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Anesthesiologist Assistant (AA) questions

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Makati2008

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If I drank the coolaid, then ther wouldn’t be posts on other threads as recent as two weeks ago where I’ve been a critic of the DNP. I’ve also got a paper trail showing this is one of the few times I’ve had much to say about anesthesia vs NP topics. But nobody has ever tried to suggest that nurses stick to floor nursing vs becoming CRNAs. To take it a step further and suggest that it is a gold rush for nurses, when at least they have background with patients vs AAs touching their first patient in AA clinicals is disingenuous. Nurses have been delivering anesthesia since the earliest days of anesthesia. AAs are a recent invention of folks that are trying to jump several steps in patient care responsibility to find the pot of gold. Kind of puts things in perspective, doesn’t it.

When I was considering AA (before the geographic constraints proved too onerous for me) I took note of the fact that almost half of AA programs were consolidated between two programs (Case Western and Nova... who have several campuses between the two of them). And no AA programs have any requirements for health care experience posted.

My big hesitation about PA and AA careers is the dependent nature, and not the quality of the providers, and there are trends that are hard to ignore regarding what independence will yield for a profession. For instance, in my field of psyche, psyche Nps in independent NP states do much better in terms of salary and benefits than psyche Nps in states that require being dependent on a physician. And by extension, AAs that practice in states where CRNAs are independent reap the reward of better wages than AAs in states where CRNAs are dependent to physicians. So they should probably go hug a CRNA rather than be jealous of what their rising tide has done for AAs boats.

I have to tend to agree. I was looking at AA prior to medical school and it was literally the same as being a PA (which I loved but I always wanted more knowledge and freedom) which to me made it an option that wasn’t worth considering but for a brief moment.

My feelings about midlevel independence are well known on this site but I will say that it’s a battle where CRNA>AA and I don’t foresee that changing anytime soon if ever. Also not having practice rights in all 50 states is a major concern since no one knows where life can/will take them.
 

pamac

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I should remember what your take is on midlevel independence, and I believe you have been a PA and are a physician, if I'm not mistaken.

I think you get where I'm coming from. If there is bias on my part, its bias against the structure of the environment and the reality that they are placed in. My outlook on investment has a very conservative flavor to it: If I invest in something, its going to be something that, first and foremost, has the least potential for falling through vs the investment that has the most potential to soar. The same thing for the advice I would give someone. If a person is in an AA practice state and they are fine with the minute uncertainty that comes with the limitations of being an AA, then more power to them to achieve their goal, but at least entertain the downsides and risks.

To me, its like deciding whose name I should tattoo on my arm (if I did such things). I love my spouse and my kids, and I'm secure in the fact that my spouse loves me back. But no matter what, my kids will be my kids, and nothing changes that so why not ink up their names? However, spouses have been known to split at least 50 percent of the time, so no matter how much I want to avoid that, sometimes it's not avoidable. That's similar to the reservation that's always been with me when deciding between PA and NP (similar to what folks looking at CRNA and AA have before them). So if you get "branded" with the title and education of an assistant, you are in a profession that isn't even your own (even though it probably should be). And all along, you know it should be your own, because you see NP's and CRNA's doing just fine with their own profession. That's what it came down to for me. My workplace may require me to report to a physician, but at the end of the day, if I walk out the door to find a new job, my ability to practice or write a script doesn't instantly terminate once there isn't a physician willing to sponsor me. No physician can say to me "I'd hate for you to cross me, because then I'd revoke my supervision and you'd be toast until you found someone else to sponsor you".

Regardless of anyone's feelings about who should be allowed to practice independently, that genie is out of the bottle in so many states that it can't be capped. I don't think that midlevels being independent has unleashed a wave of obscene practices that take place outside of their scope of practice. There might be a few that play cowboy, but most want to keep their licenses. Its just a strange structure to have built in "master and apprentice" like formula that the "assistant" world has to deal with.
 
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Makati2008

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Yep I was a PA, now physician. I can see issues with the profession (PA) tons more objectively than I could have 8-9 years ago.

Just looking at the issues at hand the PA/AA professions can’t beat the nursing lobby. They have tons more influence due to the sheer number of nurses,NP, etc...
 

psychMDhopefully

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Yep I was a PA, now physician. I can see issues with the profession (PA) tons more objectively than I could have 8-9 years ago.

Just looking at the issues at hand the PA/AA professions can’t beat the nursing lobby. They have tons more influence due to the sheer number of nurses,NP, etc...

Wow a person that has actually done PA and MD, how hard is PA school compared to medschool?
 
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