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Will Physiatrists be next?
CRNA's now to be addressed as "Nurse Anesthesiologist."
- Thread starter drusso
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deleted480308
Ain’t that some sheeeeet.
In turn the ABA is changing anesthesiologists name to “doctor and not a lowly nurse.”
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I just introduce myself as Steve. If they ask, I say I am the real doctor.
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wait... as opposed to what?
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I think aesthetic nurses will want to be called plastic surgeons.
It’s all lipstick on a pig IMO
It’s all lipstick on a pig IMO
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I hope that we use the same smear campaign against them. An eye for an eye.
Unfortunately CRNAs were born out of physician greed and groups still hire them out of greed. We physicians are so effin stupid and short sighted.
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I just saw this and was about to post this. Do CRNAs even have malpractice insurance?
It doesn’t end. Now they are propagating that it’s our finances that we are trying to protect?
Good luck getting anesthesia care during a crna break time.
(Also my auto-correct corrects “crna” to “crab”. )
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Gee whiz when will all the “posing as someone you are not” end?—Will Nurse Practitioners that work in Neurosurgery want to be called Nurse Neurosurgeons? Those in cardiology Nurse Cardiologists?
Nope Im NOT calling a nurse an Anesthesiologist. You can go to
med school/residency THEN see how you feel about Nurses wanting to be called Doctors.
Nope Im NOT calling a nurse an Anesthesiologist. You can go to
med school/residency THEN see how you feel about Nurses wanting to be called Doctors.
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If I’m not mistaken, they are also under the purview of the nursing board and not medical board. So if they get sued, what happens?
They aren’t the “captain of the ship” as the ophtho found out as his malpractice paid out $800k.
Ridiculous defense by crna that actually worked in a lawsuit.
They aren’t the “captain of the ship” as the ophtho found out as his malpractice paid out $800k.
Ridiculous defense by crna that actually worked in a lawsuit.
Educated ConsumeRX
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I’m a RNFA; I most certainly do NOT consider myself to be a “ Nurse Surgeon” ... Laughable.. even though Most** of the time, what I’m doing in a surgical case is the same as what another surgeon would be doing..
While a CRNA; is competent.. and I won’t even get into my personal opinion about their utilization , the FACT remains... they are STILL nurses, albeit advanced practice nurses... but a nurse all the same; and therefore subject to being under the supervision ** of a physician and thus practices UNDER one... They had the same opportunity to go the route of an MD... but .. didn’t...
I believe this new “ title “ is deadass.. WRONG... they are what they always have been: Certified NURSE.. Anesthetists ***
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Imagine if all the pain and related specialty societies did this!
www.aaemrsa.org
We at the AAEM/RSA, representing thousands of our resident and future physicians, along with AAEM, with an even larger membership of attending physicians, urge the AMA to lead a sizable public endeavor, including:
Open Letter to the AMA: Where is the Public Campaign Advocating for Physicians? | AAEM Resident and Student Association
The American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA) is a non-profit professional association for emergency medicine residents and medical students.
We at the AAEM/RSA, representing thousands of our resident and future physicians, along with AAEM, with an even larger membership of attending physicians, urge the AMA to lead a sizable public endeavor, including:
- Introducing a PR campaign that advocates for physician-led care and educates the public of the discrepancies in nurse practitioner care
- Increasing resources on state-level legislative operations that combat independent practice bills introduced by midlevel providers
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deleted993114
Imagine if all the pain and related specialty societies did this!
Open Letter to the AMA: Where is the Public Campaign Advocating for Physicians? | AAEM Resident and Student Association
The American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA) is a non-profit professional association for emergency medicine residents and medical students.
We at the AAEM/RSA, representing thousands of our resident and future physicians, along with AAEM, with an even larger membership of attending physicians, urge the AMA to lead a sizable public endeavor, including:
- Introducing a PR campaign that advocates for physician-led care and educates the public of the discrepancies in nurse practitioner care
- Increasing resources on state-level legislative operations that combat independent practice bills introduced by midlevel providers
I don't have a problem with CRNAs calling themselves anything but "doctor". Who cares about this? They do, in fact, have training in anesthesia and are competent to perform anesthetics. If this was not true, anesthesiologists would not use them. I have been anesthetized by CRNAs for surgeries without fear; in most instances I know the anesthesiologist probably has not personally performed an anesthetic in over a decade and is somewhere sleeping in a doctor's lounge.
