TSA Advocacy

The Texas Society of Anesthesiologists is a state component of the American Society of Anesthesiologists representing over 3,700 physician anesthesiologists, residents, medical students and anesthesiologist assistants in Texas practicing the medical specialty of anesthesiology. Our physicians have a minimum of 8 years of medical education and many continue to a 1-2-year post-residency fellowship to specialize in pediatrics, cardiac anesthesia, critical care or pain medicine. They have over 15,000 hours of clinical training and are your critical care physician during the entire surgical or procedural event, responsible for all aspects of your care, pain management and your safety and survival.

Note: All documents are pdf files


There are physicians, doctors, and mid-level providers who assist with your anesthesia care. In Texas, a non-physician must practice under the delegation and supervision of a physician. If you're confused by the mix of initials after a health care provider's name, what their training is and who regulates them, you can view this paper which we've created as a general guide. In anesthesia, there are three providers – physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. Nurse anesthetists and anesthesiologist assistants practice interchangeably at the delegatory authority of a physician anesthesiologist and while nurse anestheticists may practice under the delegatory authority of another physician, the physician remains responsible for the medical management of the patient and for all delegated acts within the physician-led care team.



Physician anesthesiologists work in hospitals but are not employees of the hospital as that would be a violation of Texas' Corporate Practice of Medicine law which protects patients from having a corporate board room dictate our medical decisions for better profits. Our clinical groups contract with hospitals to provide coverage (sometimes with one group providing exclusive coverage and other times with multiple groups in one hospital) and the anesthesia groups contract with insurance carriers separately from the hospital for payment rates and in-network status. If an insurance carrier does not have an adequate network of physicians in their in-network hospital (so called 'narrow' networks or no network due to poor payment or no negotiation), a coverage gap may result with the patient receiving a bill for our services as out-of-network. While we do everything we can to avoid this, accurate network directories, better disclosure of carrier's cost shifting onto patients, and better network adequacy enforcement by the Texas Department of Insurance (TDI) is urgently needed. The TDI can fine insurance carriers if they do not meet these needs. PAPERS ON INSURANCE ISSUES


While our members who provide pain management are represented by the Texas Pain Society, pain management is at the heart of our medical specialty. As such we support strategies to address the Opioid Crisis and believe government should be careful of unintended consequences on legitimate chronic pain patients when crafting legislation to address abuse of prescription medications. We further believe that pharmacists who play an important role in denying suspicious prescriptions, are illegally practicing medicine.


Legislative Scorecard


Texas Legislative Scorecard


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On our Member Advocacy Page you can find information about legislation, elected officials, and our Legislative Action Alerts!


Levels of Anesthesia


Local Anesthesia prevents pain by inducing the loss of sensation in a localized area of the body while the patient remains awake.

Regional Anesthesia blocks the electrical nerve impulses in a nerve or group of nerves to the site of the surgical procedure, including spinal, epidural and nerves to the arms, chest or stomach  

Minimal Sedation relieves anxiety but pre-serves consciousness. The patient is typically relaxed but readily responds to verbal commands. Blood pressure, heart rate and respiratory function are generally unaffected.

Moderate Sedation depresses consciousness and relieves anxiety and pain. Purposeful response to verbal command or light tactile stimulation is maintained. Blood pressure, heart rate and respiratory function are minimally affected.

Deep Sedation leaves the patient not easily arousable but able to responds to repeated or painful stimulation. Blood pressure and heart rate are generally maintained, but intervention may be required to maintain respiratory function.

General Anesthesia means that the patient is completely unconscious, and not responsive to painful stimuli. Blood pressure, heart rate and respiratory function is compromised.