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anaesthesiology ****** possibly a hidden gem

Discussion in 'Anesthesiology' started by godfather, Oct 16, 2001.

  1. godfather

    godfather Member 10+ Year Member

    Oct 13, 2001
    I've seen alot of discussion about the good and bad points of anaesthesia, but to me it seems like this might be one of the hidden gems of medicine. In terms of lifestyle i don't think any other field can rival it. the graduating residents i talked to this year are virtually all getting offers in the low 200k plus other incentives such as signing bonuses of 25k to start. Also the hours are pretty straightforward it seems like. I don't think any other field including derm offers such compensation straight out of residency. Anyways i've at the last moment decided to apply to anaesthsia mostly for the lifestyle. I guess my only reservation is i couldn't really get a feel for if i really enjoy this from my 1 month rotation. My other reservation is why aren't that many other us grads going into this field ie is their something i don' t know about this field( although many people are saying that the pendulum is starting to swing the other way and that anaesthesia could become like radiology and er in the next five years. if you guys remember about5 or 6 years ago before the tv show er these two fields never filled and were virtually all fmgs.)
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  3. Floyd77803

    Floyd77803 Member 10+ Year Member

    Sep 10, 2000
    Kalamazoo, MI, USA
    Actually, in the early 90's anesthesiology was one of the most competitive residencies, if not the most competitive. It does offer a good lifestyle but it has it's drawbacks. With the influx of CRNA's the future of the field is in question. I don't think it will ever cease to exist in medicine but I think the number of anesthesiologists needed will decrease as well as the compensation. It is also a very stressful field (my uncle is an ER doc now, he did like 2 years of an anesthisia residency then got out cause he couldn't take the stress). If you think about your duties in the OR if there was one person there who has the potential to cause the most serious error it is the anesthesiologist. Also I think it would tend to get rather boring downing the same thing day in and day out. However pain management is a growing field in the scope of anesthesiology and it seems like a very satisfying thing to me. Those are just some of my thoughts on the field
  4. Biz Markie

    Biz Markie Senior Member 7+ Year Member

    Jul 1, 2001
    A very close friend of the family is an anaesthesiologist. He lives a very good lifestyle but does deal with quite a bit of stress and has health problems because of it.
  5. pags

    pags Senior Member 10+ Year Member

    Aug 28, 2000
    All I have to say is..... radioholiday, ahhh.
  6. drusso

    drusso Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 21, 1998
    Over the rainbow
    I did an anesthesia rotation and the docs I worked with were not very happy. The hospital was constantly trying to undercut them with CRNA's, the surgeons were usually unruly and unprofessional, and anesthesiologists take in-house call.

    For pure lifestyle considerations, there are much better alternatives: Radiology, Derm, Ophtho, and PM&R.
  7. scrubs

    scrubs Junior Member 7+ Year Member

    Sep 14, 2001
    I just want to say I totally agree with drusso. I think you might have read the couple of threads I have been posting about anesthesiology.

    I am an anesthesia resident and my mother is actually an anesthesiologist. I was like you in a way when I was finishing medical school. I could not decide on anything, and I thought anesthesia had a great lifestyle (my mother warned me!) and I liked the income, so I thought I would go for it... big mistake (for me).

    Let me give you these insights on the lifestyle of an anesthesiologist:
    1) Yes, it is true that new graduates are getting paid well, but with the recent increase in applicants and the subsequent reduction in the current shortage of anesthesiologists, I feel confident in saying that those bonuses and salaries will decrease. My own attendings have told me that I should not look as forward to the job situation in the future as my senior residents are. Furthermore, Floyd77803's comment about CRNAs is valid. Believe me, they are capable of managing the most complex of cases and their rates are considerably less than anesthesiologists. They have a serious lobby in place in the federal government to abolish the requirement that they be supervised.

    2) I don't think the hours are very good at all (again, my mother warned me). Granted I am a resident, but just when you think your day is over, you will be asked to take over someone else's room or you will have to do add-on cases. You actually never know when you can leave - it's very unpredictable. This is true for both attendings and residents. You can't set your own hours - you will be getting up early every day and you can't take off half-days if you want. As a resident you will not see sunrise nor sunlight during the day - maybe if you are lucky you will see sunset. You will be in ONE OR all day every day.

