With the VA meltdown, I want to hear from this guy again!

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Tell me what you think after reading about this guy: Hero or nut-job?

  • Yes, he's a true hero of our profession

    Votes: 5 41.7%
  • No, he's a little nutty and must have "snapped" under the weight of the system

    Votes: 1 8.3%
  • I don't know, maybe he's a little of both

    Votes: 6 50.0%
  • He's neither, his comments are damaging and he should be ignored/forgotten

    Votes: 0 0.0%

  • Total voters
    12
  • Poll closed .

BuzzPhreed

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I want to know your thoughts. He's ex-military He posted on SDN before below:

http://forums.studentdoctor.net/threads/real-bad-oers.311518/#post-4053613

Here's his website:

http://www.medicalcorpse.com/

Here's a comment he posted on an article about the VA's changing position on the Anesthesiology News website:

As a U.S. military veteran, I deplore the VA's trend toward keeping up with the military services with regard to CRNA independent practice...even with the sickest of the sick patients. Certainly, killing off several thousand vets with substandard care will save the VA (and taxpayers) millions of dollars in future care for those who have sacrificed so much for our freedom and security. Someone will undoubtedly get a bonus and/or promotion for cost savings from malpractice-induced thinning of the VA caseload.

One of the primary reasons I resigned my regular commission as a LtCol anesthesiologist and left the USAF after 19 years of active duty service was the ever-increasing tendency to put CRNAs, nurses, nurse midwives, PAs, pharmacists, and housekeepers who watch "House" on TV in command of physician anesthesiologists. There can be no anesthesia care team when there is a civil war between the CRNAs and anesthesiologists, as happened at NHB, Travis, and elsewhere in the 1990s and early 2000s. Check out www dot medicalcorpse dot com for more details. I make negative amounts of money from paying for this ad-free site out of my own pocket since 2006.

P.S. The only MDA I know is the Muscular Dystrophy Association. There is a tendency for CRNAs to equalize themselves with anesthesiologists through the insulting use of the acronym "M.D. Anesthesiologist". Until we have MDCs (cardiologists) and MDSs (surgeons), I will remain an anesthesiologist, NOT "MDA"

http://www.anesthesiologynews.com/V...nt&d_id=3&i=October+2013&i_id=1002&a_id=24174

Let's get this guy involved in this forum! I think he's my new hero.

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I want to know what you guy's think about this guys whistleblowing technique. Seriously. There is a lot of talk on this forum about how we need to better get the message out about our patients and what we do. However there is a fine line between doing this effectively and what can come across as arrogance and narcissism. Does this guy cross that line? He's a real dude. He's out there. I'm sure he does more than a fine job at being an anesthesiologist. He's clearly very motivated. And I'm sure he's frustrated with the system. But is this an example of an effective way to change the system or just someone who went off the deep end?

Rob come on back and chime into this discussion. Let's hear your thoughts from the man himself!
 
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He used to post a lot on the milmed forum. It's been years since I've seen him post anything.

To effect meaningful positive change you need to be right, you need to be motivated, and you need to be able to navigate the politics to actually accomplish anything. He had the first two in spades but the third seemed lacking. He pissed a lot of people off and accomplished nothing. I don't think there's much to learn or adopt from his methods.

He's right about just about everything, but being right isn't enough.
 
And that, my friend, is how politics was born.
Yes. I only ever knew the guy through SDN but if he was half as abrasive in real life as he was here, it's no wonder he had such trouble.

Even here on SDN he picked fights he didn't need to, attacked people who agreed with him on many subjects and could have been natural allies (including me!); at times he was downright trollish with his thread hijacking.

But he was an entertaining read, to be sure.
 
Even here on SDN he picked fights he didn't need to, attacked people who agreed with him on many subjects and could have been natural allies (including me!); at times he was downright trollish with his thread hijacking.

There is a component of "control freak" and "anal retentiveness" that comes with being a conscientious doctor. Being conscientious doesn't even have to mean that you are necessarily clinically good, because I've seen some lousy doctors who absolutely-had-to-do-it-their-way all the time.

But seems like there is a lot of merit to what he was saying on the forums and on his website. Appears he might have finally lost it and buckled under the pressure. The stress of caring and wanting to do a good job, along with being personally invested in what you do, can take its toll after awhile, especially if no one else seems to care. And sometimes that makes you just come across as a frustrated a-hole to others. I've had my moments.
 
There is a component of "control freak" and "anal retentiveness" that comes with being a conscientious doctor. Being conscientious doesn't even have to mean that you are necessarily clinically good, because I've seen some lousy doctors who absolutely-had-to-do-it-their-way all the time.

But seems like there is a lot of merit to what he was saying on the forums and on his website. Appears he might have finally lost it and buckled under the pressure. The stress of caring and wanting to do a good job, along with being personally invested in what you do, can take its toll after awhile, especially if no one else seems to care. And sometimes that makes you just come across as a frustrated a-hole to others. I've had my moments.
Usually those types get beaten into submission and they toe the line like the rest and they go along to get along. After all, that's what everyone wants isnt it? No more independent thinkers out there..

