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Why wouldn’t you bill directly? Why wouldn’t you travel with your own recovery nurse to help recover? Why wouldn’t you require a proper medical screening? Why wouldn’t your make sure the proper equipment is there before doing a case? If you’re an anesthesiologist traveling to a dental office, it is on you to make sure all of these things are up to standard.Yeah, it's a great gig if you like working in substandard, dangerous environments, surrounded by unqualified people, a lack of proper equipment, production pressure that leaves little room for appropriate PACU care (not that there's even a PACU or anyone qualified to work in a PACU), a complete absence of any kind of medical screening or exclusion criteria (beyond ability to pay cash), where the second most qualified person in the building is a guy (or girl) who thinks an "airway" is something that's there to hold the teeth.
One can have great success getting paid a couple hundred $ per hour by said airway non-expert who's charging a $1000 cash fee for dental sedation.
Much success.
Not all dental sedation jobs are like this, but enough of them are that you should assume any recruitment pitch is a bundle of cluelessness and lies to exploit you.
Setting up an anesthesia clinic wherethe dentists come to you? Why would they do that and miss the chance to skim cash for dental sedation off the top? Never heard of it.
The sane ones who aren't running that scheme take their patients to regular ASCs.
Why wouldn’t you bill directly? Why wouldn’t you travel with your own recovery nurse to help recover? Why wouldn’t you require a proper medical screening? Why wouldn’t your make sure the proper equipment is there before doing a case? If you’re an anesthesiologist traveling to a dental office, it is on you to make sure all of these things are up to standard.
So keep those standards when you do dental cases. Problem is that you guys are the ones we hear about doing cowboy **** in dental offices. I know an MD who had a case of MH in a dental office and then later told the dentist they could reschedule and he’d just run TIVA. Wtf?Anesthesiologists have different standards than dentists pretending to be anesthesiologists.
Sorry to be blunt.
And we don't need advice on how to perform anesthesia.
I’m talking about actual recovery nurses, not high school graduate “assistants”maybe 10 years ago, I was interviewing a candidate for an Anesthesia Tech position. She had a HS degree and her current job at the time was in a dental surgery clinic doing book-keeping and recovery "nursing."
I present myself as a “dentist anesthesiologist” since that is the official title.Do you inform your patients and/or parents (for Peds) that you are in fact not an anesthesiologist in the manner that the general public assumes?
Yes you can play with words, degrees, certificates, etc. I am well aware. Genuinely curious.
So no, you don’t.I present myself as a “dentist anesthesiologist” since that is the official title.
Becoming a Dentist Anesthesiologist - ASDA
[...]Read More... from Becoming a Dentist Anesthesiologistwww.asda.org
How would you like that I present? I’m very transparent about being a dentist who completed a 3-year hospital based residency in anesthesia.So no, you don’t.
So basically the same thing as saying “I’m a DENTIST anesthesiologist that will be in charge of giving your child anesthesia today”Hi I’m suxdrugs&roc,
I will be in charge of giving anesthesia to your child and keeping them alive today. However, I am not an anesthesiologist, nor a physician. Do you understand and consent?
Why wouldn’t you bill directly? Why wouldn’t you travel with your own recovery nurse to help recover? Why wouldn’t you require a proper medical screening? Why wouldn’t your make sure the proper equipment is there before doing a case? If you’re an anesthesiologist traveling to a dental office, it is on you to make sure all of these things are up to standard.
Timely article: Dental Anesthesia and Medicaid: Evolving Policies,... : ASA MonitorChanging gears a little bit, I have experience doing some of these cases at a local ASC. They aren't great cases, and the reimbursement is abysmal for pediatric medicaid universally (in some states, the bills just go unpaid indefinitely). We used to joke that the cases don't even keep the lights on (why the ASC kept doing them is beyond me).
The key if you want to do this is to get access to the dental sedation / anesthesia codes which are different than the AMA codes. They pay much more appropriately. There was an article in this month's or last month's ASA Monitor about this, a few states are now opening them up to physicians but it is hardly widespread. To get around this, and get access to real reimbursement, several departments employ dental anesthesia folks to get access to this and then plug them into an established ASC/hospital environment. I have no clue how many dental anesthesia people there are out there, but doesn't seem like a ton.
People on here are being inappropriately disrespectful to the dental anesthesia resident. They take a lot of the same classes along side us in our fist 2 years of med school. Then they do a 3 year anesthesia residency.
Would I trust them to do my thoracotomy? No. But they are much better trained than the OMFS guys who do 6 months with us then do all their own sedations.
I would trust a dental anesthesiologist to do my dental case more than an OMFS, CRNA, or independent AA. And if I had to choose between a random dental anesthesiologist I don’t know vs some anesthesiologists I know, I’ll take the dentist everytime.
This guy will probably do more dental cases in one year than we’ll do in our whole careers. I would suspect they do a good job weeding out the sick patients.
