first of it's kind....CRNA Pain fellowship

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oreosandsake

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http://www.newswise.com/articles/fi...ip-to-certified-registered-nurse-anesthetists

The post-graduate certificate fellowship in advanced pain management is just over a year in length and covers theoretical foundations of pain; imaging and radiation safety; assessment, diagnosis, and referral; pharmacology; interventional pain practice; spiritual aspects of health and illness; and non-allopathic aspects related to pain.

Members don't see this ad.
 
How can we as physicians not put a stop to this.... absolutely asinine. There goes our profession. Why pay a pain doc $500k when you can pay a CRNA $150k to do the same thing
 
Absolutely ridiculous. I hope employers will be prudent and risk-averse enough to hire MDs and, of those, prefer graduates from ACGME-approved fellowships.
 
Members don't see this ad :)
I just read their criteria. Who are they trying to fool? Pretty ambiguous on its educational requirements if you ask me. Any employer would be insane to put this on the same level as an ACGME fellowship-trained MD.

(http://www.nbcrna.com/NSPM/Pages/NSPM-Criteria.aspx)

Nonsurgical Pain Management(NSPM) Criteria

Consistent with the NBCRNA's mission, the NSPM subspecialty certification promotes patient safety by enhancing provider quality and encourages provider lifelong learning. Through the process of obtaining the NSPM credential, the NSPM practitioner is able to demonstrate his or her advanced knowledge and skills in the subspecialty area.

INITIAL CERTIFICATION

Licensure
Unrestricted licensure as a RN and/or APRN, as applicable.



Certification Status
Current full recertification as a nurse anesthetist.



Clinical Experience

2 years of nurse anesthesia clinical experience by the time of NSPM application.



Attestations

Attest to being actively engaged in nurse anesthesia clinical practice.



Education

Evidence of completion of education activity in each of the following areas within the immediate 4 years prior to the date of application:

  • physiology and pathophysiology of pain
  • imaging safety
  • assessment/diagnosis/integration/referral
  • pharmacological treatment
  • interventional pain strategies
  • professional aspects

Clinical Competence
Three (3) letters of support from professional colleagues who have observed the practitioner's NSPM technique and/or outcomes describing:

  • evidence of competence in patient evaluation and findings
  • NSPM techniques
  • safe needle placement
  • post-care assessment

Skills Assessment
Successful completion of an assessed NSPM cadaver or an assessed NSPM simulation course.


Examination
Successful completion of the NSPM subspecialty certification examination.
 
funny thing, but nurse anesthetists are $$ where i work because the group has to pay them overtime. MD's do not get overtime.
but consider this - hire a bunch of CRNA's to do procedures and PA's to do the work ups, and you can become wealthy.
not what you originally wanted when you applied to medical school, but who knows, maybe there is some happiness in being an administrator. not for me however, i retire in 5 months . :)
 
Wow. Unbelievable.

We've gotta jump on this before the Pain forum is filled with posts like the Anesthesia forum.
 
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This is where public awareness has to come in! Only way to do this is by forcing politicians (state & local) to listen!
 
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What an appalling disregard for patient safety! 4 years of college, 4 years of med school, 1 year of internship, 2 years of surgical training, 3 years of anesthesia residency, and 1 year of fellowship. USMLE Steps x 3, anesthesia written and oral boards, pain boards...all of that work and I still find pain medicine in practice to be quite challenging. Yet CRNAs will be qualified to do what I do after completing this "fellowship."

Unbelievable. The arrogance, greed, and complete disregard for patient safety by the AANA is shameful. When will it stop? I mean seriously! Nurses performing surgery? WTF is wrong with healthcare in the US???

Do they seriously believe that they're qualified to put cement into a patient's spine or surgically implant devices? Really??? I'm shocked.
 
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Any Pain physician that allows these jokers to shadow/ perform procedures under their supervision should have their license revoked. What a joke.
 
