CRNA president

[SleepIsGood]

Check this out:

He thinks CRNAs are just as qualified to do anesthesia and now PAIN !!

http://www.walker4aanapresident.com/positionstatement.htm

Look at how political this guy is. If you check his 'blog' , a question was asked "what do you think the relationship should be with the ASA. Here's his answer:
Now that the ThoughtBridge project has come and gone, what direction do you propose for our relationship with organized anesthesiology? How do you propose to keep open the lines of communication with the ASA?
I believe that we should continue efforts to dialogue with the ASA. While we certainly do not agree on some issues, refusing to talk will not likely advance our cause. We should continue our efforts to narrow the gap between our organizations. When one sits at the table with either their friend or their enemy, they are learning about the other party. We should never give up the opportunity to learn more, and hopefully improve our relationship with the ASA. With that said, I can assure you that I am extremely committed to defending the full scope of CRNA practice. I will never agree to anything that limits CRNAs' ability to choose the type of practice setting in which they would like to practice, be it independent practice or an anesthesia care team model. There is a practice opportunity that fits most CRNAs' desires, and we must keep it that way.
To sum up my approach, it will be one that is professional and congenial, yet unyielding to any approach that would prove damaging to our profession.

I really hope that we as anesthesiologists will one day wake up and realize that the "ACT" model was a conduit for the AANA to get their foot in the door.
Anyone still believe that CRNAs are just here to 'fulfill the gap in the healthcare sytem and serve underserved areas" .

---

Members don't see this ad.

 

[coprolalia]

I really hope that we as anesthesiologists will one day wake up and realize that the "ACT" model was a conduit for the AANA to get their foot in the door.

No it wasn't.

AA's will practice under the ACT model. An anesthesiologist helping another anesthesiologist, or taking over a case is working under the ACT model.

Don't confuse the issues. Want for independent practice is a separate issue from ACT. When anesthesia was first starting to be routinely administered in the late 1800's/early 1900's for most surgical procedures, anyone from a physician to a nurse to even a med student or a guy sweeping the floor used to give it. What's been recognized in the over hundred years since then is that the best model for giving anesthesia is having an independent, separate medically-directed anesthetic under a care-team model.

This has been repeatedly borne-out in large studies (both Pine and Silber). The anesthesiologist-anesthetist (CRNA or AA) model is probably the best overall scenario for the patient, and is certainly been proven to be safer than solo-anesthesiologist or solo-anesthetist practice, and is more cost/resource-effective overall compared to anesthesiologist-anesthesiologist model.

That should be our position (and, check me if I'm wrong, believe it is). So, it doesn't really matter what the head of an organization with a political agenda says... unless people in power start to believe it.

-copro

 

[Planktonmd]

No it wasn't.

AA's will practice under the ACT model. An anesthesiologist helping another anesthesiologist, or taking over a case is working under the ACT model.

Don't confuse the issues. Want for independent practice is a separate issue from ACT. When anesthesia was first starting to be routinely administered in the late 1800's/early 1900's for most surgical procedures, anyone from a physician to a nurse to even a med student or a guy sweeping the floor used to give it. What's been recognized in the over hundred years since then is that the best model for giving anesthesia is having an independent, separate medically-directed anesthetic under a care-team model.

This has been repeatedly borne-out in large studies (both Pine and Silber). The anesthesiologist-anesthetist (CRNA or AA) model is probably the best overall scenario for the patient, and is certainly been proven to be safer than solo-anesthesiologist or solo-anesthetist practice, and is more cost/resource-effective overall compared to anesthesiologist-anesthesiologist model.

That should be our position (and, check me if I'm wrong, believe it is). So, it doesn't really matter what the head of an organization with a political agenda says... unless people in power start to believe it.

-copro

Agree.
I like how this new president refers to physicians as "Organized medicine", maybe the ASA needs to issue it's members machine guns and start collecting monthly tributes from CRNA's.

 

[stewiegriffinFG]

Once he gets his academic doctorate, he is going to wipe the floor with y'all.

