Don't Go into Anesthesiology

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at my institution CRNAs/SRNAs do plenty of regional, advanced airways, A lines, central lines...its quite disturbing...and, of course, at the same time are considered faculty...
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Boujee said:
at my institution CRNAs/SRNAs do plenty of regional, advanced airways, A lines, central lines...its quite disturbing...and, of course, at the same time are considered faculty...
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I would classify them as staff, though they may have a faculty appointment from the nursing school? Our CRNAs are employed by the hospital, we are employed by the University.
 
Boujee said:
at my institution CRNAs/SRNAs do plenty of regional, advanced airways, A lines, central lines...its quite disturbing...and, of course, at the same time are considered faculty...
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Your institution is contributing to our downfall.....You talk to your faculty about it?
 
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i completely agree with you...there is a large disconnect between the "core" administration and the junior faculty...without getting into details, there is a "pro-crna" vibe from the top...
 
I did a rotation with a private group at a community hospital. Up until this year, they had been an MD/DO only group. They hired a recent CRNA grad and began "training" him and supervising him one on one until they felt comfortable with his skills. They do a lot of U/S guided regional anesthesia and they started training him in that too. For this group, (and another local private group) their decision to hire a CRNA was purely financial. I really don't think they are looking to sell out the specialty to murses, they are trying to cope with the decreases in reimbursement.

I believe financial gain is probably one of the main reasons why many groups continue to supervise and train CRNA's. For many of the recent grads and those of us about to enter the field, supervising CRNA's seems to be a practice of career suicide. However, the guys looking to retire in the next 5-10 years probably aren't too concerned about selling out the field as they are about securing a sound retirement. I think this is one of the biggest problems we will face in this war.

Why would an older physician who supervises CRNA's want to support a study that would ultimately hurt his pocketbook if the results show that the CRNA's are unsafe and incompetent?
 
kazuma said:
I did a rotation with a private group at a community hospital. Up until this year, they had been an MD/DO only group. They hired a recent CRNA grad and began "training" him and supervising him one on one until they felt comfortable with his skills. They do a lot of U/S guided regional anesthesia and they started training him in that too. For this group, (and another local private group) their decision to hire a CRNA was purely financial. I really don't think they are looking to sell out the specialty to murses, they are trying to cope with the decreases in reimbursement.

I believe financial gain is probably one of the main reasons why many groups continue to supervise and train CRNA's. For many of the recent grads and those of us about to enter the field, supervising CRNA's seems to be a practice of career suicide. However, the guys looking to retire in the next 5-10 years probably aren't too concerned about selling out the field as they are about securing a sound retirement. I think this is one of the biggest problems we will face in this war.

Why would an older physician who supervises CRNA's want to support a study that would ultimately hurt his pocketbook if the results show that the CRNA's are unsafe and incompetent?
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It's always about the money. What these guys should have done is teach that murse to sit in the room, chart vitals and run a propofol infusion while they did the blocks. No need to teach them anything except to watch the patient for them.

Because of my disdain for CRNAs, I am not considering any jobs where CRNA supervision is the norm. Not willing to contribute to the downfall of the specialty even if it means working harder and taking less money. I am even less willing to teach a SRNA/CRNA anything. The fact that I am doing a cardiac fellowship and will be TEE certified is helping to sell myself as someone who's not interested in supervising murses.
 
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This thread was just intended to make sure the MS3/4 is aware of the potential problems/threats this specialty faces from the CRNA. If you choose to match into Anesthesiology at least you know the threat the AANA poses to the field.

At this point I hope Academia will get some good studies together and publish them. To those just entering this field or about to finish Residency in 2011 best of luck.

Blade
 
ProRealDoc said:
Because of my disdain for CRNAs, I am not considering any jobs where CRNA supervision is the norm. Not willing to contribute to the downfall of the specialty even if it means working harder and taking less money. I am even less willing to teach a SRNA/CRNA anything. The fact that I am doing a cardiac fellowship and will be TEE certified is helping to sell myself as someone who's not interested in supervising murses.
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haha, nice, you sound just like me! It's crazy that i actually get accused of being "petty" for not teaching RNs my skills. Sadly, there are no MD/DO only groups anywhere near where i live.
 
kazuma said:
I did a rotation with a private group at a community hospital. Up until this year, they had been an MD/DO only group. They hired a recent CRNA grad and began "training" him and supervising him one on one until they felt comfortable with his skills. They do a lot of U/S guided regional anesthesia and they started training him in that too. For this group, (and another local private group) their decision to hire a CRNA was purely financial. I really don't think they are looking to sell out the specialty to murses, they are trying to cope with the decreases in reimbursement.

