- Joined
- Apr 7, 2010
- Messages
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Any news?
By this "logic", there is no difference between police and criminals, because they all carry weapons and look the same in the dark.They are at it again!
This is the direct video link on Vimeo for those who have a hard time with the asa website
stick your head in the sand more why dont you?This is like jr high PTO level. The crowd cheering sounded like a group of half hearted soccer moms. Oh yay..in the background.
Lol.
I'm sure I will sleep well tonight after watching this. I work with a wonderful team of nurse anesthetists. We showed this at work this week and they just put their head down in embarrassment. One commented that CRNAs across the country think the AANA is just a bunch of crazies ruining their job and are so far out of touch with real world medicine. His words. Others sitting there nodded and agreed. I felt embarrassed for them.
I sent him home an hour early for being wise.
CJ
No one is going to pay these CRNAs any more than what they're getting so why would they want to become independent, become legally responsible for patients, take out malpractice insurance, and take on more demanding hours?
This is like jr high PTO level. The crowd cheering sounded like a group of half hearted soccer moms. Oh yay..in the background.
Lol.
I'm sure I will sleep well tonight after watching this. I work with a wonderful team of nurse anesthetists. We showed this at work this week and they just put their head down in embarrassment. One commented that CRNAs across the country think the AANA is just a bunch of crazies ruining their job and are so far out of touch with real world medicine. His words. Others sitting there nodded and agreed. I felt embarrassed for them.
I sent him home an hour early for being wise.
CJ
"best kept secret in healthcare... crnas..." thats a laugh..
their lack of medical knowledge and poor decision making because of it is the best kept secret in healthcare thats for sure...
You are a fool if you think this. A much greater percentage of them contribute to their PAC than we do to ours. They also write more letters. Where are the CRNAs who are willing to stand up and say the AANA doesn't speak for us on this issue?
Why don't you ask your "wonderful group of anesthetists" how they would feel about going on record saying that CRNA only care is second best to an ACT model or MD Anesthesia? See how that one would fly with them.
A bill in the TX house to license AAs for practice failed last week both first vote and reconsideration.
100% guarantee of failure.
Can someone delineate the possible scenarios by which CRNAs practice in the future and what the impact would be on physician anesthesiologists? For example, what would happen in CRNAs actually gain independence in every state? Will it create a 2-tiered system of anesthesia care for all cases? Or will they simply flock to ASCs? Will they drive down physician salaries by flooding the market? Would it be possible for a "senior" CRNA to lead an ACT of other CRNAs? So many questions.
F*ck. You mean in the opt-out states?Ummmm......that already exists.
IF CRNAS could magically gain complete independence tomorrow what would that do to physicians?Can someone delineate the possible scenarios by which CRNAs practice in the future and what the impact would be on physician anesthesiologists? For example, what would happen in CRNAs actually gain independence in every state? Will it create a 2-tiered system of anesthesia care for all cases? Or will they simply flock to ASCs? Will they drive down physician salaries by flooding the market? Would it be possible for a "senior" CRNA to lead an ACT of other CRNAs? So many questions.
IF CRNAS could magically gain complete independence tomorrow what would that do to physicians?
Well, it would create a system where we would do our own cases and they would do their own cases and there would be NO overlap. Meaning, I would not confer with, suggest a medical plan or examine their patients. Their complications are their complications. IT actually would improve our job market.
Consider an Operating room with 8 rooms plus endo plus ep. thats ten locations. Currently staffing with 4 mds and ten crnas.. Mds are making 325K crnas making 165 plus ot. total salaries of about 3 million give or take. Switch that over to 5 mds and 5 crnas. MDs are making 325 andcrnas are making 200. You are saving on salaries, 1/2your cases have NO MD input(which you have to explain to the patient, expose the hospital and surgeon to liability),1/2 your call are not covered by a physician which would expose yourself (the hospital) to liability and you have to find 5 experienced crnas to do the job without any supervision.
Its a win win for us. The only people that lose are the docs/ who hate being handcuffed to the anesthesia machine watching paint dry. And believe me depending on the surgeon.. this can be quite painful. It seems complete crna independence does not do anything for the crna demand at all. In fact i think it would decrease the demand.