 

[Faebinder]

He can talk the talk all he wants but Pain Medicine is not like Anesthesia.. it's not restricted to Anesthesologists it has its own official board+fellowship. The way to fight this is to make sure the local representative of the pain medicine boards gets a hold of illegal practices of pain medicine by CRNAs.

The idea that pain medicine is a field of medicine not some scope of CRNA must be reinforced. Are they also going to manage the addiction, neurologic and psychiatric part of the pain or just do spinal injections regardless?

My understanding that in many of the less regulated states, neurosurgeons/orthopedists use CRNA for pain management and have excluded anesthesiologists and pain medicine teams... that's where the damage is coming from. That needs to be stopped.

 

[Coastie]

Amazing how people can just claim things, ex nihilo, and if the BON passes it, it's fine.

When will docs start growing some teeth? Our medical system is crumbling, and the sappers from the outside are trying to put themselves in positions of privilege (treating patients), without the knowledge or experience to have the ability to do so properly. The WORST part about it is that they are so delusional, they reject any proper argument or even discussion which conflicts with their ideals, to them, it's all based on emotional arguments of "we take care of the patients, not symptoms". After all, who needs the rigorous 4 years of undergrad, the vanguard of medical school training, and the trial by fire of residency? Who needs to be trained in leadership, when after all, RNs provide all the care anyway..When was the last time YOU saw a physician give a dulcolax suppository, it was the RN who cured him, didn't you know that, doctor?

 

[jwk]

Amazing how people can just claim things, ex nihilo, and if the BON passes it, it's fine.

Clearly the BON's of most states feel they're in their own little world and that they can make their own rules. That's when "organized medicine" steps in and says ENOUGH IS ENOUGH. That's what happened in Louisiana, and will continue to happen in other states. At some point, a given task or procedure crosses the line from wherever it was into the practice of medicine. At that point, it takes someone filing a complaint or a lawsuit to intervene.

This will get worse before it gets better - remember that the incoming president of the AANA practices pain management for a neurosurgery group in Indiana. The AANA has never been interested in a collegial relationship with the ASA. The ThoughtBridge fiasco put the final nail in that coffin.

 

[toughlife]

I suggest filing lawsuits in every state against the board of nursing for encouraging its associates to practice medicine by making 'statements' that support practices that are restricted to physicians.

 

[SleepIsGood]

...... So, it doesn't really matter what the head of an organization with a political agenda says... unless people in power start to believe it.

-copro

That's just it....people (CRNAs and SRNAs) are believing it! Listen, even those 'quite, obedient ones' that you think are harmless and are cooperative....they are the one's that are lining the AANA's pockets. Each one of those CRNAs/SRNAs contribute to the AANA Political Action Committee. This Walker guy is the AANA's president elect or whatever. He thinks pain medicine and anesthesia is an extension of nursing (forget the use of 'medicine' here of course by him). How can you say that he will not push his agenda and that he wouldnt have followers?

I'm not making this stuff up. It's public record on the internet on his website. It's all there.

 

[toughlife]

That's just it....people (CRNAs and SRNAs) are believing it! Listen, even those 'quite, obedient ones' that you think are harmless and are cooperative....they are the one's that are lining the AANA's pockets. Each one of those CRNAs/SRNAs contribute to the AANA Political Action Committee. This Walker guy is the AANA's president elect or whatever. He thinks pain medicine is an extension of nurse anesthesia (forget the use of 'medicine' here of course by him). How can you say that he will not push his agenda and that he wouldnt have followers?

Well said. All they want is to use you to learn the craft and then backstab you by lobbying to get you out of the picture.

Do not teach them anything.....ever.

 

[izzygoer]

I suggest filing lawsuits in every state against the board of nursing for encouraging its associates to practice medicine by making 'statements' that support practices that are restricted to physicians.

"In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine (Hodgins and Crile, 1919; Frank v. South, 1917; and Chalmers-Francis v. Nelson, 1936).[20][19]

All occurred before 1940 and all were found in favor of the nursing profession. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were seventeen nurse anesthetists for every one anesthesiologist.[19]

The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]

For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, nurse anesthetists, respiratory therapists, paramedics, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.""

http://en.wikipedia.org/wiki/Certified_Registered_Nurse_Anesthetist




Is pain management a "related task" of anesthesia? It seems it would be very hard to legally prove that it isn't.

