AANA Dispute with APSF

[GaseousClay]

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Apparently AANA does not agree with WHO anesthesia safety recommendations and will no longer send APSF (anesthesia practice safety foundation) newsletter to their members or send any funding. GOOD RIDDANCE.

A Note from the APSF President About Support of APSF - Anesthesia Patient Safety Foundation

APSF Announcement to CRNA's - Anesthesia Patient Safety Foundation

 

[Gern Blansten]

Nice job, Dr. Warner. That is the correct decision.

 

[Fox800]

It was never about patient safety. Only about prestige, money, and duping the public.

 

[urge]

Apparently AANA does not agree with WHO anesthesia safety recommendations and will no longer send APSF (anesthesia practice safety foundation) newsletter to their members or send any funding. GOOD RIDDANCE.

A Note from the APSF President About Support of APSF - Anesthesia Patient Safety Foundation

APSF Announcement to CRNA's - Anesthesia Patient Safety Foundation

Looks like the AANA was giving “financial support” to the ASPF and felt they could change the narrative. They felt wrong.

 

[ambiturner]

So if I’m reading this correctly, this means that the AANA wants the American public to accept a level of care that is below WHO standards. And are trying to convince our politicians if the same.

 

[deleted126335]

They were upset at the standard that was selected. So now they are stuck with advocating for a lower (I mean different) standard.

 

[NICMAN]

You could write the headlines: Nurse Anesthetists oppose safety standards set by the APSF and WHO”.

Also, sine they amwant to be called “Anesthesiologists” they should at least contribute to one academic group. IARS? APSF? Nope. They are a political action group masquerading as a professional/scientific organization.

 

[Man o War]

The AANA encountered an entity that couldn’t be bought off and now they’re going to take their ball and go pout in the corner.
Nice.

 

[Iso4ane]

You could write the headlines: Nurse Anesthetists oppose safety standards set by the APSF and WHO”.

That SHOULD be a headline, and ASPF should be in full form; Anesthesia PATIENT SAFTEY Foundation.

 

[Mman]

Apparently AANA does not agree with WHO anesthesia safety recommendations and will no longer send APSF (anesthesia practice safety foundation) newsletter to their members or send any funding. GOOD RIDDANCE.

A Note from the APSF President About Support of APSF - Anesthesia Patient Safety Foundation

APSF Announcement to CRNA's - Anesthesia Patient Safety Foundation

 

[Lecithin5]

How unbelievably petty and juvenile. Bunch of whiny babies. They want to be considered equivalent to physicians despite not going through the same educational rigors nor contribute to research and innovation in the field.

 

[pgg]

You could write the headlines: Nurse Anesthetists oppose safety standards set by the APSF and WHO”.

We could, but the ASA won't.

 

[Ronin786]

This is the kind of thing that could spark a real discussion if it found its way into mainstream media instead of what Trump vomited over Twitter.

 

[Lecithin5]

“Because you didn’t let me ride shotgun, I’m not putting my seatbelt on”

 

[anesthesiadoc]

Ironic that as I am reading this thread it is populated by an ad for the midwestern.edu “doctorate in Nurse Anesthesia Program”. Et tu, SDN???

 

[coffeebythelake]

Time to start donating to apsf

 

[GA8314]

I just sent them $100 with a note thanking them for standing strong in light of the AANA situation.

 

[Noyac]

I just donated $200.

So there!

 

[Urzuz]

“its safe provision requires a high level of expertise in medical diagnosis, pharmacology, physiology, and anatomy, as well as considerable practical skill” and “wherever and whenever possible, anesthesia should be provided, led, or overseen by an anesthesiologist . . .”

Calling it now...Donations to the movement to change their names to nurse anesthesiologists will sharply rise, the movement will pass, and they will then claim to comply with WHO standards.

 

[coffeebythelake]

“its safe provision requires a high level of expertise in medical diagnosis, pharmacology, physiology, and anatomy, as well as considerable practical skill” and “wherever and whenever possible, anesthesia should be provided, led, or overseen by an anesthesiologist . . .”

Calling it now...Donations to the movement to change their names to nurse anesthesiologists will sharply rise, the movement will pass, and they will then claim to comply with WHO standards.

They defined anesthesiologist as a physician trained in anesthesia.

 

[coffeebythelake]

I just donated $200.

So there!

Me too

 

[Urzuz]

They defined anesthesiologist as a physician trained in anesthesia.

They’ll soon be raising money for a movement to change AANA to AADNPAs (American Association of Doctor Nurse Physician Anesthesiologists).

But of course it won’t be to mislead patients. They just want to be referred to by their proper credentials.