As an aside, well actually the point of the thread. I dont know if the folks on this website were aware that the VA has an initiative on the back burner or maybe not so much on the backburner that would make CRNAS and NPS completely independent to physicians inthe veterans health administration and wanted to know if anyone knew anything about it and where they were in the process?
 
ASA Blasts Proposed Change To VA Nursing Guidelines

by Adam Marcus
AN1013_001a_1889_300.jpg

The American Society of Anesthesiologists is calling “ill-conceived” a draft document from the Veterans Health Administration that, it claims, would require nurse anesthetists to practice without physician supervision and in the process jeopardize patient safety.

The ASA says the new rules abandon “team-based anesthesia care” led by physicians and undermine the quality of care in VA hospitals in the service of further expanding the scope of practice of advanced practice nurses (APRNs) and other so-called physician extenders. But the language of the Nursing Handbook—a draft copy of which the ASA provided to reporters—is sufficiently vague to raise some questions about the society’s interpretation of its intent and impact.

‘In No Way Equivalent’

AN1013_026a_1889_150.jpg


Jane Fitch, MD
In a Sept. 9, 2013, conference call with reporters, Jane Fitch, MD, the incoming president of the society, said the ASA was “deeply disappointed” with the amended handbook. Allowing nurses to practice unsupervised raises “significant” concerns for the safety of patients in the VA system, Dr. Fitch said.

“The language of the policy indicates independent practice,” said Roxanne Pipitone, an ASA spokeswoman. “The handbook doesn’t get into procedure-specific scenarios for any of the four advanced practice nursing roles,” which, along with CRNAs cover certified nurse-midwives, clinical nurse specialists and certified nurse practitioners.

Dr. Fitch, who herself was a certified registered nurse anesthetist before receiving her medical degree, said the two positions “are in no way equivalent.” CRNAs receive far less training—five to seven years compared with 12 to 14 for physician anesthetists, and one-tenth the number of hours, she said.

Although Dr. Fitch said CRNAs often do not have even a college degree, according to the policy: “A CRNA is an APRN who has completed a master’s or doctoral degree and board certification in the specialty of anesthesia. CRNAs practice in all settings in which anesthesia services are delivered including traditional hospital surgical suites and ambulatory surgical centers.”

However, Ms. Pipitone said the society does not “interpret this to mean that the VA will only allow nurse anesthetists with advanced degrees to practice independently. There is nothing in the new handbook that addresses segmenting nurse anesthetist by education received, whether they have a two-year associate degree RN or three-year diploma RN. Regardless of their education or training, they all practice as nurse anesthetists.”

Some people familiar with the issue said the ASA’s aggressive response to what could be considered a matter of worst-case interpretation of an ambiguous policy indicated Dr. Fitch’s desire to assert her political bona fides as incoming president of the society on the eve of her ascension to the position. Dr. Fitch campaigned on a theme of “I didn’t know what I didn’t know” as a nurse anesthetist—a refrain she stressed more than once during the conference call. Indeed, the email alerting reporters to the call identified her as “President Elect of the American Society of Anesthesiologists and Former Nurse Anesthetist.”

Short on Specifics

The document does not highlight any new clinical duties for CRNAs in the VA system. But the ASA points to this passage as expanding nurses’ scope of practice intolerably:

“APRNs [advanced practice nurses] practice as independent providers without regard to State Practice Acts under a set of approved privileges. Advanced practice nursing education provides the foundation for APRN core privileges. Core privileges as defined by the profession are those sets of clinical practice, procedures or interventions that all APRNs are qualified to perform based on their educational background and training.” It then lists core privileges including the taking of a history and physical examination, prescribing under an earlier VA directive, developing a care plan and ordering diagnostic and laboratory studies.

Dr. Fitch said the ASA first learned about the policy change about five months ago. The group tried to meet with VA officials to discuss the document on three occasions but was rebuffed, she added.

Vulnerable Patients

In a July 2, 2013, letter to Robert Petzel, MD, the undersecretary for health in the Department of Veterans Affairs, the ASA said it was “concerned about the impact of these policies on surgical anesthesia care within the VHA. The policies are particularly troublesome given the population serviced” by VA hospitals.
 
Usually those types get beaten into submission and they toe the line like the rest and they go along to get along. After all, that's what everyone wants isnt it? No more independent thinkers out there..

As an aside, well actually the point of the thread. I dont know if the folks on this website were aware that the VA has an initiative on the back burner or maybe not so much on the backburner that would make CRNAS and NPS completely independent to physicians inthe veterans health administration and wanted to know if anyone knew anything about it and where they were in the process?


http://forums.studentdoctor.net/threads/va-considering-independent-crna-practice.1040031/
 
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