CRNAs want it all. Check out their new attempt at pain

[toughlife]

Legislation also has been introduced in Louisiana that would allow nurse anesthetists to perform interventional pain management procedures. H.B. 684 expands the nurses’ scope of practice to perform procedures including, but not limited to, those involving the injection of local anesthetics, steroids and analgesics for pain management purposes under the direction and supervision of a physician. The procedures for pain management purposes include, but are not limited to, peripheral nerve blocks, epidural injections and spinal facet joint injections when the registered nurse anesthetist can document education, training and experience in performing such procedures. The language mirrors the advisory opinion issued by the Louisiana State Board of Nursing that has been the subject of litigation www.ASAhq.org/Newsletters/2007/02-07/stateBeat02_07.html.

The performance of interventional pain management procedures by nurse anesthetists has already been addressed by the Louisiana State Board of Medical Examiners. In 2006, the medical board issued an advisory opinion stating that nurse anesthetists could provide anesthetics for acute pain associated with surgery, but procedures for interventional pain management purposes constitute the practice of medicine and can only be performed by a physician.

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Members don't see this ad.

 

[VentdependenT]

Unreal man, completely unreal. Any doc that would agree to supervise, and thus allow, this to happen doesn't belong in this field anymore.

 

[armygas]

OK guys, I understand your concern, but let me pose a scenario. If someone like myself (for who there are probably less than 5 in the whole U.S.) who after becoming a Military CRNA and working in some of the most austere conditions and well skilled in regional techniques goes on and obtains a neursocience PhD (for which one has to have an expert understanding of the anatomy and physiology of pain). Would that be an exception?

Like I said I truly am not trying to start trouble.......

 

[jetproppilot]

Would that be an exception?

Like I said I truly am not trying to start trouble.......

GIMME A BREAK, PRIVATE.

So you're a military dude.

I respect that.

CRNAS in the military do alotta stuff abroad, unsupervised.

And probably safe, too.

Now, youre taking part in a thread trying to justify CRNAS being unsupervised in the pain milleau in the US.

SO SLIM,

HOW MANY SPINE-STIMS DID YOU PLACE ON THE CRITICALLY WOUNDED IN IRAQ???

HOW MANY CASES OF RSD DID YOU TREAT IN IRAQ??

WERE YOU BUSY WITH ESIs AND FACET BLOCKS UNDER FLUORO???

GIMME A BREAK, ARMY NURSE.

I'm deft with anesthesia.

Eleven years private practice.

I can intubate a pregnant ant. I can get a right-ventricular failure dude with PAPs in the 70s off pump. I can do an epidural blindfolded.

But I wouldnt even THINK....EVEN FOR A MILLISECOND... of marketing myself in the pain market, without a fellowship, or a year-or-two under the wing of a pain colleague.

And you are asking, with your meager NURSE crudentials, if you can make the grade???????

The fact that this bill has made it so far....utterly disgusts me.

Lemme let you in on a little something, Slim.

THE ART OF KNOWING YOUR PROFESSION IS ADMITTING WHAT YOU DON'T KNOW.

and with that last post, Jet realizes he may need to fire a SEVEN SIX TWO MILLIMETER round at his own work in this thread.

Jet shakes his head in disbelief. Laying supine on the floor of his Old Metairie home, feet together, barrel resting between his feet, he hones in on the troll....

 

[armygas]

GIMME A BREAK, PRIVATE.

So you're a military dude.

I respect that.

CRNAS in the military do alotta stuff abroad, unsupervised.

And probably safe, too.

Now, youre taking part in a thread trying to justify CRNAS being unsupervised in the pain milleau in the US.

SO SLIM,

HOW MANY SPINE-STIMS DID YOU PLACE ON THE CRITICALLY WOUNDED IN IRAQ???

HOW MANY CASES OF RSD DID YOU TREAT IN IRAQ??

WERE YOU BUSY WITH ESIs AND FACET BLOCKS UNDER FLUORO???

