CRNA pain management

[Yo GabbaPentin]

Have heard rumors of local group hiring CRNAs to do injections and run clinic. Is this even a thing? Would insurance/medicare even pay for something like that? Are we looking at crna encroachment in pain now too?

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[cowboydoc]

I got a note on a patient's previous care in a neighboring state that included a CRNA running a pain clinic. No mention of physician. Office visit with TPI then the procedures...L1/2, L2/3, L3/4, L4/5 and L5/S1 MBBs then RFA, same levels.

 

[EtherBunny]

Have heard rumors of local group hiring CRNAs to do injections and run clinic. Is this even a thing? Would insurance/medicare even pay for something like that? Are we looking at crna encroachment in pain now too?

It depends on the state as to whether it is legal or not. From the standpoint of ethics and professionalism it's absolutely wrong, no question about that. Obviously the group that wants to hire the CRNAs is sketchy as hell--they must only care about money and not patient welfare. I feel sorry for any patients who end up going there.

Pill mills, block shops, and now we may have a wave of CRNAs in pain management. Hopefully the insanity will end at some point. Otherwise we may see the end of private practice in pain management, because in general hospitals are far more selective when it comes to hiring clinicians for pain management. CRNAs would have a helluva time getting hired by a hospital to do interventional pain.

 

[lonelobo]

It depends on the state as to whether it is legal or not. From the standpoint of ethics and professionalism it's absolutely wrong, no question about that. Obviously the group that wants to hire the CRNAs is sketchy as hell--they must only care about money and not patient welfare. I feel sorry for any patients who end up going there.

Pill mills, block shops, and now we may have a wave of CRNAs in pain management. Hopefully the insanity will end at some point. Otherwise we may see the end of private practice in pain management, because in general hospitals are far more selective when it comes to hiring clinicians for pain management. CRNAs would have a helluva time getting hired by a hospital to do interventional pain.

Not true, when I was practicing in Iowa about 9 years ago I did a monthly rural outreach clinic. Come to find out there was a CRNA practicing unsupervised flouro guided injections out of the local hospital in the community.( of course he referred to himself as "Doctor".........This is more common then you guys think

 

[nvrsumr]

We have CRNAs and DNPs doing IPM in CO. Nothing can be done as state nursing board believes they can do brain surgery too.

 

[newbie04]

This was going on *at the same time / in the same building* while I was attending an SIS course this year. Same procedures as SIS.

 

[Victorinox]

Not true, when I was practicing in Iowa about 9 years ago I did a monthly rural outreach clinic. Come to find out there was a CRNA practicing unsupervised flouro guided injections out of the local hospital in the community.( of course he referred to himself as "Doctor".........This is more common then you guys think

Might be the same guy who booked people in for fortnightly ESI, who cancelled all his planned injections the day someone from the state came to observe his practice.

Smaller hospitals in the middle of nowhere seem to encourage this, he gets a few hundred extra dollars and the hospital gets thousands in facility fees.

 

[Victorinox]

This is the thin end of the ethical wedge for anesthesiologists who employ these characters. I've heard groups in North Carolina and Tennessee have CRNAs doing pain.

 

[Aether2000]

CRNAs have been doing epidural injections for pain for at least 20 years and RF, facets, SCS trials for 10. They are independent completely, and no they are not well trained. Usually it is stupid surgeons that value the convenience of the patient and the relationships with their CRNA golf buddies over the lives and welfare of their patients.

 

[Victorinox]

On the subject of training, one of these 'esteemed' CRNAs was doing serial ESI for facet joint pain

 

[lobelsteve]

CMS should deny cpt to non fellow trained providers. Private insurers will fall like dominos.

 

[Victorinox]

CMS should deny cpt to non fellow trained providers. Private insurers will fall like dominos.

This is an excellent point, one that can be supported by lobbying efforts in the current climate via-a-vis opioid epidemic.
How can we push for this?

 

[IN2B8R]

Agree with above: charlatans pretending to practice pain medicine without requisite education and training should be cut off by all payers.


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[Yo GabbaPentin]

CMS should deny cpt to non fellow trained providers. Private insurers will fall like dominos.

Should?? I had always thought that is how it went. Although with NPs all demanding 120k per year with a 30 hrs work week, full benefits and 6 weeks vacation, I might a well hire a f'ing crna. Stupid hospital system is giving NPs in this area these kind of deals.

