Opinions on Anesthesia Assistants?

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Or you could do your own physical exam like a doctor should? Why would you ever trust what a nurse says
I do my own physical exam smarty pants. I was talking about when you are not in the building and the nurses call you. So one can have a general idea of what could be possibly going on. Jerk.
 
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You misunderstand me. I generally trust most of them when about nursing level stuff (you know, the kind that's not medicine). And I love working with smart passionate people, and I show my appreciation, regardless what's written on their badge. But see the example above to understand their limits, and how the PC hospital bureaucracy is endangering patients by giving nurses too much power. There is a difference between speaking up and talking back.
You are correct. Here's the problem that a lot of people aren't getting, although thankfully some outside of anesthesia are starting to understand as the VA nursing regulations apply to ALL advanced practice nurses, not just CRNAs. And remember that a nurse just has to have a license in A state to practice in ANY state in the VA. The nurses' perspective is that the board of nursing in each state defines their scope of practice as long as it does not conflict directly with state law. If the board of nursing decides that doing an appendectomy should be in the scope of practice for nurse practitioners, their argument is that that is perfectly acceptable. It sounds far fetched, until you realize a lot of groups are letting their nurse anesthetists do TEEs and there are CRNAs setting up their own independent pain practices that in some cases include implantable devices. Crazy - but it's happening.

Read Jeff Plaegenhoff's article in the lastest issue of the Monitor for more unsettling things about APRNs. They're attacking on several fronts, not just the VA.
 
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Why don't you do some locums or something? Are you really so stuck in California that you can't make income as an AA at all? That seems to me to limiting yourself quite a bit. There are still something like 17 states to choose from. You must be doing well in CA doing something else outside of medicine.

You COULD be working as an AA somewhere else. You choose not to because you CHOOSE to live in CA. And that is your prerogative.
 
Well you seem to know a lot about my life. Sure i could work locum in ANOTHER state and leave two kids at home with a nanny. Lest u forget, this is a post about opinions on AA as a career not on making important family decisions.
 
JWK...I'm not bashing AAs at all.... And I worked for over 12 years in the field so that is hardly "very little time" or "very little experience". And I would still be working IF I could. I can remember to this day Dr. Wesley T. Frazier (the director of the program) telling me that California and a bunch of other states were "opening up" whatever that really means. So please don't bash me for telling my story and giving my honest opinion. I think you are doing a disservice to young people by not giving the full story on the whole situation. The reality is that ALL professions go through ups and downs. I remember many of the anesthesia MDS could not find jobs when I graduated. Yes, traditional pharmacy jobs can be hard to find, but the good old days of medicine for a lot of medical professions is not what it used to be either. My point about pharmacy, is that has a LOT more options than just working at Walmart or Walgreens. Pharm can be a great career choice and they can work in ALL 50 states, heck they can work all over the world. And no, I'm not married to a pharmacist!

Ironically enough, I failed out of AA school last semester and will be matriculating at a well-reputed Pharm.D. program in August. Even though California and the nation's large, desirable cities are experiencing job market issues, there are many other areas (even cities/towns in California) where the pharmacist job market is still in good shape. In my hometown in the southeast, Walmart (yes, that Walmart) starts off pharmacy managers (a position new grads are hired for) at $130k, with $20k - $50k bonus potential depending on store performance. I also know a local overnight pharmacist working for another chain (think CVS/Walgreens/Rite Aid) whose base salary is $140k, with bonus potential as well.

I don't think the practices in my hometown are hiring AAs, but CRNAs working for the local ACT groups are starting off at $120k - $130k. So, just wanted to say -- the pharmacist job market ain't all bad, unless you absolutely have to live in one of the big cities.
 
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Well you seem to know a lot about my life. Sure i could work locum in ANOTHER state and leave two kids at home with a nanny. Lest u forget, this is a post about opinions on AA as a career not on making important family decisions.
Whatever. You chose to limit yourself and make stupid decisions. Not me. Seems to me like your decision to live in California while being an AA was quite stupid. Don't care to know anything about your life and cry us a river about not being able to work as an AA.
I know what this thread is about. I was trying to be helpful but u seem to have a stick up your ass.
 
News flash...
AAs aren't able to work in every state. They may gain some momentum as the pro AA movement expands, though the ASA is diverting precious time and energy into the poorly conceived Periop Home initiative. There will be a fight to the death in every state from the combined nursing and CRNA lobby.
If you go in knowing that you may never be able to practice in any state other than where you can practice now, and know that some groups will not hire you either way because they are spineless and/or don't employ the CRNAs, or they may prefer CRNAs as they are more flexible, than it's a fine career choice.
Many groups would prefer to hire AAs BTW. AANA leadership is doing the majority of their members no favors with their militant agenda.


--
Il Destriero
 
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I don't find it odd at all. Yes, it's fine to examine the skin and whatever is their line of work (yes, the butt wiping), but don't play physical exam on me. First of all, I don't trust their physical exam skills. Second, I don't see why they need that information, since there is nothing they can/should do with it, except telling to the physician, who's supposed to examine me anyway. It also pisses the heck out of patients when they are asked the same question again and again, or are examined again and again.

