- Joined
- Jul 21, 2008
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@Aralc Why don't you use some of your free time and go on the CRNA forums to tell them to stop talking sh@t about anesthesiologists? I mean your husband IS an anesthesiologist right?
sorry to upset you by deleting my posts. Look, if you want to use an open anonymous internet forum as an excuse to say things you would never say in public because you know they are shameful and embarassing to your profession, go ahead. From what I remember, I don't think you have so far, but some of your colleagues have. Tube monkey, baby sitter, incompetent, dangerous, etc. You all are just as bad as the nurse mob.
If you haven't figured it out yet, I am referring to the lives of seidnarb, his partners, their families, as well as members of the MI68 who unfortunately received bad advice from some toxic colleagues and are now unemployed.
Like I said, feel free to continue to abuse the CRNAs, but don't think people aren't reading and judging.
@Aralc Why don't you use some of your free time and go on the CRNA forums to tell them to stop talking sh@t about anesthesiologists? I mean your husband IS an anesthesiologist right?
I'm not anonymous here. I don't go out of my way to post my name and location, but many people here know it. Countless people that I've worked with over the last 10 years know who exactly who I am here. I think I was about a week into residency in 2006 the first time someone in the hospital asked if I was that pgg guy. I even use the same moniker on other forums, one of which even appends my name and location in each .sig on each post. I don't write anything here I wouldn't be willing to say to anyone I work with.
I work with many CRNAs in the military, and the overwhelming majority of them are good CRNAs and great people. We have a good practice model that involves, among other things, schedule triage to give complex patients and cases to anesthesiologists and robust availability of anesthesiologists for help and consults. I think together we provide great care. There have been a few over the years that I haven't gotten along with or thought were bad clinicians, but not that many. My sample is biased because I mostly work in the military, and our CRNAs are a couple cuts above their civilian-trained counterparts.
All that said - the AANA is a toxic organization that is hazardous to the safe care of patients. It's long past time that CRNAs - especially the good ones, of which there are many - fully owned that organization they pay dues to, and recognized that their association's aggressive, militant, deceitful lobbying can have consequences beyond increasing their paychecks and bolstering their egos with "equivalent provider" rhetoric. Consequences like those that have befallen the Michigan 68.
I quit giving money to the American Medical Association a long time ago because I recognized what a terrible organization it was, and how it actively worked against my best interests as a physician. It is time that CRNAs recognized that the AANA is even worse. They should quit supporting it, for the good of patients, and for the good of their future employment prospects.
...disparaging CRNAs as an entire profession, that is OK, but seriously, saying there are only 2 competent team-player CRNAs that exist? And then why would a physician ever work with a CRNA? The only reason would be to make money off of them. Again, it doesn't put your profession in a good light.
And I can't like this post enough.Look Clara, I know you're mortified by the seemingly egregious behavior I am displaying on this anonymous internet forum. Please realize this is a place to vent our frustations; what is said here, at least by me, is somewhat of a hyperbole of how I actually feel. Also recognize that many here have been dealing with the duplicitous, lazy, "I'm superior to you and don't need you", overconfident, undertrained, militant attitudes of some CRNAs and their especially toxic organization - the AANA for a long time. You come on this forum having no idea what anesthesiologists have been dealing with for decades. It's easy for you to get on your judgemental high horse and criticize us.
And I can't like this post enough.
I too am tired of people who have not walked in our shoes telling us what to do, what to think and what to say. @Aralc, please come back and preach when one of your healthy patients in her 20's almost codes from being mismanaged by your midlevels. Or, much easier, next time when one of your midlevels openly ignores your instructions. Or, even easier, next time when they don't have a respectful demeanor towards you.
If any of those ever happens to you, that's when you'll begin getting a taste of what many anesthesiologists experience on a regular, even daily, basis.
Yes, Aralc, I don't have a lot of respect for that profession. That might change in the future but, for now, I believe that people should not play doctor without a medical degree, even under supervision. I believe that these people practice not at the top of their license, but even beyond it.
Please feel free to refer your family and friends to (un)supervised APRNs, since you seem so fond of them. I for one will stick to physicians who see me personally and alone.
And again, please stop judging us. I am not one of the doctors having a much higher income on account of working with APRNs.
Speaking of greed...You know in oncology, all the top institutions in the area have APPs. I would bet that is the case at all the academic institutions. So you might be out of luck.
You clearly don't know Consigliere. I bet u 500bucks he would. Have you read his posts? The man speaks what comes to mind. No filter, no qualms. Would be quick to cuss you out and keep walking. He is quite entertaining actually.The problem is that some folks dont.
Consigliere says he works with CRNAs. Do you think he would ever say something like this to their face?
You clearly don't know Consigliere. I bet u 500bucks he would. Have you read his posts? The man speaks what comes to mind. No filter, no qualms. Would be quick to cuss you out and keep walking. He is quite entertaining actually.
You know in oncology, all the top institutions in the area have APPs. I would bet that is the case at all the academic institutions. So you might be out of luck.
