Here we go again!

[Noyac]

http://www.nurse-anesthesia.org/con...Better-Outcomes-at-CRNA-only-Rural-Facilities

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Members don't see this ad.

 

[GravelRider]

 

[aneftp]

Selection basis. Duh.

I pointed that so many times that rural hospitals will punt the difficult cases so it's impossible to prove "safety" when cherry picking occurrs.

 

[RK.md]

Sums it up perfectly:

 

[criticalelement]

Let them put all this BS rhetoric out there. Nobody with functioning neurons believes any of it..

I would like to see the ASA concentrate on getting PA/AA legislation passed in every state..

 

[Planktonmd]

Let them put all this BS rhetoric out there. Nobody with functioning neurons believes any of it..

I would like to see the ASA concentrate on getting PA/AA legislation passed in every state..

The ASA is busy with the surgical home initiative which will solve this problem since anesthesiologists will no longer compete for intra-op care!

 

[Chloroform4Life]

JAMA article was not looking at CRNA vs Anesthesiologists at all. Such conclusion is not only unfounded, but idiotic.

Difference in outcome likely from being taken care of by young surgical residents vs seasoned surgeons.

 

[pgg]

JAMA article was not looking at CRNA vs Anesthesiologists at all. Such conclusion is not only unfounded, but idiotic.

Look at where it's coming from. The people running that site are functionally ******ed.

nurse-anesthesia.org is the 4chan /b/ of the medical internet

 

[Consigliere]

Let them put all this BS rhetoric out there. Nobody with functioning neurons believes any of it..

I would like to see the ASA concentrate on getting PA/AA legislation passed in every state..

In other words, the majority of the general public.

 

[Noyac]

^^^You mean the minority, right?

 

[Mman]

" The risk of dying within 30 days of the operation was the same whether a patient had surgery at a critical access hospital or a larger hospital."

So they are proud of the fact that you can be a healthier patient and have the same chance of dying as a sicker patient at the big hospital?

 

[Random Anesthesiologist]

Look at where it's coming from. The people running that site are functionally ******ed.

nurse-anesthesia.org is the 4chan /b/ of the medical internet

Run by a CRNA who couldn't get into medical school and used to post on SDN pretty frequently.

 

[chocomorsel]

Run by a CRNA who couldn't get into medical school and used to post on SDN pretty frequently.

Really? What was his/her handle?

The admin over there is always posting stuff trying to prove how useless, and over educated we are. One of the articles recently said that we all lied to get into medical school since plagiaristic phrases were found in 5% of personal statements in some study.
It's a disgusting, disturbing, hateful site and all they like talking about is how they love to piss of the anesthesiologists they work with.

 

[Planktonmd]

Really? What was his/her handle?

The admin over there is always posting stuff trying to prove how useless, and over educated we are. One of the articles recently said that we all lied to get into medical school since plagiaristic phrases were found in 5% of personal statements in some study.
It's a disgusting, disturbing, hateful site and all they like talking about is how they love to piss of the anesthesiologists they work with.

We are useless and over educated until they get in a situation they can't handle then we become necessary... I have seen that so many times.

 

[bigdan]

After looking at the post entitled "New UofM Study Shows Better Outcomes at CRNA only Rural Facilities", I gathered something different from reading the entire article. I'm no statistical wizard or research guru, but:

1) I didn't see the words "certified nurse anesthetist" anywhere in the article. It's probably poor form to try to derive cause and effect from retrospective data, worse still to do so from using ICD-9 codes as your reference marker for complications, but it's incomprehensible to claim a factor that wasn't studied (or even mentioned) is associated with an outcome.

2) The article itself offers explanations for the reasons for the reported outcomes, and those authors include:
a. critical access hospitals have the opportunity for "appropriate candidate selection before surgery"
b. critical access hospitals operated on fewer complex patients
c. critical access hospital surgeons appropriately triaged higher risk patients to larger centers before surgery
d. the study "only includes a subset of well-resourced critical access hospitals"

 

[Random Anesthesiologist]

Really? What was his/her handle?

The admin over there is always posting stuff trying to prove how useless, and over educated we are. One of the articles recently said that we all lied to get into medical school since plagiaristic phrases were found in 5% of personal statements in some study.
It's a disgusting, disturbing, hateful site and all they like talking about is how they love to piss of the anesthesiologists they work with.

Check your PM

 

[Man o War]

The major contributor to that trashy site is a nurse who couldn't get into medical school and now spends his time trashing doctors because he can't be one. Total inferiority complex. Pretty pathetic really.

 

[Man o War]

We are useless and over educated until they get in a situation they can't handle then we become necessary... I have seen that so many times.

Happened DAILY at my previous job. If patients only knew.

 

[Consigliere]

^^^You mean the minority, right?

No. I mean the majority of the general public is lacking in functioning neurons.