 

[deleted171991]

They’ll soon be raising money for a movement to change AANA to AADNPAs (American Association of Doctor Nurse Physician Anesthesiologists).

But of course it won’t be to mislead patients. They just want to be referred to by their proper credentials.

Easy. American Association of Nurse Anesthesiologists. This is what they want.

 

[Urzuz]

Easy. American Association of Nurse Anesthesiologists. This is what they want.

Nah dude according to the guy above the WHO recs defined anesthesiologist as a physician trained in anesthesia. Hence they need to have nurse physician anesthesiologist somewhere in there.

 

[deleted171991]

Nah dude according to the guy above the WHO recs defined anesthesiologist as a physician trained in anesthesia. Hence they need to have nurse physician anesthesiologist somewhere in there.

Since when does the WHO matter in this country? Or any widely-respected and -recognized international organization? 😉

 

[coffeebythelake]

i'm not versed in legality, but can the term "anesthesiologist" be protected?
or is this something that will inevitably be eroded, such as the term physician with chiropractors and naturopaths

 

[hypnosMD]

i'm not versed in legality, but can the term "anesthesiologist" be protected?
or is this something that will inevitably be eroded, such as the term physician with chiropractors and naturopaths

Sure. The ASA could issue a position statement that an anesthesiologist is a physician who has attended medical school and specialized in the practice of anesthesia and any wrongful use of the term may be considered malpractice. They should be instructed to do just this if they want any further donations. Failure to take such a position would be very telling.

 

[caligas]

Sure. The ASA could issue a position statement that an anesthesiologist is a physician who has attended medical school and specialized in the practice of anesthesia and any wrongful use of the term may be considered malpractice. They should be instructed to do just this if they want any further donations. Failure to take such a position would be very telling.

Zero chance our society does this.

 

[Mman]

Sure. The ASA could issue a position statement that an anesthesiologist is a physician who has attended medical school and specialized in the practice of anesthesia and any wrongful use of the term may be considered malpractice. They should be instructed to do just this if they want any further donations. Failure to take such a position would be very telling.

misusing the word malpractice in a position statement is probably not the advisable thing to do

 

[hypnosMD]

misusing the word malpractice in a position statement is probably not the advisable thing to do

Meh. I’ve only done a few thousand hours of expert witness work, but I would say providing service under false credentials is a slam dunk.
Young docs take heed. The naysayers almost always have a vested interest in not taking strong positions. Often, they are partners in PP groups or AMC’s (which is corporate medicine, NOT private practice) that use QZ to let their nurses practice independently while telling themselves they are docs because of their diploma. Meanwhile, they are actually merely mid-level managers profiting from a “fireman” model. They want cheap “providers”.

 

[Mman]

Meh. I’ve only done a few thousand hours of expert witness work, but I would say providing service under false credentials is a slam dunk.
Young docs take heed. The naysayers almost always have a vested interest in not taking strong positions. Often, they are partners in PP groups or AMC’s (which is corporate medicine, NOT private practice) that use QZ to let their nurses practice independently while telling themselves they are docs because of their diploma. Meanwhile, they are actually merely mid-level managers profiting from a “fireman” model. They want cheap “providers”.

the term "anesthesiologist" is not a credential and reviewing charts does not make someone a lawyer.

I fully support the ASA emphasizing the need for anesthesiologists to provide care to all patients. I also laugh at groups that use QZ modifiers. What I don't support is dumb soundbites and ads that provide no material benefit to our argument that physicians should be in charge of anesthesia care. It's like when people post that the ASA needs to have an instant response to every post on twitter.

The word "anesthesiologist" isn't what makes us experts, it's our training that does. While CRNAs attempting to call themselves anesthesiologists is laughably stupid to anybody that understands the training and we should work to ensure it does not become commonly used by less educated people, threatening the word malpractice is just dumb.

So no, the person disagreeing with you isn't somebody trying to use CRNAs to provide cheaper care nor implement a "fireman" model.

 

[drdan4]

Never Supervised. Never will. Loathe the CRNAs. But membership in the AANA should be grounds for immediate dismissal for any employed CRNA. This may not be enforceable at Academic Institutions or AMCs or any locations where the Docs can't hire/fire CRNAs. In PP it should be automatic. Their aggressive Anti-Anesthesiologist rhetoric has warranted this stance. I guarantee given the option, any CRNA would pick food on the table vs their AANA membership.

 

[Mman]

Never Supervised. Never will. Loathe the CRNAs. But membership in the AANA should be grounds for immediate dismissal for any employed CRNA. This may not be enforceable at Academic Institutions or AMCs or any locations where the Docs can't hire/fire CRNAs. In PP it should be automatic. Their aggressive Anti-Anesthesiologist rhetoric has warranted this stance. I guarantee given the option, any CRNA would pick food on the table vs their AANA membership.

