AANA-"removing physician supervision is the right thing to do"

[wannabegasgang]

Agree with the AANA ? You can sign the petition here!

Does the ASA leadership realize they're at war?

 

[staple]

This is a big deal.

 

[GassYous]

Who didn't see this coming? Paging mman to come defend the nurses again.

All the non physician providers have gone from "we are just as good if not better than doctors" to "we are also doctors" and finally landing on "we don't need doctors".

 

[vector2]

Agree with the AANA ? You can sign the petition here!

Does the ASA leadership realize they're at war?

This is the propaganda email that populates their submission form:

"
Thank you for the opportunity to submit comments on the U.S. Department of Health and Human Services’ “Regulatory Relief to Support Economic Recovery: Request for Information” (HHS-OS-2020-0016-0001).

My comments today relate specifically to question 2b. First, I strongly support HHS permanently waiving requirements that a Certified Registered Nurse Anesthetists (CRNA) be supervised by a physician (Action 193 in Appendix A). Throughout the public health emergency, facilities have required all providers to work to the top of their education and state scope of practice. We have seen CRNAs traveling from their homes to help provide critical care in states that have seen spikes in COVID-19. As CRNAs increasingly practice independently during this crisis, managing delicate intubations of COVID patients, managing ventilators, and working under stressful conditions in facilities across America, we have already shown that removing these barriers to practice benefits patients and the larger healthcare system.

Not only is the permanent removal of physician supervision of CRNAs an important part of the national response to the pandemic, but it also aligns with CMS’s Rural Health Strategy, which cited maximizing scope of practice for providers as one of its key recommendations in its report, “Reforming America’s Healthcare System through Choice and Competition.” It also conforms to recommendations from the New England Journal of Medicine as well as other independent arbiters.

While some may argue that removing physician supervision will harm patient care, this is simply a scare tactic and there is no evidence to back it up. In fact, studies have repeatedly demonstrated the high quality of nurse anesthesia care, and a gold standard study published in Health Affairs led researchers to recommend that costly and duplicative supervision requirements for CRNAs be eliminated. Letting states decide this issue according to their own laws is consistent with Medicare policy reimbursing CRNA services in alignment with their state scope of practice, and with the National Academy of Medicine’s recommendation that “advanced practice registered nurses should be able to practice to the full extent of their education and training.”

The unique “opt-out process” has proven to be an unacceptable alternative to the simple deferral to state law. On one hand, it has proven to be a useful experiment in comparing healthcare in opt-out vs. non-opt-out states, with researchers noting in Health Affairs that “(no) harm (is) found when nurse anesthetists work without physician supervision.” The results of that study are clearly in favor of letting states decide the issue by their statutes. Further, the opt-out is burdensome and counterproductive at the state level resulting in wasted time and money spent on lobbying, public relations campaigns and lawsuits.

This federal supervision requirement is impeding local communities from planning effective and efficient state regulatory frameworks that support innovation. The evidence for CRNA patient safety is clear, and the Medicare agency should eliminate the requirement for governors to request additional permission to implement their own statutes and policies. A state’s statute should not be reversed by the sole decision of the governor without public comment or legislative oversight.

Thank you for your hard work on behalf of the American people. If you have any questions, please don’t hesitate to contact me."

 

[ambiturner]

“It also conforms to recommendations from the New England Journal of Medicine as well as other independent arbiters.”

...I guess I missed the NEJM issue where we suggested removing ourselves from healthcare?

 

[Endee]

This is the bed that anesthesiologists made years ago. The biggest of own-goals. The long term sequelae of letting nurses work with minimal supervision, not showing up for induction, letting them do procedures, etc. One day, any physicians that are left that still own and run their own groups will realize this and turn the tide by getting rid of all of their CRNAs and/or ceasing participating in CRNA training programs. Hopefully it won’t be too late by that point.

I recently found out that a facility in Florida that had contracted anesthesia services will absorb the department and employ them in a 1:8 QZ model a la Atrium in Charlotte. That is happening and will continue to happen until people wake up that “playing nice” with AANA/CRNAs is destroying the profession.