CRNAs were created by the greed of anesthesiologists. Like many creations, they are coming back to bite them in the ass. Anesthesiologists should blame themselves. What should you do? Create another, more docile class of providers, like "PA Anesthetists" to compete with CRNAs at a lower cost. Don't get mad- take rational action to address your "problem".
The world is moving more and more toward ancillary providers assuming the role of physicians. This is happening, and will continue to happen. There are CRNAs doing "pain management". I don't care- they are terrible providers and rather quickly patients and providers know the difference. Quality, if there is a difference, will declare itself.
I must say that I would personally rather have an anesthetic administered by a US trained CRNA, rather than an FMG of dubious training (not Northern European or Canadian, which is essentially the same as US medical training). Anesthesia and Pain has really suffered from personnel quality issues. Neurosurgery, mostly due to the efforts of John Van Gilder, has far less quality issues, as they addressed this at the level of the training programs and who could be accepted into their residencies.
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I feel like I have to address the above post, just for any future reader who stumbles on it.
At any proper hospital, the anesthesiologist (I guess I have to specify physician now, since the nurses are calling themselves anesthesiologists as well) should be the most skilled person in the room, and they are a vast majority of the time. If you've never worked with these nurse anesthetists you don't know how basic their skill levels are. I wouldn't be so comfortable getting a full anesthetic from them even for a basic case. Remember, any basic case can go downhill in a matter of seconds, and when that happens you want a doctor there to save you.
The nurses have no proper medical training, they cannot properly pre-op patients. They cannot run through differential diagnosis in a matter of seconds, when it matters. They often miss big things.
There are Anesthesiology Assistants (AAs) in response to your "PA anesthetist" comment. These are assistants that must have supervision by a physician. However, the nurse anesthetists fight tooth and nail to limit their scope of practice in many states because physicians often prefer working with AAs. The nurses will often site that they have more training (if you'd even call it that) than AAs, but then they overlook the fact that they themselves have far less training than a physician.
Bottom line is, a lot can go wrong with even a basic general anesthetic, so if you or anyone you care about is having a procedure done, make sure there is a physician anesthesiologist managing the case.
At any proper hospital, the anesthesiologist (I guess I have to specify physician now, since the nurses are calling themselves anesthesiologists as well) should be the most skilled person in the room, and they are a vast majority of the time. If you've never worked with these nurse anesthetists you don't know how basic their skill levels are. I wouldn't be so comfortable getting a full anesthetic from them even for a basic case. Remember, any basic case can go downhill in a matter of seconds, and when that happens you want a doctor there to save you.
The nurses have no proper medical training, they cannot properly pre-op patients. They cannot run through differential diagnosis in a matter of seconds, when it matters. They often miss big things.
There are Anesthesiology Assistants (AAs) in response to your "PA anesthetist" comment. These are assistants that must have supervision by a physician. However, the nurse anesthetists fight tooth and nail to limit their scope of practice in many states because physicians often prefer working with AAs. The nurses will often site that they have more training (if you'd even call it that) than AAs, but then they overlook the fact that they themselves have far less training than a physician.
Bottom line is, a lot can go wrong with even a basic general anesthetic, so if you or anyone you care about is having a procedure done, make sure there is a physician anesthesiologist managing the case.
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deleted993114
I only practiced OR anesthesia half time for two years after training, so my experience with them is very limited. It sounds like you have quite a bit of experience with them- I do not.
I was a part of an anesthesia group for a few years who did use CRNAs. There were several anesthesia providers who were terrible anesthesiologists who just hid in the anesthesia office. About 3/4 of the anesthesia guys were involved with the cases and did a good job.
So you observations are obviously much better than mine, as they were mostly as an observer, rather than a participant in the process. Come to think of it, I did aspirate with the last anesthetic I had about 3 months ago. A bladder bx (I have a little cancer problem I am dealing with) and when I was going to sleep, the CRNA told me she was going to use an LMA. Before I could tell her that was not such a good idea (hx of reflux), I was off to sleep. Fortunately, I did not have to be admitted, but was wheezing pretty damn good for a couple weeks afterward.