 

[Faebinder]

"In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine (Hodgins and Crile, 1919; Frank v. South, 1917; and Chalmers-Francis v. Nelson, 1936).[20][19]

All occurred before 1940 and all were found in favor of the nursing profession. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were seventeen nurse anesthetists for every one anesthesiologist.[19]

The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]

For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, nurse anesthetists, respiratory therapists, paramedics, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.""

http://en.wikipedia.org/wiki/Certified_Registered_Nurse_Anesthetist

You must be a CRNA, cause you didn't catch the part where we are talking about pain medicine... you know, the science of stopping chronic and acute pain... not necessarily through intervention?

 

[izzygoer]

You must be a CRNA, cause you didn't catch the part where we are talking about pain medicine... you know, the art of stopping chronic and acute pain... not necessarily through intervention?

Well I am a CA-2 resident in training. What that has to do with the facts I am not sure. You can assume I am a CRNA if it makes you feel better.

And if you read the post

"Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]"


Pain management could legally be considered a related task of anesthesia.

 

[Coastie]

There were also no antibiotics before WW2.

Next.

"In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine (Hodgins and Crile, 1919; Frank v. South, 1917; and Chalmers-Francis v. Nelson, 1936).[20][19]

All occurred before 1940 and all were found in favor of the nursing profession. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were seventeen nurse anesthetists for every one anesthesiologist.[19]

The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]

For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, nurse anesthetists, respiratory therapists, paramedics, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.""

http://en.wikipedia.org/wiki/Certified_Registered_Nurse_Anesthetist




Is pain management a "related task" of anesthesia? It seems it would be very hard to legally prove that it isn't.

 

[Coastie]

Well I am a CA-2 resident in training. What that has to do with the facts I am not sure. You can assume I am a CRNA if it makes you feel better.

Doubtful.

 

[toughlife]

Well I am a CA-2 resident in training. What that has to do with the facts I am not sure. You can assume I am a CRNA if it makes you feel better.

And if you read the post

"Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]"


Pain management could legally be considered a related task of anesthesia.

is that what they are calling the sophomores SRNAs nowadays?

 

[dfk]

There were also no antibiotics before WW2.

Next.

sure there was.
wasn't it UV light??

 

[Planktonmd]

"In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine (Hodgins and Crile, 1919; Frank v. South, 1917; and Chalmers-Francis v. Nelson, 1936).[20][19]

All occurred before 1940 and all were found in favor of the nursing profession. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were seventeen nurse anesthetists for every one anesthesiologist.[19]

The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[21][22]

For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, nurse anesthetists, respiratory therapists, paramedics, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.""

http://en.wikipedia.org/wiki/Certified_Registered_Nurse_Anesthetist




Is pain management a "related task" of anesthesia? It seems it would be very hard to legally prove that it isn't.

When you want to prove a point please try to find evidence from unbiased sources and try not to entirely depend on inputs on wikipedia by other CRNA's.
The administration of anesthetics in the U.S. 70 - 80 years ago was done by nurses and others because at that time the knowledge we had about anesthesia was very limited to say the least, since that time and thanks (exclusively) to the scientific work of many great Anesthesiologists, this field has become complex and diverse enough to exceed the capacity and education of nurses.
It became a medical specialty, and it will remain a medical specialty.
That doesn't mean other professionals can not administer anesthetics or intubate as you illustrated, it simply means that only anesthesiologists practice the full scope of this medical specialty, all the others just give anesthesia.

 

[Lumbago]

The practice of chronic pain is not defined by the ability to give anesthesia nor is the practice of chronic pain even a related task of anesthesia. This is a dangerous oversimplification and one that should be vigorously contested by all physicians who practice pain.

 

[Taurus]

Well I am a CA-2 resident in training. What that has to do with the facts I am not sure. You can assume I am a CRNA if it makes you feel better.

If you're an anesthesiology resident, I'm Bush.

