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Anesthesia's Future?

Discussion in 'Clinical Rotations' started by AB, Mar 31, 2000.

  1. AB


    I am considering Anesthesia as a residency. The field seems to have been shaken up in recent years. Any thoughts on the matter? ANY advice is appreciated!! [​IMG]
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  3. This field has actually been doing really well recently. After years of decline, there is now a real demand for anesthesiologists.

    Nurses are infiltrating this field, but they run into resistance from hospitals and patients. After all, do you want a nurse or a doctor in control of your life during surgery? I'll take the doctor!
  4. diamondhog

    diamondhog Junior Member 10+ Year Member

    Mar 10, 2000
    St. Louis University
    I agree with LeeRoy. I think the field is begining to bounce back a little.
  5. jdaasbo

    jdaasbo Senior Member 10+ Year Member

    Jan 7, 1999
    Current events:

    You folks should check out what has been happening concerning HCFA and CRNA reimbursement in the last three weeks. For info check out the ASA homepage.
  6. jdaasbo

    jdaasbo Senior Member 10+ Year Member

    Jan 7, 1999
    this is from the ASA site:

    WASHINGTON, D.C., March 22, 2000 -- In an effort to halt a Medicare proposal that would eliminate a critical Medicare benefit for all seniors and will likely even endanger their lives, hundreds of physicians converged on Capitol Hill today to urge members of Congress to intervene in what has become a bureaucratic quagmire with Medicare's regulatory agency.

    The physician members of the American Society of Anesthesiologists are turning to their representatives and senators to block a Health Care Financing Administration (HCFA) proposal that would remove ANY physician supervision of anesthesia. The ramifications are that nurses, often with less than two years of technical training, could be the sole providers of anesthesia to the nation's oldest and potentially sickest segment of the population.

    Senator Jon Kyl, R-AZ, told the doctors in Washington, D.C., on Tuesday that he will now join the other co-sponsors of the Safe Seniors Assurance Study Act of 1999 (S. 818/ H.R. 632), because it appears that HCFA has not sufficiently reviewed current data or conducted new studies to ensure that seniors will be safe if the requirement for physician supervision of nurse anesthetists is removed.

    "It is obvious now that all concern for patient safety has been lost to bureaucracy," said Ronald A. MacKenzie, D.O., president of the national physician group of more than 35,000 members. "HCFA is saying that it has made this proposal based on reasoning that anesthesia is 'relatively safe' now and that there is no evidence to compare the differences between anesthesiologists' care and nurses' care. That reasoning is dangerously flawed.

    "If HCFA goes ahead and removes this safeguard, seniors stand to lose not only a critical Medicare benefit, but even more frightening, people will die. Is that the evidence that HCFA needs?" Dr. MacKenzie asked.

    While he agrees that patient safety in this country has improved over the last few decades, from 1 in 10,000 deaths to less than 1 in 250,000 deaths, Dr. MacKenzie notes that this safety level was only achieved WITH THE INVOLVEMENT OF ANESTHESIOLOGISTS. In fact, a recent scientific study of more than 65,000 Medicare patients in 219 hospitals in Pennsylvania revealed that there was a 28-percent higher rate of deaths and a 21-percent lower chance to rescue seniors who have complications after receiving anesthesia from a nurse anesthetist who is not supervised by an anesthesiologist.

    "These are frightening figures," Dr. MacKenzie said. "We could turn back the patient-safety clock to the 1960s when ether was still being used. Yet when we met Monday with HCFA's Administrator [Nancy-Ann Min DeParle], I was told the Pennsylvania study is not relevant to HCFA's decision. How can the increased risk of seniors dying NOT be relevant?"

    HCFA claims that its proposal would not affect care but only defer the scope-of-practice issue to the states. Dr. MacKenzie notes, however, that Medicare is a national program, and as such, needs to set national minimum standards. The current physician supervision requirement has been in effect since the Medicare program was established in 1966.

    "This is about people, not government," Dr. MacKenzie said. "It's about patients' rights, not states' rights, the right of Medicare beneficiaries in every state to the best available medical care during anesthesia. If HCFA's proposal is approved, Medicare patients would be subject to potentially 50 different levels of anesthesia care in this country, not only where they live but where they may travel as well." All Medicare patients, even those living in rural areas, are now assured of the same level of care because physician supervision is all that is required, and surgeons would continue to be available for supervision in those areas, Dr. MacKenzie said.

    Furthermore, this proposal will not save any money for the government, hospitals or patients, Dr. MacKenzie added. "It costs the government the same if a nurse anesthetist is supervised by a physician or not." In fact, studies show that costs are actually lower when anesthesiologists are involved because of the reduced need for additional medical consultations and preoperative tests, he said.

    Dr. MacKenzie said members of the American Society of Anesthesiologists will do everything in their power to continue to advocate for their patients, now not only in the operating room, but before every appropriate agency and congressional committee in Congress to seek a resolution that keeps seniors safe.

    "HCFA does not need to do anything but leave the long-standing and safe standards in place for Medicare patients. Seniors would then be assured that they will continue to receive good quality medical care. Only if a scientific study proves that unsupervised nurse anesthetists are just as safe should this sensible patient safety rule be changed," Dr. MacKenzie said.

    Founded in 1905, the American Society of Anesthesiologists is a scientific and educational association of anesthesiologists that was organized to advance the practice of anesthesiology and to improve the quality of care of the anesthetized patient. It is the largest organization of anesthesiologists in the world with more than 35,000 members.
  7. Absolutely agree that anesthesis should remain a doctors province. Unfortunately, when cold hard cash comes in . . . the government yiels to nurses . . . you see your Nurse Practitioners, your OB RNs, your Peds RNs, your Psychiatric Rs (not to mention psychologists and social workers).
    Medicine is a high stakes endeavor that should be left to the best trained personnel . . . doctors.
    Unfortunately, due to lobbying and $$$$$, all sorts of Non-doctors will be practicing medicine. (Have you seen the ads for Chiropractic "Physicians"?)

  8. suliman25

    suliman25 New Member

    Jul 23, 2000
    philadelphia, pa
    I think anesthesiology is heading for a rebound. I would never let a CRNA give me anesthesia. It is too dangerous.
    Has anyone heard of any good anesthesia residency programs?
    I've heard that UPenn has a good reputation but it is actually a horrible place to do residency.
  9. surg

    surg 10+ Year Member

    Dec 16, 2001
    I am a surgery resident and have friends who are in anesthesia. The general impression that I get is that the job market is excellent with starting salaries >200K. You can virtually work in the city of your choice! In many fields you have to spends years building a practice (referrals, in fields like anesthesia and radiology this is not a factor.
  10. Sleepydoc97


    Jul 8, 2010
    The business side of Anesthesiology continues to evolve. We are currently seeing a trend away from all physician models to the Anesthesia Care Team model. In the Anesthesia Care Team you have a combination of MDs and CRNAs (usually at a ratio of 1:3 to 1:4) providing care. As a doc, it means that you will be supervising CRNAs much of the time and providing hands on care only part of the time. There are still plenty of jobs, but the nature of the work has changed from hands on to management and supervision.
  11. Chonson

    Chonson Junior Member 10+ Year Member

    Oct 1, 2004
    This post is over a decade old. Thank you for reviving it!

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