 

[DocVapor]

Anyone eloquent up for writing a rebuttal that you can provide here? I'll then use the AANA's own web form to copy the text overtop of theirs, using their own system against them.

 

[coffeebythelake]

Its all about ego and money to the AANA

 

[secretasianman]

This is the bed that anesthesiologists made years ago. The biggest of own-goals. The long term sequelae of letting nurses work with minimal supervision, not showing up for induction, letting them do procedures, etc. One day, any physicians that are left that still own and run their own groups will realize this and turn the tide by getting rid of all of their CRNAs and/or ceasing participating in CRNA training programs. Hopefully it won’t be too late by that point.

I recently found out that a facility in Florida that had contracted anesthesia services will absorb the department and employ them in a 1:8 QZ model a la Atrium in Charlotte. That is happening and will continue to happen until people wake up that “playing nice” with AANA/CRNAs is destroying the profession.

This is all academic ivory tower docs with their head in the sand who continue to profit from training their replacements.

 

[FFP]

Its all about ego and money to the AANA

That's what humans do.

We are living in a post-modern society, with very little respect for experts. We went from "everybody is a winner" to "everybody can be an expert", and the profit-grabbing megacorporations love it.

Now we know why they didn't want to pay doctors for thinking, but for doing. What's the thinking equivalent of "monkey see, monkey do"? You can't replace a doctor with a nurse and say it's the same level of thinking and medical decision-making.

 

[chessknt]

I love how using covid19 to justify practicing 'at the top' of their 'scope' like it is some enormous sacrifice they have made to save all the sick covid patients. CRNAs wont come near the ICU at one hospital where I work and at the other I couldnt make it to a crashing floor patient so a CRNA used roc to paralyze the patient while the hospitalist 'managed' him. I came in to a paralyzed man who had received 2mg versed 45 minutes ago on a precedex drip at 1. CRNA peaced out immediately and hospitalist used the only sedative he was familiar with. A+ care, would award independent functioning status again.

 

[Consigliere]

God I am so glad I don't do anesthesia anymore. This WILL pass and anesthesiology will be an even bigger embarrassment then it already is. I feel sorry for current and future residents.

 

[Matthew9Thirtyfive]

I love how using covid19 to justify practicing 'at the top' of their 'scope' like it is some enormous sacrifice they have made to save all the sick covid patients. CRNAs wont come near the ICU at one hospital where I work and at the other I couldnt make it to a crashing floor patient so a CRNA used roc to paralyze the patient while the hospitalist 'managed' him. I came in to a paralyzed man who had received 2mg versed 45 minutes ago on a precedex drip at 1. CRNA peaced out immediately and hospitalist used the only sedative he was familiar with. A+ care, would award independent functioning status again.

What I don’t understand is why isn’t the ASA talking about this stuff to the public? I’m only an MS2, but even when I was an OR tech I saw gross mismanagement by CRNAs. It happens all the ****ing time.

 

[Southpaw]

What I don’t understand is why isn’t the ASA talking about this stuff to the public? I’m only an MS2, but even when I was an OR tech I saw gross mismanagement by CRNAs. It happens all the ****ing time.

The ASA nuthugs the supervision model. This means dependence on the CRNA. It puts you in a bind to speak openly and perhaps negatively about the pitfalls of people you’re 100% dependent on for your model of anesthesia delivery. Plus the ASA always wants to keep its hands clean and take the high road. Long term no question it’s a losing strategy.

 

[Matthew9Thirtyfive]

The ASA nuthugs the supervision model. This means dependence on the CRNA. It puts you in a bind to speak openly and perhaps negatively about the pitfalls of people you’re 100% dependent on for your model of anesthesia delivery. Plus the ASA always wants to keep its hands clean and take the high road. Long term no question it’s a losing strategy.

So basically they don’t really care about anesthesiologists.

edit: I don’t understand why all the physician organizations just don’t care about physicians. The AMA is trash too. Is it just all the boomer docs who got theirs and want to keep it?

