HR 5246 and AANA

Senate bill introduced to mirror HR5246. Keep sending in the letters!
http://www.asahq.org/news/asanews052406.htm

i read that thread on the other website, and the fundamental disconnect the AANA and the nursing anesthetists students have is that they continue to labor under the false assumption that our training is equivalent and meets the same end-purpose. it is apparent that many of them believe that there is no longer a need for anesthesiologists - that they can do the same job.

i don't know how we change this grossly inaccurate perception. but, aside from the money issue (which drives everything in this dispute, granted), i really think we need to do a better job as a profession at spelling out exactly why and how "anesthesiolgy" is not just putting a tube down someone's trachea and dialing a wheel, skills which any monkey can be trained to do.

i have worked with nurse anesthestists who have 20+ years experience. quite frankly, they are excellent at what they do. they can deliver a beautiful anesthetic and do things that i'm not yet capable of. however, even at this stage in my training, i can clearly see certain things about the medical aspects of a patient's care that many of them just don't understand - it's not part of their training. they just don't have those building blocks. personally, i am already far beyond the level in my training where whatever knowledge any nurse anesthetist has and could possibly offer to me compared to what i want and need to know - and indeed have to know on a deeper level - about anesthesia is inadequate. this is why we will continue to need attending anesthesiologists. we've made great strides in our profession over the past 30 years, not because of the clever and ingenious innovations of nurse anesthetists. we need to continue to move forward, not backwards. every patient deserves this.

the bottom line is that CRNAs are not trained to manage the big picture parts of patient care nor to advance our field. we are. this is a skill set that is not always required in our profession, but there are clearly times when it is - that is why there is and always will be a role for both of us.

it is a shame that they see this legislation as a threat. i think that there needs to a clear and better definition of our roles on the healthcare team that everyone can understand. the nurse anesthetist training, as much as they may not believe it, is not equivalent to what we go through in residency. that seems to be the biggest piece of this issue they cannot grasp.

you cannot "train 4-6 times more CRNAs" for the cost of one anesthesiologist because our roles are not equivalent. there will always be more enlisted men than there are officers.

CONTACT YOUR LOCAL CONGRESSMAN/WOMAN AND STATE SENATORS AND LET THEM KNOW THIS!

VolatileAgent said:

i read that thread on the other website, and the fundamental disconnect the AANA and the nursing anesthetists students have is that they continue to labor under the false assumption that our training is equivalent and meets the same end-purpose. it is apparent that many of them believe that there is no longer a need for anesthesiologists - that they can do the same job.

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Thats not what they are claiming. They have no pretensions about claiming that the TRAINING is equivalent. What they are claiming is that CLINICAL/PATIENT OUTCOMES are equivalent. Essentially, they are arguing that MDA training is overkill.

And frankly, they do have studies to back them up. Multiple studies have shown that CRNAs can do the routine surgeries with no difference from MDAs. Now if you want to argue that 1% of all surgeries require explicit MDA training, then go ahead, but you need to do a study to PROVE that MDAs do a better job in those circumstances.

Until MDAs start putting out studies showing that MDAs are better than CRNAs in actual patient outcomes, you are fighting a losing battle.

i don't know how we change this grossly inaccurate perception. but, aside from the money issue (which drives everything in this dispute, granted), i really think we need to do a better job as a profession at spelling out exactly why and how "anesthesiolgy" is not just putting a tube down someone's trachea and dialing a wheel, skills which any monkey can be trained to do.

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Well this will help somewhat, but what you REALLY need to do is put out studies PROVING that MDAs do a better job than CRNAs.

here's a start:

http://www.ncbi.nlm.nih.gov/entrez/..._uids=10861159&query_hl=2&itool=pubmed_docsum

done
and sent to program for distribution to entire faculty and staff.
and sent to 103 friends via e-mail.

UTSouthwestern said:

Senate bill introduced to mirror HR5246. Keep sending in the letters!
http://www.asahq.org/news/asanews052406.htm

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What the difference between HR5246--Medicare Teaching Anesthesiology Funding Restoration Act of 2006--and HR5348--Medicare Anesthesiology Teaching Funding Restoration Act of 2006? The PDF for 5348 is not parsing.

