Cdph (i.e. the State) California

[energyjk]

---

Members don't see this ad.

 

[Maverikk]

Are the surgeons putting in orders for all that propofol, roc and versed. They have to practice 'under the order of a physician,' should've said a physician who is liable for their anesthesia care.
Are the orthopods responsible for the blocks being done?

 

[UscGhost]

Are the surgeons putting in orders for all that propofol, roc and versed. They have to practice 'under the order of a physician,' should've said a physician who is liable for their anesthesia care.

It would be a lawyers dream if the surgeon was putting in orders for anesthesia meds

 

[centdoc]

Finally, hopefully, those crNas accept the message… cali ain’t lettin’ them practice independently. However I won’t be surprised if they fight this… they are woefully so egotistical. The statement clearly says they are not allowed to practice medicine. This makes me happy inside

 

[Maverikk]

They aren't allowed to practice medicine in any state I believe, I could be wrong but I always thought it just meant they were under the liability of the person doing the procedure legally. This a rebuke, it's a not a change in practice, they can still practice independently of anesthesiologists.
All QZ billing is independent practice, if you're the anesthesiologist you're the liability sponge. If you've good CRNAs it may be tolerable to some especially since it pays more, if you've travel cowboys it will be a circus until someone gets hurt, you'll have a target on your back from the lawyers.

 

[nimbus]

This is not actually a change. CRNAs have never been able to practice medicine. CDPH likely sent the letter to emphasize that because some facilities (eg Modesto) were playing fast and loose with the rules.

 

[centdoc]

WE know they can’t practice medicine, but they think they can. When they spout bs “we can work independently” “we’re actually better than anesthesiologists” and do so at facilities with no anesthesiologist in sight, and the surgeon, GI doc, pain doc, whoever, isn’t signing the chart for them, then they’re effectively practicing medicine. This statement puts them back in their hole.

 

[secretasianman]

Surgeons need to write “I order the crna to perform the anesthesia” and sign it on every chart. Then there is no gray area as to who is legally accountable.

Finally, hopefully, those crNas accept the message… cali ain’t lettin’ them practice independently. However I won’t be surprised if they fight this… they are woefully so egotistical. The statement clearly says they are not allowed to practice medicine. This makes me happy inside

It would be a lawyers dream if the surgeon was putting in orders for anesthesia meds

It would be a lawyers dream if the surgeon was putting in orders for anesthesia meds

 

[DocMcCoy]

Surgeons need to write “I order the crna to perform the anesthesia” and sign it on every chart. Then there is no gray area as to who is legally accountable.

Ours have sign an order with similar verbiage to book a case.

 

[NicholasPavona]

Hahahaha! Failures....

 

[nimbus]

Tangentially related but I worked at a HealthSouth owned surgery center many years ago. That facility required the anesthesiologists to co-sign the podiatrists’ H&Ps. Haven’t seen that for a long time.

 

[Maverikk]

Tangentially related but I worked at a HealthSouth owned surgery center many years ago. That facility required the anesthesiologists to co-sign the podiatrists’ H&Ps. Haven’t seen that for a long time.

Ive never seen that. Why? Why sign an HP you didn’t do?

 

[nimbus]

Ive never seen that. Why? Why sign an HP you didn’t do?

It was explained to me that they needed an H&P from a physician. I signed them even though I don’t know anything about feet.

 

[Coffee PRN]

It was explained to me that they needed an H&P from a physician. I signed them even though I don’t know anything about feet.

We do that where I’m at for non-physicians too. I usually just copy paste my pre-anesthesia note. Just a box they need checked.

 

[MTGas2B]

It was explained to me that they needed an H&P from a physician. I signed them even though I don’t know anything about feet.

We would do that for peds dental stuff sometimes. The kids all had h&ps by their pediatrician. Sometimes they weren’t within 30 days, colds, scheduling delays, etc. We were asked to write a new one if the peds one was past 30 days. The dentists couldn’t do it.

 

[circleK]

Not to derail but we had a retina guy whose H&Ps were so bad we finally forced him to get them from another physician. Once brought a patient with an LVAD and didn’t mention any PMH.

 

[abolt18]

Not to derail but we had a retina guy whose H&Ps were so bad we finally forced him to get them from another physician. Once brought a patient with an LVAD and didn’t mention any PMH.

Wasn't mentioned because he probably had no idea.

 

[narcusprince]

In my current gig I find the hospitalists miss stuff all the time. Some are notoriously worse then others. Especially given the doctors have different language cultural backgrounds then my patients. I seriously don’t understand with a population of 50% spanish speaking patients why they aren’t learning medical Spanish.

 

[amyl]

Like the GI dr who thought their patient was having a strange arrhythmia and called me to the room. Crna clueless as well.
Um he’s v paced - now I know no one reads my preops 🤦‍♀️ or looks at the patient and the big weird lump in his upper left chest 🤦‍♀️🤦‍♀️

 

[joshmir]

View attachment 392243View attachment 392244

It actually says a clinical psychologist can give the orders

 

[centdoc]

That’s jacked up

 

[nimbus]

It actually says a clinical psychologist can give the orders

New gig for psychologists? Director of anesthesia…lol

 

[amyl]

That must be a typo. I think they mean psychiatrists- for ect w sedation I’d imagine. Psychologists don’t have dea numbers right?

 

[psycho-matic]

That must be a typo. I think they mean psychiatrists- for ect w sedation I’d imagine. Psychologists don’t have dea numbers right?

Prescriptive authority for psychologists movement - Wikipedia

en.m.wikipedia.org

Psychologists may prescribe in seven states: New Mexico, Louisiana, Illinois, Iowa, Idaho, Colorado, and Utah, as well as the Public Health Service, the Indian Health Service, the U.S. military, and the U.S. territory of Guam.

 

[centdoc]

The Modesto Bee is following up on the CDPH action. The crNas are still stupid about it…. The article has a stupid crNa saying, “It is the Nursing Practice Act that gives CRNAs legal authority to administer anesthesia after a physician orders a course of treatment that includes anesthesia.” Perry said the same reasoning applies to physician anesthesiologists, who administer anesthesia after a patient’s physician or surgeon orders a course of treatment.

Seriously thinks that we work under the order of a surgeon… I can’t even smh anymore it’s so stupid how they continue to think they are equal to us. I know I’ve never had a surgeon give me any orders.

Read more at: https://www.modbee.com/living/health-fitness/article292428549.html#storylink=cpy