If I say never, will you believe me? As I said, I don't trust their physical exam skills, especially when about negative predictive value. I want the general appearance, mental status and vitals, and I'll move my butt for the rest, as I am supposed to. Unless the patient is worsening, I don't see the need for a nurse to do physical exams on a patient (even then, just call me). Nursing should be what mothers do to their children; medicine is what doctors do to them.

If you mean nursing, in the real meaning of the word, then bingo! Actually, many of them are not really trained for much more, if we consider the level of understanding disease processes.

I have been interrupted by nurses, while treating a stuporous patient with a MAP of 50 on 3 pressors, because they needed to clean the crap from his butt for 20 minutes, so that he won't develop a skin lesion by morning (when he was going to be dead anyway, absent a miracle). Not only that, but they gave him Fentanyl on top of it, so that he won't be bothered when turned (he didn't need it). Which brought the MAP to 40, for those 20 minutes. And these were ICU nurses, la crème de la crème.

Abso-friggin-lutely! I have the utmost respect for nurses who excel at their job; I trust them, cherish them and take every opportunity to point out the good job they are doing.

No offense, but your responses (and lack of acceptance/understanding) are obtuse. I'm glad I don't work with, or around, people like your thinking. You'd get annoyed by my reality checks, boss.


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No offense, but your responses (and lack of acceptance/understanding) are obtuse. I'm glad I don't work with, or around, people like your thinking. You'd get annoyed by my reality checks, boss.


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You'd be surprised how nice I try to be to competent people. Who are usually older, more experienced, and easier to collaborate with than some of the young brainwashed generations of " nurse power" (although there are exceptions both ways). And I don't consider myself anybody's boss, just the decision-maker (captain of the ship etc.) when about the patient. The buck literally stops with me, so it's only fair that the last word is mine. I rarely impose my veto; I usually let people skin the cat the way they are used to, as long as it's a good one. I really do try not to micromanage if it's not likely to change outcomes. Also known as picking my battles. I vent on this forum so I won't in real life.

But I definitely don't like the cult of personality nurses enjoy in this country. I don't expect it to lead to anything good for the healthcare system, and for the patients as a group. I also don't like young nurses and doctors being brainwashed into this team and equality BS; in the end, the physician is like a dying man, alone, regardless of how many are gathered around his deathbed. As long as we don't share the liability and responsibility equally, as long as our knowledge levels are not comparable, we are not a team of equals as professionals, just as human beings. Only people who've shared the burden of important decisions, the kind that keep doctors up at night, would understand. In medicine, that's the difference between a trainee and an attending; you are like trainees, always relying on our safety net. That's the part of me I am sure you wouldn't like. :)
 
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Well said.

One other thing -- I think it should be said that there is an inherent degree of instability associated with being an AA. I have heard that there are several hospitals in south FL that have used AAs for the last few years that have recently fired them all and revoked their practice privileges at their facilities. I also heard that the same thing is happening at a large hospital in Texas that has served as a primary clinical site for an AA program there for the last few years. Am also familiar with similar situations occurring throughout GA. And when/if the VA decides to follow through with permitting NPs & CRNAs to practice independently, how will that alter the dynamic of anesthesia practice in other hospital/private settings? Just a few things to think about....

BTW, I heard the anesthesia job market (for both AAs and CRNAs) had gotten pretty tight over the last few yrs, but maybe things are starting to pick up?
 
One other thing -- I think it should be said that there is an inherent degree of instability associated with being an AA. I have heard that there are several hospitals in south FL that have used AAs for the last few years that have recently fired them all and revoked their practice privileges at their facilities. I also heard that the same thing is happening at a large hospital in Texas that has served as a primary clinical site for an AA program there for the last few years. Am also familiar with similar situations occurring throughout GA. And when/if the VA decides to follow through with permitting NPs & CRNAs to practice independently, how will that alter the dynamic of anesthesia practice in other hospital/private settings? Just a few things to think about....

BTW, I heard the anesthesia job market (for both AAs and CRNAs) had gotten pretty tight over the last few yrs, but maybe things are starting to pick up?
And this little tidbit has nothing to do with the fact that you failed out of AA school?
 
And this little tidbit has nothing to do with the fact that you failed out of AA school?

Those factors are relevant regardless of whether or not I failed out, so.... no? I was very hesitant about those kinds of issues when I first matriculated into the program and realize that I never quite had the "stomach" to pursue a career with that kind of stuff going on. Even if I was still in the program, my sentiments would be the same. At my age, it makes me wish I had just enrolled in the local accelerated BSN program (3 semesters) and applied to either NP or CRNA programs after a year or two.
 
Those factors are relevant regardless of whether or not I failed out, so.... no? I was very hesitant about those kinds of issues when I first matriculated into the program and realize that I never quite had the "stomach" to pursue a career with that kind of stuff going on. Even if I was still in the program, my sentiments would be the same. At my age, it makes me wish I had just enrolled in the local accelerated BSN program (3 semesters) and applied to either NP or CRNA programs after a year or two.
Yeah, that BSN thing would have been smart. NPs/CRNAs are the new MDs it looks like.
I think the AA thing is a good career if you live in one of the minority of states were they are allowed to work. The openings of other states is slow to happen. Although I don't understand why there can't be a federal mandate/law like for MD/DO's where we are allowed to work anywhere.
The PharmD may work out well for you in the long run. However, I hear that the market there is saturated as well.