GIMME A BREAK, ARMY NURSE.

I'm deft with anesthesia.

Eleven years private practice.

I can intubate a pregnant ant. I can get a right-ventricular failure dude with PAPs in the 70s off pump. I can do an epidural blindfolded.

But I wouldnt even THINK....EVEN FOR A MILLISECOND... of marketing myself in the pain market, without a fellowship, or a year-or-two under the wing of a pain colleague.

And you are asking, with your meager NURSE crudentials, if you can make the grade???????

The fact that this bill has made it so far....utterly disgusts me.

Lemme let you in on a little something, Slim.

THE ART OF KNOWING YOUR PROFESSION IS ADMITTING WHAT YOU DON'T KNOW.

and with that last post, Jet realizes he may need to fire a SEVEN SIX TWO MILLIMETER round at his own work in this thread.

Jet shakes his head in disbelief. Laying supine on the floor of his Old Metairie home, feet together, barrel resting between his feet, he hones in on the troll....

My name is not Slim it is Mike (Captain(P) Mike....haven't been a Private since 1988........and Slim implies[SIZE=-1] ---small in girth or thickness in proportion to height or length--- for which I am not ).

[/SIZE]Never said I was going to do it, but I think the fact that I will have a Neuroscience PhD and a stong clinical background SLIM changes things no (rude begets rude.... I am an an Army Nurse Anesthetist SLIM....just for the record).

I mean the things you speak of are technical skills (i.e the procedures) but it is the expert knowledge of the reasons behind the techniques that is offered by that training. I could send you two of my manuscripts on RSD/CRPS if you like. So say after all of this I have 2-3 research articles in high impact journals then that bears no weight? Are you saying I wouldn't have the knowledge base to understand the reasoning behind the procedures and the most current treatment options along with the pharmacological reasoning behind the treatments? Like I said there are probably 3-5 other CRNAs with this specific training and experience.

Anyone can be taught a procedure, no? But not everyone goes through a PhD program specifically focused on the nervous system.

Again, who knows if I would do this, I was just presenting a scenario because rules always have exceptions.

Mike (BTW UFC 72 is starting if anyone is interested....... MMA is my other hobby nothing better than giving and taking ass kickin' y'all gotta join a local club just for the workout seriously)

 

[Hoya11]

OK guys, I understand your concern, but let me pose a scenario. If someone like myself (for who there are probably less than 5 in the whole U.S.) who after becoming a Military CRNA and working in some of the most austere conditions and well skilled in regional techniques goes on and obtains a neursocience PhD (for which one has to have an expert understanding of the anatomy and physiology of pain). Would that be an exception?

Like I said I truly am not trying to start trouble.......

I just dont get where there is room for negotiation in terms of credentials required for a job. Being a pain doctor is a job done by MDs. If you want this job you have to go to medical school. period.

If your looking for a CPA, you dont settle for a guy who is good in math, got A's in a few finance classes, and runs his own successful business... you want the damn cpa, not these partially related fields. It may be true that the business savy guy may be able to do the taxes, but he is not eligible to be hired and have the same responsibilities as the CPA simply by virtue of degree, this is the whole purpose of having credentials and degrees!

Its not like you can build your own MD. I dont get this mentality that i have seen from many other nurses in the field that if they go to CRNA school, get some kind of other degree like DNP or Phd or whatever, they have built their own MD. Its not apples to apples. You do not know precisely what goes into being an MD, so you would not be capable of assessing whether you have attained equality with one. So speculating what might be enough to do an MD job is pointless. No matter what you add on top of what, if your not adding an MD you will always be a mid-level who is working for an MD with less responsibility, less liability, and less pay.

 

[MacGyver]

Unreal man, completely unreal. Any doc that would agree to supervise, and thus allow, this to happen doesn't belong in this field anymore.

