Gut check: Payment Parity in Anesthesia; Implications for Pain...

[drusso]

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Opinion | It's Time for Reimbursement Parity in Anesthesia

Equal pay for equivalent services from CRNAs is essential to protecting timely access to care

www.medpagetoday.com

"Capitalism works when the market is allowed to determine the value of a service based on factors including quality, availability, and demand. In a functioning market, shortages and demand help shape prices. But when reimbursement structures artificially determine that one qualified provider's work is worth less than another's for providing the same service, we move further away from a competitive market."

 

[Agast]

That's a great way for their natural enemy, the Anesthesia Assistant, to take their place

 

[willabeast]

I found this funny because where I used to work the CRNAs had very strong union backing along with interesting holiday and overtime rules that applied to all RNs. The result was that MD anesthesia were sometimes cheaper than CRNA. Holiday Premium Stacking: In rare scenarios under select union bylaws, if an hourly employee works critical overtime directly overlapping a recognized premium holiday, specific contract clauses may stack incentives, though this is a localized exception rather than a company-wide policy. State Law Multipliers: Because per diem workers are hourly, they qualify for progressive overtime structures under California labor rules. For instance, a per diem CRNA can make 1.5x their base rate after 8 hours of work in a single day and 2x (double time) after 12 hours.

 

[drusso]

I found this funny because where I used to work the CRNAs had very strong union backing along with interesting holiday and overtime rules that applied to all RNs. The result was that MD anesthesia were sometimes cheaper than CRNA. Holiday Premium Stacking: In rare scenarios under select union bylaws, if an hourly employee works critical overtime directly overlapping a recognized premium holiday, specific contract clauses may stack incentives, though this is a localized exception rather than a company-wide policy. State Law Multipliers: Because per diem workers are hourly, they qualify for progressive overtime structures under California labor rules. For instance, a per diem CRNA can make 1.5x their base rate after 8 hours of work in a single day and 2x (double time) after 12 hours.

This is one reason RNs and CRNAs vote Blue.

 

[bedrock]

This is one reason RNs and CRNAs vote Blue.

And Bill Clinton is the reason that CRNAs have the scope of practice they have.

But.........did slick willy choose CRNA to do anesthesia for his own surgeries, no, he choose a much better trained anesthesiologist.

 

[Ducttape]

But.........did slick willy choose CRNA to do anesthesia for his own surgeries, no, he choose a much better trained anesthesiologist.

prove it.



99% certain that he did not have the option of having a CRNA perform his cardiac anesthesia.

NY Presbyterian didnt seem to employ CRNAs in 2004 and definitely wouldnt have used them in CABG surgeries.

they probably werent involved in his stent placement in 2010.

apparently there were a few crnas that started in 2009 at NY Presbyterian (according to google), but highly unlikely that the cardiology department would request a crna. if anything, to treat a celebrity, they would have used an anesthesiologist.

 

[bedrock]

prove it.



99% certain that he did not have the option of having a CRNA perform his cardiac anesthesia.

NY Presbyterian didnt seem to employ CRNAs in 2004 and definitely wouldnt have used them in CABG surgeries.

they probably werent involved in his stent placement in 2010.

apparently there were a few crnas that started in 2009 at NY Presbyterian (according to google), but highly unlikely that the cardiology department would request a crna. if anything, to treat a celebrity, they would have used an anesthesiologist.

This is well known. I don't time to find 7 citations for you and I don't care if you don't believe me.

The underlying point is democrats are responsible for undermining the authority of physicians by delegating inappropriate power to mid levels.

 

[Agast]

This is well known. I don't time to find 7 citations for you and I don't care if you don't believe me.

The underlying point is democrats are responsible for undermining the authority of physicians by delegating inappropriate power to mid levels.

Are the independent practice states primarily blue states?

 

[Ducttape]

Anesthesia Pro — Your Career. Your Money. Your Life. Handled.

The complete resource for CRNAs and Anesthesiologist Assistants. Career tools, financial planning, 50-state practice authority, CE tracking, and a curated job board.

anesthesia-pro.com

states that CRNA can operate fully independently:

states that require anesthesiology supervision:

just to reiterate, blue states such as NY, NJ, Mass, Penn, Cali all require physician supervision. so do red states texas and florida.

of the 21 states with full CRNA practice, 11 are red, 7 are blue (+1 which isnt a state) and 2 are purple. so more red than blue.



you do realize that CRNA independent practice started in 2001. CMS allowed independent practice on Nov 13, 2001.

who was the president at the time?

it wasnt Clinton. it was Bush, who was inaugurated Jan 20, 2001.

the House was republican.
the Senate was initially equally divided until dems got a 1 vote majority when Jeffords switched to independent.



the first state to pass full practice authority was Iowa.

 

[SSdoc33]

This is well known. I don't time to find 7 citations for you and I don't care if you don't believe me.

The underlying point is democrats are responsible for undermining the authority of physicians by delegating inappropriate power to mid levels.

????

neither party is physician friendly, but this is a construct you have created in your own mind. mid-level creep occurs independently from politics as it is economically/market driven. so-called blue states actually appear to have more restrictions than red states. you know, that whole "regulation" thing that republicans hate

 

[DOctorJay]

the private anesthesia group that supports my network didn't want to start a residency so the network is developing a CRNA school. great.

 

[bedrock]

the private anesthesia group that supports my network didn't want to start a residency so the network is developing a CRNA school. great.

geez. I'm so glad I'll be basically retired by the end of the decade.

 

[Ducttape]

This is one reason RNs and CRNAs vote Blue.

RNs tend to vote blue because they have empathy, which is much more prevalent in liberals than conservatives.