Good luck.
 
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Thanks. But something else I ended up being disappointed with was the fact that, even in states where AAs are allowed to work, there is often only a small handful of hospitals that hire them. Of course, a common reason for this is CRNA opposition, but a lot of the anesthesia groups out there just don't want to deal with the extra rules associated with using AAs, having to worry about following the TEFRA guidelines, not being able to have them take call without the anesthesiologist at the hospital, etc. In my area, the family practice MD/DO residency program just had its # of spots seriously reduced so that they could have more slots to train the local NP students who are enrolling in the new online NP program.

But for me, I'm now in $60k+ worth of debt after completing just two semesters of the AA program. The other thing to consider is that all the AA programs are very EXPENSIVE now (all cost $100k+ for tuition alone -- some of them are closer to $130k-$140k) and most of them are located in expensive big cities (tho not a problem if someone lives there already w/family). I had no idea until recently that many of the CRNA programs throughout the southeast still cost just $50k - $70k. There is even a CRNA program out there that allows students to live wherever they want in the US, attend "online" classes, and do clinicals locally. I could have done the accelerated BSN and CRNA/NP school afterwards and still have made it out cheaper than what the AA program tuition alone costs. Also -- I'm not saying I attended one of these programs, but I have been told (by a legitimate source) that there are at least two AA programs out there whose retention rates have dropped to well below 90%. So that brings up an interesting question, is the problem related to the quality of the teaching, or are some of the AA programs having to accept less qualified students since there are so many AA programs recruiting applicants now?

The pharmacy market is saturated right now, but I live in one of the least desirable mid-sized cities in the US (according to polls, etc.) and the job market has been pretty strong for the last few years as compared to other cities, so I'm hoping things don't change too much over the next few years. IMO, the worst part of it all is knowing that my AA loan will probably have ballooned from $60k to $100k+ by the time I graduate. Probably going to have no choice but to go on IBR. On the other hand, I guess it's never too late to give nursing a shot.....
 
Thanks. But something else I ended up being disappointed with was the fact that, even in states where AAs are allowed to work, there is often only a small handful of hospitals that hire them. Of course, a common reason for this is CRNA opposition, but a lot of the anesthesia groups out there just don't want to deal with the extra rules associated with using AAs, having to worry about following the TEFRA guidelines, not being able to have them take call without the anesthesiologist at the hospital, etc. In my area, the family practice MD/DO residency program just had its # of spots seriously reduced so that they could have more slots to train the local NP students who are enrolling in the new online NP program.

But for me, I'm now in $60k+ worth of debt after completing just two semesters of the AA program. The other thing to consider is that all the AA programs are very EXPENSIVE now (all cost $100k+ for tuition alone -- some of them are closer to $130k-$140k) and most of them are located in expensive big cities (tho not a problem if someone lives there already w/family). I had no idea until recently that many of the CRNA programs throughout the southeast still cost just $50k - $70k. There is even a CRNA program out there that allows students to live wherever they want in the US, attend "online" classes, and do clinicals locally. I could have done the accelerated BSN and CRNA/NP school afterwards and still have made it out cheaper than what the AA program tuition alone costs. Also -- I'm not saying I attended one of these programs, but I have been told (by a legitimate source) that there are at least two AA programs out there whose retention rates have dropped to well below 90%. So that brings up an interesting question, is the problem related to the quality of the teaching, or are some of the AA programs having to accept less qualified students since there are so many AA programs recruiting applicants now?

The pharmacy market is saturated right now, but I live in one of the least desirable mid-sized cities in the US (according to polls, etc.) and the job market has been pretty strong for the last few years as compared to other cities, so I'm hoping things don't change too much over the next few years. IMO, the worst part of it all is knowing that my AA loan will probably have ballooned from $60k to $100k+ by the time I graduate. Probably going to have no choice but to go on IBR. On the other hand, I guess it's never too late to give nursing a shot.....
I'm sorry you made a choice that ended up being bad for you personally. It really isn't that easy to fail out of an AA program. The student groups are pretty tight, and everyone wants to see their classmates succeed. I know almost every program director personally - none of them are duds, and success of their students is their highest priority.

We encourage prospective students to spend time shadowing AAs and anesthesiologists, to ask questions, and to find out as much about the career as they can before they apply to a program. I've been doing this for decades - I'm totally aware of the limitations on locations that we can practice, thanks entirely to CRNAs around the country. Geographic restrictions will certainly not appeal to some people, but this is not something that is hidden. I get online questions from prospective students all the time and am very direct about where we do and don't work. The fact remains that job placement is essentially 100%, even if it's not your first choice of places to work. I agree - none of the programs are cheap. Graduate education isn't cheap anywhere. All of the programs put their costs on their website - that's not something that is hidden either.

Your "legitimate source" doesn't know what they're talking about. There are no AA programs whose retention rates have "dropped to well below 90%". Programs have to meet certain accreditation standards, including retention. There is nothing to be gained by enrolling students only to have them drop out after 2 semesters. AA programs don't lack for applicants - they all have many times more applicants than they do spots in each class.