 

[Southpaw]

So basically they don’t really care about anesthesiologists.

edit: I don’t understand why all the physician organizations just don’t care about physicians. The AMA is trash too. Is it just all the boomer docs who got theirs and want to keep it?

They're run by anesthesiologists. I think it's more accurate to say they care, but they're wrong. You just can't continue to preach the team concept when 1 of the 2 team members is a completely and wholeheartedly unwilling participant. Eventually you have to say 'OK fine, screw you, we're moving on...', but the ASA will never do that. Meanwhile, since forever AAs have been like 'hey guys we're here...hire us' and anesthesiologists have been like 'nahhhh we like the CRNAs even though they stab us in the back at every opportunity'. It's stupid. Also, the west coast anesthesiologist ninjas have been rocking it solo (MD only) forever and doing just fine.

The only physician organization that openly advocates completely for physicians, that I know of, is the AAEM. And I learned of them here. And they're an extreme minority organization to ACEP, the larger organization for EM which is another field that is being completely destroyed for myriad factors.

 

[SaltyDog]

west coast anesthesiologist ninja

Looks like I found my new tag line.

 

[Southpaw]

Looks like I found my new tag line.

it's yours. it's deserved. can't say I never did anything for you.

 

[Endee]

Meanwhile, since forever AAs have been like 'hey guys we're here...hire us' and anesthesiologists have been like 'nahhhh we like the CRNAs even though they stab us in the back at every opportunity'. It's stupid.

God this is so true.

I wish y’all could appreciate how many times I went around the country trying to talk to ACT groups about bringing on AAs only to get turned down in one way or another in favor of CRNAs. And this was even while I was literally on the ASAPAC board.

 

[zero0]

This is the bed that anesthesiologists made years ago. The biggest of own-goals. The long term sequelae of letting nurses work with minimal supervision, not showing up for induction, letting them do procedures, etc. One day, any physicians that are left that still own and run their own groups will realize this and turn the tide by getting rid of all of their CRNAs and/or ceasing participating in CRNA training programs. Hopefully it won’t be too late by that point.

I recently found out that a facility in Florida that had contracted anesthesia services will absorb the department and employ them in a 1:8 QZ model a la Atrium in Charlotte. That is happening and will continue to happen until people wake up that “playing nice” with AANA/CRNAs is destroying the profession.

There will always be sellouts willing to train CRNAs. Even if the academics took a stand and resigned they'd be replaced overnight. Not like it matters either way, it's already too late. The MBAs own healthcare and all they care about is the bottom line. Why pay for better anesthesia when it all looks the same in the PACU, give or take some unnecessary thrashing and a few missed arrhythmias? The real fun starts when they're out of the hospital or back in the ICU and start crashing, but by then the CRNA has washed their hands, their blood is on the ICU doc.

 

[kidthor]

There will always be sellouts willing to train CRNAs. Even if the academics took a stand and resigned they'd be replaced overnight. Not like it matters either way, it's already too late. The MBAs own healthcare and all they care about is the bottom line. Why pay for better anesthesia when it all looks the same in the PACU, give or take some unnecessary thrashing and a few missed arrhythmias? The real fun starts when they're out of the hospital or back in the ICU and start crashing, but by then the CRNA has washed their hands, their blood is on the ICU doc.

The actual bottom line, in fact, would support MD only practice. Yet the admins are fooled by random line items without seeing the big picture. The paying of multiple "40 hour" (really 32 hour) "FTE" CRNAs and their overtime probably makes them equal to if not more expensive than a hard working proper anesthesiologist. Healthcare admin accounting skills are sad.

 

[Nivens]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

 

[MirrorTodd]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

Whoowee that right there is a leadership problem. That resident needs a drill sergeant to light a fire under their ass. I just recently had a short convo with choco about the merits of yelling and the effectiveness of it as a teaching tool, but if there ever was a time for yelling or person to ve yelled at, it is that resident.

 

[caligas]

This is the bed that anesthesiologists made years ago. The biggest of own-goals. The long term sequelae of letting nurses work with minimal supervision, not showing up for induction, letting them do procedures, etc. One day, any physicians that are left that still own and run their own groups will realize this and turn the tide by getting rid of all of their CRNAs and/or ceasing participating in CRNA training programs. Hopefully it won’t be too late by that point.