I believe financial gain is probably one of the main reasons why many groups continue to supervise and train CRNA's. For many of the recent grads and those of us about to enter the field, supervising CRNA's seems to be a practice of career suicide. However, the guys looking to retire in the next 5-10 years probably aren't too concerned about selling out the field as they are about securing a sound retirement. I think this is one of the biggest problems we will face in this war.

Why would an older physician who supervises CRNA's want to support a study that would ultimately hurt his pocketbook if the results show that the CRNA's are unsafe and incompetent?
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Basically, the real enemies are the old anesthesiologists who are selling out the field. CRNAs are just doing what you would expect them to do - something you would do if you were in their shoes.
 
leaverus said:
haha, nice, you sound just like me! It's crazy that i actually get accused of being "petty" for not teaching RNs my skills. Sadly, there are no MD/DO only groups anywhere near where i live.
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Location is not as big of a deal for me provided I get the opportunity to do my own cases and steer clear of having to deal with obnoxious, know-it-all CRNAs. As long as there's airport within an hour drive, I'm cool with that.
 
BLADEMDA said:
We are at war with the Anesthesia Nurses/AANA and we are losing.
It is quite possible or even highly likely that the Federal Govt. via CMS (Medicare/Medicaid) will realize that Anesthesiology/Anesthesia is a field of Nursing and NOT a field of Medicine.

The leadership has sold out the profession and continues to train M.D./DO replacements every day right alongside you at your Residency Programs.
The ASA and University Chairs have about 5 years left to act swiftly and make corrective actions.

I must strongly caution Medical Students about the pitfalls of this field and advise the stronger applicants to Match elsewhere.

After graduating Medical School you deserve more than becoming a Glorified Anesthesia Nurse.
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The post above still seems very reasonable; however, if you love this field and this is your career choice then go for it. Please support the ASA PAC and if possible promote studies to show differences between CRNA/SRNA and Attending/Resident.

The recent graduates and entering classes are some very bright people. A better group overall than the 1980s and 90s. I truly wish you all great success in your career and personal lives.
 
BLADEMDA said:
We are at war with the Anesthesia Nurses/AANA and we are losing.
It is quite possible or even highly likely that the Federal Govt. via CMS (Medicare/Medicaid) will realize that Anesthesiology/Anesthesia is a field of Nursing and NOT a field of Medicine.

The leadership has sold out the profession and continues to train M.D./DO replacements every day right alongside you at your Residency Programs.
The ASA and University Chairs have about 5 years left to act swiftly and make corrective actions.

I must strongly caution Medical Students about the pitfalls of this field and advise the stronger applicants to Match elsewhere.

After graduating Medical School you deserve more than becoming a Glorified Anesthesia Nurse.
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Do you mean "decide"? "Realize" implies recognition of the truth, but I know that is not what what you believe. Agreed?
 
scudrunner said:
Do you mean "decide"? "Realize" implies recognition of the truth, but I know that is not what what you believe. Agreed?
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Ask the AANA whether the word should be "decide" or "realize." By the way, I do make spelling and semantic errors from time to time. I never bothered to think anyone would "analyze" every last word of my posts.

Blade
 
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BLADEMDA said:
Ask the AANA whether the word should be "decide" or "realize." By the way, I do make spelling and semantic errors from time to time. I never bothered to think anyone would "analyze" every last word of my posts.

Blade
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I know the AANA would like everyone to believe anesthesia is a field of nursing, and when I read it coming from you, it seemed significant.

BTW, I didn't set out to analyze every word your post, nor do I care about spelling/grammar, so no need to get defensive.
 
pgg said:
We should hook him up with medicinesux and exPCM. :)
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:laugh:

So for you attendings, can I throw out a hypothetical situation? (I obviously can, I guess the real question is whether anyone will bite...)