 

[bedrock]

RNs tend to vote blue because they have empathy, which is much more prevalent in liberals than conservatives.

liberals have suicidal empathy.

 

[Agast]

The actual quote from Wu was

“Every person, every single human being, has the legal right to come to the United States and seek asylum or shelter, and those policies have been in place for a long time."

I wonder what the purpose of editing her words was

 

[bedrock]

The actual quote from Wu was

“Every person, every single human being, has the legal right to come to the United States and seek asylum or shelter, and those policies have been in place for a long time."

I wonder what the purpose of editing her words was

Even that is a crazy statement.
open door Immigration/border policies of modern democrats are one of the primary reasons they lost in 2016 and 2024

Anyone edit the words of Douglas Murray?

 

[paindoc007]

Still a crazy statement.
open door Immigration/border policies of modern democrats are one of the primary reasons they lost in 2016 and 2024

I feel bad for you. You seem like someone who thinks politics around the clock. And get worked up over everything. Must be miserable to be around socially

 

[Agast]

do you think maybe there’s a problem with lying and misinformation to make a point?

 

[bedrock]

do you think maybe there’s a problem with lying and misinformation to make a point?

I would say both parties do that, but that still doesn't mean its appropriate.
Out of respect for you and because I don't want to post something that is factually incorrect, I removed the wu meme.

 

[bedrock]

I feel bad for you. You seem like someone who thinks politics around the clock. And get worked up over everything. Must be miserable to be around socially

I feel bad for you. You're clearly a jerk with the same arrogant and condescending attitude that caused your party to get their ass handed to them in the last election.

 

[Ducttape]

it is interesting that i cannot find the attribution of that quote to douglas murray.

i assume the context he was discussing was with regards to islam, but that is an assumption.



if so, he is wrong. the political left is not supporting islam. the pleads are not for islam. they are for the peoples of palestine.

 

[bedrock]

it is interesting that i cannot find the attribution of that quote to douglas murray.

i assume the context he was discussing was with regards to islam, but that is an assumption.



if so, he is wrong. the political left is not supporting islam. the pleads are not for islam. they are for the peoples of palestine.

Duct,

I have a book from Douglas Murray and this quote is accurate.
With respect you need to review some news outside the left wing national legacy media. It is obvious the left is supporting Islam and conveniently overlooking immigration of muslims who openly state their goal is to bring sharia law to the UK and the US.

 

[Crabbygas]

Getting back to the original topic..... I have to admit that my hat is off to the nurses for how effective they have been at advocating for themselves. I know a place where they effectively make more than the docs. It's an inefficient outfit that often has empty rooms. The nurses don't stay if the cases are done so they often get paid 8 or 10 hours for doing 4-6 hours of actual work. The docs get a little of that benefit but one of them is always in the building so the nurses score. Not sure what the answer is other than don't work there.

 

[Ducttape]

Duct,

I have a book from Douglas Murray and this quote is accurate.
With respect you need to review some news outside the left wing national legacy media. It is obvious the left is supporting Islam and conveniently overlooking immigration of muslims who openly state their goal is to bring sharia law to the UK and the US.

which book is it? i did an extensive search online and did not find any attributable link.

i dont look at left wing national legacy media. i have not logged on to CNN since 2024, right after the election. i never logged on to MSNBC (now MSNow). i am not a subscriber to Wash Post or CNN or NY Times (thats why i rarely comment on articles from these sites posted here).

the left as a whole is not supporting islam. that is a lie propagated by right wing media.

your hypocrisy is noted, and you should look at news outside of the Foxosphere.

Getting back to the original topic..... I have to admit that my hat is off to the nurses for how effective they have been at advocating for themselves. I know a place where they effectively make more than the docs. It's an inefficient outfit that often has empty rooms. The nurses don't stay if the cases are done so they often get paid 8 or 10 hours for doing 4-6 hours of actual work. The docs get a little of that benefit but one of them is always in the building so the nurses score. Not sure what the answer is other than don't work there.

to be clear, nurses =/= nurse practitioner.

please be careful of saying that to a nurse practitioner.

hospitals cannot directly charge for nurses.

but yes a model heavy of APPs is being favored by some hospitals - NPs cost a lot less than physicians and are easier to hire and fire.

 

[drusso]

which book is it? i did an extensive search online and did not find any attributable link.

i dont look at left wing national legacy media. i have not logged on to CNN since 2024, right after the election. i never logged on to MSNBC (now MSNow). i am not a subscriber to Wash Post or CNN or NY Times (thats why i rarely comment on articles from these sites posted here).

the left as a whole is not supporting islam. that is a lie propagated by right wing media.

your hypocrisy is noted, and you should look at news outside of the Foxosphere.


to be clear, nurses =/= nurse practitioner.

please be careful of saying that to a nurse practitioner.

hospitals cannot directly charge for nurses.

but yes a model heavy of APPs is being favored by some hospitals - NPs cost a lot less than physicians and are easier to hire and fire.

RNs, CRNAs, and NPs are harder to fire because they form unions. Doctors don't unionize.

 

[buddababa]

I DECLARE UNIONIZATION


(the office reference for those that don't get it)

 

[clubdeac]

Opinion | It's Time for Reimbursement Parity in Anesthesia

Equal pay for equivalent services from CRNAs is essential to protecting timely access to care

www.medpagetoday.com

"Capitalism works when the market is allowed to determine the value of a service based on factors including quality, availability, and demand. In a functioning market, shortages and demand help shape prices. But when reimbursement structures artificially determine that one qualified provider's work is worth less than another's for providing the same service, we move further away from a competitive market."

View attachment 425008

You should post this in the anesthesia forum. They’ll lose their minds. I I’ve asked them why they let CRNAs take over their field and they went bizerk