You're clueless about pain. Nurses think that pain is just about injections. It's a lot more than that. You have to have training in neurology, psychiatry, PM&R, and anesthesiology. If you spent just a little bit of time in a pain clinic, you would see that. Furthermore, since narcs are so commonly prescribed in pain, the states and govt have no interest in letting people start passing out these meds like if they're candy. The nurses have as much chance of successfully arguing that pain is part of nursing as the Lousiana BON and AANA did. Zip. It's just a matter of time before this goes national.

 

[fakin' the funk]

sure there was.
wasn't it UV light??

And whiskey

 

[Jeff05]

to those who maintain that anesthesia was delivered by nurses 60 years ago...

1. the mortality of anesthesia has decreased exponentially thanks to both advancements made by physicians and provision of those advanced techniques by said physicians

2. read the famous 6-sigma article. the provision of medicine is now infinitely more complex than it was 30 years ago. now we practice medicine based on an ever-expanding body of evidence. thus, the true value of a physician's training is his/her ability to view new evidence critically through the lens of a vast body of knowledge and experience gained through an intense undergraduate, graduate, and postgraduate training (also ongoing learning as an attending)


i URGE everyone to go to the ASA website, along with your state's anesthesiology society website and DONATE to the political action committee.

this is not just about the preservation of our specialty, this is about the highest level of patient advocacy.

 

[Planktonmd]

And whiskey

I bet you guys don't even know what Mercurochrome is.

 

[Tenesma]

CA-2 resident in training


dude - you gave yourself away with that line...

by the way, there was no end-tidal CO2, pulse oximetry, multi-lead EKGs, transducers, etc before WW2... and the mortality rate w/ anesthesia was VERY HIGH... so maybe it was a good thing that MDs took over the field...

 

[izzygoer]

If you're an anesthesiology resident, I'm Bush.

You're clueless about pain. Nurses think that pain is just about injections. It's a lot more than that. You have to have training in neurology, psychiatry, PM&R, and anesthesiology. If you spent just a little bit of time in a pain clinic, you would see that. Furthermore, since narcs are so commonly prescribed in pain, the states and govt have no interest in letting people start passing out these meds like if they're candy. The nurses have as much chance of successfully arguing that pain is part of nursing as the Lousiana BON and AANA did. Zip. It's just a matter of time before this goes national.

Clinical training hours
DNP: 1000*
PA: 2400
MD/DO: >12000

*Offered PT & online

Yet, DNP's want to be called "Doctor", be autonomous in all clinical settings (outpt, inpt, ER), be equivalent to PCP's, gain full hospital privileges & compare their silly NBME exam to USMLE.

Nursing residencies in derm, cards, GI next?

NP report

CRNA's doing pain

Future of medicine?
1) Don't hire DNP's or CRNA's
2) Hire PA's & AA's
3) File lawsuits to bring APN's under BOM

Hi Mr. President, nice response you can save your inferiority complex for the CRNAs thanks.

 

[izzygoer]

CA-2 resident in training


dude - you gave yourself away with that line...

yes i must have. The piece of paper in my closet that says M.D. is is really from a school of nursing as well..

 

[deleted126335]

.

 

[swpm]

There were also no antibiotics before WW2.

Hey hey, back during the Civil War, barbers performed surgery with carpentry tools. What are you trying to say, that the guys down at the local Supercuts shouldn't be doing lap choles?

 

[Taurus]

yes i must have. The piece of paper in my closet that says M.D. is is really from a school of nursing as well..

You know how you can easily spot a nurse from a mile away?

Because they don't know enough to make a coherent argument. Therefore, they just point to propaganda material from the ANA or AANA and think that is enough to convince people that they know what they're talking about. I hear it all the time when CRNA's try to justify that pain is within their scope. Most CRNA's don't know what pain is all about because they don't do it. They just listen to what the AANA wants them to believe. "Well, the BON and AANA said so. Here look, it says so on their websites." Uh, well, the courts beg to differ.

Crawl back to allnurses.

 

[mstng]

You know how you can easily spot a nurse from a mile away?