CRNA schools are moving to the DNP route. That increases their tuition 50% because of the additional year of education, so in the near future, virtually all CRNA programs are likely to be more expensive than AA programs. All are getting more expensive, and there are certainly CRNA schools right now that are just as expensive as the AA schools. Remember that their tuition and fees (just like the AA programs) are set by the universities, not the programs. You would be shocked how little the programs get as a percent of tuition charged. BTW - There are no fully-online CRNA programs, although there are programs with distance-learning options. You didn't read their online catalogs very carefully. You can't "live wherever they want" and pull that off. Programs have formal contractual relationships with clinical sites - you can't go to a 20 bed rural hospital that does a couple surgical procedures a week and get your clinical time in. The program you're thinking about has a limited number of clinical sites. There are online DNP programs for CRNAs that already have their master's degrees. That should tell you something right off about the value of that concept - a DNP confers no additional scope of practice, and in fact, these add-on degrees offer no clinical work whatsoever.
 
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JWK, My old residency program seems to have gotten rid of all the CRNAs and hired nothing but AAs. Guess they got sick of all that drama. And there was plenty, with AA students rotating and all and no SRNAs. This in a state of Independent practice CRNAs. Kudos to the department.
 
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I'm sorry you made a choice that ended up being bad for you personally. It really isn't that easy to fail out of an AA program. The student groups are pretty tight, and everyone wants to see their classmates succeed. I know almost every program director personally - none of them are duds, and success of their students is their highest priority.

We encourage prospective students to spend time shadowing AAs and anesthesiologists, to ask questions, and to find out as much about the career as they can before they apply to a program. I've been doing this for decades - I'm totally aware of the limitations on locations that we can practice, thanks entirely to CRNAs around the country. Geographic restrictions will certainly not appeal to some people, but this is not something that is hidden. I get online questions from prospective students all the time and am very direct about where we do and don't work. The fact remains that job placement is essentially 100%, even if it's not your first choice of places to work. I agree - none of the programs are cheap. Graduate education isn't cheap anywhere. All of the programs put their costs on their website - that's not something that is hidden either.

Your "legitimate source" doesn't know what they're talking about. There are no AA programs whose retention rates have "dropped to well below 90%". Programs have to meet certain accreditation standards, including retention. There is nothing to be gained by enrolling students only to have them drop out after 2 semesters. AA programs don't lack for applicants - they all have many times more applicants than they do spots in each class.

CRNA schools are moving to the DNP route. That increases their tuition 50% because of the additional year of education, so in the near future, virtually all CRNA programs are likely to be more expensive than AA programs. All are getting more expensive, and there are certainly CRNA schools right now that are just as expensive as the AA schools. Remember that their tuition and fees (just like the AA programs) are set by the universities, not the programs. You would be shocked how little the programs get as a percent of tuition charged. BTW - There are no fully-online CRNA programs, although there are programs with distance-learning options. You didn't read their online catalogs very carefully. You can't "live wherever they want" and pull that off. Programs have formal contractual relationships with clinical sites - you can't go to a 20 bed rural hospital that does a couple surgical procedures a week and get your clinical time in. The program you're thinking about has a limited number of clinical sites. There are online DNP programs for CRNAs that already have their master's degrees. That should tell you something right off about the value of that concept - a DNP confers no additional scope of practice, and in fact, these add-on degrees offer no clinical work whatsoever.

Regarding the distance CRNA programs, I was actually thinking of one other than TWU. I forget the name of it, but they allow students to set up rotations in their home communities and prefer (possibly require) that students continue working part-time as ICU nurses. Also, I just read an article earlier discussing Duke U's plan to create a new distance CRNA program that will allow students to do the same thing. Apparently these distance programs are going to allow their students to set up new rotation agreement contracts with local hospitals that are willing to enter into such agreements.

About the retention rates being below 90% for at least 2 programs, this has to be the case because I know students at both of these programs and know how many students started at each program last year and how many have failed out so far. Unless the students I know are lying about how many students initially matriculated or about the # who have failed out, the retention rates at these programs for their current classes is only 80%-85%, somewhere around there. But like I said, I'm only familiar with the stats for the current classes, so maybe this is the first time the retention rates have dipped below 90%.

With so many CRNA programs out there now (and many that don't even require ICU experience anymore), I have to wonder how these thousands of CRNA students make it thru their programs every year and yet I failed out. It makes me wonder..... would the same thing have happened if I had gone to CRNA school instead? Do the CRNA programs just grade their students more leniently? Are their exams and lab sim finals easier than those in AA programs? Or would I have done just as poorly in CRNA school? I know so many seemingly numb-skulled kids getting accepted to CRNA programs with 3.1-3.2 GPAs and a year of ER or acute care clinic experience that I can't help but think things would've ended better.

I agree that the DNP is a waste of time/money and I would have done everything I could to get accepted to a masters level CRNA program, but the nurses I know seem to be eating it up. They think it's the final step in their education to make themselves equivalent to physicians. But the reason I mentioned CRNA programs being cheaper is because, the way I look at it is -- if someone wants to go to AA school, they have no choice but to pay six figure tuition rates (believe Emory is now close to $140k or more) regardless of where they go, but at least with CRNA programs there is the option to apply to cheaper programs.

This is one reason I almost wish I had just done the accelerated BSN followed by a public online NP program...... sure the salary for an NP isn't quite on the level of what most CRNAs earn, but I could have finished the whole process (both degrees) with less than $40k -$50k of debt.
 
