A Cry For Help

[Coastie]

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Just look at the Physician Assistants now in other specialties. are they clamoring for independence? Are there studies showing that PAs are better than physicians? are more cost effective? I dont know of any do you? The crnas are yelling and screaming that theyve been doing anesthesia for a hundred years before we even started doing anestheisia. My retort.. there is a reason we got involved in anesthesia in the first place. There is a reason why it is a medical specialty.

It's a medical specialty because we invented it....and the nurses came along later..and in smaller numbers. The nursing history rewrite is unbelievable..and when they came along, they contributed nothing in terms of research or safety, just rode the gravy train.

 

[bcat85]

straight up guys, what is the deal on anesthesia in the future? I am planning on going into it, but SDN has an almost doomsday forecast for the specialty as a whole. It seems that every specialty has a turf war of some sort... NP's with family practice, cardiology with CTS, etc. I really enjoy the work, more than most every specialty I have rotated in, but I'm a little worried about the future. Should I do it or should I pick something else?

 

[Planktonmd]

straight up guys, what is the deal on anesthesia in the future? I am planning on going into it, but SDN has an almost doomsday forecast for the specialty as a whole. It seems that every specialty has a turf war of some sort... NP's with family practice, cardiology with CTS, etc. I really enjoy the work, more than most every specialty I have rotated in, but I'm a little worried about the future. Should I do it or should I pick something else?

Don't do it.

 

[cchoukal]

great question. people can correct me if i am wrong but AA/PA schools almost require the same requirements to get into medical school and many if not all take the mcat. Thus, they have a more broad science backround and a stronger undergrad education more suitable then nursing for medical decision making. NUrses dont even take real chemistry or physics classes. And lastly, I believe AAs have more academic humility which is essential I repeat essential for lifelong learning and improvements. Crnas know everything before they even start school. Dumb asses. they dont even know what they dont know.

So i believe your mother would be well served by having an AA as part of the team taking care of her the above being a few among many.

So their credentials are even MORE like ours than the nurses' are and we expect that they won't some day exploit that fact and try to lobby for independence?

And academic humility? Is it reasonable to assign that trait to the whole group?

I'm not trying to be an instigator, but I just don't see the difference; it looks like we're trying to substitute one mid-level for another, who just happens to be, at this moment, less politically active.

 

[bmalon3]

I have been reading the discussions about this, and I figured I would give my two cents. I am an AA-s and before that I went to a clinical lab science program. Both of these programs are located in Allied division of medicine. Advanced practice nurses and nurses are trained in the school of nursing. They take a lot of nursing ethics classes and are brain washed with propaganda that they can take over doctor's positions. Sure not all of them want to do this, but with such a large amount of contributors to their national organization the higher ups can pass whatever laws they need to. In the allied health sector we are trained to work with doctors, and to consult them whenever a problem arises. A.A.'s are qualified Anesthesia providers with a science background (medical school prereqs), and a science based curriculum. That's why you don't see P.A.'s and AA's trying to take over the world. Also the allied health profession is closely tied to physicians, as not one specialty can practice or get reimbursed without physician supervision. If anyone want's more info. on the A.A. profession send me a message! Apparently there is another school in the works.

Also, there are more and more A.A.'s graduating every year. 10 years ago less than 60 graduated per year. Now its around 200!

 

[maceo]

So their credentials are even MORE like ours than the nurses' are and we expect that they won't some day exploit that fact and try to lobby for independence?

And academic humility? Is it reasonable to assign that trait to the whole group?

I'm not trying to be an instigator, but I just don't see the difference; it looks like we're trying to substitute one mid-level for another, who just happens to be, at this moment, less politically active.

I do all my own cases at the private practice. we do hearts, OB peds.. etc about the only thing we dont do is transplants and really really sick kids which are farmed out. I get 8 weeks vacation. I LOCUM at this one place where all i do is supervise on my vacation weeks . I am not allowed to do my own cases there. WOuldnt be cost effective im told. there are a bunch of AAs there. And I am telling you.. they are much much better. they think better, and have better decision making skills. The crnas have a nursing mentality and protocol driven. They just dont have it upstairs, so to compensate they are exceedingly defensive. I do get along with all of them though.