    3) I think the worst part of the job is the horrible stress. You are constantly vigilantly watching the monitors for arrthymias, hypotension, etc. You are responsible for every heartbeat, every blood pressure reading, and every breath. It is really frightening to suddenly look up, see a blood pressure of 60/30, look over the curtain and see blood everywhere. Even if the surgeon caused the problem, it is your responsibility to fix it so the patient can survive. Also, you might be thinking that if you are constantly watching what's happening this won't happen to you. But it will - a patient can loose 1 liter of blood in seconds...

    4) I could go on with a huge list of negatives about this field, but I won't. I will just add that you will not be respected in this field. The surgeons have no idea what you do, and they don't care. They have no respect for you. Nor do many of the nurses in the room ( I think that's because they know that you are replaceable by a CRNA). (And it's not like you interact with these people for a few minutes and then you can let it go - you will be with these people the entire day and it can be very frustrating.) Even many patients have no idea the degree of risk they are assuming in undergoing anesthesia. I am frightened for them!

    This field has totally changed my attitude about medicine. I feel so anxious and burnt out.

    I think the idea that anesthesia has a great lifestyle stems from the view that they have no long-term responsibility for patient care (i.e., no phone calls in the middle of the night). Well, the degree of responsibility you have for someone's life while in the OR more than makes up for that. You can easily cause major problems, or you will be trying to save the patient from the surgeon's problems. It is incredibly stressful. If you want the better lifestyle, I highly recommend taking drusso's advice. Of course, you will never know what it is really like, until you are there and have the responsibility (like me). I strongly recommend you spend some serious time with anesthesia attendings and residents (i.e., take call to see the ruptured AAA and trauma in the middle of the night). I just don't want you or anyone else to go into anesthesia as blindly as I did - make an informed decision about your career.

    Sorry to be so "preachy." Please let me know if I can provide you with anymore information... :)
  8. 12R34Y

    12R34Y 10+ Year Member

    Apr 5, 2000
    What about ER? ER is basically shift work, no call and no patient to either round on or hassle you. the average nationwide pay was 197,000/year for ER docs in like 1998. pretty good to me. three year residency etc... etc.. etc...Doesn't ER seem great?

  9. DO2

    DO2 Junior Member 10+ Year Member

    May 18, 1999
    Report: U.S. Facing Shortage of Anesthesiologists
    NEW YORK (Reuters Health) - There is a shortage of anesthesiologists in the US that will continue for years unless more people are attracted to the field, according to a report in the October issue of the Mayo Clinic Proceedings.

    ``It appears now that, in addition to focusing on the financial resources needed to support the healthcare needs of an aging population, national health policymakers need to re-examine whether the number of healthcare professionals is sufficient to care for the elderly, in particular when they require surgery, are afflicted by painful conditions, or become critically ill,'' Dr. Armin Schubert from the Cleveland Clinic Foundation said in a clinic statement.

    Schubert and colleagues used data from federal agencies, the American Medical Association and the American Society of Anesthesiologists to estimate the supply of anesthesiologists in 2001 and beyond.

    Based on the growth of the need for anesthesia since 1994, there is currently a shortage of anesthesiologists that ranges from 1,200 to 3,800, the investigators determined. They calculated that by 2005, assuming continued growth, the shortage will increase to between 1,000 and 4,500 anesthesiologists.

    However, by 2010 the shortage may disappear or be reduced to a shortfall of 1,000 anesthesiologists, assuming that the number of residency positions increases by 15% per year until 2006, Schubert's team notes.

    The researchers believe that to address the shortage, almost 60% more anesthesiologists will need to be trained by 2005 than were graduated in 2000, and almost 100% more will need to be trained by 2010.

    The need to increase the number of anesthesiologists suggests that training programs should admit more graduates of foreign medical schools, according to the authors. They add that the Medicare fee structure needs to be modified to allow anesthesiologists to earn more, in order to attract people to the field.

    In an accompanying editorial, Dr. Ronald D. Miller from the University of California, San Francisco and Dr. William L. Lanier, editor-in-chief of the journal, note that the shortfall of anesthesiologists results from policies in the 1990s that encouraged a return to general practice.