As a patient (the only time I encounter anesthesia guys unless they are supervising CRNAs for ssedation during stims), despite being a physician, I think they would tell me to go to hell if I "insisted" on an anesthesiologist. I always want my treating physicians (God knows I have had a lot of them) to treat me like all their other patients so they are not out of their comfort zone. The urologist was a little yanked that I aspirated, but I told him to forget it. I actualy had one of my former partners (he was OR anesthesia) do the anesthetic for an ACL about 25 years ago. The surgeon liked femoral nerve blocks, for post op pain. I had a spinal (his idea- I told him whatever), but he forgot to do the femoral nerve block, so did it after the spinal (I was too looped on versed to object). He bagged my femoral nerve (I have a motor and sensory deficit, but no pain)- took about 30 yards off my drives, but otherwise am okay. He was upset, but I told him not to sweat it, just don't do it on other folks in the future, as they would sue.
What would you suggest for me the next time I have surgery (as I usually get 2-3 per year at this stage of the game)? I really think I would be a little embarrassed to ask for an anesthesia guy who can do his own cases if this is not the model they use.
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As an anesthesiologist who practices both pain and OR anesthesia I would be glad to take care of an MD personally if requested.
Well, they have more training years than anesthesiologists... 
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I mean, everyone wants a piece of the pie.
We have chiros calling themselves physicians, American chiropractic board of physicians:
We also have psychologists calling themselves prescribers after taking an online course with no medical background.
We have Dentist that do 2 years of dental anesthesia training and call themselves anesthesiologists.
So I’m not surprised that nursing is attempting move on this.
We have chiros calling themselves physicians, American chiropractic board of physicians:
We also have psychologists calling themselves prescribers after taking an online course with no medical background.
We have Dentist that do 2 years of dental anesthesia training and call themselves anesthesiologists.
So I’m not surprised that nursing is attempting move on this.
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allowing them to practice independently and let the quality speak for itself is a slippery slope. why do harm to those patients, and will those patients know any better? they have not earned the MD/DO and training to evaluate and care for the patient independently. they should never be allowed to practice independently period. once a gate is opened, it will be very hard to close it back.
as for the anesthetic administered by FMG - i would be careful about your western centric comment. FMGs practicing in US went through US residency training. also i've observed anesthetics delivered in other non-western countries and they are just as competent as we are (i can't vouch for all countries but you get the idea) I'm a US grad who trained at a good program. FMG attendings did not equal delivering bad anesthetic. it's all up to the individual and how much you let yourself degenerate over the years of laziness that determines your skills.
I'm sorry about some of the complications you've seen with your anesthetics. There are definitely good and bad anesthesiologists out there, but the difference is far greater when comparing physician anesthesiologists to the nurse anesthetists.
I just replied to your earlier post because I did not want a student or someone from the general public to read it and think that physicians were supporting the thought of a nurse anesthetist functioning independently, the nurse anesthetists should never function independently, they should always be supervised and the care should be managed by a physician anesthesiologist.
With respect to requesting a physician doing the entire case, I realize that at some hospitals its impossible. However, you should ALWAYS have a physician anesthesiologist managing/leading the case. What I mean by that is, the physician anesthesiologist should pre-op you, come up with a plan, be there for the start and end of the case along with being immediately available if anything were to go wrong. The nurse anesthetist is a physician anesthesiologists assistant, they can sit in the room and monitor you, but the plan should be made by the physician.
I think the next time you have a procedure done, you should speak to the anesthesiologist and let them know about these 2 previous issues you've had to deal with so that they are more careful next time. If a physician anesthesiologist can't do the entire case themselves, I'd insist that they come up with the plan, and I'd want them there for the start/end of the case and immediately available if anything went wrong.
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as a physician, you should always be able to request that the primary "anesthetist" is a board certified anesthesiologist. that anesthesiologist should be in the room for induction. if that anesthesiologist is confident in having a CRNA help with monitoring afterwards, then that is appropriate.
but, the idea of using an LMA for your situation was a poorly thought out "plan" that an anesthesiologist would have avoided just by doing a standard chart review.
if you go to a hospital that is not willing to accommodate, then its time to find a different hospital.
but, the idea of using an LMA for your situation was a poorly thought out "plan" that an anesthesiologist would have avoided just by doing a standard chart review.
if you go to a hospital that is not willing to accommodate, then its time to find a different hospital.