I recently found out that a facility in Florida that had contracted anesthesia services will absorb the department and employ them in a 1:8 QZ model a la Atrium in Charlotte. That is happening and will continue to happen until people wake up that “playing nice” with AANA/CRNAs is destroying the profession.

So Atrium did end up going with 1:8?

even for cardiac etc?

 

[FFP]

Whoowee that right there is a leadership problem. That resident needs a drill sergeant to light a fire under their ass. I just recently had a short convo with choco about the merits of yelling and the effectiveness of it as a teaching tool, but if there ever was a time for yelling or person to ve yelled at, it is that resident.

Good luck with that. That will cut your academic career short, faster than you can say "political correctness". You know, "words are violence".

I call them "snowflakes" for a reason. I am constantly surprised that they don't have to wear diapers, given how spoiled and entitled they are. It takes a special type of potty-training just to teach them to call their attendings "doctor", which one would think is common sense.

I absolutely agree that one needs strong emotions to cause lasting memories. Treating trainees with gloves is a disservice to their education; they are becoming glorified midlevels.

 

[Endee]

So Atrium did end up going with 1:8?

even for cardiac etc?

I don't know their details.. I'm pretty sure that deal did go through though with Mednax being kicked out and this new group taking over using a weak supervision/QZ model. It also happened in TX (Corpus Christi, I think?) and also I think I remember it hearing about it happening in one of the upper midwestern states.

 

[dr doze]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

There are plenty of practices like that. I used to work in one. It is one of the reasons Why I left. There was a certain logic to it. Good work, excellent clinical skill and going the extra mile weren’t rewarded. So the incentive was to do as little as possible, dodge the hard cases, and race for the door.

 

[MirrorTodd]

Good luck with that. That will cut your academic career short, faster than you can say "political correctness". You know, "words are violence".

I call them "snowflakes" for a reason. I am constantly surprised that they don't have to wear diapers, given how spoiled and entitled they are. It takes a special type of potty-training just to teach them to call their attendings "doctor", which one would think is common sense.

I absolutely agree that one needs strong emotions to cause lasting memories. Treating trainees with gloves is a disservice to their education; they are becoming glorified midlevels.

Ya thats why I'm gonna try hard as hell to stay out of academics. At least until I can tell any place F U I'm out. Admittedly I would like to teach at some point, but not within the next ten years at least.

 

[Brick Majors]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

This, right here is the cold truth. And it’s not just academia.

 

[GassYous]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

Jesus dude. Aren't you at one of the "top" programs in the country? My friend graduated from there and the stories I've heard about the residents are less than impressive.

Looks like I found my new tag line.

ninja please

 

[ugm12]

Complex financial and work place dynamic reasons aside, how can allowing nurses to practice a medical specialty without a medical degree OR physician guidance POSSIBLY be the best thing for patients? 🤷🏻‍♂️
Doesn’t the petition end there? Surely any lay member of the public would agree with that. The fact that this request is even being heard out by governing bodies is lunacy.

As a previous AA now internal medicine physician - “you don’t know what you don’t know” and lack of accountability for when patient care goes completely tits up, are what need bringing to people’s attention. Then non-medically trained people wouldn’t WANT to take on a doctor’s role without the training.

 

[Urzuz]

Not sure what it's like elsewhere, but at my academic shop 80-90% of our anesthesiologists fall far short of the physician mark: doing the bare minimum clinically, failing to keep up with the field, bitching when relief doesn't come promptly enough, canceling cases because they are "uncomfortable", etc etc. This gets passes on to the residents. We have a resident who believes it's perfectly acceptable to page the floor leader at 2:30 PM to ask for relief because she's "pre-call".

Point is, there are obviously failures at the national leadership level. But I see too many folks calling for a national solution to a problem they fail to address on an individual level every. single. day. If you picked anesthesiology so you could work like a nurse and be called doctor, you too are blurring the lines, but in reverse. It's every bit as damaging to the specialty as a nurse anesthetist introducing themselves as "Doctor x".