Regarding the distance CRNA programs, I was actually thinking of one other than TWU. I forget the name of it, but they allow students to set up rotations in their home communities and prefer (possibly require) that students continue working part-time as ICU nurses. Also, I just read an article earlier discussing Duke U's plan to create a new distance CRNA program that will allow students to do the same thing. Apparently these distance programs are going to allow their students to set up new rotation agreement contracts with local hospitals that are willing to enter into such agreements.

About the retention rates being below 90% for at least 2 programs, this has to be the case because I know students at both of these programs and know how many students started at each program last year and how many have failed out so far. Unless the students I know are lying about how many students initially matriculated or about the # who have failed out, the retention rates at these programs for their current classes is only 80%-85%, somewhere around there. But like I said, I'm only familiar with the stats for the current classes, so maybe this is the first time the retention rates have dipped below 90%.

With so many CRNA programs out there now (and many that don't even require ICU experience anymore), I have to wonder how these thousands of CRNA students make it thru their programs every year and yet I failed out. It makes me wonder..... would the same thing have happened if I had gone to CRNA school instead? Do the CRNA programs just grade their students more leniently? Are their exams and lab sim finals easier than those in AA programs? Or would I have done just as poorly in CRNA school? I know so many seemingly numb-skulled kids getting accepted to CRNA programs with 3.1-3.2 GPAs and a year of ER or acute care clinic experience that I can't help but think things would've ended better.

I agree that the DNP is a waste of time/money and I would have done everything I could to get accepted to a masters level CRNA program, but the nurses I know seem to be eating it up. They think it's the final step in their education to make themselves equivalent to physicians. But the reason I mentioned CRNA programs being cheaper is because, the way I look at it is -- if someone wants to go to AA school, they have no choice but to pay six figure tuition rates (believe Emory is now close to $140k or more) regardless of where they go, but at least with CRNA programs there is the option to apply to cheaper programs.

This is one reason I almost wish I had just done the accelerated BSN followed by a public online NP program...... sure the salary for an NP isn't quite on the level of what most CRNAs earn, but I could have finished the whole process (both degrees) with less than $40k -$50k of debt.

School has definitely gotten more expensive. Emory went from 6 semesters to 7 and bumped up tuition. When I went through 5 years ago it was about 65k for tuition, now it's about 100k. Yikes..
 
About the retention rates being below 90% for at least 2 programs, this has to be the case because I know students at both of these programs and know how many students started at each program last year and how many have failed out so far. Unless the students I know are lying about how many students initially matriculated or about the # who have failed out, the retention rates at these programs for their current classes is only 80%-85%, somewhere around there. But like I said, I'm only familiar with the stats for the current classes, so maybe this is the first time the retention rates have dipped below 90%.
If that were true, these programs would be on probation with their accreditation. They are not. None of them are. They certainly would be if the retention rates were as abysmal as you are claiming.
 
If that were true, these programs would be on probation with their accreditation. They are not. None of them are. They certainly would be if the retention rates were as abysmal as you are claiming.

Does a program only go on probation after the school graduates the class that has experienced the failures/drop-outs? I'm 110% sure these programs have lost the students they've lost, because I know some of them. Back when they were enrolled in these programs & were struggling, they even came close to assuming they'd get a "free pass" to the next semester because they knew that it would only take a couple more failures for their program's retention rate to drop to below 90%. But they still failed anyways. If a program starts with 35 or 36 people and loses 5, then the retention rate is reduced to 85%-86%. At at least one of these programs, I know the names of every single student who has failed out (don't want to be too specific but at least 5-7) as well as how many their class started with. So that's why I wondered, maybe the probation isn't handed down until that particular class graduates?
 
Does a program only go on probation after the school graduates the class that has experienced the failures/drop-outs? I'm 110% sure these programs have lost the students they've lost, because I know some of them. Back when they were enrolled in these programs & were struggling, they even came close to assuming they'd get a "free pass" to the next semester because they knew that it would only take a couple more failures for their program's retention rate to drop to below 90%. But they still failed anyways. If a program starts with 35 or 36 people and loses 5, then the retention rate is reduced to 85%-86%. At at least one of these programs, I know the names of every single student who has failed out (don't want to be too specific but at least 5-7) as well as how many their class started with. So that's why I wondered, maybe the probation isn't handed down until that particular class graduates?
Schools make an annual accreditation report that is very specific about how many drop out and for what reason. Not every student that drops out is due to academic issues. If things are as bad as you say, they would show up with their next annual report. Again, schools gain nothing and risk a lot by losing students, especially for academic failure. It hints at a problem with the program, or a problem with student selection, or both.
 
Schools make an annual accreditation report that is very specific about how many drop out and for what reason. Not every student that drops out is due to academic issues. If things are as bad as you say, they would show up with their next annual report. Again, schools gain nothing and risk a lot by losing students, especially for academic failure. It hints at a problem with the program, or a problem with student selection, or both.

Do you know when the next annual report is going to be released? I would be interested in seeing it myself, if it is going to be made available for public access. I think you're going to be surprised by what you see when you read it. Is attrition due to # of students that failed out the only statistic they look at when determining whether to revoke accreditation? Or do they also take into account the # of students who withdrew by preference?
 