Yet I would bet you $1000 right now that there are attendings in YOUR INSTITUTION that are either 1) "supervising" CRNAs and thus selling you out; 2) teaching the CRNAs features of "advanced pain management."

Its time to start cleaning hte skeletons out of the closet. Your MDA attendings have become filthy greedy. 300k isnt good enough for them, they want an extra $100k per year so they sell your profession out to the CRNAs.

 

[armygas]

Being a pain doctor is a job done by MDs. If you want this job you have to go to medical school. period.

Ahhh, you bring to light an interesting point, MDs have an unrestricted license and can prescribe virtually any treatment and can practice in any area with or without board certification.

So say the Family Practice Doc working with a CRNA group prescribes a "pain intervention" and the patient goes to the CRNA group who "fills the prescription" because they have the technical expertise to perform the procedure.......... see what I mean?

Also why is there a CRNA (actually 2) on the AAPM board? http://www.aapainmanage.org/aboutus/Advisors.php and 72 CRNAs, 3 AAs, and a veterinary anesthetist (good god) that are acknowledged as types of providers?
http://www.aapainmanage.org/search/MemberSearchResults.php

BTW UFC 72 was worth the money tonight....

 

[CremeSickle]

Ok.


For the record i have heard this legsilation is already doomed to fail (*cheer*) and CRNAs shouldnt be doing pain management outside the typical OR pain management.

However, this thread has already become an example of why these threads were supposed to be banned.

JPP, whats the deal? You close one thread in violation and THEN make it a sticky, this one remains open and yer playing the argument game. Are we following the new rules or not? If not fine, if so then enforce them. That means on blade and toughlife as well as idiot militant nurses.

ie: no political BS or CRNA vs MD/DO on this forum.

 

[VentdependenT]

I'd bet you some cash that those nurses are in the PALLITIVE CARE field. They aren't working the fluro machine and inserting needles into peoples c-spines.

Those MENTAL HEALTH PROFESSIONALS aren't implanting spinal cord stims....I'm sure of it. Same goes for the FP's. Good luck if they get sued overstepping their training boundaries. GAME OVER.

Dude, land a DO/MD and go into an INTERVENTIONAL PAIN fellowship. Them's the dues. A PHD is great. Awsome. It doesn't change the situation. My medical school Neuroanatomy PHD isn't grabbing the epidural needle and doing radiologic guided facet blocks even though he knows more than anyone in the damn hospital about neuroanatomy.

Come up with some landmark paper and maybe you can be an honorary physician like those parents in Lorenzo's Oil.

 

[armygas]

Come up with some landmark paper and maybe you can be an honorary physician like those parents in Lorenzo's Oil.

Believe me I understand "paying dues", I have been doing it all my life cuz you know as well as I that if you don't put "money in" then you don't get the "profit". I just try (on these sort of topics) to present the reality that these changes have been put in motion well before our time. People get (understandably) heated over this sort of stuff...... I understand the concept of "territory" and all professions will be loyal to their circumstance and fight hard for their "territory". I get it and that should happen (without all the high-schoolish insults)!!! I enjoy the thread (you may not enjoy me, but I don't think I have ever threatened to "assinate" anyone (JPP) but I would like to get JPP into the octagon for 3 five minute rounds and see what he's got and let him see if I am "Slim" or not......"lets get it on").

Seriously you all have nothing to worry about with me, I am a career soldier and will more than likely: buy a huge house in San Antonio, spend thirty years in the US Army taking care of the anesthetic needs of U.S. service members , retirees and their family (because they above all should have the best care), take my investments, retire as a Colonel with a huge pension and lifelong medical benefits, then work as a Anesthesia, Pharm, Phys, or Biochem Professor for Army SRNAs as a GS13/14 for the next twenty years or until I die (whichever comes first), live a long (hopefully) comfortable life, and provide my children with any opportunity they want.




Itzalllllgoood!
Mike

 

[armygas]

CRNAS in the military do alotta stuff abroad, unsupervised.

And probably safe, too.

