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We all know that politicians and hospital administrators are ignorant *****s, stupid, and don't give a damn about quality care. They are interested in one thing: cutting costs as much as possible without killing an unacceptable number of patients. In this regard, CRNAs fit their bill. But do you honestly believe they don't already know that anesthesiologists are far more trained than CRNAs? It's not that they don't know this. It's that they don't care. So why force upon the profession more training to widen the training discrepancy, when the existing training discrepancy between anesthesiologists and CRNAs already doesn't matter to the powers that be?
I don't disagree that they only care about $.
Here's the thing, if what you're saying is true then Anesthesia for MDs is already dead.
I think Blade is right, there needs to be a larger and marketable difference between the CRNA and the MD. If the gap remains the same then the trends will remain the same.
What is the solution? To keep the gap the same and to compete for the same patients? I guess I did see that one operative home model where the anesthesiologists basically run an inpatient floor for perioperative patients.
The Perioperative Surgical Home (PSH) Model of Care
The Problem:
Too often, perioperative care plans are variable and fragmented. The surgical-need decision often disconnects patients from their typical medical care. Surgical patients may experience lapses in care, duplication of tests and preventable harm. Costs rise, complications occur, physicians and other health care team members are frustrated, and the patient and family endure a lower-quality experience of care.
The Solution:
ASA recognizes that innovation must occur within the patient’s episode of surgical/procedural care, and a new model of perioperative care must be developed in our patient’s best interests. To address such issues, ASA has committed to the Perioperative Surgical Home (PSH) model of care – A patient-centered, physician-led system of coordinated care striving for better health, better health care and reduced costs of care.
These goals will be met through shared decision-making and seamless continuity of care for the surgical patient, from the decision for surgery through recovery, discharge and beyond. Each patient will receive the right care, at the right place and the right time.
The Role of the Anesthesiologist in the PSH:
Anesthesiologists will need to view becoming perioperative physicians as an expansion of the specialty as we learn to navigate and negotiate in the face of finite, if not decreasing fiscal resources. The PSH model will broaden the anesthesiologist’s scope of practice in order to promote standardization and improve clinical outcomes as we move toward more patient-centered continuity of care throughout the preoperative, intraoperative and postoperative periods.
Visit the Perioperative Surgical Home website for more information on this new model of care.
I guess this is another solution. The trends dictate that MDs need to do something.