AA Question

[Sarah007]

Hey,
I've recently become interested in the anesthesiologist assistant route and I'm wondering what the career outlook is for this career. I've searched for jobs online and found very few, but I'm wondering if this is because they would be recruited before getting out of school. Has anyone had any personal experience job hunting as an aa? Any information you could provide would be appreciated. Thanks!

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[Endee]

I'm an AA student right now. The job outlook is excellent. 99.9% of jobs are not posted on any kind of website or public forum. Your job hunting begins as soon as you start clinical rotations because those are all potential employers. You will not have a problem finding a job but don't expect to get a good one without some legwork.

 

[facetguy]

I'm an AA student right now. The job outlook is excellent. 99.9% of jobs are not posted on any kind of website or public forum. Your job hunting begins as soon as you start clinical rotations because those are all potential employers. You will not have a problem finding a job but don't expect to get a good one without some legwork.

What makes for a good AA job? Salary (what is the average good salary anyway?), hours, bennies?

 

[Taurus]

The future is very bright. In 5 years, the number of schools went from 2 to 7 and more are in the planning stages. Several more states approved AA licensure and no doubt there will be more states in the future.

 

[facetguy]

What makes for a good AA job? Salary (what is the average good salary anyway?), hours, bennies?

Anybody?

 

[jwk]

Anybody?

It all depends on what you're looking for. Most importantly, and this is in any profession, money isn't everything.

Salary and benefits are dependent on where you work, how much you work, local custom, and whether you work for a hospital or a group. Some work a straight 7-3 M-F kind of schedule. Others work three 12's. Some take call, some don't. Private practice groups tend to have better benefits than hospitals, but hospitals sometimes have better salaries to make up for the lack of benefits.

I would venture a guess that few of this years graduating class will make less than $90k their first year. With OT, some will make significantly more than that. BUT - you have to look at everything to make a comparison and make informed decisions.

 

[facetguy]

I agree that salary isn't everything. But $90k/yr is a pretty hefty cut from some of the starting salaries we tend to see thrown around sometimes. Or perhaps $90k is more realistic, while the higher salaries spoken about here in public are more like outliers.

Nobody knows for sure what lies ahead in terms of healthcare reform and future salaries. But does anyone think that AAs are particularly susceptilbe to salary slashing? Perhaps their relatively small numbers leave them more vulnerable?

 

[jwk]

I agree that salary isn't everything. But $90k/yr is a pretty hefty cut from some of the starting salaries we tend to see thrown around sometimes. Or perhaps $90k is more realistic, while the higher salaries spoken about here in public are more like outliers.

Nobody knows for sure what lies ahead in terms of healthcare reform and future salaries. But does anyone think that AAs are particularly susceptilbe to salary slashing? Perhaps their relatively small numbers leave them more vulnerable?

What I should have said was that few would have a base salary of less than $90k. Most new grads will work extra shifts and OT, easily boosting their compensation another $40k or more on top of that.

Anesthesia compensation, like any other industry or profession, is primarily related to supply and demand. The demand is high, and the supply is still relatively limited.

 

[facetguy]

jwk, what are your thoughts on CRNAs blocking further expansion of the AA profession through political/legislative action? If I were considering going into the AA profession, I'd have to at least consider this. Haven't the CRNAs been successful in blocking new AA legislation in a few states recently?

 

[mike hammer]

AA's are more susceptible to salary slashing then CRNA's due to the limitations of practice. Whether this vulnerability is more theoretical then real will be revealed if anesthesia reimbursements get cut further.

 

[jwk]

jwk, what are your thoughts on CRNAs blocking further expansion of the AA profession through political/legislative action? If I were considering going into the AA profession, I'd have to at least consider this. Haven't the CRNAs been successful in blocking new AA legislation in a few states recently?

It's rare that legislation passes on the first attempt. Usually it takes 2-4 years, and we don't let it drop just because of a single attempt.

 

[jwk]

AA's are more susceptible to salary slashing then CRNA's due to the limitations of practice. Whether this vulnerability is more theoretical then real will be revealed if anesthesia reimbursements get cut further.

