How are Crnas more cost effective?

[Mman]

That's exactly the issue. 80-90% of the cases are the easy cases even in rural hospitals.

They will punt the more challenging cases. So if u do bread and butter 80-90% of the time. Who wouldn't want to do bread and butter.

If they paid u X amount and u get to do bread and butter all day getting paid the same X amount to do 30% complex patients at another place.

What would you choose? So they keep doing easy cases. Collect their pay checks. Low liability. And still get to claim they are just as safe as MDs.

I'm not arguing they are "just as safe as MDs". I'm saying the opposite. I'm just telling you what actually happens. Plenty of small hospitals have 1 anesthesiologist supervising CRNAs, but you can't have somebody on call 24/7/365 so there are periods of time in a week where there is no anesthesiologist coverage and the surgeons are legally responsible for the CRNA. What happens in those situations is the surgeons will only do the sicker patients/bigger cases during times when the anesthesiologist is around. If it's something that can't wait, they transfer the patient to another facility.

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[criticalelement]

Some AMC centers are still all-MD, in full ACT territory, years after takeover. There must be something about that, too.

Usually the condition of the sale is that they do not bring in crnas for x number of years

 

[BLADEMDA]

That's exactly the issue. 80-90% of the cases are the easy cases even in rural hospitals.

They will punt the more challenging cases. So if u do bread and butter 80-90% of the time. Who wouldn't want to do bread and butter.

If they paid u X amount and u get to do bread and butter all day getting paid the same X amount to do 30% complex patients at another place.

What would you choose? So they keep doing easy cases. Collect their pay checks. Low liability. And still get to claim they are just as safe as MDs.

They claim they are safer than MDs

 

[Planktonmd]

They claim they are safer than MDs

The funny thing they are even trying to convince us of this lie! We work with them and bail them out everyday but we are supposed to ignore reality and believe the propaganda!

 

[aneftp]

They claim they are safer than MDs

Again. We all want independent double blinded studies on safety.

Problem is no one gonna to risk theirs lives to sign up for such studies.

And doing "retroactive" billing data to try to provide "safety" (see AANA funded "study" along with ASA funded "study").

How do u want to prove safety when difficult cases get punted to tertiary care center?

So they can keep claiming since punting cases eliminates any potential cases that prove they are more harmful.

 

[urge]

Again. We all want independent double blinded studies on safety.

Problem is no one gonna to risk theirs lives to sign up for such studies.

And doing "retroactive" billing data to try to provide "safety" (see AANA funded "study" along with ASA funded "study").

How do u want to prove safety when difficult cases get punted to tertiary care center?

Simulation?

 

[pgg]

Simulation?

How do you get the CRNAs to sign up for that study?

 

[aneftp]

How do you get the CRNAs to sign up for that study?

We can't provide they are unsafe. There is so much selection bias in surgery so retrospective analysis from billing data can't prove anything.

 

[pgg]

We can't provide they are unsafe. There is so much selection bias in surgery so retrospective analysis from billing data can't prove anything.

I assume "prove" got autocorrected to "provide" ...

I agree. But the question remains. How do you get CRNAs to sign up for a simulator study?

 

[deleted171991]

How do you get CRNAs to sign up for a simulator study?

You pay them overtime rates.

 

[pgg]

You pay them overtime rates.

Surely even the greediest of CRNAs aren't dumb enough to walk, sheep-like, into a study run by anesthesiologists and created to explicitly prove their inferiority.

Would YOU sign up for a sim study, run by the AANA, with the goal of proving equivalence?

 

[deleted171991]

It was a tongue-in-cheek answer to a rhetorical question.