Whoowee that right there is a leadership problem. That resident needs a drill sergeant to light a fire under their ass. I just recently had a short convo with choco about the merits of yelling and the effectiveness of it as a teaching tool, but if there ever was a time for yelling or person to ve yelled at, it is that resident.

I am in one of those solo MD “anesthesia ninja” practices and we had a new hire (happened to be a new grad as well) call me to be relieved at 6pm since she had a “long day” the next day. I laughed and hung up.

 

[SaltyDog]

I am in one of those solo MD “anesthesia ninja” practices and we had a new hire (happened to be a new grad as well) call me to be relieved at 6pm since she had a “long day” the next day. I laughed and hung up.

Shoulda told her “Sorry, this is a solo MD practice, we don’t hire CRNAs.”

 

[MirrorTodd]

done

 

[GassYous]

I know we're all talking about how people especially residents shouldn't complain. But I have done **** all today to actually make me a better doctor. I gave breaks to CRNA's in the cardiac rooms this morning and now I've been sitting around for the past 4 ****ing hours waiting for a perivalvular leak to get started. This is a huge waste of my time as a resident. They should've sent me home at noon so I could ****ing study. They are likely paying some crna to sit around as well, so its wasting money and wasting my time. You bet your ass I expect to relieved at 6, because I don't deserve to be treated like this as a resident. I deserve to be trained or at least have my time respected. /rant

Why aren't you sitting in the cardiac room? Why are you giving breaks to crnas?

 

[DocVapor]

I am in one of those solo MD “anesthesia ninja” practices and we had a new hire (happened to be a new grad as well) call me to be relieved at 6pm since she had a “long day” the next day. I laughed and hung up.

Jesus. I'm a new grad PP partnership track and I'm walking around before I leave every day making sure no-one needs anything, staying post call to help get morning pre-ops done, reviewing every consult chart I can get my hands on, and restructuring the curriculum for rotating med students. What is wrong with my generation? (Granted I am a non-trad... but I'm not that much older).

 

[coffeebythelake]

I know we're all talking about how people especially residents shouldn't complain. But I have done **** all today to actually make me a better doctor. I gave breaks to CRNA's in the cardiac rooms this morning and now I've been sitting around for the past 4 ****ing hours waiting for a perivalvular leak to get started. This is a huge waste of my time as a resident. They should've sent me home at noon so I could ****ing study. They are likely paying some crna to sit around as well, so its wasting money and wasting my time. You bet your ass I expect to relieved at 6, because I don't deserve to be treated like this as a resident. I deserve to be trained or at least have my time respected. /rant

Audiobooks and small review books are your friend.

 

[dr doze]

Complex financial and work place dynamic reasons aside, how can allowing nurses to practice a medical specialty without a medical degree OR physician guidance POSSIBLY be the best thing for patients? 🤷🏻‍♂️
Doesn’t the petition end there? Surely any lay member of the public would agree with that. The fact that this request is even being heard out by governing bodies is lunacy.

As a previous AA now internal medicine physician - “you don’t know what you don’t know” and lack of accountability for when patient care goes completely tits up, are what need bringing to people’s attention. Then non-medically trained people wouldn’t WANT to take on a doctor’s role without the training.

1. It is not about what is the best thing for patients.
2. While in reality advanced practice Nursing is "Medicine light", they are legally separate disciplines practiced by Doctors and Nurses and regulated by their individual state boards.

 

[dipriMAN]

Whoowee that right there is a leadership problem. That resident needs a drill sergeant to light a fire under their ass. I just recently had a short convo with choco about the merits of yelling and the effectiveness of it as a teaching tool, but if there ever was a time for yelling or person to ve yelled at, it is that resident.

It’s not just residents. I also noticed many of the attendings at my training institution when I was a resident that would complain about getting out, basically heckle the board after noon because they wanted to go home. Attendings that prefer to work with CRNAs than residents because they want to hang out in the lounge all day, or that complain about calls when they come in to do a 12 hour overnight shift at 6 or 7PM and never have to work postcall.