    ``It can happen in other specialties as well,'' Miller and Lanier note. ``Ultimately, the erosion of any important component specialty will do harm to the future intellectual and service missions of medicine and, unfortunately, the patients we serve.''

    SOURCE: Mayo Clinic Proceedings 2001;76:969-970, 995-1010.
  10. scrubs

    scrubs Junior Member 7+ Year Member

    Sep 14, 2001
    There is certainly a current shortage of anesthesiologists, but there are a lot of people graduating now and there is a ton of recruitment going on. As I said, the supply-demand comes and goes in waves (in every specialty - it's just anesthesia has been harder than most). While there is a shortage now, it will be overcome by MDs AND CRNAs. BTW Dr. Ronald Miller is the chairman of the department of UCSF (no.1 program in anesthesia) and one of the authors of the main anesthesia textbook.
    If anyone is considering anesthesia, I suggest checking out his 2-volume text from your library and making sure you like the material.

    12R34Y - ER does seem great, but it is also very stressful. I did my intern year at one of the busiest community hospitals in the suburbs of Chicago. The ER docs (even relatively younger ones) were really burnt out and tired. They must also manage code situations (usually they are first to intubate and put in lines), massive MI, PE, etc. They have pressure to get patients in and out, call consultants, call primary attendings, and manage multiple patients at once. Their shifts usually don't end when they are supposed to because of paperwork and finishing up odds and ends. Also, doing alternating day shifts and night shifts can be very tiring.

    Actually, I think I should just shut up. I have become so pessimistic that I can see the negatives of just about everything! Sorry I'm so negative - I should just quit medicine and move to another country! :)

    Just do what will make you happy (and don't think too much about money - what good is it if you hate walking into work everyday?)!

    Take care!
  11. kundun

    kundun Senior Member 10+ Year Member

    Jan 9, 1999
    got anything bad to say about ophthalmology? lol...I'm sure you do..
  12. scrubs

    scrubs Junior Member 7+ Year Member

    Sep 14, 2001
    Yes I do... Don't get me started!!!!
    Hee!Hee!Hee! :D ;)
  13. jylu

    jylu Junior Member 7+ Year Member

    Sep 2, 2001
    Ophto is so unbelievably boring... Money is good, lifestyle is great, but couldn't do because I knew I'd hate it by the time I finished the residency.
  14. Justin4563

    Justin4563 Banned Banned

    May 19, 2001
    New Jersey
    hey scrubs what do you want the nurses in the room and the surgeons to do?? give u oral???? Anytime someone hints at any disrespect or lack oif understanding either give them a verbal spanking..... or keep your composure and tell them where you are coming from.. I have dealt with tons of disrespectful surgeons and I dont give a **** who they are,, I give them a verbal spanking.... If all of us did this,,,, there would be less disrespect...
  15. snowballz

    snowballz Senior Member 7+ Year Member

    Apr 29, 2001
    Why not just shut your mouth, instead of giving them a "verbal spanking"? Aren't ALL residents disrepected at some point or another? My goodness, the very nature of the whole residency idea is near slavery.

    Can't you get nixed by attendings for being a jerk? I could see letting loose on another resident, but on an attending...I just don't see it.

    I'd like to hear Scrubs take on peds.... ;)

  16. Sandpaper

    Sandpaper Member 10+ Year Member

    Oct 16, 2001
    As a 4th year who's applying to anesthesia, I got one word for ya scrubs....quitcherwhinin'. I have been reading your whiny posts all over the place and my advice consists of the two "ups"...suck it up and keep that chin up. There are positives and negatives in all fields of medicine. If there is a perfect field, we'd all be clamoring for it. That said, some specialties are more stressful than others, but one does not go into medicine expecting it to be a cakewalk. Medical school sucks so far, and I expect residency to be the same. I am sorry you're unhappy with your experiences, but for everyone of you, I have spoken with ten others who love anesthesia. Hell, the surgeons here tell me to do anesthesia. You're stomped on cuz 1) you're a lowly resident, and 2) you let them stomp you. If you know what you're doing and you are confident of that fact, screw them all. Sh--t, medicine is not the end all, quit if ya don't like it. Go start a band or sumthin'.
  17. Magree

    Magree Senior Member 7+ Year Member

    Sep 5, 2001

    I am no expert on anesthesia and I'm sure I will be corrected if I'm wrong ;). But from all these posts it seems like, perhaps more than most specialties, if you have the aptitude and attitude good for anesthetics then it will be a well paying wonderful life. But if you don't you will be punished more than you will be paid. Scrubs is that right?