AAs are not under the board of nursing. They are i believe under the board of medicine. So it woul dbe difficult for them to claim independence. Not that they would want to. Its a team approach and they embrace it

 

[maceo]

I have been reading the discussions about this, and I figured I would give my two cents. I am an AA-s and before that I went to a clinical lab science program. Both of these programs are located in Allied division of medicine. Advanced practice nurses and nurses are trained in the school of nursing. They take a lot of nursing ethics classes and are brain washed with propaganda that they can take over doctor's positions. Sure not all of them want to do this, but with such a large amount of contributors to their national organization the higher ups can pass whatever laws they need to. In the allied health sector we are trained to work with doctors, and to consult them whenever a problem arises. A.A.'s are qualified Anesthesia providers with a science background (medical school prereqs), and a science based curriculum. That's why you don't see P.A.'s and AA's trying to take over the world. Also the allied health profession is closely tied to physicians, as not one specialty can practice or get reimbursed without physician supervision. If anyone want's more info. on the A.A. profession send me a message! Apparently there is another school in the works.

Also, there are more and more A.A.'s graduating every year. 10 years ago less than 60 graduated per year. Now its around 200!

Thanks for joining bmalon. maybe you can shed some light on your backround for the poster who was interested.. I fully support the PA/AA field.

we need more legislation for AA/ PA anesthesia practice. The time has come. the days of arrogant/ dangerous CRNA rhetoric will becoming to an end. I encourage anyone who is interested in anesthesia to support AA/PA legislation.

 

[bmalon3]

For AAs the curriculum is heavily geared towards the sciences. We do not take any nurse ethics courses or anything related to that. Some people in my class too the MCAT to get accepted, and others took the GRE. Everyone did very well as IMO there is a lot more competition to get into the AA programs. Right now there are 7 schools including their satellites. Some schools can support 45 and others only 6. If you look at the incoming class stats for Emory on their website it's very impressive. (just google emory aa program and you can learn about it) From day one we are taught how to work in the ACT approach. Even in lab simulations that's how it's structured. The instructors at our specific institution are some of the best practitioners out there and have earned a great deal of autonomy because of the relationships built with their attendings. We are just as capable as any CRNA, but we won't take an MD's job at the end of the day because we are governed by the Medical Board. Our profession is closely tied with Anesthesiologist as we could not be a profession without their support.

The AA profession was founded by Anesthesiologists and because of that we are closely tied to whatever legislation the ASA passes. Sure we have our own governing body The American Academy of Anesthesiologist Assistants, but we really do not have enough money or power as group to get anything passed without help from the ASA and other physicians. I know the nursing board tried to stop P.A. legislation when they were first introduced, and now they are trying to block AAs from practicing in all 50 states.

again if anyone has any questions pertaining to the profession just msg me.

 

[dhb]

Our profession is closely tied with Anesthesiologist as we could not be a profession without their support.

👍

 

[fakin' the funk]

Not bottom quartile. My stats are sick, btw. And I'm not spineless, my balls are titanium. People tell me I should be a surgeon all the time. I tell them I'm not that stupid.

🙄

 

[Dejavu]

Are you training crna's there? How about AA's?
Do crna's do regional? How about central lines? Are they in on the bigger cases while a resident is doing his or her 25th total joint? Do they get out at 3:30pm while a resident is kept late and sent in to relieve them?

These are some of the questions you guys need to ask while interviewing.

Let's see...

Yes, no, no, no, no, no

In fact, CRNAs get residents out for all lectures, meetings, etc. That is not to say that residents don't work until their room is done sometimes while some CRNAs go home. It is often based on the luck of drawing a busy room, compared to others, but that works both ways too.

 

[Dejavu]

Don't do it.

Do it. This conversation and concern has been around for at least 34 yrs that I personally know about and nothing much has changed. Based on that, I very much doubt that things will change drastically in your lifetime. Inertia is a major force in the universe.

Again, please, I don't want to start something, I am just reporting history. Flame wars are the single most un-productive thing on the internet, which is filled with un-productive stuff. I avoid participating.