 

[BLADEMDA]

Researchers analyzed data from 1.6 million hospital stays for four common operations: gallbladder removal, colon surgery, hernia repair and appendectomy. The team compared Medicare patient outcomes for those who had their operations at 828 critical access hospitals with data from patients at more than 3,600 larger hospitals.


I would not have my colon resection at one of these hospitals; instead, I would choose a skilled colo-rectal surgeon who has performed thousands of minimally invasive procedures and utilizes ERAS protocols for care.

http://www.erassociety.org/

https://www.mskcc.org/blog/what-are-benefits-minimally-invasive-colorectal-surgery

 

[Stank811]

http://jama.jamanetwork.com/article.aspx?articleid=1674237

http://archsurg.jamanetwork.com/article.aspx?articleID=1680690

To add to Blades post:

Looks like critical access hospitals are falling behind and are costing 10-30% as much for similar post op admissions. CRNAs are bringing a lot of value to those hospitals and the system as a whole.

Critical access hospitals will either close or turn into triage centers for larger systems. Hospitals systems will then loose money on their staffing of the critical access hospitals with CRNAs only and will look for their anesthesia group to help figure out workforce management and OR management at these critical access hospital sites.

 

[Stank811]

http://www.wsj.com/articles/new-risks-at-rural-hospitals-1451088096

 

[Carbocation1]

[URL='http://ovidsp.tx.ovid.com.revproxy.brown.edu/sp-3.20.0b/ovidweb.cgi?&S=OMOBFPNJBEDDPLBKNCIKPAMCNGMOAA00&WebLinkReturn=Full+Text%3d&Browse=Toc+Children%7cYES%7cS.sh.22.23.26.41.42%7c1%7c60']Anesthesia & Analgesia 122(6) June 2016 [/URL]

Physician Supervision of Nurse Anesthetists: To Opt In or To Opt Out?

Thomas R. Vetter, MD, MPH,* Edward J. Mascha, PhD,† and Meredith L. Kilgore, PhD§

CONCLUSIONs
The data presented by Sun et al. indicate that the 2001 CMS opt-out rule is not associated with increased access to anesthesia care for a subset of 4 common urgent surgical procedures during the 1998 to 2010 epoch. Additional health services studies and data are needed to validate these initial findings. Furthermore, the effect of 2001 CMS opt-out rule on the quality, cost, and hence the value of anesthesia care remains largely unknown.

 

[ProRealDoc]

http://www.nurse-anesthesia.org/con...Better-Outcomes-at-CRNA-only-Rural-Facilities

Nonsense! I work in a rural hospital and the mortality rate would certainly be higher if there were no anesthesiologists around tp bail the CRNAs. The same pathologies that affect patients in big cities don't magically disappear in rural areas.

 

[KurtBrie]

Just some added clarification

- All front page articles on that website are published through the "ADMIN" account. There are over 20 users who write articles but any CRNA user can write one and it gets reviewed by one of 8 "administrators" then published through the generic "ADMIN" account.

- The original creator of the website took the MCATs, was accepted to a D.O. school and decided to forgo medical school to attend CRNA school (at one point he posted an acceptance letter to medical school and his MCAT scores). He is no longer active on the website.

 

[Random Anesthesiologist]

Just some added clarification

- All front page articles on that website are published through the "ADMIN" account. There are over 20 users who write articles but any CRNA user can write one and it gets reviewed by one of 8 "administrators" then published through the generic "ADMIN" account.

- The original creator of the website took the MCATs, was accepted to a D.O. school and decided to forgo medical school to attend CRNA school (at one point he posted an acceptance letter to medical school and his MCAT scores). He is no longer active on the website.

Haha if you say so. I was an astronaut. Once I posted my acceptance letter to astronaut school and my astronaut scores.

We'll never know since it's a closed site. But funny what you can find on social media...

If you lie about one thing, what else are you lying about? But, if it's true that he is no longer active, the rest of your admins are pretty much terrible at journalism. But very creative with making up stories to fit a narrative.

Also, that is not my name on top there so I'll take it down (wouldn't want angry letters going to the wrong person), but thank you to the member here who noticed that. I literally just did a search on twitter and that's what popped up.

 

[Man o War]

Just some added clarification

- All front page articles on that website are published through the "ADMIN" account. There are over 20 users who write articles but any CRNA user can write one and it gets reviewed by one of 8 "administrators" then published through the generic "ADMIN" account.

- The original creator of the website took the MCATs, was accepted to a D.O. school and decided to forgo medical school to attend CRNA school (at one point he posted an acceptance letter to medical school and his MCAT scores). He is no longer active on the website.

Then we aren't talking about the same person.

 

[KurtBrie]

Then we aren't talking about the same person.

Maybe not?

There is only one owner of that website though.