Let me ask you this, do you think every Military Hospital has an Anesthesiologist?

CRNAs are the sole providers in many CONUS facilities as well, Slim

 

[Hoya11]

Ahhh, you bring to light an interesting point, MDs have an unrestricted license and can prescribe virtually any treatment and can practice in any area with or without board certification.

So say the Family Practice Doc working with a CRNA group prescribes a "pain intervention" and the patient goes to the CRNA group who "fills the prescription" because they have the technical expertise to perform the procedure.......... see what I mean?

Also why is there a CRNA (actually 2) on the AAPM board? http://www.aapainmanage.org/aboutus/Advisors.php and 72 CRNAs, 3 AAs, and a veterinary anesthetist (good god) that are acknowledged as types of providers?
http://www.aapainmanage.org/search/MemberSearchResults.php

BTW UFC 72 was worth the money tonight....

Someone would have to supervise the injection that was prescribed, to ensure it was done right, and for liabililty sake. Although I have heard before that doctors may do any procedure, I dont think the FP would go and do a laminectomy if the patient needed it. Along the same lines he would not be able to ensure quality of the injection or want to take on the liability of the procedure done by someone with questionable training. These things would be beyond the scope of his practice, just like doing the injections or being equal with an MD is beyond the scope of a CRNA. If everything went well and no one got sued i suppose it is possible for this event to occur, but why would anyone opt for this extra liability and stick their own neck out cuz this pain guy doesnt want to go to medical school. Ill take the expert with the MD, who doesnt need supervision, and wont drag me into it if the injection goes wrong.

 

[powermd]

Let me ask you this, do you think every Military Hospital has an Anesthesiologist?

CRNAs are the sole providers in many CONUS facilities as well, Slim

There has been a lot of press lately about how the military CUTS CORNERS in mental health care. CRNAs practicing independently (wherever) is a failing of the health care system. Just because the military is doing one (or two, or three) things WRONG, you aren't justified in adding another mistake.

Optomotrists may want to do LASIK, but they'll never perform eye surgery without getting an MD, and doing an ophthalmology residency. Why should interventional pain management be any different? OPTOMETRY IS OPTOMETRY. MEDICINE IS MEDICINE. NURSING IS NURSING.

Although it certainly looks that way to some, the issue at hand is NOT ABOUT PAYING YOUR DUES. The issue is WHO CAN PRACTICE MEDICINE. The CRNA lobbies are chipping away at the foundation of health care - DOCTORS PRACTICING MEDCINE. Despite not being trained physicians, they think you don't need to be a DOCTOR to practice MEDICINE.

IT SEEMS YOU FEEL THIS WAY TOO: PHD + CRNA = MD WITH ANESTHESIOLOGY RESIDENCY AND INTERVENTIONAL PAIN MANAGEMENT FELLOWSHIP.

??? I'm curious as to what you're actually saying here. Are you asserting that you are the DE FACTO EQUIVILANT to a PHYSICIAN? Or are you asserting that PAIN MANAGEMENT AND/OR ANESTHESIOLOGY is NOT MEDICINE, and can thus be practiced by anyone who thinks they have appropriate training?

I see a DANGEROUS SLIPPERY SLOPE here that is putting our high STANDARD OF CARE at risk across the board in all medical fields.

 

[jwk]

Also why is there a CRNA (actually 2) on the AAPM board? http://www.aapainmanage.org/aboutus/Advisors.php and 72 CRNAs, 3 AAs, and a veterinary anesthetist (good god) that are acknowledged as types of providers?
http://www.aapainmanage.org/search/MemberSearchResults.php

Just about anyone can be a member of the AAPM that is interested in pain management - the list includes PT's, OT's, social workers, etc.

Interesting that the standards for the AAPM make no mention of physician involvement, just that individuals involved with pain management practice within their legal scope of practice for their jurisdiction. There are no educational, training, or fellowship requirements, just "appropriate training". Probably explains why not too many facilities are on the list considering there are probably thousands of pain clinics in the country (and of course a number of those listed are for CRNA's). Sounds like accreditation for sale IMHO.