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there's got to be a physician teaching them this. we should identify that Physician and have the societies he belongs to sanction him. ridiculous, despicable. pt safety is completely disregarded
 
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On the flip side of this, most of these people have a long demeaning road ahead. Even if their certificate is made of gold, it's still a nursing certificate. I pity the fool who deceives a pt into thinking they are a real doctor and then has a lawsuit.
 
they will open a private in office suite and will perform injections, with a "pain doctor" who is not board certified, but willing to dispense meds and "refer" to the CRNA for injections. no hospital or ASC need be involved. no oversight by anyone.


another huge negative mark on Pain Medicine as a whole.
 
Members don't see this ad :)
not with self-pay... or if the insurance company doesnt look. not with medicare, unless there is an audit - how often does that happen?

face it, pain as a whole has a lot of dubious players. you and i try do it the right way. but for each one of us, there are at least 1-2 "doctors" and "noctors" that are billing medicare, requesting self-pay, and doing injections that are not fluoroscopically guided when they need to be, are not with appropriate monitoring, dosing, following standards of care.

NPs doing injections in Vermont. CRNAs supposedly legally doing pain blocks and epidurals they have no training to do so in Montana. multiple non-fluoroscopically guided multilevel facet joint injections in Mass. its all over, and this is one more nail in that coffin.

sorry better go get breakfast... probably explains bad mood.
 
So where does the future take us?
 
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We need to attack the money. Whose stims are they using? Whose RF generator and cannulas? Who's discography manometers?

When Boston had a rogue distributor in NH selling to a nurse, we got the president of the corporation involved, and he shut it down.

Can someone investigate, and report back?
 
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I'll be starting fellowship training next summer. I am excited with the prospect of pain management practice and have no intention of changing my mind if CRNAs take the field by storm.

Here's an ad (http://olneyhamiltonhospital.com/services/pain-management-services/) at a small Texas hospital that has a 'COA-accredited' CRNA without physician backing from what I can tell. I'm sure that there are a number of other examples out there. Is this where things are going with our field, and, if so, will CRNAs be able to practice without an accredited pain management physician at their side/working at their hospital or clinic?
 
Check out "Pain Care" clinics in New Hampshire. They're owned by a pain doctor who surrendered his medical license for unprofessional behavior. A lot of CRNAs doing procedures without any supervision by the pain doctors in the practice but undoubtedly the doctors are skimming a lot of money off the top.

Anyone know one of these jokers at the practices in New Hampshire? They should be censured/banned by the ASIPP branch in their area.
 
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Yeah, it's pretty unbelievable (or believable?) seeing the number or crnas on the PainCare website who are performing advanced interventional procedures. Have the physicians in that practice have any shame or dignity? Good God. But looking at the public documents regarding unsavory actions of the Founder, none of this surprises me. Again, we physicians are our own worst enemy. Why are we training/employing these crnas???!!
 
In order for insurance to reimburse a procedure, isn't there some kind of check for the credentials of the provider? What kind of procedures can midlevels like nurses bill for? Anything?

Can we boycott insurance companies that are reimbursing CRNAs and refuse to see their patients? If an insurance company is paying a CRNA for pain procedures, dump that insurance company.
 
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The guys at Dartmouth should be leading the fight against that group.
 
This is just what insurance companies want. Fast and cheap without regard to quality.
 
http://olneyhamiltonhospital.com/services/pain-management-services/

Olney Hamilton Hospital is pleased to announce the addition of Pain Management Services. Intervention Pain Management Therapy is available with a Physician Referral.