  18. gasdoc

    gasdoc Member 7+ Year Member

    Mar 29, 2001
    Before I start, I should say that I am still a transitional intern going into anesthesia and not an anesthesiology resident like Scrubs yet. Boy, after reading SCRUB's terrrifying and DEPRESSIVE posts, even Stanley Miller (UCSF anesthesia chair and god of anesthesia) himself as a 4th year student would NOT go into the field. I have one advice for SCRUBS: PLEASE QUIT while you are ahead. If you cannot stand the heat, get out of the fire. May be you will be happy being a primary care doc (i.e. internist or family pracititioner) working in a office managing diabetes and hypertension from 9-5 (but seeing may be 1 patient every 10-15 minutes...talking about stress) and may be 1 call of home in your local HMO!
    As for surgeons showing disrespect, I talked to both academic and community attg anesthesiologists and they both say that the disrespect is more of an academic phenomenon. In the community hospitals, one hand feeds the other. That is, the surgeon depends on the anesthesiologist to keep the patient well during the procedure as well as to work fast in prepping the next pt. In return, the anesthesiologist depend on the surgeons to provide the cases. In fact, its not surgeons who run ORs, but anesthesiologists. You piss off an anesthesiologist in the community setting and he will make your life miserable (i.e. delay your cases, slow down prepping your patients, cancel your cases, or whatever he wants since he controls the OR schedule). So, they are, bottomline, much more inclined to work as a team.
    About the emergencies that occur in the OR, well that's why you have 3 years to train w/ attg backup. It sounds like you are going to a BRUTAL program w/ little help. Most of the programs I interviewed at and the one I am going to next year seem to have very good attg backup. I just don't think SCRUB should use his one person point of view to poison the minds of all these potential budding anesthesiologists. HE DEFINITELY DON'T SEEM TO BE THE RIGHT KIND OF PERSON TO BE AN ANESTHESIOLOGIST.

    Common sense will tell you, if CRNAs who are nurses (and God knows that most nurses are trained at community colleges and such), who are by nature probably are not as smart as doctors, can handle even the most difficult cases, as Scrubs says, then why cannot most competent doctor. In fact, as Scrubs say, CRNAs feel they can practice independently (actually the vocal minority of CRNAs) then why is it so HARD for him as a doctor? I am sure Scrubs has some good points but there are positives as well as negatives to every field and for him to literally just list the EXTREME NEGATIVES of anesthesia is wrong. So, I thought I should put in a positive side to anesthesia.
  19. gasdoc

    gasdoc Member 7+ Year Member

    Mar 29, 2001
    I should say Ronald Miller, no Stanley.
  20. meandragonbrett

    meandragonbrett Member 10+ Year Member

    May 2, 2001
    just beacuse nurses are tarined at CC doesn't meant that they are ANY less capable of doing something you can do. Do you understand what it takes to become a CRNA? Those that have gone to a two year school must complete two more years to obtain a BS in Nursing or BSN, once that has been obtained, they must work for about 1-2 years in a Critical care unit, which gives them the ability to be able to monitor the patients correctly during the procedure. Then the BSN must apply for a spot in a CRNA school, which is by far MORE competetive than medical school. That is a two year program, that is so intense, they are unable to work becuase of having to do studies and having to do cases. You guys say that the training of a CRNA is not comparable to a MDA, you are wrong. The CRNA program is a Anesthesia residency put into two VERY intense years. That's my .2 cents worth, if you don't like hwat I have to say, then too bad.
  21. navs

    navs Member 10+ Year Member

    Oct 16, 2001
    I definetly am not one to demean CRNAs, because like MDA's they go thru their stressful training as well and DO have a role as a health care provider.