There's no real basis for that opinion, since AA's and CRNA's are paid the same in the practices they work in now. The only limitation is independent practice, but 2/3 of CRNA's work in ACT practices now, so what affects them will affect us and vice versa.

 

[mike hammer]

The basis for this opinion is based on the supervision ratio, AA's must be directed or supervised at 2-1 and 4-1 ratios, unlike CRNA's you can have 6-1 or 8-1 if you want for supervision, this can mean a lot as reimbursements drop, you really do not think that anesthesiologists are going to cut their own salaries before yours, do you.

 

[Taurus]

Bottom line is that AA's have very strong support from anesthesiologists. We can't get enough of them. It is inevitable that more AA programs will open and more states will license them. The msot recent AA program is a CWRU satellite program in Houston, TX.

http://www.anesthesiaprogram.com/default.htm

The AA workforce will grow percentage-wise much faster than CRNA's or anesthesiologists. There will be tens of thousands of AA's in a matter of decades.

If CRNA's don't want to practice with anesthesiologists, then let them fight among themselves for the few non-anesthesioligist gigs out there. That only depresses their own earning potential. What the CRNA's are afraid of are AA's displacing them from ACT practices where more than 80% of all CRNA's work under anesthesiologist supervision. That's what it comes down to.

 

[mike hammer]

I am so happy you can see "decades" down the road. In decades anesthesia practice will be nothing like it is now and so the staffing patterns will be different. Not sure there will be a need for "tens of thousands of AA's", or CRNA's or anesthesiologists.

 

[jwk]

The basis for this opinion is based on the supervision ratio, AA's must be directed or supervised at 2-1 and 4-1 ratios, unlike CRNA's you can have 6-1 or 8-1 if you want for supervision, this can mean a lot as reimbursements drop, you really do not think that anesthesiologists are going to cut their own salaries before yours, do you.

I'm not sure how many practices go for medical direction (1:4 max) vs medical supervision (no max). I know a lot of practices that that do the former, not many that do the latter, and many practices that were formerly supervision now go the medical direction route. Why? Because running a CRNA "stable", as they were known in the 80's, really is much more of a scam as far as patient care than a medically directed practice.

In a medically directed practice, patients are assured of having an anesthesiologist personally involved with their case. There is no such requirement for a medically supervised arrangement. But hey, you're a CRNA/SRNA so you're really not concerned with anesthesiologists anyway, right? What really bothers you is the competition from AA's, and that truly scares the crap out of you. Go ahead, it's OK to say it.

 

[Taurus]

I am so happy you can see "decades" down the road. In decades anesthesia practice will be nothing like it is now and so the staffing patterns will be different. Not sure there will be a need for "tens of thousands of AA's", or CRNA's or anesthesiologists.

The AANA sees the future of anesthesia as CRNA's working alone.

I have a different picture. I envision a team composed of anesthesiologists, AA's, and CRNA's working together. I also see the inevitable increased use of technology to automate some of the tasks being done today. You already see that with the Sedasys system recently approved for colonoscopies. Why pay someone $120k to sit on a stool and chart away? The rooms will be redesigned for better efficiency. There will be automated anesthesia machines like McSleepy. Despite these technological advances, there will be a strong demand for AA's and anesthesiologists. Teams of anesthesiologists, AA's, and CRNA's will quickly get patients in and out of rooms.

Given the trends, I think my vision is more likely. Just see how the PA profession took off in the 1990's despite the NP's best efforts to block them.

 

[mike hammer]

No the competition from AA's does not concern me, the medical direction model has not been proven to be any safer under any circumstances. The cost effectiveness or lack of has been demonstrated repeatedly, that is why there are more collaborative settings and Indy CRNA settings then ever before.

As for the future, the trend has been for more and more autonomy for non-MD providers not less Taurus your vision is one of todays model with a few new technological advances, not likely.

 

[jwk]

No the competition from AA's does not concern me, the medical direction model has not been proven to be any safer under any circumstances. The cost effectiveness or lack of has been demonstrated repeatedly, that is why there are more collaborative settings and Indy CRNA settings then ever before.

It's an apples to oranges comparison, since independent CRNA's are not involved in open hearts, transplants, major neuro (except for emergent craniotomies) major peds, etc.