Ok.


However, this thread has already become an example of why these threads were supposed to be banned.

JPP, whats the deal? You close one thread in violation and THEN make it a sticky, this one remains open and yer playing the argument game. Are we following the new rules or not? If not fine, if so then enforce them. That means on blade and toughlife as well as idiot militant nurses.

ie: no political BS or CRNA vs MD/DO on this forum.

I still don't get why y'all want to ban these threads. The separate anesthesia forums were created to get them out from under some of the more clueless rogue moderators on SDN. The forum was going to be litely moderated to promote open discussion. Now open discussion (in many cases) is only behind closed doors.

If you don't like a particular thread, then simply don't read it and don't post on it. Don't close it down or limit topics simply because you find them irritating. It's still easy enough to ban offensive posts or posters.

 

[armygas]

IT SEEMS YOU FEEL THIS WAY TOO: PHD + CRNA = MD WITH ANESTHESIOLOGY RESIDENCY AND INTERVENTIONAL PAIN MANAGEMENT FELLOWSHIP.

I actually don't feel that way at all, but I do think the procedures themselves are not beyond the capabilities of CRNAs. That is my point.

 

[armygas]

It's still easy enough to ban offensive posts or posters.

That is very true and I agree that personal insults (ahem...... JPP) and threats (ahem...... JPP) fit that category, but it is definitely not an open discussion when you start banning people just because you don't agree with what that person is saying, its called censorship............


Regimes that promoted censorship--------The Nazi Party, The Bath Party, Stalin.........(shall I go on?) Is that how you want to respresent your particular organization?

By the way JPP the invitation into the octagon is still out there........

 

[CremeSickle]

I still don't get why y'all want to ban these threads. The separate anesthesia forums were created to get them out from under some of the more clueless rogue moderators on SDN. The forum was going to be litely moderated to promote open discussion. Now open discussion (in many cases) is only behind closed doors.

If you don't like a particular thread, then simply don't read it and don't post on it. Don't close it down or limit topics simply because you find them irritating. It's still easy enough to ban offensive posts or posters.

Why? It should be self evident. These threads make physicians (Anesthesiologists) look bad. Moreover, they often boil down to one (or more) of our members summarily insulting another individual because they are not physicians, not only is this unprofessional but its disgusting uncouth behavior from physicians.

Lets we forget, nurses already have more support and trust from the public than physicians do (and AAs have none). Spouting insults at nurses on a public forum will only serve to confirm the feelings the general public has that physicians dont care about patients, but only care about their pocket books.

 

[armygas]

There has been a lot of press lately about how the military CUTS CORNERS in mental health care. CRNAs practicing independently (wherever) is a failing of the health care system. Just because the military is doing one (or two, or three) things WRONG, you aren't justified in adding another mistake.

Our scope in detailed in this regulation, you really have no idea... www.army.mil/usapa/epubs/pdf/r40_68.pdf

 

[BLADEMDA]

Why? It should be self evident. These threads make physicians (Anesthesiologists) look bad. Moreover, they often boil down to one (or more) of our members summarily insulting another individual because they are not physicians, not only is this unprofessional but its disgusting uncouth behavior from physicians.

Lets we forget, nurses already have more support and trust from the public than physicians do (and AAs have none). Spouting insults at nurses on a public forum will only serve to confirm the feelings the general public has that physicians dont care about patients, but only care about their pocket books.

AA's have none? Now who is insulting a qualified provider of Anesthesia? The fact is AA's are EQUAL to CRNA's and should be treated as such.