PharmD's have career options IF IF IF IF they can find a job. That's a big IF. Look on the pharmacy forums - there's a glut of pharmacists.

Surely you entered the AA profession knowing California was not open to AAs at present. Don't trash the whole profession because your personal track didn't go as planned, you didn't research the profession well, or made poor choices. AAs that want to work are all working. Job placement is virtually 100% as more practices look to AAs as the preferred provider instead of militant CRNAs. Most AAs are perfectly happy with their career choice. They may change job locations, but very few leave the profession.

And since you appear to have worked in the profession very little - AAs do indeed make decent money right after graduation - their incomes rise as they gain seniority, and there is certainly more than "a few more thousand bucks" difference between starting and experienced AAs.
do you mind me asking, the highest CRNA salary I have heard of is 300K+ (top 10%) what is the highest AA salary you heard of. I am asking you because you seem to know a lot about this profession and because you participate in every single AA forum on SDN
thank you
 
This thread makes me shake my head.

If we do not want another provider uprising then we shouldn't be hiring AAs and limit the use of CRNAs. If you believe that AAs will not eventually rise up to try and claim independence you are not a good student of history. PAs have already started to do it around the country, CRNAs and NPs do it now and there have been a couple of small AA uprisings (one sued the medical board somewhere to get to practice regional). The only reason we have not seem more on a concerted effort is because of the small numbers of AAs.

The ASA made the worst choice ever supporting AAs instead of simply supporting ONE physician ONE patient (even if it is not realistic financially). The MOMENT we elected to support AAs we said that all patients do not need a physician and only opened the door further for nurses to practice independently. It is a slippery slope we should have never started on and should reverse course as soon as possible. Let the AAs fight their own battles, spend MY MONEY on PHYSICIAN issues. I do not care what happens to them.

Contrary to the swath of AA love on this forum a few of my partners who worked with AAs and their students had nothing positive to say about them and felt they had to spend much more time watching and monitoring an AA than a CRNA. Remember, these are guys who left such practices to work in a physician only one, they have no reason to lie to me.

For those considering AA school. Goto medical school instead. AAs are likely doomed by definition. The future will see the expansion of 'collaborative' practices where MDs are utilizing CRNAs under QZ billing to avoid the risk of fraud associated with meeting the TEFRA rules for medical direction (QK). This is a practice AAs cannot legally work in as they are limited by CMS rules to QK only billing. While nurse only practice seems to be expanding it really isn't expanding in a way that impacts us. They wont be taking over hospitals in large population centers where MDs want to live, ever.
 
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This thread makes me shake my head.

If we do not want another provider uprising then we shouldn't be hiring AAs and limit the use of CRNAs. If you believe that AAs will not eventually rise up to try and claim independence you are not a good student of history. PAs have already started to do it around the country, CRNAs and NPs do it now and there have been a couple of small AA uprisings (one sued the medical board somewhere to get to practice regional). The only reason we have not seem more on a concerted effort is because of the small numbers of AAs.

The ASA made the worst choice ever supporting AAs instead of simply supporting ONE physician ONE patient (even if it is not realistic financially). The MOMENT we elected to support AAs we said that all patients do not need a physician and only opened the door further for nurses to practice independently. It is a slippery slope we should have never started on and should reverse course as soon as possible. Let the AAs fight their own battles, spend MY MONEY on PHYSICIAN issues. I do not care what happens to them.

Contrary to the swath of AA love on this forum a few of my partners who worked with AAs and their students had nothing positive to say about them and felt they had to spend much more time watching and monitoring an AA than a CRNA. Remember, these are guys who left such practices to work in a physician only one, they have no reason to lie to me.

For those considering AA school. Goto medical school instead. AAs are likely doomed by definition. The future will see the expansion of 'collaborative' practices where MDs are utilizing CRNAs under QZ billing to avoid the risk of fraud associated with meeting the TEFRA rules for medical direction (QK). This is a practice AAs cannot legally work in as they are limited by CMS rules to QK only billing. While nurse only practice seems to be expanding it really isn't expanding in a way that impacts us. They wont be taking over hospitals in large population centers where MDs want to live, ever.
You really need to learn some history of my profession before you start slamming it. There have not been, nor will there be, a push for independent practice among AA's. Our practice is limited under both state and federal law - that's not going to change. We have plenty to deal with trying to get practice rights in more states - independent practice is a non-issue for us. Nobody has sued a medical board to do regional. And one of the primary practice guidelines for AA's is that the best person to decide the ultimate scope of practice for an AA is the local anesthesiologist at the local level. You don't want your AAs to blocks, regional, etc? Fine. We're cool with that. Tell that to a CRNA and see what kind of reaction you get.

You think supporting AA's pushed CRNA's towards more independent practice? That's laughable unless it's due to the fact that AA's were getting graduate degrees from top university medical schools while diploma RN's were getting certificates in nurse anesthesia from community hospital CRNA mills, which caused nurse anesthesia programs to up their game. Two of the three founders of the AA profession were presidents of the ASA, and sought a solution to the gross shortage of anesthesia providers of any type at a time when technology was enabling explosive growth of the number and complexity of surgical procedures being performed. AA practice continues to expand, albeit slowly, and we move into more states and more practices every year.