If you magically became an M4 again (but staying in 2010), would you choose anesthesiology for your career, foreseeing what you do about the state of the specialty in the next 20-30 years?
 
GoodmanBrown said:
If you magically became an M4 again (but staying in 2010), would you choose anesthesiology for your career, foreseeing what you do about the state of the specialty in the next 20-30 years?
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Yes. Being an anesthesiologist at pediatrician wages would beat being a pediatrician.

(Nothing but respect for those people who can be / want to be pediatricians.)
 
I really used to think you guys were exhagerating about the whole CRNA taking over thing...

That was until I got to work with some CRNAs at this hospital this month.

People, it is scary, this CRNA I worked with kept on harping on the fact that she'd heard that now it was going to be MD/DO and DNP...

And that to her knowledge all three got the same preparation...she said she couldn't wait to get her DNP and become a doctor...



P.S. And does anyone know why do they act as if they know more than a physician? Scary
 
doctorperez said:
I really used to think you guys were exhagerating about the whole CRNA taking over thing...

That was until I got to work with some CRNAs at this hospital this month.

People, it is scary, this CRNA I worked with kept on harping on the fact that she'd heard that now it was going to be MD/DO and DNP...

And that to her knowledge all three got the same preparation...she said she couldn't wait to get her DNP and become a doctor...



P.S. And does anyone know why do they act as if they know more than a physician? Scary
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The problem is that CRNA's/DNP/DPT's - they all don't know what they don't know.

To not know what you do not know is the scariest type of ignorance that is possible.

Everyone wants in the "tree house" of being a "doctor" without climbing the necessary steps to be allowed in.

My (DO) college is starting an online course for current CRNA's to get their "Doctor of nursing practice in anesthesia" so that when then CRNA schools change their degrees to doctors, the current CRNA's have means to become a "doctor" too.
 
"I am equal in the perioperative period extending from preop to post op. That has been born out in EVERY SINGLE STUDY done. So I feel totally and absolutely comfortable saying that when it comes to the spectrum of anesthesia I am absolutely equal to my physician counter parts with the exception of those who have a fellowship. It isnt ego bub, its reality


Militant CRNA
 
BLADEMDA said:
"I am equal in the perioperative period extending from preop to post op. That has been born out in EVERY SINGLE STUDY done. So I feel totally and absolutely comfortable saying that when it comes to the spectrum of anesthesia I am absolutely equal to my physician counter parts with the exception of those who have a fellowship. It isnt ego bub, its reality


Militant CRNA
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He hasn't done his "fellowship" at USC yet, than he'll be as smart as me.:thumbup:
 
BLADEMDA said:
"I am equal in the perioperative period extending from preop to post op. That has been born out in EVERY SINGLE STUDY done. So I feel totally and absolutely comfortable saying that when it comes to the spectrum of anesthesia I am absolutely equal to my physician counter parts with the exception of those who have a fellowship. It isnt ego bub, its reality


Militant CRNA
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As an individual CRNA you may possess special powers and knowledge which allow a newly minted anesthesia nurse provider to function safely solo.

However, as a profession the vast majority of newly minted CRNAS lack the knowledge and skill to practice Independently. I am looking forward to the studies which must now come forth from academia to prove my point. Since your "rights" are only as good as your Union and your peer group it will be quite a shock:eek: to you when the published data shows just how poorly trained the "average" CRNA really is for solo practice.
 
IlDestriero said:
He hasn't done his "fellowship" at USC yet, than he'll be as smart as me.:thumbup:
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"Ill remember that when im working independently making ....what you do and all my own decisions with ASA 3 & 4 patients. Ill be busy taking contracts from restrictive practices and all MDA practices because I give the SAME level of care for less money and am happy to do it. I AM a skilled Nurse Anesthetist and I AM more flexible, better prepared and PROVEN to be equal to my MDA colleagues in giving safe, quality anesthesia care in over 60 studies"

Militant CRNA
 
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BLADEMDA said:
"Ill remember that when im working independently making ....what you do and all my own decisions with ASA 3 & 4 patients. Ill be busy taking contracts from restrictive practices and all MDA practices because I give the SAME level of care for less money and am happy to do it. I AM a skilled Nurse Anesthetist and I AM more flexible, better prepared and PROVEN to be equal to my MDA colleagues in giving safe, quality anesthesia care in over 60 studies"

Militant CRNA
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There seems a bit of a contradiction here. :)

Honestly, if someone actually posted that, I get the feeling that they are just trying to push buttons- not that they actually believe what they wrote.
 
siednarb said:
The problem is that CRNA's/DNP/DPT's - they all don't know what they don't know.