This discussion is not about who is better or who has more support. It is about the MINIMUM standard in the USA to practice Medicine. I believe the public would DEMAND MD level care if they knew all the facts. While CRNA's are capable providers and can do the job they are not Physicians; as such, they should never be allowed independent practice. While you view this issue as about "money" I see it as a basic philosophical difference in the health care system. Even in a socialized system I believe MidLEvel Nurses with DNP/DNAP should not practice Independently. This is why we have Medical Schools in the USA and all around the world. They exist so the graduate will one day (after the appropriate post graduate training) practice Independently.

Blade

 

[MacGyver]

Spouting insults at nurses on a public forum will only serve to confirm the feelings the general public has that physicians dont care about patients, but only care about their pocket books.

Yeah, and the reason CRNAs want to get into pain medicine is because they want to help patients and not because of the $$$$.

 

[Gern Blansten]

American Academy of Pain Management is a "pay your money, get a certififcate" operation to offer credentials to those whop do not have them. It is not a respected organization and is considered a sham by most. American Academy of Pain Medicine is the sponsoring organization for the American Board of Pain Medicine which is a secondary route to board certification in pain, albeit a less respected route than the ABA's certificate. ABPM is considered ABMS equivalent in Texas, California, and Florida. It is what I would consider the other more legitimate certificate in pain and is more multidisciplinary, but is only for physicians(maybe dentists as well, I am not sure on this) and thetest is fairly rigorous(doesn't compare to the primary certififcate in Anesthesiology though).

So, in summary, touting the AAPManagement thing is meaningless. A janitor could send them money and they would let him be a member.

 

[VolatileAgent]

...but I would like to get JPP into the octagon for 3 five minute rounds and see what he's got and let him see if I am "Slim" or not......"lets get it on").

my money's on jet.

 

[VolatileAgent]

Our scope in detailed in this regulation, you really have no idea... www.army.mil/usapa/epubs/pdf/r40_68.pdf

yes, and the military has a very different concept about what is considered "informed consent" as well.

 

[BLADEMDA]

Our scope in detailed in this regulation, you really have no idea... www.army.mil/usapa/epubs/pdf/r40_68.pdf

Army Gas,

You are misunderstanding the post. Yes, the military allows you to practice Anesthesia solo. But, does this make it the standard for the civilian population? I think not. You are to be congradulated for taking care of out troops. You are probably an excellent provider of Anesthesia. But, civilian Medicine should be restricted to Physicians only regardless of the skill of the midlevel provider. This maintains a MINIMUM standard level for the public.
One that has proven to work well throughout the world.

Of course, I understand you disagree with me. You envision a health care system where Midlevels with PhD or DNAP can practice Independently. THis is something all of Medicine must fight to stop and the battle begins with the AANA.

Blade

 

[CremeSickle]

Thats correct.

AAs dont exist to the public in comparison to MDs and RNs.

AA's have none? Now who is insulting a qualified provider of Anesthesia? The fact is AA's are EQUAL to CRNA's and should be treated as such.

This discussion is not about who is better or who has more support. It is about the MINIMUM standard in the USA to practice Medicine. I believe the public would DEMAND MD level care if they knew all the facts. While CRNA's are capable providers and can do the job they are not Physicians; as such, they should never be allowed independent practice. While you view this issue as about "money" I see it as a basic philosophical difference in the health care system. Even in a socialized system I believe MidLEvel Nurses with DNP/DNAP should not practice Independently. This is why we have Medical Schools in the USA and all around the world. They exist so the graduate will one day (after the appropriate post graduate training) practice Independently.

Blade

 

[CremeSickle]

Oh exactly MG.

Its all about money!

Yeah, and the reason CRNAs want to get into pain medicine is because they want to help patients and not because of the $$$$.

 

[armygas]

Blade,
I respect that post. and on your ending point..........

Of course, I understand you disagree with me. You envision a health care system where Midlevels with PhD or DNAP can practice Independently. THis is something all of Medicine must fight to stop and the battle begins with the AANA.

Blade

Believe it or not I am against the DNP thing...I think its a good idea but if someone wants to have a terminal degree they must fully coordinate and appreciate and the efforts and that should be required to obtain that status (but that is a whole different can of worms).