    My major point though is if one can do ALL the aspects of anesthesia as a nurse, what is the point of MDs getting involved at all?? Some will argue there is no point since they believe anesth. just entails a persons ability to put in lines and intubate.

    U probably could teach an athlete to do what an anesth. guy, or for that matter a surgeon or any other field who does procedures, how to do that. Would anyone argue that pro-athletes are MUCH more dextarious then doctors?? I wouldn't, but does that mean they should be allowed to practice medicine?? I don't think so.

    The difference is that an MD is OBVIOUSLY more knowledgeable about medicine then a nurse is. That is the major difference, in my mind. NOT the actual ability to do the techniques of anesthesia.

    Either way it doesn't matter what u, I, or anybody else says, the fact is CRNAs will ALWAYS have a role in dispensing health care, just like P.A.s, N.P., optometrist, etc. They will have to do it under supervision though in majority of states though due to the legal POWER of the AMA, ACS, and ASA which ALL whole heartedly will support this point. And maybe the most powerful group of all the "baby boomers" who in NO WAY will ever put up with having a nurse treat them during surgery other then an MD.
  22. migraineboy

    migraineboy Member 7+ Year Member

    Dec 22, 2001
    Meandragonbrett - I find it rather insulting that you imply tht the road to becoming a CRNA is as difficult if not more difficult than becoming an anesthesiologist. Before I get into this, please allow me to say that I feel both CRNA's and anesthesiologists play an important role in the OR. As for training, please. Am I supposed to be impressed that it takes an entire 4 years to become a BSN? All of us who went to med school at least completed either a B.S. or a B.A., and many have graduate degrees in various areas. I taught nursing anatomy during undergrad and it was nothing comapared to the anatomy we took in med. school. I also took two advanced nursing classes (advanced pharmacology and pathophysiology) during my undergrad years and, again, nothing like we took in medical school. Actually, two of the easiest undergrad classes I have taken. As for nurses working in the ICU, exactly how much of that time is spent in the decision making process? From what saw on my prior ICU, CCU, SICU rotations, the docs made the clinical decisions and wrote the orders. Comparing getting into a CRNA program to getting into med school is comparing appples and oranges. Sure, maybe because many BSN's want to get into the CRNA programs the overall acceptance rate is lower than med school acceptance rates. However, to be fair, you would have to have those same BSN's apply to med school and then compare acceptance rates. Please, go take the MCAT. As far as CRNA programs being difficult, I am sure they are. More difficult than anesthesia residency, I doubt. So you can't work while you are in school because you are so busy? Do you see a bunch of med students/interns/residents holding down side jobs at McDonalds? I think you would do the CRNA'a a better service by saying that the road to becoming a CRNA is long and difficult (which I am sure it is) and by saying they can perform a wide variety of functions in the OR (which I know they can). Your "anything you can do I can do better" attitude won't help you climb up the food chain when you are shoving your rhetoric down the throats of physicians and soon-to-be physicians. And that's my 2 (not.2) cents worth.
  23. Meandragonbrett,

    Talk about a boat load of mis-information! Now, are you a "CRNA" student yourself or a wannabe CRNA student or a wannabe medicalstudent? I'm amazed how people "think" they know so much about this CRNA vs MD debate. I'm even more amazed when individuals on the nursing side of the fence claim to be EQUAL to an MD as an overall anesthesiology provider. Just as an opthalmologist uses "techs" to dilate/refract/screen patients an anesthesiologist would employ a CRNA to set-up and monitor a patient. That doesn't mean that a optho tech is equal to an opthalmologist (nor a NP=family practice doc, nurse midwife=OBGYN, PA=internist)...SOMEONE has to take the responsiblity...and that's the job of the MD...But somehow, some CRNA's think that their training and existence is equal to that of an MD anesthesiologist in the medical world...

    Now how would you know that CRNA training is as good if not better than an MD residency? I would ONLY believe YOU if you 1. went through a BSN and then CRNA school AND 2. You then went to medical school (for 4 years) and anesthesiology residency training (for 4 years) YOURSELF AND was BOARD CERTIFIED. Otherwise, you are just spouting your-hurt-ego, must-prove-that-i'm-better-than-others, false-information all based only on opinion garbage....

    It's easy to talk trash, but 10x harder to back it up...