Is it that one is Republican sponsored and the other Democrat sponsored, but ultimately the same thing?

Wow, just checking that link. Amazing, they really do think CRNAs= Anesthesiologists. Or better yet CRNAs >>>>Anesthesiologists. More cost effective, less training, cheaper to train, similar outcomes. I got a better idea, why not let nurses compete with medical students into anesthesiology residency programs. That way, they get paid just like residents, dont' lose their precious income while training and get the training they need to say that yeah, the are equal to anesthesiologists. Oh wait, they will probably complain and say that four years is too long and the hours associated with residency training is unbearable. Sigh, just can't win.

I dont see any statement on that link that specifically states "CRNA=Anesthesiologist". But I can see how people that continue to not understand that some things they support have negative implications of others here may take it that way

Here is my main aurguement which Im sure nobody here cares. But I will put it into prospective for you from my point of view. Whether you guys are mature enough to listen to the other side and debate this issue cleanly is another thing. Though Im not expecting much in that dept.

SO we increase training reimburstments for you to 1:1 instead of 1:2. Of course good things may come from this. Some things stated here and by pro MD advocates on allnurses.com include the purchase of new devices and equipment for teaching and pt care purposes as well as INCREASED SALARIES.

First of all increasing this ratio for residencys will have 2 major effects that works againts my profession. We all know that money talks in our current healthcare system. Training programs that house both SRNAs and residents would benefit financially by cutting SRNA spots while adding additional resident spots. I mean who wouldnt if you can increase your revenu by possibly millions. Next is that programs that house residency training and staff CRNA's would eventually cut CRNA staff. why pay the CRNA $150k and work him 40hrs a week when resident reimburstment is the same while making way less that half of that and you can work them 80hrs a week.

Again for reasons no other than these obivious large financial gains on the MD part that will eventually effect CRNA training and employement am I against these bills.

Please dont be stupid and display a lack of business sense and aurgue that eventually with resident training being reimburst 50% more than SRNA training that SRNA training will not decrease while resident spots increase.

If I was a MD or practice manager or academic institution and saw that I could increase revenu and salaries substantially by cutting SRNA/CRNA positions and adding resident spots I would do it no doubt. Its only common sense.

So in closing it shouldnt seem so off base that CRNA's are lobbying against these bills. If they wouldnt be lobbying against them they would be stupid. And to think the ASA wanted us to endorse this change. Come on, I think the lack of credit you guys have given us continues to effect decisions the ASA makes on a daily basis. CRNA=CRNA so snap out of whatever nightmare you are having. No where in that thread did anyone state CRNA=MD. Of course people there are proCRNA and have a screw MD attitude. Afterall its a Nurse Anesthesia forum, if you cant take the heat dont even step into the kitchen. I do ask you guys to look at one thing. I notice only one Med student spoke up for the ASA views and put on a rather good debate. Why is it that no one here has the balls to speak their mind and debate the issues?

VolatileAgent said:

i read that thread on the other website, and the fundamental disconnect the AANA and the nursing anesthetists students have is that they continue to labor under the false assumption that our training is equivalent and meets the same end-purpose. it is apparent that many of them believe that there is no longer a need for anesthesiologists - that they can do the same job.

i don't know how we change this grossly inaccurate perception. but, aside from the money issue (which drives everything in this dispute, granted), i really think we need to do a better job as a profession at spelling out exactly why and how "anesthesiolgy" is not just putting a tube down someone's trachea and dialing a wheel, skills which any monkey can be trained to do.

i have worked with nurse anesthestists who have 20+ years experience. quite frankly, they are excellent at what they do. they can deliver a beautiful anesthetic and do things that i'm not yet capable of. however, even at this stage in my training, i can clearly see certain things about the medical aspects of a patient's care that many of them just don't understand - it's not part of their training. they just don't have those building blocks. personally, i am already far beyond the level in my training where whatever knowledge any nurse anesthetist has and could possibly offer to me compared to what i want and need to know - and indeed have to know on a deeper level - about anesthesia is inadequate. this is why we will continue to need attending anesthesiologists. we've made great strides in our profession over the past 30 years, not because of the clever and ingenious innovations of nurse anesthetists. we need to continue to move forward, not backwards. every patient deserves this.

