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CRNA pain management

Yo GabbaPentin

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    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?
     

    cowboydoc

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      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

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        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.
         
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        lonelobo

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          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
           

          newbie04

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            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.

            17103496_1477000788991106_8460424735867050620_n.jpg
             

            Victorinox

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              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.
               

              Aether2000

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                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.
                 

                IN2B8R

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                  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

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                    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

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                      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....
                       
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                        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

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                          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
                           
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                          painfree23

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                            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
                             

                            NJPAIN

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                              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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                              drrosenrosen

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                                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.
                                 
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