 

[Dejavu]

You guys have a CRNA school, right?

I've heard that you don't allow regional, neuraxial, or central line placement for SRNAs/CRNAs. Is this true?

True on both counts.

 

[BLADEMDA]

Do it. This conversation and concern has been around for at least 34 yrs that I personally know about and nothing much has changed. Based on that, I very much doubt that things will change drastically in your lifetime. Inertia is a major force in the universe.

Again, please, I don't want to start something, I am just reporting history. Flame wars are the single most un-productive thing on the internet, which is filled with un-productive stuff. I avoid participating.

Flame war? We can agree to disagree on issues while remaining civil (even on the internet).

The field of Anesthesiology is undergoing a "transformation" (an Obama word) unlike anything in the past 50 years. Even past presidents of the ASA have admitted CRNA to MD ratios of 9:1 are not out of the realm of possibilities. The threat from the AANA has always been real and present but the current situation has escalated from Orange to Red.

Do I think we will always need Anesthesiologists? Yes. Do I think we will need as many as we are producing? Not if the AANA/CRNAs keep pumpimg out record numbers of new graduates. The "cheaper" alternative is a CRNA doing the case with minimal supervision. This means less positions available for Anesthesiologists.

In short you see the world through the lens of a 1985 AANA. It is time to get a new pair of glasses. The proposed AANA paradigm leaves the medical specialty of Anesthesiology in grave jeopardy. Under Obamacare CRNAs are far more likely to gain more autonomy then remain in the rigid 4:1 model of the past. The only thing we know for certain is that change is constant and those who adhere to the status quo eventually go the way of the dinosaur.

Hence, in all honesty I could not advise a Medical Student to choose the field of Anesthesiology when a CRNA with DNAP can do the same job for less (per recent AANA studies/propaganda). If the medical student has good grades and USLME scores then choose another specialty. If however Anesthesiology is his/her choice then be forewarned about the hazards/pitfalls of that decision: In 20 years when you end up as a glorified CRNA with DNAP the only person to blame is staring back at you in the mirror.







The scale consists of five color-coded threat levels, which are intended to reflect the probability of a terrorist attack and its potential gravity.

• Severe (red): severe risk
• High (orange): high risk
• Elevated (yellow): significant risk
• Guarded (blue): general risk
• Low (green): low risk

 

[Planktonmd]

Do it. This conversation and concern has been around for at least 34 yrs that I personally know about and nothing much has changed. Based on that, I very much doubt that things will change drastically in your lifetime. Inertia is a major force in the universe.

Again, please, I don't want to start something, I am just reporting history. Flame wars are the single most un-productive thing on the internet, which is filled with un-productive stuff. I avoid participating.

He should not do it because he seems to want us to tell him it's going to be OK, and that the risk of the whole specialty degrading into a nursing domain is not real.
No one can make such promise.
If you need this type of assurance then you are not ready to take the risk and you are likely to be disappointed.

 

[Dejavu]

He should not do it because he seems to want us to tell him it's going to be OK, and that the risk of the whole specialty degrading into a nursing domain is not real.
No one can make such promise.
If you need this type of assurance then you are not ready to take the risk and you are likely to be disappointed.

Truthfully, you and Blade (above post) have me. I cannot quarantee to the OP that what you say will happen won't happen. I personnally hope it doesn't, I just don't think it will.

But, I suppose could be very wrong about this.

 

[335230]

ok

 

[cfdavid]

Blade and Plankton:

I respect all your comments. I just am not sure how to predict what fields will be still left once Obamacare / whatever new law comes down the pike.

What will the role of PQRI be ? The role of the "bundling" experiments authorized by HHS? Will insurance companies be allowed to keep raising rates like this - if not then who gets cut and how? Will procedures become elective and out of pockets ?

There are just SO many variables its hard for me to predict. Don't you guys agree?

I am just fresh from rotating out of other fields. I think there are some fields that have less problems going forward and offer a good lifestyle (radiology, derm to name two ps even derm has NP's coming up in the next 5 years !), but there are many other fields that are facing a lot of problems as well (primary care, ob / gyn with midwives, psych with np's, etc ...).