 

[dipriMAN]

Why aren't you sitting in the cardiac room? Why are you giving breaks to crnas?

Because some CRNAs “do cardiac”, happened at my residency, they made a big deal about doing their cardiac cases, at the expense of a resident being unassigned when they could have been out into that room.

theres blame all around, not just my generation in training , the older faculty in training programs will do anything to appease the CRNAs they work with.

 

[coffeebythelake]

It’s not just residents. I also noticed many of the attendings at my training institution when I was a resident that would complain about getting out, basically heckle the board after noon because they wanted to go home. Attendings that prefer to work with CRNAs than residents because they want to hang out in the lounge all day, or that complain about calls when they come in to do a 12 hour overnight shift at 6 or 7PM and never have to work postcall.

Man I dont know why there is all this hate directed towards academics. My institution is nothing like this. (Well maybe there are one or two attendings like this). Having said that i do agree that the incentive system must be in line with efficiency and hard work. Being hard working and enthusiastic shouldn't be rewarded by being funneled more work.

 

[sevoflurane]

God I am so glad I don't do anesthesia anymore. This WILL pass and anesthesiology will be an even bigger embarrassment then it already is. I feel sorry for current and future residents.

Did you retire already? Fuak....yeah.

 

[Matthew9Thirtyfive]

Someone posted this on r/medicine and a mod who is an anesthesiologist deleted it because “I sAiD sO” and then called the residents petulant children.

 

[MirrorTodd]

done

 

[Steve_Zissou]

I don't make the rules, I'm also not trying to make waves...anywhere really, especially as a resident. It's also an outside rotation where we get a lot of our advance type numbers and we do cardiac primarily elsewhere. Our program director has indirectly threatened us as a group that we need to keep this rotation since we get our numbers there and we sure as hell wouldn't get them at our home institution. Long story short: this is a necessary rotation.

There was a post on reddit about NP independence and a MD was saying “I have medical students rotate with me all the time and work under my NP, they’ve never brought up any issues with it.” I responded something like “no ****, when Med students can have their careers significantly impacted by one bad impression, we tend to avoid controversy and making waves.”

 

[Matthew9Thirtyfive]

There was a post on reddit about NP independence and a MD was saying “I have medical students rotate with me all the time and work under my NP, they’ve never brought up any issues with it.” I responded something like “no ****, when Med students can have their careers significantly impacted by one bad impression, we tend to avoid controversy and making waves.”

And your response probably got deleted by the simping mods. r/medicine is in love with midlevels.

 

[Steve_Zissou]

And your response probably got deleted by the simping mods. r/medicine is in love with midlevels.

I think I was far enough from the main posts to not get deleted, but yeah /r/medicine let’s through very few FPA related posts and very few midlevel posts in general.

 

[GassYous]

I don't make the rules, I'm also not trying to make waves...anywhere really, especially as a resident. It's also an outside rotation where we get a lot of our advance type numbers and we do cardiac primarily elsewhere. Our program director has indirectly threatened us as a group that we need to keep this rotation since we get our numbers there and we sure as hell wouldn't get them at our home institution. Long story short: this is a necessary rotation.

I was going to say that it sure sounds like being able to give breaks to crnas is an essential skill to learn except that we now know that they want to eliminate you completely. I'm glad you're getting your numbers by going into crna rooms. Great rotation, sounds valuable.

 

[MirrorTodd]

done

 

[abolt18]

I know we're all talking about how people especially residents shouldn't complain. But I have done **** all today to actually make me a better doctor. I gave breaks to CRNA's in the cardiac rooms this morning and now I've been sitting around for the past 4 ****ing hours waiting for a perivalvular leak to get started. This is a huge waste of my time as a resident. They should've sent me home at noon so I could ****ing study. They are likely paying some crna to sit around as well, so its wasting money and wasting my time. You bet your ass I expect to relieved at 6, because I don't deserve to be treated like this as a resident. I deserve to be trained or at least have my time respected. /rant

This crap is RIDICULOUS!