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But, have you read the latest AANA backed propaganda? CRNAs are just as safe as MD (A)s. Hence, where is the liability? Also, the training is equivalent per the AANA.
They have the evidence to back up those claims in court. Where is your evidemnce they aren't safe as a group? Thus, each malpractice case must be evaluated based on its own merits and not based on just Solo CRNA care. You must prove deviation from the standard of care and for CRNAs that means the AANA standards.
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If CRNA = MD(A), then wouldn't they need to fulfill both the AANA and the ASA standards?
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Do CRNAs pay any liability/mal-nursing insurance? If not, can we as physicians (working in a group with CRNAs) refuse to cover them?
You are incorrect. The standard of care for an independently practicing CRNA has nothing to do with the AANA. They will be held to the standard of care of an expert in the field.
I could be a neurosurgeon right now. I have an unrestricted medical license. So long as I have privileges to do it at whatever setting I am in, I'm good to go. The only problem is that legally I will be held to the same standard of care as a board certified neurosurgeon. (Another problem would be negotiating contracts with insurers for payment) But back to the point...you are held medicolegally to the standard of care of an expert in the field.
An independently practicing CRNA is going to be held to the standards of a board certified anesthesiologist.
In other words, even a mediocre defense attorney is going to kill them in court.
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CRNAs are considered "experts" as well. A defense attorney would try hard to establish MD bias against CRNAs in order to taint the testimony. Yes, CRNAs are held to the same standard of care but whose standard?
MD=DO but don't DO's have their own governing Board and exams for licensure? Same thing for CRNAs. THey have their own Board and regulatory bodies. Remember CRNA claims "Equivalence" to MD just as DOs claim Equivalence.
They could try as hard as they want to show bias, but they'd have no way of proving they didn't receive inadequate training.
I mean any rational person can do the math on years and hours of training and minimum acceptable standards for each and they would be SOL. Even the JV legal squad would hang them out to dry.
I mean any rational person can do the math on years and hours of training and minimum acceptable standards for each and they would be SOL. Even the JV legal squad would hang them out to dry.
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there cant be two experts.. standard of care is standard of care. there is no difference depending on who the practicioner is. If the standard of care to get a consult on a pulmonary cripple... if you dont get one. you are below the standard of care. doesnt matter who it is..
And osteopaths dont claim equivalnece. they are equivalent. period. Nurses are not. they are nurses.. get your facts straight blade. im ashamed of you
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You are missing the point. DOs have their own Osteopathic Boards. They even have their own Anesthesia Board Certification exam. While they may be SIMILAR to our Boards they are NOT identical. Yet, they are equivalent in a court of law and for the state Boards of Medicine.
Although it pains me to say this the AANA Boarded CRNA has their own Boards (Nursing, AANA exam) and regulatory bodies. Similarly, the Courts have ruled that Anesthesia is both Nursing when practiced by a CRNA and Medicine when practice by an MD/DO. Hence, the standard of care for a CRNA is set by the AANA and its regulatory bodies and not the ASA. While many CRNAS/AANA have adopted those standards they did so after review and their own decision making process.
Thus, be careful by making claims that just because one is CRNA doing solo anesthesia that violates "standard of care." All mishaps/malpractice must be evaluated on case by case basis based on the facts.
http://www.aocaonline.org/
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HorseSh iT
osteopaths are physicians nurses are not.
so if crnas changed their npo guidelines to say a cheeseburger and fries is ok to eat 5 mins prior to surgery that would be ok? as long as the crna were practicing solo. Cmon.
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Anesthesia: Practice of Nursing and Practice of Medicine
State legislatures, through licensing laws, determine what is and is not the practice of medicine and what is and is not in the publics best interest. Licensing laws, however, do not create monopolies for professions. Many professions are authorized to practice in the same, related, or similar fields and as a result have overlapping practice areas. Because of this overlap, many areas of practice are not the exclusive province of one healthcare profession or solely the practice of medicine. For example, anesthesia administration is a series of functions through which patients are rendered insensitive to pain; these functions can and do constitute the practices of nursing, dentistry, or medicine. Courts have long recognized the administration of anesthesia by nurses as a proper nursing function. Consequently, anesthesia administration is an area that is both the practice of medicine and the practice of nursing.These previously published articles are intended for reference to gain a greater understanding of the role anesthesia care plays as a part of the practice of nursing and the practice of medicine.
Please note: These articles are not intended as legal advice nor are they advice on the law of any state. If legal advice is required, the services of a competent attorney should be sought.
Anesthesia: A practice of nursing (April 1987)
Anesthesia It's finally the practice of medicine (April 1999)
The overlap between the practice of medicine and the practice of nursing (February 1998)
The administration of anesthesia and the practice of medicine (June 1990)
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you didnt answer the question
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The answer is eating a burger 5 minutes before having surgery is just as wise as spitting on the skin before doing an Epidural. I doubt the AANA endorses either one.