    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by meandragonbrett:
    just beacuse nurses are tarined at CC doesn't meant that they are ANY less capable of doing something you can do. Do you understand what it takes to become a CRNA? Those that have gone to a two year school must complete two more years to obtain a BS in Nursing or BSN, once that has been obtained, they must work for about 1-2 years in a Critical care unit, which gives them the ability to be able to monitor the patients correctly during the procedure. Then the BSN must apply for a spot in a CRNA school, which is by far MORE competetive than medical school. That is a two year program, that is so intense, they are unable to work becuase of having to do studies and having to do cases. You guys say that the training of a CRNA is not comparable to a MDA, you are wrong. The CRNA program is a Anesthesia residency put into two VERY intense years. That's my .2 cents worth, if you don't like hwat I have to say, then too bad.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
  24. navs

    navs Member 10+ Year Member

    Oct 16, 2001
    To support what TRG was saying, I remember talking to several anesthesiologists about CRNAs and their proficiency.

    The MDA's were telling me one strong point in this bureacratic debate on Capital Hill is the fact that there are some MDA's who were CRNAs before they went to med. school and they are fully supporting the fact that CRNAs are NOT as capable as MDs.

    IF they are saying that, considering they went thru both pathways, what argument is there left??
  25. gasdoc

    gasdoc Member 7+ Year Member

    Mar 29, 2001
    This "meandragonbrett" sounds like some (fe)male CRNA or SRNA (student) who cannot stand being in a lowly position b/c he/she is STILL under the supervision of an anesthesiologist.

    I agree w/ all subsequent posters who point out:
    1. How can you compare competitiveness of CRNA school to medical school? ALL medical school students are college educated folks who were at the TOP of their respective universities, and most oftentime at VERY GOOD NATIONAL universities. So, is a top nursing student from some dangy community college or private no-name college now COMPARABLE to a top pre-med from a National university. To make this comparison shows are moronic and unsophisticated "meandragonbrett" REALLY IS. He or she is just making his/her CRNA's look even worst!
    2. Virtually all CRNA turned anesthesiologists agree that medical school and anesthesiology training is much more intense and broad based than cRNA/nursing training. They do not feel a CRNA is at all as well trained to handle the OR as an anesthesiologist. This should be one of the strongest arguments as MeanDragonbrett's stupid argument. As a previous poster says, you must have been there to know the difference.
    3. MEDICAL SCHOOL STUDENTS DO NOT have the luxury of working because you cannot juggle a nursing job and MEDICAL school at the same time. So, for you CRNAs to say you had to go to school and go to work as a nurse just proves your schooling is NOT AS TOUGH as you say.

    IN conclusion, MeanDragonBrett just proves to us doctors and medical students that it is MUCH EASIER to become a nurse and CRNA and that nursing students, overall, are not as intelligent as medical students and physicians. If he has a problem, why don't he do a survey w/ ORDINARY PEOPLE, society in general, and see who THEY think is smarter or more able to manage their medical problems! It is very ARROGANT for nurses, b/c that's what a CRNA is, a certified REGISTER NURSE anesthetist, to think they are as good as a doctor. THEY WILL BE WENT HELL FREEZES OVER.
  26. navs

    navs Member 10+ Year Member

    Oct 16, 2001
    I totally agree with the theory that MDs are better then nurses in medical mx., but caution in trying to increase the already present rift between doctors and nurses.

    I do however WHOLE HEARTEDLY agree with the fact if u asked a common layman who he wants making the medical decisions for him he would want a MD over a nurse (actually he would probably laugh at the question itself) and facing the facts that medical school is more VAST and incompasses learning a lot more then CRNAs would like to admit to.
  27. MacGyver

    MacGyver Banned Banned

    Aug 8, 2001
    About the CRNA vs MD thing...

    I think everybody agrees that the training for MDs is superior. I think a lot of you are missing the point when you argue that the only thing that matters is whether the training pathways for MDs and CRNAs are equivalent. I think no rational person thinks they are, not even the lobby groups for CRNAs. Instead, we need to look at this from a "necessary skills to perform the job" perspective, not a training perspective.