I don't envision independent practice, I was "brought up" in an environment to "know what I know and what I don't" and to seek consultation when appropriate (i.e. consulting the surgeon or anesthesiologist (when one is available) for ASA 3 and 4 cases...... that is an excellent way to practice and everyone works and learns together).

Unfortunately in this fight it is all or none with no in between and like all political issues will always be polarized, thats just the way it is.....

Being military I don't care about the money otherwise I would have gotten out when my obligation for my CRNA training was up, so that allows me to bring a different perspective on these matters. The reimbursement issues I cannot speak of because in this environment you don't deal with that.... and when you do civilian per diem, you fill out your sheets turn them in and again do not manage those issues.

 

[Disciple]

Ahhh, you bring to light an interesting point, MDs have an unrestricted license and can prescribe virtually any treatment and can practice in any area with or without board certification.

So say the Family Practice Doc working with a CRNA group prescribes a "pain intervention" and the patient goes to the CRNA group who "fills the prescription" because they have the technical expertise to perform the procedure.......... see what I mean?

That's just it. The FP shouldn't be "prescribing" any interventional pain procedure. He/she should refer the patient to a surgeon or pain-doc who evaluates the patient, makes the diagnosis and then makes that determination.

Also why is there a CRNA (actually 2) on the AAPM board? http://www.aapainmanage.org/aboutus/Advisors.php and 72 CRNAs, 3 AAs, and a veterinary anesthetist (good god) that are acknowledged as types of providers?
http://www.aapainmanage.org/search/MemberSearchResults.php

The American Academy of Pain Management (AAPM) allows membership to anyone who applies who claims to be interested in "pain management". It has nothing to do with with interventional pain procedures of any kind. Most pain physicians know this.

If you want to join a legitimate pain medicine organization, the American Academy of Pain Medicine (also AAPM) also exists.

AAPM vs. AAPM

You can see how some may use this as an opportunity to pull the wool over the eyes of the public.

 

[armygas]

That's just it. The FP shouldn't be "prescribing" any interventional pain procedure. He/she should refer the patient to a surgeon or pain-doc who evaluates the patient, makes the diagnosis and then makes that determination.

Hey got no problem with that.

So what if the anesthesiologist working in his/her clinic at one location makes the determination prescribes the intervention and then sends the patient to see the CRNA working in the group who performs the technical procedure (and they split the billing 50/50)?

I know of several examples where that routinely is occurring and is a very profitable endeavor for both parties involved.

 

[Disciple]

What you don't realize is that the Pain-Medicine community is trying to eliminate "block-jocks" or physicians who only do interventional procedures with little understanding of how to effectively diagnose and treat chronic painful conditions.

So, your reasoning doesn't fly.

Physicians should not be able to "order" procedures to be carried out by a technician just as they would not "order" for a surgery to be done by a technician.

 

[jetproppilot]

Ok.


For the record i have heard this legsilation is already doomed to fail (*cheer*) and CRNAs shouldnt be doing pain management outside the typical OR pain management.

However, this thread has already become an example of why these threads were supposed to be banned.

JPP, whats the deal? You close one thread in violation and THEN make it a sticky, this one remains open and yer playing the argument game. Are we following the new rules or not? If not fine, if so then enforce them. That means on blade and toughlife as well as idiot militant nurses.

ie: no political BS or CRNA vs MD/DO on this forum.

Youre right, creme.

Apologies.

Wont happen again.

BTW Army, not threatening you, per se.

Jets .762 is for capping threads (like this one) and screennames (not people) who only post politically.

Again, sorry for interacting on this thread and not closing it a long time ago.

And JWK et al, I (somewhat) agree with your opinion that some of these threads are useful.......I like the suggestion someone made about a "political" area in the public forum where if you wanna take part you can....but at the same time it doesnt litter the forum with political catfights.

I need to look into how to get that done.