What's your solution "even if it is not realistic financially"? One on one anesthesiologist / patient nationwide is a simple impossibility. We're 50 years past that - it's time to deal with the present and future, not the past. For those practices that want to be MD-only - more power to you if you can make that work, and I know there are places that do that. However, they dwindle in number every year. Your idea that expanding independent CRNA practice doesn't effect you is nonsense. It most certainly does. And please - "collaborative practice" is simply caving to the demands of CRNA's for independent practice. How many anesthesiologists does a "collaborative" group need? 1:10? 1:15? My very large group, overall, an absolutely by-the-book TEFRA practice, is about 1:2. And we all work - there's none of our docs billing QZ from the golf course which is what is being done in many "collaborative" practices, as CRNA's further laugh themselves silly all the way to the bank.

You want to work solo? Do it. For those that want to work with an allied health professional interested in working with them rather than stabbing them in the back, AA's are an excellent choice, especially considering the only other alternative.
 
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Not that I need to prove myself to you.

https://aaaa.memberclicks.net/assets/aaaa ar q2 2015 revised.pdf

Read how this AA talks about it. Sounds like the beginnings to me.

Also read about the AA suing

http://forums.studentdoctor.net/threads/aa-sues-anesthesiologist.478199/

PAs are also limited but they are working to change the laws.

http://www.comphealth.com/resources/pa-np-resources/physician-assistants-time-independent-practice/

So please do not pretend to smooth talk me little buddy. You and the rest of the mid levels are a threat to physicians. The very act of promoting any of you (including AAs) is a sum negative for physician practice.

Principals are principals. I firmly believe that we should be standing by the idea of one physician one patient because it is the highest level of quality. Even if that is not possible we should still be promoting it at all times, not AAs. Doing anything else cheapens physician care. AAs are just another competitor for physician jobs and of a much lower quality. We already have the nurses to compete with promoting AAs is like doing the same thing and expecting a different result (the definition of insanity). I am and will always be, against it.

Ive felt that way since the ASA decided to lower standards and promote your kind. Its shameful.


You really need to learn some history of my profession before you start slamming it. There have not been, nor will there be, a push for independent practice among AA's. Our practice is limited under both state and federal law - that's not going to change. We have plenty to deal with trying to get practice rights in more states - independent practice is a non-issue for us. Nobody has sued a medical board to do regional. And one of the primary practice guidelines for AA's is that the best person to decide the ultimate scope of practice for an AA is the local anesthesiologist at the local level. You don't want your AAs to blocks, regional, etc? Fine. We're cool with that. Tell that to a CRNA and see what kind of reaction you get.

You think supporting AA's pushed CRNA's towards more independent practice? That's laughable unless it's due to the fact that AA's were getting graduate degrees from top university medical schools while diploma RN's were getting certificates in nurse anesthesia from community hospital CRNA mills, which caused nurse anesthesia programs to up their game. Two of the three founders of the AA profession were presidents of the ASA, and sought a solution to the gross shortage of anesthesia providers of any type at a time when technology was enabling explosive growth of the number and complexity of surgical procedures being performed. AA practice continues to expand, albeit slowly, and we move into more states and more practices every year.

What's your solution "even if it is not realistic financially"? One on one anesthesiologist / patient nationwide is a simple impossibility. We're 50 years past that - it's time to deal with the present and future, not the past. For those practices that want to be MD-only - more power to you if you can make that work, and I know there are places that do that. However, they dwindle in number every year. Your idea that expanding independent CRNA practice doesn't effect you is nonsense. It most certainly does. And please - "collaborative practice" is simply caving to the demands of CRNA's for independent practice. How many anesthesiologists does a "collaborative" group need? 1:10? 1:15? My very large group, overall, an absolutely by-the-book TEFRA practice, is about 1:2. And we all work - there's none of our docs billing QZ from the golf course which is what is being done in many "collaborative" practices, as CRNA's further laugh themselves silly all the way to the bank.

You want to work solo? Do it. For those that want to work with an allied health professional interested in working with them rather than stabbing them in the back, AA's are an excellent choice, especially considering the only other alternative.
 
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Not that I need to prove myself to you.

https://aaaa.memberclicks.net/assets/aaaa ar q2 2015 revised.pdf

Read how this AA talks about it. Sounds like the beginnings to me.

Also read about the AA suing

http://forums.studentdoctor.net/threads/aa-sues-anesthesiologist.478199/

PAs are also limited but they are working to change the laws.

http://www.comphealth.com/resources/pa-np-resources/physician-assistants-time-independent-practice/

So please do not pretend to smooth talk me little buddy. You and the rest of the mid levels are a threat to physicians. The very act of promoting any of you (including AAs) is a sum negative for physician practice.

Principals are principals. I firmly believe that we should be standing by the idea of one physician one patient because it is the highest level of quality. Even if that is not possible we should still be promoting it at all times, not AAs. Doing anything else cheapens physician care. AAs are just another competitor for physician jobs and of a much lower quality. We already have the nurses to compete with promoting AAs is like doing the same thing and expecting a different result (the definition of insanity). I am and will always be, against it.

Ive felt that way since the ASA decided to lower standards and promote your kind. Its shameful.
There is nowhere in that op-ed article that talks about or proposes independent AA practice.

