a Federally Qualified Health Center in rural Missouri, said her clinic is essential to a community where the nearest hospital is 45 minutes away.

"The clinic being open is incredibly important to these kids receiving healthcare," said Luke. "Having Medicaid allows them to come in for their well-child checks, and for us to do some monitoring and treating of things before they get to scary points."

The report says to stay afloat, many rural hospitals have already been forced to close less profitable units. In 2022, 52% eliminated their maternity wards, compared to 36% of urban hospitals.

The report also reveals disparities, with about 40% of American Indian and Alaska Native people more likely to live in non-metro areas without access to adequate healthcare.

Joan Alker is the executive director and co-founder of the Center for Children and Families at Georgetown University. She said Medicaid helps recipients through much-needed preventive care.

"People wind up sicker and then, they're in the emergency room," said Alker, "and children can't get their asthma inhalers and they miss school."

Statistics show Medicaid helps prevent medical debt, covers most nursing home residents, and funds a significant portion of births and maternal care - issues Dr. Luke said her patients are familiar with, firsthand.

"For our families, both financially and medically, as well as mentally," said Luke, "it's really important to know that they have that coverage."

Just over 24% of Missouri's population lives in rural areas.

This month is National Blood Donor Month, and blood donor groups are making sure people know the importance of giving blood.

Blood can't be manufactured, so people need to donate blood at their local blood bank. Nearly 400 people a day donate blood to the American Red Cross in the DMV metro area.

Bethany Bray Patterson, communications director of the National Capital and Greater Chesapeake Region of the American Red Cross, said donor blood is used in a variety of medical situations.

"Donated blood," said Patterson, "goes to people who are heading into surgery, fighting cancer, newborn babies in the NICU and people who are living with sickle cell disease and other chronic illnesses."

Patterson added that someone in the U.S. needs a life-saving blood transfusion every two seconds.

However, only 3% of eligible donors donate each year. According to America's Blood Centers, if just 1% more of Americans donated, blood shortages would be alleviated.

Patterson said the blood supply in the country is stable, but organizations like the Red Cross are also on the look out for universal donors.

"There is an increased need right now for type O blood donation, and platelet donations," said Patterson. "Type O blood is always in demand. It's often going out to hospitals faster than it's coming in through blood donation, because it is the universal blood type. It's used the most by hospitals."

You can find blood donation locations and schedule an appointment at RedCrossblood.org.




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Community Health Centers are stepping up to meet a critical need for dental care across Tennessee.

Dental visits at these clinics have increased by 19% and patient numbers have risen by nearly 16%, underscoring the importance of these services.

Libby Thurman, CEO of the Tennessee Primary Care Association, said the demand has grown, especially as more people have gained dental coverage through TennCare, the state's Medicaid program. Thurman explains TennCare did not cover dental services for adults until recently, although it did cover children.

"In 2023, the state expanded access to dental services under TennCare for adults," Thurman noted. "We have had some challenges keeping up with that demand, and that really stems from just making sure we have enough dentists to serve all of those patients."

In 2023, Community Health Centers in the state provided more than 79,000 dental visits to more than 35,000 patients. Across the state, 24 of the 30 health centers now offer dental health services.

Thurman stressed the importance of having access to dental care, since it is so closely tied to a person's overall health. She added the clinics integrate dental services into their broader mission of providing whole-person care.

"Dental care, aside from just oral health, actually has a lot of links to systemic health," Thurman explained. "It's linked to a lot of chronic disease management - so, if your oral health care is unmanaged, likely your chronic disease could be worsened."

Thurman emphasized Community Health Centers provide care to all, regardless of a person's insurance or income status. They also have a sliding-fee scale, so patients are often able to get dental care at a lower cost than they might find elsewhere.