The difference is training. Our training is not equivalent to CRNAs so that’s a pretty big point to gloss over.This is the same argument CRNAs use.
As has been stated by others before, if you want to be an anesthesiologist go to medical school.
See the comment I just posted, but we do actually do a lot of the same cases, at least at my program. (We are in traumas, neurosurgery, and regional and we do get icu training our third year). I’m not saying the training is identical, but to try and discount our training is disingenuous.It's important to be respectful of all trainings, and but this is unfortunately the mindset that got the ASA and our specialty in the mess it's in right now. Just to set a few facts straight-
DA's do not sit the same cases as physicians. Most training programs exclude DAs from cardiac, OB, neuro, trauma, regional cases. There is also no DA program that has ICU training included. These are huge gaps in knowledge, and factually you cannot argue the training is the same.
Most hospitals will not credential a graduated DA to do any cases besides a head and neck case. There are very good reasons for this, many of which come from risk management and insurance companies unwilling to underwrite their policies. What the DA's are able to do in the office is another story.
Out of respect, the ASA has let DA's join the organization. This is weird to me, as ASDA does not let physicians join. Go figure lol.
I am not advocating for or against DA's. Statistically, there are so few of them that I could care less about what they do and how they do it. But, I am really fed up with everyone claiming they have physician level training, when in fact no one besides an MD/DO can match that.
not equivalent to CRNAs, not equivalent to anesthesiologists.The difference is training. Our training is not equivalent to CRNAs so that’s a pretty big point to gloss over.
I have to ask because I/we are making assumptions.See the comment I just posted, but we do actually do a lot of the same cases, at least at my program. (We are in traumas, neurosurgery, and regional and we do get icu training our third year). I’m not saying the training is identical, but to try and discount our training is disingenuous.
I only do the anesthesia. I do not do any dentistryI have to ask because I/we are making assumptions.
Are you doing the anesthesia and another dentist is doing the surgery? Or are you doing both simultaneously?
I agree with everything in this post.Yeah, it's a great gig if you like working in substandard, dangerous environments, surrounded by unqualified people, a lack of proper equipment, production pressure that leaves little room for appropriate PACU care (not that there's even a PACU or anyone qualified to work in a PACU), a complete absence of any kind of medical screening or exclusion criteria (beyond ability to pay cash), where the second most qualified person in the building is a guy (or girl) who thinks an "airway" is something that's there to hold the teeth.
One can have great success getting paid a couple hundred $ per hour by said airway non-expert who's charging a $1000 cash fee for dental sedation.
Much success.
Not all dental sedation jobs are like this, but enough of them are that you should assume any recruitment pitch is a bundle of cluelessness and lies to exploit you.
Setting up an anesthesia clinic wherethe dentists come to you? Why would they do that and miss the chance to skim cash for dental sedation off the top? Never heard of it.
The sane ones who aren't running that scheme take their patients to regular ASCs.
Reverse that statement. That’s EXACTLY what the dentist is going to say, when you’re in court……I only do the anesthesia. I do not do any dentistry
Dude, they’re not some general dentist who got a weekend certification in anesthesia. They do 3 years of training. Do they know as much as us? No. But they don’t do as much cases as we do. You’re not giving them enough credit.I agree with everything in this post.
Wait til something bad happens (and you’re trying to explain why an anoxic brain injury or death occurred (and I’m referring more specifically to pedi dentistry, here)), in a surgery to “repair” teeth that were going to fall out in the next 2-4 years, anyway.
If it requires “real anesthesia”, then it needs to be done in a “real anesthesia” place.
You’ll quickly find out the difference between “Doctor Doctor” and “Doctor Dentist”, when the Dentist disavows any knowledge of how the rest of the body functions, or how to address any airway issues, beyond those little white things they work on.
“In Texas, er, the “dentist’s office”, you’re on your own….” (to quote an old movie some may know)
No thank you…..
That’s good. It’s not safe when OMFS does both the anesthesia and the procedure.I only do the anesthesia. I do not do any dentistry
A dental anesthesiologist is going to be better at doing dental cases than a typical general physician anesthesiologist.Anesthesiologists have different standards than dentists pretending to be anesthesiologists.
Sorry to be blunt.
And we don't need advice on how to perform anesthesia.
I’m not addressing the credentials of a “doctor dental anesthesiologist”, I’m addressing the PRACTICE of “dental anesthesia”, outside of a safe environment, doing anesthesia for procedures with a dentist (a proceduralist, not a physician).Dude, they’re not some general dentist who got a weekend certification in anesthesia. They do 3 years of training. Do they know as much as us? No. But they don’t do as much cases as we do. You’re not giving them enough credit.
While thats true...I’m not addressing the credentials of a “doctor dental anesthesiologist”, I’m addressing the PRACTICE of “dental anesthesia”, outside of a safe environment, doing anesthesia for procedures with a dentist (a proceduralist, not a physician).
Then go for it. I’d rather be at a place with PACU nurses that are NURSES (not dental hygienists watching a pulse ox), glidescopes, bronchoscopes, EKG machines, etc, etc.While thats true...
