CRNA clinical doctorate

[catcolalex]

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The aana has said that by 2016 it wants to make entrance into CRNA practice a clinical doctorate. how will this effect the way CRNA's are viewed by anesthesiologists? Will it improve relations when CRNA's have more education, or erode them because the CRNA's will have "doctor" in front of their name? Your thoughts......

 

[Tenesma]

a clinical doctorate!! I think that is fantastic! We need more anesthesia providers to help with the current and future shortage of providers...

However, a few issues:
1) will CRNAs be grandfathered in? or will they be required to take extra course work?
2) If the clinical doctorate requires further education both basic and clinical then that will be great - however if this is just a name change, then it is a sham to bolster their egos at the expense of misguiding patients.
3) the clinical doctorate will be a doctorate of nursing as CRNAs maintain that their art of anesthesia is the art of nursing... this can be very confusing/misleading for patients, as Doctor in the hospital setting implies the art of medicine.

If CRNAs or wanna-be-CRNAs want to be doctors why not do the 4 years of medical school and the 4 years of residency (+1-2 years of fellowship) and really not have to worry about how they are addressed?

 

[powermd]

a clinical doctorate!! I think that is fantastic! We need more anesthesia providers to help with the current and future shortage of providers...

However, a few issues:
1) will CRNAs be grandfathered in? or will they be required to take extra course work?
2) If the clinical doctorate requires further education both basic and clinical then that will be great - however if this is just a name change, then it is a sham to bolster their egos at the expense of misguiding patients.
3) the clinical doctorate will be a doctorate of nursing as CRNAs maintain that their art of anesthesia is the art of nursing... this can be very confusing/misleading for patients, as Doctor in the hospital setting implies the art of medicine.

If CRNAs or wanna-be-CRNAs want to be doctors why not do the 4 years of medical school and the 4 years of residency (+1-2 years of fellowship) and really not have to worry about how they are addressed?

That would be hard. 🙁
Better just to change laws and create new degrees!

Maybe one day the nursing model will win out over the medical one in all aspects of health care. Imagine when we have nurse-cardiologists placing stents in people. Or nurse-orthopedists doing knee replacements. Hey, with enough protocol in place, medicine could be completely automated and practiced by robots one day. Then they wouldn't have to pay us one red cent! Wouldn't that make the nursing lobbies happy? No money or jobs for any of us!

 

[GasPundit]

So you're a CRNA competing with a physician for a position. Maybe it's a hospital doing the hiring, maybe it's a group. Maybe you're a group of CRNA's competing with a group of MDA's for a contract.

You're a "doctor," but it's unclear what that really means aside from you want to reimbursed as much as the physicians.

But, you're slowly realizing your lobby led you astray. You see, when you're in direct competition with the physicians, want to be treated equally, want to be paid equally...you need to bring something to the table. There needs to be a reason to hire you when you're no cheaper, no better, and can't do TEE/regional/lines/pain mgmt/medical mgmt/critical care like the physician can.

So you've changed your name. Fine. Your local multidirectional state community college also just opened a CRNA school, making it the 9th in your county. They're taking ANYONE. (This is only half in jest; look at the rate of increase of CRNA schools.)

If I were a CRNA, I'd be pretty upset with the AANA. The enemy of good is better, and CRNA's have it pretty darn good right now.

 

[KungPOWChicken]

Do CRNA's do epidurals or spinals? What exactly is the extent of their practice. Do they manage pediatric cases. I would imagine that their practice is very limited.

 

[2ndyear]

I don't think this will be popular. Right now training for CRNA's is 2-3 years. Assuming they add a year or more this is increasing the costs of their education for essentially the title Dr. Granted it's a cool title but scope of practice already can't change that much except for at the state level. If they make it an option I doubt it will catch on (why spend the money on school). You can already get a nursing doctorate as a CRNA if you really want the title, look at how popular that is. If it goes like the PharmD did then we'll just get used to it. I think those are good places to look to see what happens with more education. Look at pharmD's. Did they gain anything by going to a clinical doctorate? Do you call the guy behind the counter at Walgreen's Dr? Does it matter? I'm not sure, but lets find out before we freak out.

Yes, CRNA's are trained in regional techniques as well as peds, neonates, hearts, etc. I am a TY at a pretty busy community place though and there has not been a single CRNA on an OB floor, in a peds room, in a heart room, in a vascular room, in a neurosurg case. And the group has a ton of them, they just utilize them in different areas. CRNA's are happy, MD's are happy, everyone makes out well. Just because they have spent time doing hearts or peds doesn't make them experts, or even have the desire to do them in the real world. I was 'trained' to put in chest tubes this year. Will I ever do one in practice? Geesh, I sure hope not. I'll be on the phone asking for a surgeon pretty quick.

 

[nitecap]

So you're a CRNA competing with a physician for a position. Maybe it's a hospital doing the hiring, maybe it's a group. Maybe you're a group of CRNA's competing with a group of MDA's for a contract.