You clearly don't know Consigliere. I bet u 500bucks he would. Have you read his posts? The man speaks what comes to mind. No filter, no qualms. Would be quick to cuss you out and keep walking. He is quite entertaining actually.
I bet you he wouldn't. Despite employing the anesthetist he has to work with them every day no matter what. Anybody can be a stud on the internet.
You know in oncology, all the top institutions in the area have APPs. I would bet that is the case at all the academic institutions. So you might be out of luck.
And in most specialties the midlevels accept physicians as team lead, are respectful, know their scope, work well collaboratively and do not claim equivalence (much less belong to organizations that claim equivalence and pay dues to make this political reality).
Aralc, I think you are comparing apples to oranges. Most doctors think midlevels are very valuable team members. Somehow CRNAs as a profession have "gone off the rails" and it's like watching a train wreck in slow motion. I just hope other specialties aren't heading the same direction. I'm actually surprised when I speak to my friends who are anesthesiologists that they arent *more* disgusted with the crna profession.
THEN EFF YOU!takin' a life or two, that's what the hell I do. you don't like the way I'm livin'?
Speaking of greed...
In my last practice we had 7 CRNAs.
2 of those,competent, bright and super easy to get along with. Had mutual respect for each other.
Why don't you check out Nurse Anesthesia .org and see how much so many of them despise us and get off on pissing us off.
I meant employer, not employee, greed.
Have you seen the compensation level of their executives? All the semi-useless middle managers, the hospital bureaucracies? There is a ton of waste there, just where the bosses like it. They need to make money to pay for all those non-productive people.Cmon now, you think academic hospitals are raking in the dough?
Again, why do you feel entitled to judge us? I bet you make more than many of us here.If you want to get the big bucks, get a degree in hospital administration and earn it.
I am not going to be soft on entitlement mentality here, any more than I was with the nurses.
Again, why do you feel entitled to judge us? I bet you make more than many of us here.
To follow your logic, it must be only your fault.I bet you I don't. I probably make less than the CRNAs.
To follow your logic, it must be only your fault.
I don't either, as long as they don't exploit me and my work.I don't go around being bitter at people making more than I do, or getting more recognition.
I meant employer, not employee, greed.
I have no problems if a nurse does something protocol-based. (If it's protocol-based, maybe we don't need an APRN in the first place, just an RN.)
My problem is when I go in for something that cannot be looked up in a cookbook, which is 80% of medicine. For example, I don't think these people should diagnose without supervision. I don't think they should even prescribe/adjust treatments, unless if it can be reduced to the same algorithm the physician would follow.
Please don't compare APRNs with fellows. Fellows are board-certified attendings in a base specialty (in your case, internal medicine). They might be at the level of an APRN when about oncology, but I doubt they can compare when about everything else.
I want somebody who understands how the body works, both healthy and diseased, not just regurgitates facts or protocols. Because mistakes usually happen with one of the latter people; and they usually don't even realize they're wrong. I and my family have been misdiagnosed even by doctors, which is a great reason to place even less trust in less educated people.
I don't either, as long as they don't exploit me and my work.
To follow your logic, it must be only your fault.
Going back to the subject of entitlement: I feel entitled to get the care I pay for. If I pay many tens of thousands of dollars for cancer therapy, I want the most competent people, not their "extensions".
Yes, mother.That is a valid point. Maybe the CRNAs feel that way as well, as your first point suggests.
Look, if you feel exploited, there are still better strategies than devolving into bitterness.
Find alternative employment, work your way up to being the owner. Realize that exploitation is abusive and vow never to endorse or be part of such a system again.
I trust you.If you want the best care in the world, there will be residents and fellows, and most likely APPs in that practice. Now, as professional courtesy to a fellow physician, the oncologist may try to see you personally at every visit without an extender, but there WILL most likely be an extender of some sort involved in your care.
The oncologist will personally evaluate you at the initial visit, and with every treatment decision. Even for the chemo checks, they will staff the case, and probably see you for a few minutes.
For a routine chemo check, trust me, you don't need the attending.
Ok you made me laugh.Yes, mother.
I trust you.
I promise I won't ask for the attending to check my blood pressure either.
Guess that's what happens when the IM doc pays a visit.This thread is beginning to feel like medicine rounds: let's ignore the obvious and debate some more about minor stuff.
Ok ok ok.
You all have my allegiance to fight against the forces of evil that are responsible for this brutal mess.
I do think enlisting the help of the 'good' APPs would benefit the cause.
The resistance, you might say.
(Ps, calling them tube monkeys is unlikely to help in your recruitment efforts. But a situation like this might help wake them up).
But in case anyone really doesn't know:
Advanced practice providers. Just learned that is the preferred terminology over MLP - midlevel provider.
Whatever, in my opinion, not a big deal, but if you all get upset by MDA, I suppose they can get all huffy over MLP.
Lol APP....I just call them what they are - nurse.
APP sounds silly. Advanced compared to what? At least midlevel describes the level of training in general accurately ... But if they thinks that's derogatory somehow I have no problem with nurse, NP or PA.
But whatever. We should start calling ourselves "elite force practitioners" or "jedi knight doctors".