The ASA requirements for a safe location to practice anes are not complex. Oxygen, suction, airway equipment, rescue meds..
Any anesthesiologist or dentslal anesthesiologist can make sure that those are available
So does this mean you think every kid that need anesthesia for dental work should be don in a hospital? That would be amazing, but unfortunately that’s not reality. Hospital wait lists for dentistry are already extremely long (often more than a year wait).I’m not addressing the credentials of a “doctor dental anesthesiologist”, I’m addressing the PRACTICE of “dental anesthesia”, outside of a safe environment, doing anesthesia for procedures with a dentist (a proceduralist, not a physician).
Now do the same for surgeons.Reverse that statement. That’s EXACTLY what the dentist is going to say, when you’re in court……
If your skillset/comfort requires a top of the line OR suite, thats fine. Many are that way. I am not interested in doing peds, OB, cardiac, etc for those reasons.Then go for it. I’d rather be at a place with PACU nurses that are NURSES (not dental hygienists watching a pulse ox), glidescopes, bronchoscopes, EKG machines, etc, etc.
Maybe some of you feel “luckier” than I do. I have limits on what I’ll do, for the “convenience” of others…
I mean them no offense, but I find this statement funny. I would agree that for many of those cases, their training is probably adequate. In no way is their training at doing such a basic anesthetic superior.A dental anesthesiologist is going to be better at doing dental cases than a typical general physician anesthesiologist.
Says the guy who isn't comfortable practicing unless he has a top of the line OR suite..... otherwise its "unsafe"I mean them no offense, but I find this statement funny. I would agree that for many of those cases, their training is probably adequate. In no way is their training at doing such a basic anesthetic superior.
OMFS requires 2 years of Med school, and their residency spends 3-6 months doing Anesthesia.We’re early this year for an anesthesia hating on OMFS post. Happy New Year! We’ve been safely sedating our patients for decades and will continue to do so. See y’all next year!
OMFS doesn’t require two years of med school. Some do it but some don’t.OMFS requires 2 years of Med school, and their residency spends 3-6 months doing Anesthesia.
Now do dentists….
Says the guy who isn't comfortable practicing unless he has a top of the line OR suite..... otherwise its "unsafe"
The standards/recommendations that have been set for NORA are followed and exceeded by dentist anesthesiologists, and states often have standards that exceed those.
And that’s my point. I don’t have an issue with “dental anesthesiologists”. My issue is with DENTISTS, who try to do dental procedures in unsafe places/situations, to pad their pocketbook or be “convenient”, that will point the finger back at YOU (anesthesiologist, CRNA, dental anesthesiologist), when a medical/airway/other event occurs.That's great - but most dental offices don't have one of you.
There are many that have very poor facilities, supplies, and staff that try to recruit anesthesiologists and CRNAs to come work for them on an hourly basis. Many of these places are dangerous, IMO.
You (a dentist anesthesiologist to-be) are not the problem. The hate you're getting here is undeserved. Even OMFS do a fine job.
But if there were enough of you, WE wouldn't keep getting cold calls and emails trying to recruit us to do dental office work.
It's regular dentists, trying to rope us in on shoestring budgets so they can charge large cash fees to patients, that are the problem.
Well, the location may or may not be safe.And that’s my point. I don’t have an issue with “dental anesthesiologists”. My issue is with DENTISTS, who try to do dental procedures in unsafe places/situations, to pad their pocketbook or be “convenient”, that will point the finger back at YOU (anesthesiologist, CRNA, dental anesthesiologist), when a medical/airway/other event occurs.
“I’ve got a capnograph, pulse ox, BP, and rhythm strip!”, may meet ASA minimum standards, but doesn’t constitute “safe”…
That's great - but most dental offices don't have one of you.
There are many that have very poor facilities, supplies, and staff that try to recruit anesthesiologists and CRNAs to come work for them on an hourly basis. Many of these places are dangerous, IMO.
You (a dentist anesthesiologist to-be) are not the problem. The hate you're getting here is undeserved. Even OMFS do a fine job.
But if there were enough of you, WE wouldn't keep getting cold calls and emails trying to recruit us to do dental office work.
It's regular dentists, trying to rope us in on shoestring budgets so they can charge large cash fees to patients, that are the problem.
Supporting dental anesthesiologists that are better qualified with more training than crnas?You guys are wild that support this.
We should probably let optometrists and podiatrists do anesthesia as well.
And that’s my point. I don’t have an issue with “dental anesthesiologists”. My issue is with DENTISTS, who try to do dental procedures in unsafe places/situations, to pad their pocketbook or be “convenient”, that will point the finger back at YOU (anesthesiologist, CRNA, dental anesthesiologist), when a medical/airway/other event occurs.
“I’ve got a capnograph, pulse ox, BP, and rhythm strip!”, may meet ASA minimum standards, but doesn’t constitute “safe”…