You're a "doctor," but it's unclear what that really means aside from you want to reimbursed as much as the physicians.

But, you're slowly realizing your lobby led you astray. You see, when you're in direct competition with the physicians, want to be treated equally, want to be paid equally...you need to bring something to the table. There needs to be a reason to hire you when you're no cheaper, no better, and can't do TEE/regional/lines/pain mgmt/medical mgmt/critical care like the physician can.

So you've changed your name. Fine. Your local multidirectional state community college also just opened a CRNA school, making it the 9th in your county. They're taking ANYONE. (This is only half in jest; look at the rate of increase of CRNA schools.)

If I were a CRNA, I'd be pretty upset with the AANA. The enemy of good is better, and CRNA's have it pretty darn good right now.

I believe if i am not mistaken that your lobbying group has lead you astray and put you in your current situation of feeling threatened by CRNA's. THe CRNA lobbying groups are only getting more robust and more financially sound than ever before. The CRNA clinical Doctorate will only make the profession of Nurse Anesthesia look even more applealing to politicians while lobbying. NOt exactly sure how much more eduaction or training will be required but a first impression is everything and with clinical doctorate in the title, and CRNA's already doing 90% of what an MDA does, damn that sure looks even better for CRNA's in the future.

And no I do not think CRNA's should have DR. in front of their names because that may very well be misleading to patients. Pt's should know exactly what training their anesthesia provider has. I have never once witnessed a Phd Nurse educator or practitioner intro themselves to pt's as Dr. so and so and belive me earning a clinical doctorate won't at all change that mentality. That just opens up the opportunity for a huge lawsuit if Clinical Doc CRNA intros as Dr. Joe Blow and pt thinks he's MD and malpractice suit filled and CRNA didnt clarify.

Another thing that you guys on this board assume is that all CRNA's have equivalent training. Though you have a 4 yr residency plus fellowship I have met MD's that went to UAB or other strong programs that are great, while on the other hand met MDA's that had a very weak residency and not even have a fellowship. As an SRNA in OR it is very easy to differentiate these MD's with diff. training. As a Baylor SRNA we take same A & P as med students. We take 24hr call with residents along with 80hr work weeks all for free, actually it cost us. We insert hundred's of lines, do level one trauma cases, Hrts, a ton of high risk OB at county hospitals, epidurals, spinals ect.

Dont judge a book by it's cover. So dont judge a clinician based on biases and prejudices. JUdge that Clinician on work ethic, clinical preformance, communication with superiors/subordinates ect. Not all CRNA's practice the same just like not all MDA's do.

Both groups are here for the long run and will be working together for many many many more years. Communication through all this is vital as is the need to not hold animosity for one another. I do how ever think the relationship is headed for a bumpy future. Consulting older MDA's many say as a resident they never felt threatened by CRNA's and welcomed them to learn. Boy have times changed. By assessing this board I see many CRNA hater that arent even done with med school. And many of you residents will be in for a rude awakening when you get that first job and eventually become partner in group that employs 20 plus CRNA's. You will be eating your words when your Groups profits along with your salary is dimishing because you cant find enough CRNA's to handle the large case load, or all your CRNA's quit s/t the very attitude you have now.

 

[deleted50478]

The problem with CRNA's isn't your ability to carry out bread and butter anesthesia. It's the fear of having our future salaries undercut by CRNA's. People go into Anesthesia with the expectation of a good lifestyle, and CRNA's may threaten that. Both MDA's and CRNA's are threatened by the expansion of CRNA training programs. What all you CRNA's seem to fail to realize is that by flooding the market, you will not only potentially undercut the MDA's salary, you will undercut your own even more. At least MDA's are protected somewhat by having that extra 10% of things to offer. At least we can study transplant or critical care. What are you going to do, go back to wiping bottoms and logging vitals? CRNA's salaries will fall dramatically if the supply exceeds demand. The problem is that while doctors understand supply and demand and therefore limit the number of training slots in each field, CRNA's seem to be out to shoot yourselves in the foot with ever increasing training slots. Your precious lobbying group should start lobbying to protect it's own members excellent current position rather than focusing on becoming fake doctors and such.

 

[jwk]

Do CRNA's do epidurals or spinals? What exactly is the extent of their practice. Do they manage pediatric cases. I would imagine that their practice is very limited.

And you would imagine wrong. Learn a little first before you guess (incorrectly). And yes, they do spinals, epidurals, kids, open hearts, transplants, yada, yada, yada.

Can we please stop this quickly before it deteriorates into another MD vs CRNA thread?

 

[Tenesma]

it already has deteriorated.... please close this thread

 

[sunnyjohn]

it already has deteriorated.... please close this thread

👍

 

[MS3NavyFS2B]

The aana has said that by 2016 it wants to make entrance into CRNA practice a clinical doctorate. how will this effect the way CRNA's are viewed by anesthesiologists? Will it improve relations when CRNA's have more education, or erode them because the CRNA's will have "doctor" in front of their name? Your thoughts......

what a joke...more dumbing down of medicine...what a shame.