    Instead of arguing pointlessly about who gets more training, we need to be asking more job-related questions such as:

    1) Do you ABSOLUTELY have to have all the training as an MD anesthesiologist to do the job effectively? I would compare this to driving. Everybody knows that a NASCAR race car driver is more experienced and has more training than us normal drivers. But do you really need that NASCAR training to drive a car? No. CRNAs are the normal drivers and MDs are the NASCAR racers. Now, any sensible CRNA would not argue that they are better trained, but what they WOULD argue is that our extra training doesnt really do any good or put us at an advantage because you really dont need that extra stuff to do a good job in the OR.

    2) Lets suppose that a CRNA is left unsupervised in the OR. How many SUCCESSFUL cases can they handle on their own with no supervision? 10%? 20%? 50%? 70%? Surely, they could probalby handle some very routine and simple surgical cases on their own with no supervision. But how do you quantify this? They cant handle ALL THE surgeries on their own I would assume. But are they able to do a majority of cases effectively with no supervision?

    I dont think the CRNA lobby is trying to argue taht their training is better than MDs. What they are arguing is that the job duties of an anesthesiologist DO NOT REQUIRE all the extra training of a residency-trained MD and that all the necessary knowledge to be competent can be obtained thru the CRNA pathway.

    Essentially, what they are saying to us MDs is that "yes, you are more highly trained but so what? Who cares? In the OR, we can do just as good as you because you dont need to use all that fancy extra training you get"

    What, we, as MDs need to do to quash this assault is not argue whether or not we have more/better training because thats a moot point to the congressional lobby and CRNA groups. This battle will be won on the grounds of whether or not we can convince people that YOU MUST HAVE THE MD-RESIDENCY PATHWAY TRAINING IN ORDER TO DO SUCCESSFUL SURGERY CASES.

    We need evidence and statistics to back this up. Without such evidence, its only a matter of time before CRNAs creep up on us, the reason being monetary. Hospitals would LOVE to use CRNAs instead of MDs because it would save them a ton of money. What we need to buid a case on should be based on the argument that to do so would put lives at risk unnecessarily. So far, the anesthesiologists have not argued this point effectively.
  28. bigfrank

    bigfrank SDN Donor 7+ Year Member

    Feb 20, 2002
    The above opinion seems to be the overwhelming consensus. Thank you ALL so much for your well-thought-out and long replies.

    Best wishes,

  29. gasrx

    gasrx Member 7+ Year Member

    I think the only people who worry about the MDA vs. CRNA BS are medical students. I have not hear one attending worry or have a fear about being replaced by a CRNA.
  30. DuneHog

    DuneHog Senior Member 7+ Year Member

    Feb 6, 2002
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> I think the only people who worry about the MDA vs. CRNA BS are medical students. I have not hear one attending worry or have a fear about being replaced by a CRNA. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Obviously - because attendings already have jobs. The real concern is that CRNAs may be hired for anesthesia positions instead of newly graduated MDAs.
  31. dr.evil

    dr.evil Senior Member Physician 7+ Year Member

    Oct 30, 2001
    Well, I'm going back to the original post and I was a little shocked how everyone jumped all over scrubs. I think the guy was just being honest about his profession and how he feels he made a bad decision hastily on the superficial basis of lifestyle and money. I think a lot of my classmates are doing the same thing just because they're not sure what else to do and they need a good paying job to pay off their butt-load of loans.

    Now don't get me wrong. I hate whiners but I really didn't feel he was whining so much as saying how bad decisions can haunt you. The bad thing is that he came down on anesthesiology as a whole instead of simply saying it was a poor decision on his part. Anesthesiology can be great for those who enjoy their work and understand their role in the O.R.

    As I am going in to surgery, I have the utmost respect for the person on the other side of the curtain. My patients will rarely remember what I did to them but will often remember what the anesthesiologist did to them. Those gripes are heard by me on evening rounds so I want them to do the best job possible. And that's just what the patient knows. I will really depend on the anesthesiologist in many aspects as I go through my career. I feel bad for scrubs if he feels he is a subordinate in the O.R. and this varies from institution to institution.

    Just like any other specialty, be well informed and well exposed to the profession prior to making a decision that will carry you through the rest of you life. Many specialties look great from the outside but may not be a good fit for you as an individual.

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