Because they don't know enough to make a coherent argument. Therefore, they just point to propaganda material from the ANA or AANA and think that is enough to convince people that they know what they're talking about. I hear it all the time when CRNA's try to justify that pain is within their scope. Most CRNA's don't know what pain is all about because they don't do it. They just listen to what the AANA wants them to believe. "Well, the BON and AANA said so. Here look, it says so on their websites." Uh, well, the courts beg to differ.

Crawl back to allnurses.

This from a med student... You guys crack me up.

 

[sevo85288]

Interesting. My colleague at a large institution (largest HMO in CA) saved 3 patients from dying last week with a a couple of newly minted CRNAs. they didn't know how to ventilate after they pushed the white stuff. The surgeon kicked her of the room after realizing what was happening. People are dying and will die if CRNAs practice anesthesia without supervision and a 1:2 ration of MD to nurse. They were just discussing in their group phasing out CRNAs b/c of a lack of economic advantage and increased deaths/injuries recently. Apparently, the young MDs are pushing to take over. It is a pendulum.

 

[jwk]

Interesting. My colleague at a large institution (largest HMO in CA) saved 3 patients from dying last week with a a couple of newly minted CRNAs. they didn't know how to ventilate after they pushed the white stuff. The surgeon kicked her of the room after realizing what was happening. People are dying and will die if CRNAs practice anesthesia without supervision and a 1:2 ration of MD to nurse. They were just discussing in their group phasing out CRNAs b/c of a lack of economic advantage and increased deaths/injuries recently. Apparently, the young MDs are pushing to take over. It is a pendulum.

C'mon, you know that's an aberration, and wild stories and anecdotes do nothing to further the cause. I have a really hard time believing that even a new CRNA doesn't "know how to ventilate after they pushed the white stuff". You want to give the impression that this is the rule rather than the exception when it simply isn't.

Many hospitals with bonafide by-the-book ACT practices are 1:3 and 1:4, and do just fine with their very competent AA's and CRNA's.

 

[toughlife]

This from a med student... You guys crack me up.

So why are you calling yourself an attending physician if you are a nurse?

 

[fascinoma]

Well I am a CA-2 resident in training.

I'm not going to address whether or not you're a "CA-2 resident," but just as a side note, when I read this post I thought of something I had read a while ago.

There was an article on cnn.com about a year ago talking about how the Allies dominated the Axis powers in terms of catching spies and such. I cut and paste a few lines from that article, which i thought i'd share:

.As the war went on, counterespionage officials (the Allies) developed ways of spotting suspicious letters. ..Telltale signs of a spy's handiwork included rambling letters with no apparent point, often sent to neutral countries with too many stamps..




Physicians are a very observant bunch. We've all spent at least 1 month in the ED sorting through those in pain vs. drug seekers--our built-in B.S. meters are very sensitive and quite unforgiving.

well, time for a nap. want to get in as many as possible before i begin my pgy1 intern year...

 

[izzygoer]

I'm not going to address whether or not you're a "CA-2 resident," but just as a side note, when I read this post I thought of something I had read a while ago.

There was an article on cnn.com about a year ago talking about how the Allies dominated the Axis powers in terms of catching spies and such. I cut and paste a few lines from that article, which i thought i'd share:

.As the war went on, counterespionage officials (the Allies) developed ways of spotting suspicious letters. ..Telltale signs of a spy's handiwork included rambling letters with no apparent point, often sent to neutral countries with too many stamps..




Physicians are a very observant bunch. We've all spent at least 1 month in the ED sorting through those in pain vs. drug seekers--our built-in B.S. meters are very sensitive and quite unforgiving.

well, time for a nap. want to get in as many as possible before i begin my pgy1 intern year...

There are people who read these threads who are not doctors and know what CA means.

Half the medicine people don't know what CA means.

If adding the qualifier "resident in training" after CA it makes me a nurse then so be it.








If people are going to knit pick this much and decode every word in a post it is borderline............ but have fun I guess.

Go back and use the enigma machine on my previous posts as well and see what it comes up with.

Unless I have been really pretending to be an anesthesiologist for the last 2 months with abstract posts on here so that the second a CRNA topic came up I could be the wolf in sheep's skin.