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Standard of care
There are several things to notice about the standard of care. First, standards of care are not issued by professional associations. The standard of care is what others in the profession would do under similar circumstances. What a professional association says about the standard of care is irrelevant unless an expert says it is what the members of the profession do. While experts may sometimes refer to statements by a professional association, only the members of the profession can establish the standard of care and they do it by their conduct. Second, you have to consider the real world circumstances of why and when the court is determining the standard of care. As a rule, courts do not care about standards of care when everything goes well. If we are concerned about a standard of care, then something has gone wrong and a patient and lawyer are looking for someone to blame. Both the patient and the practitioner will offer expert testimony as to the standard of care. Usually, their experts differ either on the "standard" or on how it should be applied to the facts of the particular case. Under our system of jurisprudence, the trier of fact, sometimes a court, but often a jury, has the ultimate responsibility of determining the standard of care. No one really knows the extent to which juries are influenced by their sympathy for an injured plaintiff. Finally, it is at least theoretically possible for the standard of care followed by the members of a profession to be below a reasonable standard. Were that to occur, the courts would apply a standard of care that was reasonable and not necessarily the practices followed by the profession.
In healthcare, defining the standard of care is complicated. It is not just the things that everybody does or that most people do that constitutes the standard of care. It is the things that practitioners do that relate to quality outcomes that define the standard of care. Which brings me to Tiger Woods, the very successful professional golfer. When Tiger Woods plays a golf tournament, he wears a red shirt on the last day of the tournament. He does this every time. Does this make the wearing of a red shirt on the last day of the tournament a standard of care for professional golfers? Obviously not. First, even Tiger Woods does not win every golf tournament in which he wears a red shirt on the last day of the tournament. While Tiger Woods has been very successful, he does not win every time. In fact, he does not even win most of the time. Moreover, golfers who do not wear red shirts win golf tournaments as well. There is no scientific evidence that wearing red shirts on the last day of a golf tournament has any bearing on winning or losing golf tournaments.
AANA website/Propaganda
There are several things to notice about the standard of care. First, standards of care are not issued by professional associations. The standard of care is what others in the profession would do under similar circumstances. What a professional association says about the standard of care is irrelevant unless an expert says it is what the members of the profession do. While experts may sometimes refer to statements by a professional association, only the members of the profession can establish the standard of care and they do it by their conduct. Second, you have to consider the real world circumstances of why and when the court is determining the standard of care. As a rule, courts do not care about standards of care when everything goes well. If we are concerned about a standard of care, then something has gone wrong and a patient and lawyer are looking for someone to blame. Both the patient and the practitioner will offer expert testimony as to the standard of care. Usually, their experts differ either on the "standard" or on how it should be applied to the facts of the particular case. Under our system of jurisprudence, the trier of fact, sometimes a court, but often a jury, has the ultimate responsibility of determining the standard of care. No one really knows the extent to which juries are influenced by their sympathy for an injured plaintiff. Finally, it is at least theoretically possible for the standard of care followed by the members of a profession to be below a reasonable standard. Were that to occur, the courts would apply a standard of care that was reasonable and not necessarily the practices followed by the profession.
In healthcare, defining the standard of care is complicated. It is not just the things that everybody does or that most people do that constitutes the standard of care. It is the things that practitioners do that relate to quality outcomes that define the standard of care. Which brings me to Tiger Woods, the very successful professional golfer. When Tiger Woods plays a golf tournament, he wears a red shirt on the last day of the tournament. He does this every time. Does this make the wearing of a red shirt on the last day of the tournament a standard of care for professional golfers? Obviously not. First, even Tiger Woods does not win every golf tournament in which he wears a red shirt on the last day of the tournament. While Tiger Woods has been very successful, he does not win every time. In fact, he does not even win most of the time. Moreover, golfers who do not wear red shirts win golf tournaments as well. There is no scientific evidence that wearing red shirts on the last day of a golf tournament has any bearing on winning or losing golf tournaments.
AANA website/Propaganda
The AANA website can talk about the standard of care and how it is determined until they are blue in the face, but it's still irrelevant.
In a court, the standard of care is what is testified to by the expert witness. If the plaintiffs bring an anesthesiologist testifying that standard of care was breached in some manner causing harm and the defense attorney has a CRNA saying it wasn't breached, each side will list the credentials of their "expert" and crossexamine the other's.
Juries are extremely favorable towards physicians when it comes to handing out judgments. If a CRNA is arguing against the expert opinion of an anesthesiologist in court, they will lose nearly 100% of the time.
I'm not saying CRNA independent practice is automatically considered violating the standard of care in some areas of the country. I am saying that if and when things go wrong and the care that was provided is inferior, they are going to be in a nearly defenseless position in a court room.
In a court, the standard of care is what is testified to by the expert witness. If the plaintiffs bring an anesthesiologist testifying that standard of care was breached in some manner causing harm and the defense attorney has a CRNA saying it wasn't breached, each side will list the credentials of their "expert" and crossexamine the other's.
Juries are extremely favorable towards physicians when it comes to handing out judgments. If a CRNA is arguing against the expert opinion of an anesthesiologist in court, they will lose nearly 100% of the time.
I'm not saying CRNA independent practice is automatically considered violating the standard of care in some areas of the country. I am saying that if and when things go wrong and the care that was provided is inferior, they are going to be in a nearly defenseless position in a court room.
