Physician duties · CRNA · Alabama
Signing for a Certified Registered Nurse Anesthetist in Alabama: what the physician takes on
Required in some cases; see the conditions below. Alabama does not name a specific instrument.
Genuine ambiguity, flagged for legal review: Ala. Code § 34-21-81 requires a CRNA to function 'under the direction of or in coordination with' an 'immediately available' physician, podiatrist, or dentist — built into the scope definition, not a filed agreement. Some secondary sources claim full independence; the statutory text does not support that reading.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Available remotely (no on-site requirement)
Ala. Code § 34-21-81 requires the directing/coordinating physician, podiatrist, or dentist to be 'immediately available,' not necessarily on-site — but an Alabama Board of Nursing declaratory-ruling process (Dunn II / Lloyd Ray, 2024) resolves CRNA scope questions case-by-case rather than through a fixed rule chapter, so treat this as an unsettled area rather than a firm, universally-applied standard.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
CRNAs administer anesthesia-related drugs (including controlled substances) as part of anesthesia care under the direction/coordination relationship above; authority flows from the anesthesia scope-of-practice definition and DEA registration tied to the anesthesia care setting, not a separate outpatient-prescribing certificate like CRNP/CNM's QACSC.
Written agreement
Not required
No filed, board-approved written agreement is required (unlike CRNP/CNM's Collaborative Practice Agreement) — but the statute itself requires an 'immediately available' directing/coordinating physician, podiatrist, or dentist, with no numeric ratio cap or QA regime like CRNP/CNM's. Treat this as a structural condition built into scope of practice, not a true agreement-free independence.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — No CRNA-specific ownership rule was found in this research pass; presumably subject to the same general Title 10A professional-entity constraints as other clinicians.
What physicians charge for this role
Typical monthly compensation in Alabama
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. This state's proximity rules add a small premium.
About Alabama's rules
Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.
Other clinicians in Alabama: see the state overview.