I know what you are saying Blade regarding other fields and still being the only "players" in their field.

But, would you want to be a neurosurgeon (as tough as that career is) making $200,000 less than today? As far as I can tell, CT surgeons have been hit bad in the last 10 years. I would not want to pursue one of these more demanding fields in this environment, I would rather go back to dental school and make less but be happy at work with low stress.

I love anesthesiology and think I may do a pain fellowship.

I think in general your generations of doctors had it decent to good, my generations of docs in many fields will have it mediocre at best. This is based on SGR, the broken budget, and the public demand for "free stuff" with no work for it.

I love you guys, but I am just not sure what field is going to be immune from all these issues going forward and still offer a decent lifestyle. Perhaps derm? radiology? but I can't figure out too much more after those that those of us could stomach going forward. 😳

I'm in the NICU right now. They also use NP's (inevitably some will go the DNP route), and they have a suprising amount of "flexibility" even with the 27 weekers'. Sure, they're supervised but at some point they'll get cocky just as CRNA's have been in our field for, apparently, an awful long time.

The GOOD part to all of this is that it WILL unify physicians. Sure, there are a handful of specialties where encroachment has not occured to any appreciable extent (surgery, interventional cards, IR etc.), but MANY other specialties are going to feel what anesthesiology has been dealing with for years.

We're already seeing said specialties all of the sudden come to the "rescue" of anesthesiology with folks in leadership positions posting editorial responses to the various allegations that are being made. They are doing this precisely because they know they're increasinly coming under similar pressures, not out of the goodness of their hearts (more than likely).

All of us coming into the field just need to be vigilant, creative, do a great job, get extra training, take on leadership positions when possible, donate, and become active. It's not that hard. This is up to us.

cf

 

[335230]

ok

 

[pgg]

I have not been given private forum access for some reason,

You may wish to PM Arch - I know the request queue was backed up recently, but he'll get you taken care of.

 

[Apollyon]

I'm looking out for you guys!

A few days ago, my waitress and I were chatting. She said she came here to go to school. I asked her for what. She said to do nursing, then become an anesthesiologist.

I corrected her to CRNA and anesthetist. I also cautioned her against the rhetoric of the AANA. I then corrected her again as to CRNA, and how nurses should do at least a year on the floor/unit before CRNA school, instead of going straight through. To this she agreed.

I finally, again, said that anesthesiologists are doctors.

I'll revisit this issue with her PRN/ad lib.

 

[Mman]

This is for real. Stop using them. We have given up so much already. Now with Obama plus the media... Well, our jobs and our patients are at risk. I can't provide the top quality care I give every single one of my patients if I'm running 4 rooms. It just isn't possible. Spoke to a resident colleague of mine who went ACT this past week.... Wow... The things I heard. Ridiculous and freak'n dangerous.

I'd say that what gets done in various places is more dependent on the individuals there than on the ACT or MD only model. I've seen people doing their own cases that kinda scare me, too.

The ACT model is still the best model. I believe it is a waste of your medical education and graduate medical training to be sitting on the chair for the duration of a lap chole. Your brain works better than that. It can multitask and process lots of complex info at once.

Besides, if anyone really wants to take the argument that their should be no ACT model, they pretty much have to argue that all of residency should be 1 on 1 with an attending. Because supervising a couple first year residents in the OR is not as easy (and likely more dangerous) as supervising several good experienced CRNAs.

The militant CRNA lobby that wants to practice independently is obviously stupid and greedy and doesn't care about the patients. That doesn't mean the ACT model is broken, however.


(I also fully support using AAs alongside CRNAs)

 

[combatwombat]

Just thought this was ironic

 

[Southpaw]

Just thought this was ironic

Guess SDN has to pay the bills also. Maybe they also let the DNP online programs advertise in the primary care forums.

 

[pgg]

Guess SDN has to pay the bills also. Maybe they also let the DNP online programs advertise in the primary care forums.

Google ads are keyword based, so they sorta match the context of the page they appear on. I don't think SDN has any input over what text ads appear. It's all automated. I bet the ads that show up in threads about scotch or watches or cars or guns are similarly targeted.