Tiaan Hancke, MS, CRNA,APRN

Advanced Pain Management Fellowship, COA accredited

Providing pain management services for the following

  • Low Back Injury
  • Neck Injury
  • Spinal Disc Herniation or derangement
  • Radiculopathy
  • Neuropathy
  • Chronic Pain Syndrome
Treatment options include

Steroid injections ~ Cervical, Thoracic, & Lumbar Spine ~Epidural Steroids ~ Facet Injections ~ SI Joint Injections Knee, Hip & Elbow Injections ~ Intercostals Nerve Injections ~Trigger Point Injections ~ Physical Therapy Referrals

To schedule an appointment or contact Olney Hamilton Hospital at 940.564.8125.
 
http://olneyhamiltonhospital.com/services/pain-management-services/

Olney Hamilton Hospital is pleased to announce the addition of Pain Management Services. Intervention Pain Management Therapy is available with a Physician Referral.

Tiaan Hancke, MS, CRNA,APRN

Advanced Pain Management Fellowship, COA accredited

Providing pain management services for the following

  • Low Back Injury
  • Neck Injury
  • Spinal Disc Herniation or derangement
  • Radiculopathy
  • Neuropathy
  • Chronic Pain Syndrome
Treatment options include

Steroid injections ~ Cervical, Thoracic, & Lumbar Spine ~Epidural Steroids ~ Facet Injections ~ SI Joint Injections Knee, Hip & Elbow Injections ~ Intercostals Nerve Injections ~Trigger Point Injections ~ Physical Therapy Referrals

To schedule an appointment or contact Olney Hamilton Hospital at 940.564.8125.


Surprised the Docs in Texas has allowed this to fly since they have one of the strongest state organizations in the country
 
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here's a tip, change WH administration.... Bill Clinton initiated this CRNA storm....
 
Someone please pass this along to Brian Bruel &/or Benoy Benny. They are in positions of power in TX pain, and can address it.
 
http://olneyhamiltonhospital.com/services/pain-management-services/

Olney Hamilton Hospital is pleased to announce the addition of Pain Management Services. Intervention Pain Management Therapy is available with a Physician Referral.

Tiaan Hancke, MS, CRNA,APRN

Advanced Pain Management Fellowship, COA accredited

Providing pain management services for the following

  • Low Back Injury
  • Neck Injury
  • Spinal Disc Herniation or derangement
  • Radiculopathy
  • Neuropathy
  • Chronic Pain Syndrome
Treatment options include

Steroid injections ~ Cervical, Thoracic, & Lumbar Spine ~Epidural Steroids ~ Facet Injections ~ SI Joint Injections Knee, Hip & Elbow Injections ~ Intercostals Nerve Injections ~Trigger Point Injections ~ Physical Therapy Referrals

To schedule an appointment or contact Olney Hamilton Hospital at 940.564.8125.

You've gotta be kidding me. Scope of practice, anyone???
 
here's a tip, change WH administration.... Bill Clinton initiated this CRNA storm....
Yes because addressing the issue of CRNAs are going to high on the list of priorities for a new President
 
Yes because addressing the issue of CRNAs are going to high on the list of priorities for a new President
actually CMS and its chief director (elected by the WH) have specifically targeted pain management physicians salaries and want to 'distribute' this revenue to many providers, including CRNAs. Its all about redistribution and a part of a bigger plan of socialized/scrutinized medicine....
 
can you show me the direct quote? id like to read it, and pass it on to Paul and Carson et al.
if you are talking to me, I am referring to the Pain Medicine article 2 years ago with recommendations of diversifying the pain medicine provider mix to include CRNA, and
revenue distribution. I can find it for you when I get a chance.
 
Pain Management Fellowship Tuition and Fees
Tuition and Fees for Pain Management Fellowship


Semester I (fall) Semester II (spring) Semester III (summer)
Credit Hours 8 credit hours 8 credit hours 6 credit hours 22 credit hours

Total Cost $ $42,655
*Paid directly to the AANA

**Additional costs include books, travel, lodging and state licensure at assigned clinical sites.
 
Well, that's torn it. Abandoned C-arms will pile up in vacant lots across the USA as pain docs return to the OR in droves.
 