Their national board strongly pushes them into AANA membership as part of their recertification process. I'm far too lazy to look up the details myself but they make the process way quicker and easier if they are AANA members. Basically it's the equivalent of the ASA controlling the ABA.

And yes the AANA is terrible.

 

[Man o War]

Never Supervised. Never will. Loathe the CRNAs. But membership in the AANA should be grounds for immediate dismissal for any employed CRNA. This may not be enforceable at Academic Institutions or AMCs or any locations where the Docs can't hire/fire CRNAs. In PP it should be automatic. Their aggressive Anti-Anesthesiologist rhetoric has warranted this stance. I guarantee given the option, any CRNA would pick food on the table vs their AANA membership.

My old group started hiring AAs. We never hired a single CRNA after we got AAs credentialed at our hospital. I realize not everyone has that option, but it felt nice to actually do something about this nonsense for once. And we were considered a good group to work for as a mid level, so us shutting them out was a big deal at the time. Lots of drama.....

 

[Block-Buster]

I doubt you could have hired any CRNAs even if you had wanted to after hiring an AA. They are a shockingly tight-knit professional community that will blackball the F&*K out of any practice that tries to fight against their stranglehold on the midlevel anesthesia provider market.

 

[ProRealDoc]

I doubt you could have hired any CRNAs even if you had wanted to after hiring an AA. They are a shockingly tight-knit professional community that will blackball the F&*K out of any practice that tries to fight against their stranglehold on the midlevel anesthesia provider market.

If they had to choose between putting food on their table or blackballing a practice that uses AAs, I think they'd choose the former.

 

[Man o War]

I doubt you could have hired any CRNAs even if you had wanted to after hiring an AA. They are a shockingly tight-knit professional community that will blackball the F&*K out of any practice that tries to fight against their stranglehold on the midlevel anesthesia provider market.

When we announced the hiring of our first AA, they all attempted to band together cartel style and threaten us. We will all quit, you won’t be able to fill shifts, yada yada. We said fine, quit.
We all decided (with the exception of a couple) that we would rather work our butts off than deal with any more of their attitudes if it came down to that.
Guess how many actually quit?
There were plenty of tantrums and toddler like antics, but that was it.
We continued to get plenty of CRNA applications, so I don’t think it had any effect in the long run on our hiring prospects.

 

[Block-Buster]

Good for you. That is wonderful. Wish more places had the balls to do that.

 

[Status Sciaticus]

I doubt you could have hired any CRNAs even if you had wanted to after hiring an AA. They are a shockingly tight-knit professional community that will blackball the F&*K out of any practice that tries to fight against their stranglehold on the midlevel anesthesia provider market.

Let em blackball you. More openings to hire more AAs.

When we announced the hiring of our first AA, they all attempted to band together cartel style and threaten us. We will all quit, you won’t be able to fill shifts, yada yada. We said fine, quit.
We all decided (with the exception of a couple) that we would rather work our butts off than deal with any more of their attitudes if it came down to that.
Guess how many actually quit?
There were plenty of tantrums and toddler like antics, but that was it.
We continued to get plenty of CRNA applications, so I don’t think it had any effect in the long run on our hiring prospects.

You go, Glen Coco!

 

[Mman]

we had about 5% of our CRNAs leave after we started hiring AAs. It is no longer an issue.

 

[jwk]

I doubt you could have hired any CRNAs even if you had wanted to after hiring an AA. They are a shockingly tight-knit professional community that will blackball the F&*K out of any practice that tries to fight against their stranglehold on the midlevel anesthesia provider market.

They make a lot of noise, but they're but, especially in an area with limited options, they're not going to uproot their families just to be pissy.

However - there are PLENTY of groups that have talked about hiring AAs and the CRNAs threatened to leave, and the group totally caved - like the one in Ohio recently where the nurses actually put their names on a Change.org petition. And that's in Ohio, where AAs have been working for nearly 50 years. Another group in Birmingham hired an AA and the nurses made her life miserable. They told their docs they would play nice if they agreed to never hire another AA. They agreed - 25 years later, they've still never hired another AA.

At some point, I hope the FTC takes notice of these tactics as illegal restraint of trade.

 

[Man o War]

They make a lot of noise, but they're but, especially in an area with limited options, they're not going to uproot their families just to be pissy.

However - there are PLENTY of groups that have talked about hiring AAs and the CRNAs threatened to leave, and the group totally caved - like the one in Ohio recently where the nurses actually put their names on a Change.org petition. And that's in Ohio, where AAs have been working for nearly 50 years. Another group in Birmingham hired an AA and the nurses made her life miserable. They told their docs they would play nice if they agreed to never hire another AA. They agreed - 25 years later, they've still never hired another AA.