 

[Taurus]

I think it is more critical than ever for physicians to conduct studies to demonstrate differences in the outcomes between physicians and nurses. Regulators are using the garbage studies that the nurses have put out to make policies because the physicians have not offered valuable studies of their own. Secondly, it is more critical than ever for us to be aware of who we are training. Don't train or hire NP's or CRNA's.

IOM Report Says Nurses Need More Training, Independence

By Katherine Hobson

Nurses need increased training, more opportunity to assume leadership roles and an end to barriers that prevent them from practicing “to the full extent of their education and training,” says a new report from the Institute of Medicine.

The report, by the IOM’s Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, says the health-care overhaul legislation will increase demand for medical services as more people have insurance coverage — and that nurses will play a key role in meeting that demand. (The Association of American Medical Colleges recently said health-care overhaul legislation will exacerbate a projected shortage of physicians.)

The most controversial recommendations of the committee — which includes nurses, doctors, academics and other health industry participants and is chaired by former HHS head Donna Shalala — are likely to be those that deal with so-called “scope of practice,” i.e. the authority nurses have to order tests, prescribe medicine and perform other medical services. As Kaiser Health News writes, the report “calls for states and the federal government to remove barriers that restrict what care advanced practice nurses — those with a master’s degree — provide and includes many examples of nurses taking on bigger responsibilities.”

Advanced practice nurses include nurse practitioners, certified nurse midwives and certified registered nurse anesthetists (CRNAs). (The latter will be familiar to Health Blog readers — we’ve followed the heated debate about whether anesthesia services provided by a CRNA working independently of a physician should be reimbursed by Medicare. States can opt out of this requirement by petitioning CMS.)

This report says CMS should reimburse advanced practice nurses the same as a physician if the same care is being provided, and calls for the FTC to make sure scope of practice rules aren’t anti-competitive, KHN points out. Efforts to expand the scope of what a nurse can do are often met with pushback by physicians, who argue even advanced practice nurses don’t have the same education and training as doctors.

The IOM report also calls for the establishment of residency training programs for nurses, an increase in the percentage of nurses who get at least a bachelor’s degree to 80% by 2020 and an increase the number of nurses who obtain doctorates.​

 

[epidural man]

Don't do it.

Agree 100%.

Quit now and become a dentist - then 1 yr residency/fellowship (or whatever the hell they call it) in something.

If you are a med student, you can get into dental school and finish in less time than you would as an anesthesiologist, and make a ton more money - and a better life style.

Just sayin.....

 

[Double Bonded]

Agree 100%.

Quit now and become a dentist - then 1 yr residency/fellowship (or whatever the hell they call it) in something.

If you are a med student, you can get into dental school and finish in less time than you would as an anesthesiologist, and make a ton more money - and a better life style.

Just sayin.....

seriously?

(might as well mention that dental residencies are optional)

 

[epidural man]

seriously?

(might as well mention that dental residencies are optional)

Serious about what?

That it would take less time? Yes, I think this is true in almost every instance unless someone is close to finishing (4rth year - then its pretty darn close.)

That they make more money? I think this is probably true in most cases - yes. When i see the cars my dentist friends drive compared to mine - it just drives this point home.

Better life style? Abso****inlutely. No call. No weekends. I can't imagine that putting on crowns is more stressful than trying to do anesthesia on a 350lb women with EF of 15% that is a full stomach and obtunded because she fell in the bathroom and now has a subdural hematoma and needs emergent surgery. (That was my oral board question a few years back...hahaha).

Plus, dentists has been completely brilliant with whole insurance thing - and I don't think that the health care woes have (or will) much effected them. They may have to eventually sell the yacht, and pay Paco the pool boy less - who knows.

 

[ProRealDoc]

I think it is more critical than ever for physicians to conduct studies to demonstrate differences in the outcomes between physicians and nurses. Regulators are using the garbage studies that the nurses have put out to make policies because the physicians have not offered valuable studies of their own. Secondly, it is more critical than ever for us to be aware of who we are training. Don't train or hire NP's or CRNA's.