Wow if people are this paranoid about CRNAs then we are in serious trouble.

 

[izzygoer]

You know how you can easily spot a nurse from a mile away?

Because they don't know enough to make a coherent argument. Therefore, they just point to propaganda material from the ANA or AANA and think that is enough to convince people that they know what they're talking about. I hear it all the time when CRNA's try to justify that pain is within their scope. Most CRNA's don't know what pain is all about because they don't do it. They just listen to what the AANA wants them to believe. "Well, the BON and AANA said so. Here look, it says so on their websites." Uh, well, the courts beg to differ.

Crawl back to allnurses.

Should I give you the number to the registrars office of my med school and current program director so you can check my credentials?? Get a life already. This level of paranoia is definitely though.

If your point is to immediately label someone you don’t know as something they are not.............
the second they disagree with you, then the strength of your argument, which does have valid points ................is reduced to that of a 10 year olds.


Yes I’m an anesthesiologist who doesn’t find the need to grab the pitch forks start hanging CRNAs the second someone says something. Because they have been saying it for decades.








The point of my original post was that this legal question with CRNAs is not something that happened in the last year or two years. This has been going on for a very long time.


Threatening to carpet bomb lawsuits was done a long time ago. It didn’t help too much then either when the major legalities of this field were decided. Good luck challenging those again 50 years later.

Go north south east west of any major city in this country and when you get into the boondocks.


You find out very very quickly what nurses can do legally when patients need surgeries and there isn’t an anesthesiologist in sight.




This specific argument over interventional pain, Im glad people are finally trying to draw a line in the sand, but it’s small potatoes and too late IMO.




How many people will this affect?


How many CRNAs who could even afford the equipment and technology to do interventional pain if they wanted to?

How many medicine docs are going to say to their patients, well I don’t know what the hell is causing your pain or how to treat it so let me send you to the nurse down the street?

How many patients are going to pay to see a crna when there is a neurosurgeon next door?

How many heroin addicts are going to wait for an appointment? For everyone that actually shows up and gets thrown out on his ass in the clinic amid a flurry of expletives........... there are 10 more who go to the family doc office above the liquor store to get their narcs.


How many neurologists, neurosurgeons, IR and fp guys are taking weekend certification courses and adding “pain management” to their practices? Probably the same as the number of chiropractors who legally offer laser resurfacing in NYC.



how many CRNAs legally practice independently in OR s across this country? One hell of a lot more than will ever even consider interventional pain. It’s Small potatoes


This is the reality of medicine today.

You can have the champagne for me if Louisiana means something more for you.

I wonder whether I should now consider a pain fellowship since there will be no competition from crnas there.


People talk about dangerous precedents. Come to NYC. Up the street from sinai there are 2 independent NPS that advertise chronic pain management. Who the hell knows what goes on in their office. Patients who need surgeries get sent to “their” neurosurgeons. I know it because the neuro surge is quack quack and lets the entire OR know how profitable his referrals are every time he does a case


Nurses doing cards is far more offensive to me.

There are CRNAs in the midwest doing “bread and butter cards” cases whatever that means at a string of ambulatory centers. You think lawsuits will change that sometime soon?

People say it will change when the nurse injures someone. They did injure someone.

When that happens they ask why an anesthesiologist was not present

And the centers drag out their prostitutes to show the jury that no anesthesiologist responded to their ad for a Cardiac anesthesiologist with 10 years experience with a salary 200k..............when that happens the malpractice is zilch.

Its called entrepreneurship as practiced by the capitalist pigs who have mastered it



The time for precedents was 50 years ago.


You want to say crnas are bad incompetent don’t know what the hell they are doing, are dangerous to patients, more power to you. The bottom line is the Genie was let out of the bottle a long time ago, good luck putting it back in.

I know the difference between CRNAs and me and so do you and so does everyone else who goes through 4 years of med the hell of internship and then this.


as long as patients don’t have a clue and anesthesiology groups are allowed to practice capitalism, not much will change.

That’s my opinion.

Since I will probably be banned I will spare the moderator the theatrics. I’m done with this bye.

 

[Taurus]

Jet, you got your glock ready?