the bottom line is that CRNAs are not trained to manage the big picture parts of patient care nor to advance our field. we are. this is a skill set that is not always required in our profession, but there are clearly times when it is - that is why there is and always will be a role for both of us.

it is a shame that they see this legislation as a threat. i think that there needs to a clear and better definition of our roles on the healthcare team that everyone can understand. the nurse anesthetist training, as much as they may not believe it, is not equivalent to what we go through in residency. that seems to be the biggest piece of this issue they cannot grasp.

you cannot "train 4-6 times more CRNAs" for the cost of one anesthesiologist because our roles are not equivalent. there will always be more enlisted men than there are officers.

CONTACT YOUR LOCAL CONGRESSMAN/WOMAN AND STATE SENATORS AND LET THEM KNOW THIS!

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Believe me I know the training is not equivalent. And I think I speak for most CRNA's and say that you guys can have the 1-5% of the care(whatever numbers you may hear) that we dont provide.However to think that my profession is going to bow down to yours so you can increase numbers in a way that potentially adversly effects us is a joke.Thats like saying the US Government should recruit terrorists for al-Qaeda so they can faq us down the road.

BIS said:

So in closing it shouldnt seem so off base that CRNA's are lobbying against these bills. If they wouldnt be lobbying against them they would be stupid. And to think the ASA wanted us to endorse this change. Come on, I think the lack of credit you guys have given us continues to effect decisions the ASA makes on a daily basis. CRNA=CRNA so snap out of whatever nightmare you are having. No where in that thread did anyone state CRNA=MD. Of course people there are proCRNA and have a screw MD attitude. Afterall its a Nurse Anesthesia forum, if you cant take the heat dont even step into the kitchen. I do ask you guys to look at one thing. I notice only one Med student spoke up for the ASA views and put on a rather good debate. Why is it that no one here has the balls to speak their mind and debate the issues?

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Because it has been debated so much that it makes most people on this site nauseated to debate any further with you. So go back and read the many many other posts refering to this issue. By the way nurse, why do you feel the need to insult everyone here with your little comments like, mature enough to listen, have the balls to speak, etc. The majority of the posters here are mature, although we do have a few like yourself, and we don't feel the need to hash out something that has been beaten to death with you under your previous name, nitecap.
By the way, when you finally graduate from your nurse program and join a ATC, let me know how your tone goes over with your new bosses.

BIS said:

First of all increasing this ratio for residencys will have 2 major effects that works againts my profession. We all know that money talks in our current healthcare system. Training programs that house both SRNAs and residents would benefit financially by cutting SRNA spots while adding additional resident spots. I mean who wouldnt if you can increase your revenu by possibly millions. Next is that programs that house residency training and staff CRNA's would eventually cut CRNA staff. why pay the CRNA $150k and work him 40hrs a week when resident reimburstment is the same while making way less that half of that and you can work them 80hrs a week.

Click to expand...

As was said in that forum several times, a program can't just add resident spots on a whim. I know an administrator that spent two years adding 2 spots. Population growth and the aging baby boomer population makes using residents as the sole work force is time prohibitive. By the time they added 2-3 residents they would discover they now need 2-3 more. More importantly, the CRNA's can cover the less educational cases. Programs can use this a selling point. No CA-3 wants to spend the day doing 2-hr lap choles (I wouldnt' anyway). When CRNAtoMD, or whatever his handle was, said this it is no less true than it is now.

Nitecap said:

Again for reasons no other than these obivious large financial gains on the MD part that will eventually effect CRNA training and employement am I against these bills.

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So since these "obivious" large financial gains are the products of paranoia, you have no problem with the bill, excellent.

the Sleepmaster said:

Please dont be stupid and display a lack of business sense and aurgue that eventually with resident training being reimburst 50% more than SRNA training that SRNA training will not decrease while resident spots increase.