IOM Report Says Nurses Need More Training, Independence

By Katherine Hobson

Nurses need increased training, more opportunity to assume leadership roles and an end to barriers that prevent them from practicing "to the full extent of their education and training," says a new report from the Institute of Medicine.

The report, by the IOM's Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, says the health-care overhaul legislation will increase demand for medical services as more people have insurance coverage — and that nurses will play a key role in meeting that demand. (The Association of American Medical Colleges recently said health-care overhaul legislation will exacerbate a projected shortage of physicians.)

The most controversial recommendations of the committee — which includes nurses, doctors, academics and other health industry participants and is chaired by former HHS head Donna Shalala — are likely to be those that deal with so-called "scope of practice," i.e. the authority nurses have to order tests, prescribe medicine and perform other medical services. As Kaiser Health News writes, the report "calls for states and the federal government to remove barriers that restrict what care advanced practice nurses — those with a master's degree — provide and includes many examples of nurses taking on bigger responsibilities."

Advanced practice nurses include nurse practitioners, certified nurse midwives and certified registered nurse anesthetists (CRNAs). (The latter will be familiar to Health Blog readers — we've followed the heated debate about whether anesthesia services provided by a CRNA working independently of a physician should be reimbursed by Medicare. States can opt out of this requirement by petitioning CMS.)

This report says CMS should reimburse advanced practice nurses the same as a physician if the same care is being provided, and calls for the FTC to make sure scope of practice rules aren't anti-competitive, KHN points out. Efforts to expand the scope of what a nurse can do are often met with pushback by physicians, who argue even advanced practice nurses don't have the same education and training as doctors.

The IOM report also calls for the establishment of residency training programs for nurses, an increase in the percentage of nurses who get at least a bachelor's degree to 80% by 2020 and an increase the number of nurses who obtain doctorates.
​

The highlighted red text is the only true part of the article I actually agree with.

 

[maceo]

I think it is more critical than ever for physicians to conduct studies to demonstrate differences in the outcomes between physicians and nurses. Regulators are using the garbage studies that the nurses have put out to make policies because the physicians have not offered valuable studies of their own. Secondly, it is more critical than ever for us to be aware of who we are training. Don't train or hire NP's or CRNA's.

IOM Report Says Nurses Need More Training, Independence

By Katherine Hobson

Nurses need increased training, more opportunity to assume leadership roles and an end to barriers that prevent them from practicing “to the full extent of their education and training,” says a new report from the Institute of Medicine.

The report, by the IOM’s Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, says the health-care overhaul legislation will increase demand for medical services as more people have insurance coverage — and that nurses will play a key role in meeting that demand. (The Association of American Medical Colleges recently said health-care overhaul legislation will exacerbate a projected shortage of physicians.)

The most controversial recommendations of the committee — which includes nurses, doctors, academics and other health industry participants and is chaired by former HHS head Donna Shalala — are likely to be those that deal with so-called “scope of practice,” i.e. the authority nurses have to order tests, prescribe medicine and perform other medical services. As Kaiser Health News writes, the report “calls for states and the federal government to remove barriers that restrict what care advanced practice nurses — those with a master’s degree — provide and includes many examples of nurses taking on bigger responsibilities.”

Advanced practice nurses include nurse practitioners, certified nurse midwives and certified registered nurse anesthetists (CRNAs). (The latter will be familiar to Health Blog readers — we’ve followed the heated debate about whether anesthesia services provided by a CRNA working independently of a physician should be reimbursed by Medicare. States can opt out of this requirement by petitioning CMS.)

This report says CMS should reimburse advanced practice nurses the same as a physician if the same care is being provided, and calls for the FTC to make sure scope of practice rules aren’t anti-competitive, KHN points out. Efforts to expand the scope of what a nurse can do are often met with pushback by physicians, who argue even advanced practice nurses don’t have the same education and training as doctors.

The IOM report also calls for the establishment of residency training programs for nurses, an increase in the percentage of nurses who get at least a bachelor’s degree to 80% by 2020 and an increase the number of nurses who obtain doctorates.​

there is no better study than outcomes. When people start dying and anesthesia mishaps and accidents start happening left and right only then will the democrats start to reep what they sow. What is unfortunate is the un knowing patients will suffer the consequences all to save money.