Cromwell and coauthor Brian Dulisse, a health economist at RTI, analyzed 481,440 hospitalizations covered by Medicare. They found that the frequency of nurse anesthetists’ providing anesthesia without anesthesiologist supervision grew from 1999 to 2005. As of 2005, 21 percent of surgeries in opt-out states and 10 percent in non-opt-out states used nurse anesthetists without anesthesiologists, as opposed to 17.6 percent and 7.0 percent in 1999. The authors speculate that the increase could be due to anesthesiologists’ taking on more privately insured cases and leaving more Medicare cases to certified registered nurse anesthetists...
BladeThe AANA goal is 1 doctor/MD (Fireman) and 10 CRNAs. The "call" is covered by the CRNA with phone consultation to the MD if needed. If things get real busy the 1 MD has to do his/her own room during the day.
Under the AANA scenario 3 MDs get fired or have to work for CRNA wages. In 20 years the AANA goal is DNAP CRNA= MD Anesthesiologist for salary and privileges. A SENIOR crna will provide backup to all the anesthesia providers (MD and CRNA).
100% guarantee of failure.
I find it very hard to believe that those numbers are accurate.
Many of the CMS numbers make the assumption that QZ billing = independent practice, even if the care was actually supervised or directed. Maybe that's in play in that statistic.
U
You know what Blade... I've thought about this a lot and I actually think even if CRNAs become independent in all 50 states with the rollout of Obamacare and zealous hospital execs as well as insurance companies looking to cut costs I think a 2 tier system will develop in anesthesia. MD provided anesthesia and midlevel provided anesthesia with no overlap or collaboration that would 1. Finally allow the official objective comparison to be made and we know how that will turn out and 2. anesthesiologists will naturally attract more keen patients that have good health insurance or are wealthy and want MD anesthesia because they know better. I think all the **** insurance will naturally get filtered out and it may benefit anesthesiologists while proving to the public that doctors are superior. Just like in real life you have the choice of shopping at Walmart or Bloomingdales for your clothes.
Exactly, I completely agree.
I don't. Patients will have no choice about who provides their anesthesia. Just like they don't about who reads their X-rays or MRIs
Hospitals like to advertise things, ours sure does. Anesthesiologists supervising care could be a safety talking point for advertising and implied superiority over other area hospitals. Patients do have a say in where their surgery is done. Now the hospital across town has to compete. They're not going to put up a sign that says CRNAs are equal to MDs and not to worry.I don't. Patients will have no choice about who provides their anesthesia. Just like they don't about who reads their X-rays or MRIs
May 2014 National Occupational Employment and Wage Estimates
http://www.bls.gov/oes/current/oes_nat.htm
Anesthesiologists are #1 in mean hourly wage and annual wage.
What non-surgical specialties are good investments nowadays other than Derm?What matters to you is the FUTURE of Anesthesiology and not its past. A post about 2014 hourly wage is about as relevant to you as posting my 2010 salary income: they are both in the past.
Like the stock of a company you need to be concerned about LONG TERM growth prospects for your specialty. If Anesthesiology was a stock would you be a buyer at today's prices? I'm sure it would be a Large Value stock in 2015 but the question remains is the current PE ratio justified and will the "E" be shrinking for the Physician Anesthesiologists as the "E" for CRNAs increases over time.
I'm still not worried. I think I'll have a job for my career. Again, my crew is very good but I have to intervene daily with both the new grads and old alike. They get into trouble, often.
My sister in law works in an opt out state. When they renewed their contract this pass fall the hospitals (granted its a large, very nice hospital) sole request was please stop hiring so many CRNAs.
CRNA schools have become total mills. Just like lawyers, just like pharmacy, and now nurse anesthesia. Almost anyone can go be a CRNA. I worked with a new grad (working on year 1 post training) Friday and she's super nice, but I'm not sure she ever had a clue. I rested well again.
What non-surgical specialties are good investments nowadays other than Derm?
The question isn't whether you will have a job in the future but rather will the AANA campaign to stain our profession take its toll. The constant propaganda that an anesthesia nurse is equal to a Physician Anesthesiologist demeans the profession and the value of our education not to mention the impact on patient care.
The beauty of Anesthesiology is that you are investing in a field of unlimited demand: surgery. This remains true even if the types of surgeries/procedures change, because the Anesthesia component is always a constant.
Two fields I would not want to invest in long term include Heme-Onc and Allergy-Immunology. The former will fall the level of Infectious Disease once therapies start to dramatically improve (5-10 years?), and the latter is highly prone to encroachment by mid-levels and Family Practitioners.