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"...Anesthesiologists of course tend to favor the supervision requirement because they have a financial interest in the same and can also claim the mantel of patient safety, because of their more substantial professional education and experience.

If you ask an anesthesiologists what differentiates his or her service from that of a CRNA, the answer that you are likely to get is that “I am a physician.” That is of course empirically true. There are occasions when having a physician capable of making medical decisions available to assist the surgeon in an emergency is a net plus. The problem is that in the overwhelming number of cases having both a “belt and suspenders” is an expensive luxury.

The delivery of anesthesia is a technical service. Over time the technical expertise in delivering the service is about the same as between physicians and nurses and frankly in some cases nurses do it better, particularly in the delivery of epidurals during delivery.

It is also true that anesthesiologists, although they are physicians, tend to get a little rusty in the medical department because they are delivering a technical service and to some extent operate in a routine that does not call upon their medical expertise margin as physicians, thus reducing the benefit of that superior education as a practical matter...".

Holland & Hart Healthcare Lawblog "The Great Nurse Anesthetist "Opt Out" Debate.