At some point, I hope the FTC takes notice of these tactics as illegal restraint of trade.

This is what happened at our place. They refused to let our first AA sit at the lunch table. They refused to give him breaks or take over a case for him when it was his turn to go home. They wouldn’t speak to him in the hallway.
Fortunately he was an older former military guy who would tell you to go screw yourself right to your face, so he didn’t care. But we did.
It got so bad that we actually had our attorney write up hostile work environment statutes and told them all we would fire them on the spot if one more incident occurred. And by law, we would be shielded according to our attorney. It stopped when they realized we would follow through.
The childish nursey nurse nonsense needs to not be tolerated or it will continue.

 

[pgg]

The way strip mall CRNA mills are flooding the market with new graduates (many of them with really marginal training), I wonder if the CRNA job market is going to remain strong enough for them to be picky.

 

[coffeebythelake]

The way strip mall CRNA mills are flooding the market with new graduates (many of them with really marginal training), I wonder if the CRNA job market is going to remain strong enough for them to be picky.

its a race to the bottom for these "advanced" nursing degrees
do as little as possible - the nurses want and expect this
programs try to make the most money as possible
no standards at all
at the expense of training and experience
but indoctrinate them with this idea that they can do anything
call certificates as residencies, fellowships to bolster their name
if i was a patient i would be ****ing scared

 

[AdmiralChz]

It’s so easy to say “we only hire AAs” but even if we could, we have 100 anesthetists in our group - we usually have to hire 10 or so a year. There simply aren’t enough AAs out there to hire - it’s a small group, and they are highly sought-after by PPs.

And definitely talk to “trailblazing” AAs who enter previously CRNA-only practices. It’s a tough, TOUGH situation as illustrated above. Honestly, it’s not dissimilar to women entering traditionally all-male military academies 20ish years ago (the Citadel, VMI) - ridiculous hazing and only the most hardened and tough made it through.

Nurses are like this universally, though. It’s every bit as bad when ICUs traditionally staffed by NPs go off-script and hire a new PA graduate.

 

[jwk]

It’s so easy to say “we only hire AAs” but even if we could, we have 100 anesthetists in our group - we usually have to hire 10 or so a year. There simply aren’t enough AAs out there to hire - it’s a small group, and they are highly sought-after by PPs.

And definitely talk to “trailblazing” AAs who enter previously CRNA-only practices. It’s a tough, TOUGH situation as illustrated above. Honestly, it’s not dissimilar to women entering traditionally all-male military academies 20ish years ago (the Citadel, VMI) - ridiculous hazing and only the most hardened and tough made it through.

Nurses are like this universally, though. It’s every bit as bad when ICUs traditionally staffed by NPs go off-script and hire a new PA graduate.

We're trying 🙂 The first Wisconsin class just finished, IU's first class is in their second year, and there are new programs in the discussion phase.

One of the best tools my group has from a recruiting standpoint is our AA student rotations. We have 10 or more students at any given time (easy with 80+ anesthetizing locations each day). If you're interested in establishing a student rotation, PM me and I can put you in touch with some program directors.

 

[Block-Buster]

I would think getting training sites & rotations wouldn't really be that much of an issue for AA training programs. I know I'd be way more open to teaching an AA student than an SRNA. The real impediment is state laws that don't allow AAs to practice in 33 states.

 

[pocafx]

Marian in Indianapolis seems to be starting a crna school

 

[OTCAwesome]

It’s so easy to say “we only hire AAs” but even if we could, we have 100 anesthetists in our group - we usually have to hire 10 or so a year. There simply aren’t enough AAs out there to hire - it’s a small group, and they are highly sought-after by PPs.

And definitely talk to “trailblazing” AAs who enter previously CRNA-only practices. It’s a tough, TOUGH situation as illustrated above. Honestly, it’s not dissimilar to women entering traditionally all-male military academies 20ish years ago (the Citadel, VMI) - ridiculous hazing and only the most hardened and tough made it through.

Nurses are like this universally, though. It’s every bit as bad when ICUs traditionally staffed by NPs go off-script and hire a new PA graduate.

Oh man, tell me about it. My wife is a trauma surgery PA, had been with an all PA group prior to moving. New job is with an all NP group, fist PA they have ever hired, it's bad to the point that she's considering switching over to CV surgery (all PA group) if things don't improve.

 

[coffeebythelake]

Oh man, tell me about it. My wife is a trauma surgery PA, had been with an all PA group prior to moving. New job is with an all NP group, fist PA they have ever hired, it's bad to the point that she's considering switching over to CV surgery (all PA group) if things don't improve.

This pisses me off so much