I had forgotten about the regional issue in Ohio (nearly 10 years ago and long since decided) but if you read that entire thread, you'll see my explanation of why it came about and why it was done, as well as the concept about the anesthesiologist at the local level being in the best position to decide what is appropriate for their particular practice.

I don't care what PA's do. We aren't them.

I'm not smooth talking and I'm not your little buddy.

Again - all MD practice - more power to you. If you can do it, maintain it, make money at it in a time of decreasing compensation and increasing regulation, more power to you. I support you 100%. If total MD anesthesiology practice was remotely possible, there would be no need or desire for CRNAs or AAs. It's not possible. AAs are not competing for physician jobs - but CRNAs most certainly are, and both AMCs and hospitals looking for more money are more than happy to push what they view as a cheaper alternative and see you as low hanging fruit. If you don't like or support the AA concept, that's certainly your prerogative - we can agree to disagree and you certainly don't have to hire any.
 
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*sigh*

Every AA job is a physician job lost, little buddy. So yes, you are most certainly competing with us for jobs.

But you keep telling yourself that "AAs are different". I am a student of human nature and human nature seeks independence, power and money. AAs will do it eventually and while you do not read that in the AA newsletter I most certainly see it.

We do not have to agree to disagree, you are wrong.

There is nowhere in that op-ed article that talks about or proposes independent AA practice.

I had forgotten about the regional issue in Ohio (nearly 10 years ago and long since decided) but if you read that entire thread, you'll see my explanation of why it came about and why it was done, as well as the concept about the anesthesiologist at the local level being in the best position to decide what is appropriate for their particular practice.

I don't care what PA's do. We aren't them.

I'm not smooth talking and I'm not your little buddy.

Again - all MD practice - more power to you. If you can do it, maintain it, make money at it in a time of decreasing compensation and increasing regulation, more power to you. I support you 100%. If total MD anesthesiology practice was remotely possible, there would be no need or desire for CRNAs or AAs. It's not possible. AAs are not competing for physician jobs - but CRNAs most certainly are, and both AMCs and hospitals looking for more money are more than happy to push what they view as a cheaper alternative and see you as low hanging fruit. If you don't like or support the AA concept, that's certainly your prerogative - we can agree to disagree and you certainly don't have to hire any.
 
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-Now, AA'S can work in 18 states including Washington DC with limitation in Texas and Michigan so technically we can say 20 states.
-AA'S can make anything from 120k-250k depending on many factors ( location, hours, experience,overtime.....).
-currently AA'S are fighting to be official in California ( Assembly Bill 890) and there are positive feeling about AA'S becoming official in CA by 2019.
- three new AA programs just opened ( Indiana university, medical college of Wisconsin, university of Colorado).
-AA=CRNA expect that CRNA'S can make more in rural areas (since the can practice in more states and without MD supervision in some locations.)
-why AA'S when we have CRNA'S?
The answer may be funny but simple, CRNA'S are becoming powerful and AA's are needed to make sure that CRNA'S don't become so powerful to replace MD Anesthesiologists. When Anesthesiologist and CRNA practice independently and perform the same job ( with exception to pain management specialists) hospitals and clinics will hire CRNA's over anesthesiologists because they get paid way less than MD's. How to prevent CRNA'S from becoming that powerful in the future? answer is AA'S.
-all those changes happened in less than 5 years and the scope on AA practice is getting wider and it's safe to say that AA'S may become official in 35 states by 2025. The need for Anesthesia providers in the US is big and as less anesthesiologists are graduating ( due to competitions for residency spots.) AA'S and CRNA'S are needed to cover shortage in the market.
- In conclusion, AA'S are needed to cover shortage in the Anesthesia market, balance the power between anesthesiologists and CRNA'S. and add more diversity to the health system ( same with PA and NP, MD and DO).
sources: AA shadowing, American Academy of Anesthesiologist Assistants.
 
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Could anybody tell me which states AA are allowed to work?

Thanks
 
I’ve worked with AAs and CRNAs and can’t tell the difference. They both perform the same duties and save for the name tag, I wouldn’t be able to tell them apart based on their level of clinical competency.
 
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worked with an AA student. it was absolutely the most fun and collegial environment ive ever seen coming from working with nurses that think they can do it all without you.

I did a few big peds back cases, and we moved much faster and in sync. Of course they cant be in the room by themselves, and as the resident in the case it was my case, but the attending let me "supervise."

My student AA was respectful, had great knowledge, and did things well.
 
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Ironically enough, I failed out of AA school last semester and will be matriculating at a well-reputed Pharm.D. program in August. Even though California and the nation's large, desirable cities are experiencing job market issues, there are many other areas (even cities/towns in California) where the pharmacist job market is still in good shape. In my hometown in the southeast, Walmart (yes, that Walmart) starts off pharmacy managers (a position new grads are hired for) at $130k, with $20k - $50k bonus potential depending on store performance. I also know a local overnight pharmacist working for another chain (think CVS/Walgreens/Rite Aid) whose base salary is $140k, with bonus potential as well.

I don't think the practices in my hometown are hiring AAs, but CRNAs working for the local ACT groups are starting off at $120k - $130k. So, just wanted to say -- the pharmacist job market ain't all bad, unless you absolutely have to live in one of the big cities.
Sounds great fam..... but then you have to be a pharmacist. Job satisfaction plummets after 2-3 years of pharmacy.
 
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