To not know what you do not know is the scariest type of ignorance that is possible.

Everyone wants in the "tree house" of being a "doctor" without climbing the necessary steps to be allowed in.

My (DO) college is starting an online course for current CRNA's to get their "Doctor of nursing practice in anesthesia" so that when then CRNA schools change their degrees to doctors, the current CRNA's have means to become a "doctor" too.
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My experience in the SICU this month has been great so far. Most of the nurses are pretty good, and it really does help to have good relationships with them. I find it simply saves time when I can ask a nurse questions in the morning versus hunting that data down in the computer.

Probably 80% of the younger nurses want to become SRNA's.... Whatever. Good for them. Most are, like I said, pretty good. But, there are a couple that I've run across that are so cocky that it's almost funny. They think they know the physiology, but they really don't. They follow protocol. It's very scary, though, when you realize that they really do THINK they know MUCH more than they actually do.


This is not a new phenomenon, however, and surely isn't limited to medicine even. Though, in medicine, people can get seriously hurt by it.

cf
 
this is the norm in all of medicine. from family practice NPs to Hospitalist NPs, to other para professionals. They key to life and career is to always stay one step ahead. I would highly encourage all you motivated guys/gals to get your MBAs and aim to become CEO of your hospital.Work your way into the exec suit. There is a big need for physician/business leaders...Stay one step ahead....
 
As someone who just matched into anesthesiology, this topic is certainly on my mind and is very worrisome. There has to be some kind of proactive action coming from the ASA to curb this spread of CRNA as sole providers of anesthesia. If this does not happen, there is a chance as Blade points out that our specialty may become the domain of nurses. The current and future anesthesiologists need to wake up and stomp this misinformation coming out of the AANA. The claims that their studies (which they flaunt on their front page) make are preposterous. We really need to lobby against unsupervised practice and make it clear to patients that a CRNA does not equal to an MD.
 
this thread is really stressing out. i'm leaning towards anesthesiology right now, but then i read a thread like this and i start to reconsider just purely for the fact that i won't have a job post-residency (currently an MS3)...
 
sevo85288 said:
this is the norm in all of medicine. from family practice NPs to Hospitalist NPs, to other para professionals. They key to life and career is to always stay one step ahead. I would highly encourage all you motivated guys/gals to get your MBAs and aim to become CEO of your hospital.Work your way into the exec suit. There is a big need for physician/business leaders...Stay one step ahead....
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This is the norm. Mayo Scottsdale does not even have family medicine docs. All of their primary care is done by NP's and PA's. Don't you just love how the ivory towers contribute to our downfall. Disgusting.
 
sarcoid said:
Your comment is FALSE:

http://www.mayoclinic.org/familymedicine-sct/doctors.html

Where do some people come up with this stuff?!?
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My comment comes from a private practice internal medicine physician who lives and works in Scottsdale and sees a plethora of patients who have gone to Mayo and have never seen a doc for their primary care needs. Why would I make something like this up? I have no interest in spreading false statements. This doctor and I had a conversation about midlevel providers and they told me about Mayo. I honestly would have thought they would have more docs than what are listed to cover such a large area. I will see if I can find out more details.
 
I hope I can ask two questions to anyone who would answer. But, I will start by saying that I keep checking on Anesthesiology form cause I love my Anesthesiologist. I had an emergency surgery at 8:00 PM two months ago. While everyone was preparing for the surgery, he stood beside me, kept working, documenting, while talking to me in a very professional yet very kind manner to calm me down (since I was alone and non of my family made it to the hospital yet). After this surgery, I had three more, and I requested him by name to be the my Anesthesiologist. He always came supervising a nurse anesthetist.
Question 1: Can the patient request an Anesthesiologist instead of a nurse anesthetist for their surgery?
Question 2: Don't you agree that hospitals do not want to be sewed therefore, they have to have the supervision of an Anesthesiologist?
 
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