 

[Dejavu]

I have a simple solution to the "nurses need more training and independence". I felt the same way back in 1987 when I was a CRNA.

What did I do about it? I quit my job, went to finish pre-med requirements I didn't have, applied to med school, did anesth residency and got my "more training and independence" the legitimate way.

If the nurses who want more "independence" are good enough practitioners to deserve it, then they are smart enough to go to med school and get it; without using legislation as a poor short-cut to it.

 

[skatertudoroga]

For AAs the curriculum is heavily geared towards the sciences. We do not take any nurse ethics courses or anything related to that. Some people in my class too the MCAT to get accepted, and others took the GRE. Everyone did very well as IMO there is a lot more competition to get into the AA programs. Right now there are 7 schools including their satellites. Some schools can support 45 and others only 6. If you look at the incoming class stats for Emory on their website it's very impressive. (just google emory aa program and you can learn about it) From day one we are taught how to work in the ACT approach. Even in lab simulations that's how it's structured. The instructors at our specific institution are some of the best practitioners out there and have earned a great deal of autonomy because of the relationships built with their attendings. We are just as capable as any CRNA, but we won't take an MD's job at the end of the day because we are governed by the Medical Board. Our profession is closely tied with Anesthesiologist as we could not be a profession without their support.

The AA profession was founded by Anesthesiologists and because of that we are closely tied to whatever legislation the ASA passes. Sure we have our own governing body The American Academy of Anesthesiologist Assistants, but we really do not have enough money or power as group to get anything passed without help from the ASA and other physicians. I know the nursing board tried to stop P.A. legislation when they were first introduced, and now they are trying to block AAs from practicing in all 50 states.

again if anyone has any questions pertaining to the profession just msg me.

Hi. Please tell me the salary and vacation time for for AA? Is it the same as CRNA?

 

[skatertudoroga]

I feel that AA would be better for me than MD or DO anesthesia assuming 2yrs of training versus 9years of training and a constant $150k/yr salary versus $350k/yr salary. But I am afraid that if I do this then 2yrs from now there might be oversaturation of crna/aa and as such a serious drop in job availability or salary. I could definitely live off $150k/yr. And that would mean 7yrs of living like a man as opposed to starving as a student/resident. But if AA salary drops to $100k/yr i dont think i could enjoy it long-term. I want to have a trophy wife. So please convince me to apply to AA schools. Thanks.

 

[fakin' the funk]

I can't imagine that putting on crowns is more stressful than trying to do anesthesia on a 350lb women with EF of 15% that is a full stomach and obtunded because she fell in the bathroom and now has a subdural hematoma and needs emergent surgery. (That was my oral board question a few years back...hahaha).

And, your answer, sir?

 

[vetsleeper]

It is truly unfortunate that you as a student hold the view that CRNAs are unsafe. The ASA and the AANA are trying to find common ground for collaboration and support when third party payers and other players in the field of healthcare, seek to limit our practices and severely decrease our reimbursement fees. It is hard enought to work towards providing the general population with safe, evidence based,affordable anesthesia care without aneshtetists and anesthesiologists drawing "battle lines in the sand".
You say "it's not about money", well what is it about? The studies that have been done on both sides of this debate can be questioned and picked apart. But the bottom line is that there is strength and safety in unity and the experienced MDAs that have realized the advantages of working with Board Certified Nurse Anesthetists can and will tell you that!
Focus on honing your own skills and making certain that the people around you are as skilled, if not more so, as yourself. In order for this to happen, physicians and nurses need superior training in anesthesia delivery. CRNAs are not going away. They were here in the beginning and they will help shape the future of anesthesia delivery for the future.

 

[Mman]

It is truly unfortunate that you as a student hold the view that CRNAs are unsafe.

A good CRNA supervised by a competent anesthesiologist is very safe. A CRNA that thinks they can and should practice independently is definitely not safe as they have already demonstrated a lack of sound judgment.

The ASA and AANA should work together to ensure that patients receive the best care possible. And the best care always involves an anesthesiologist!