These CRNA will not be able to advance to clinical environment without pain management physicians proctoring. We need to go after the guys/gals who are teaching this program (if they are physicians) and/or the guys who are giving them clinical rotation opportunities and proctoring training.

This kind of nonsense will continue to pop up, unless we go after the physicians who has started.
 
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Check out "Pain Care" clinics in New Hampshire. They're owned by a pain doctor who surrendered his medical license for unprofessional behavior. A lot of CRNAs doing procedures without any supervision by the pain doctors in the practice but undoubtedly the doctors are skimming a lot of money off the top.

Anyone know one of these jokers at the practices in New Hampshire? They should be censured/banned by the ASIPP branch in their area.

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Jeremiah L. Loch, CRNA, DOMTP, ND, LMT, PhD, DAAPM
Anesthesia Associates & Valley Pain Care Centers
Plano, IL


Look at initials of this instructor......he wants so bad to be a Doctor of " Medicine"
 
More on him

V. Rev. Fr. Jeremiah Loch CRNA, D.O.M.T.P., PhD, DAAPM
Fr. Jeremiah Loch is a US CRNA (nurse anaesthetist) and an ordained Russian Orthodox priest with several years experience specializing in comprehensive pain management. He holds a PhD in Religion and Health Sciences and presently incorporates additional extensive training and experience in classical osteopathy, classical naturopathy, spirituality, and functional medicine for the management and relief of pain and suffering and the promotion of health and well-being.
 
Program Requirements
Graduates will be required to complete four semesters of graduate study that includes 19 academic credits and four supervised clinical practicum (one per semester) for a total of 240 mandatory clinic hours. The didactic component of the program will be completed online, while the clinical component will be performed in-person at an approved clinical site. Please see the additional State Eligibility information for online programs in the >Academic Standards and Policies section of this Bulletin.

That is from the Hamline program. I love how they tout these fellowships as a 12 month fellowship to make them seem equivalent to ours, but then they only have 19 academic credits for the year which is far less than I ever had in any single semester of med school and only 240 clinical hours. I am pretty sure I put in more hours than that in during my first month of fellowship all while studying for boards. Even after evaluating hundreds of pain and MSK patients as a resident and 2 months so far of fellowship, I know I still have a lot to learn before I am ready to head out on my own. These folks are likely no where close to competent when done.
 
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More on him

V. Rev. Fr. Jeremiah Loch CRNA, D.O.M.T.P., PhD, DAAPM
Fr. Jeremiah Loch is a US CRNA (nurse anaesthetist) and an ordained Russian Orthodox priest with several years experience specializing in comprehensive pain management. He holds a PhD in Religion and Health Sciences and presently incorporates additional extensive training and experience in classical osteopathy, classical naturopathy, spirituality, and functional medicine for the management and relief of pain and suffering and the promotion of health and well-being.
If he collects the whole alphabet, he can use the alchemy he learned in his naturopathy course to turn all of the letters into a MD.
 
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Pain Management Fellowship Tuition and Fees
Tuition and Fees for Pain Management Fellowship


Semester I (fall) Semester II (spring) Semester III (summer)
Credit Hours 8 credit hours 8 credit hours 6 credit hours 22 credit hours

Total Cost $ $42,655
*Paid directly to the AANA

**Additional costs include books, travel, lodging and state licensure at assigned clinical sites.
6-8hrs/wk = ~1.5hrs/day. Yup, certainly sounds sufficiently rigorous to do these independently
 
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Got in mail:


Seeking a part time supervisory physician for the NP/PA on staff for an outpatient private practice in Metairie Louisiana
The PA/NP will examine patients, perform Joint and Trigger point injections.
Very minimal time commitment with all of the work being chart reviews
Ideally looking for a Physician 1 day per month to just review charts
We prefer someone BC in pain medicine, Family medicine, internal but will consider GP as well.

Please send resume for consideration to [email protected]



HCRC Staffing
[email protected]
www.hcrcstaffing.com
 
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