 

[Victorinox]

Seriously, though, I think something needs to be done, because this character in Iowa, and probably others, are treating patients, and clearly getting reimbursed.

Spoke with a faculty at a big name program in the south east, who is aware of this, he told me the untrained shysters supposedly use fluoro but never seem to have any saved images for some reason - curious....

 

[pjuer]

CMS should deny cpt to non fellow trained providers. Private insurers will fall like dominos.

Some of us old dinosaurs were doing this before fellowships were widely available

 

[lobelsteve]

Some of us old dinosaurs were doing this before fellowships were widely available

 

[Ducttape]

Some of us old dinosaurs were doing this before fellowships were widely available

why I left emergency medicine years ago and did a whole new residency and fellowship.

 

[myrandom2003]

At the Becker’s Spine Pain conference there is a lecture from AANA about “partnering with academia to provide advanced post-graduate subspecialty pain management education for nurse anesthetist”

So clearly nurse anesthetist organizations continue to work on finding a way to expand their scope of practice.

 

[clubdeac]

This guy in Manhattan KS is doing all interventional work independently. And he's even calling himself a doctor. Absolutely disgusting

Our Team

 

[nvrsumr]

This guy in Manhattan KS is doing all interventional work independently. And he's even calling himself a doctor. Absolutely disgusting

Our Team

"board certified for anesthesiology"....

 

[clubdeac]

of note he admits to getting his masters in nurse anesthesia but states he then went on to get his doctorate. What bs doctorate was that?? It's amazing this crap is allowed to happen

 

[Green Grass]

It's crazy that they can just self decide that certain training aspects are "required" or their training is now a "doctorate". They are just self-promoting themselves without any checks or balances. It's nuts.

 

[GlowInTheDark]

This guy in Manhattan KS is doing all interventional work independently. And he's even calling himself a doctor. Absolutely disgusting

Our Team

Sounds like somebody that needs reported to medical board.

 

[nvrsumr]

Medical board has no say over nurses in my state

 

[lobelsteve]

Medical board has no say over nurses in my state

He is impersonating a physician by advertising himself as a doctor.

 

[painfree23]

of note he admits to getting his masters in nurse anesthesia but states he then went on to get his doctorate. What bs doctorate was that?? It's amazing this crap is allowed to happen

He probably wrote a paper. They call it their “capstone” project or something

He is impersonating a physician by advertising himself as a doctor.

but he is a doctor, does he say he is a “physician”? Not saying I agree with it at all, but don’t think medical board can say anything

 

[NOSfan]

We have CRNAs and DNPs doing IPM in CO. Nothing can be done as state nursing board believes they can do brain surgery too.

 

[Ducttape]

which is why they couldn't get in to medical school.


oh wait.........................

 

[NJPAIN]

Medical board has no say over nurses in my state

You’re so correct. About 15 years ago we had a CRNA who owned an ASC. Multimillionaire. He introduced himself as a doctor. Registered as medical director with the state as a doctor. The head of the N.J. society of anesthesiologists called the medical board. Medical board said “ we can’t do anything because we have no jurisdiction over non physicians, call the nursing board”. His response was “ what if this was a plumber impersonating a physician, would I need to call the plumbing board to handle this?”.


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[lonelobo]

Cause you know all us Doctors are Heartless Bastards

 

[drrosenrosen]

My favorite thing is running across a Nurse Jackie type, who has become convinced that she stands as the last line of defense between her patients and me, the ignorant, money-grubbing doctor. This stuff has gotten way out of hand. Honestly, I don't think this direction is going to change short of a supreme court case between medical and nursing boards.

 

[lobelsteve]

In healthcare, anyone calling themselves a doctor and offering medical services is holding themselves out as a physician. I would want the courts to decide.

 

[Ferrismonk]

of note he admits to getting his masters in nurse anesthesia but states he then went on to get his doctorate. What bs doctorate was that?? It's amazing this crap is allowed to happen

His bio states DNP. Doctor of nursing practice. i.e. Nurse practitioner

 

[clubdeac]

His bio states DNP. Doctor of nursing practice. i.e. Nurse practitioner

Yeah shady... since when do you call NPs doctors? His website specifically says "Doctor in Manhattan". If that's not misleading I don't know what is