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Again population growth, aging population that will inevitably require more surgical procedures.

BIS said:

If I was a MD or practice manager or academic institution and saw that I could increase revenu and salaries substantially by cutting SRNA/CRNA positions and adding resident spots I would do it no doubt. Its only common sense.

Click to expand...

CRNAs are going nowhere, they are needed. I have no idea what the pay is for SRNAs (is it you paying the institution like Med Students?) but it can't be more than a resident. More CRNAs will be needed so more must be trained. Common sense.

Nitecap said:

So in closing it shouldnt seem so off base that CRNA's are lobbying against these bills. If they wouldnt be lobbying against them they would be stupid. And to think the ASA wanted us to endorse this change. Come on, I think the lack of credit you guys have given us continues to effect decisions the ASA makes on a daily basis. CRNA=CRNA so snap out of whatever nightmare you are having. No where in that thread did anyone state CRNA=MD. Of course people there are proCRNA and have a screw MD attitude. Afterall its a Nurse Anesthesia forum, if you cant take the heat dont even step into the kitchen. I do ask you guys to look at one thing. I notice only one Med student spoke up for the ASA views and put on a rather good debate. Why is it that no one here has the balls to speak their mind and debate the issues?

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I have a finite amount of time and am willing to use it ONLY on enjoyable, enlightening, and/or beneficial ways. Arguing on a nurses forum is none of the three. I really don't have the spare time to peruse and post on several forums . Besides, as you say, one did go there and typing to Deepz and URgettingSleepy was no more productive than speaking to the wall of my dog's doghouse. No intelligent responses, just "get those letters out".

So I guess, other than paranoia, you really have no argument.

Cheers Nitey.

Noyac said:

Because it has been debated so much that it makes most people on this site nauseated to debate any further with you. So go back and read the many many other posts refering to this issue. By the way nurse, why do you feel the need to insult everyone here with your little comments like, mature enough to listen, have the balls to speak, etc. The majority of the posters here are mature, although we do have a few like yourself, and we don't feel the need to hash out something that has been beaten to death with you under your previous name, nitecap.
By the way, when you finally graduate from your nurse program and join a ATC, let me know how your tone goes over with your new bosses.

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Seems like we have 2-3 nitecaps here these days. You guys are funny, but wrong. If you are tired of debating these issues than why are people here still creating these threads? Thought that is what the members only section was for. Seems like its your people that are beating the horse to death im just kicking it when its down.

Thank you nitecap/BIS, I now see the light. I will stop trolling nurse anesthesia forums and will fight tooth and nail against this new bill. Anyways, Get a life.

cloud9 said:

As was said in that forum several times, a program can't just add resident spots on a whim. I know an administrator that spent two years adding 2 spots. Population growth and the aging baby boomer population makes using residents as the sole work force is time prohibitive. By the time they added 2-3 residents they would discover they now need 2-3 more. More importantly, the CRNA's can cover the less educational cases. Programs can use this a selling point. No CA-3 wants to spend the day doing 2-hr lap choles (I wouldnt' anyway). When CRNAtoMD, or whatever his handle was, said this it is no less true than it is now.



So since these "obivious" large financial gains are the products of paranoia, you have no problem with the bill, excellent.



Again population growth, aging population that will inevitably require more surgical procedures.



CRNAs are going nowhere, they are needed. I have no idea what the pay is for SRNAs (is it you paying the institution like Med Students?) but it can't be more than a resident. More CRNAs will be needed so more must be trained. Common sense.



I have a finite amount of time and am willing to use it ONLY on enjoyable, enlightening, and/or beneficial ways. Arguing on a nurses forum is none of the three. I really don't have the spare time to peruse and post on several forums . Besides, as you say, one did go there and typing to Deepz and URgettingSleepy was no more productive than speaking to the wall of my dog's doghouse. No intelligent responses, just "get those letters out".

So I guess, other than paranoia, you really have no argument.

Cheers Nitey.

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Yo cloud

you´re referencing abilities are unparelled!