Honest question, why do you guys keep training CRNAs?

[MedicineZ0Z]

They've effectively taken over the field. Why train them? I can't wrap my head around it.

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[nimbus]

Probably for cash.

 

[chocomorsel]

Everything always leads to MONEY!!!

Plenty of attendings on here will give you a multitude of reasons. They are mostly B.S rationalizations because ultimately they make money off them.

 

[deleted171991]

They've effectively taken over the field. Why train them? I can't wrap my head around it.

Because it's a job requirement. At least, at my job, SRNAs are trained by the CRNAs (and all I have to do is protect my patients).

Unfortunately, it's too late to stop training them. That ship has sailed. They really don't need us for training. Monkey see monkey do. All I do is point out major mistakes, so they won't hurt future patients. It's definitely a different level of teaching than what I offer to the residents (if only they were smart enough to listen).

I've been telling everybody on this forum not to go into anesthesia. Already corporate departmental politics are dictated by CRNAs, they have a say in the hiring (and firing) of anesthesiologists; this is only going to get worse in the future, especially as PPs disappear. While a large number of practices are still MD-only, the number is decreasing exponentially every year. This specialty will be eaten up by the midlevels, with the docs as firefighters. At least, in other specialties, one can open one's own practice, if one is really good. In anesthesia, one will be stuck with a job that's the lesser of the evils in the area, which may include teaching one's replacements. Welcome to the dusk of medicine.

 

[MedicineZ0Z]

Because it's a job requirement. At least, at my job, SRNAs are trained by the CRNAs (and all I have to do is protect my patients).

Unfortunately, it's too late to stop training them. That ship has sailed. They really don't need us for training. Monkey see monkey do. All I do is point out major mistakes, so they won't hurt future patients. It's definitely a different level of teaching than what I offer to the residents (if only they were smart enough to listen).

I've been telling everybody on this forum not to go into anesthesia. Already corporate departmental politics are dictated by CRNAs, they have a say in the hiring (and firing) of anesthesiologists; this is only going to get worse in the future, especially as PPs disappear. While a large number of practices are still MD-only, the number is decreasing exponentially every year. This specialty will be eaten up by the midlevels, with the docs as firefighters. At least, in other specialties, one can open one's own practice, if one is really good. In anesthesia, one will be stuck with a job that's the lesser of the evils in the area, which may include teaching one's replacements. Welcome to the dusk of medicine.

Terrible. And your organization does nothing?

 

[Mman]

They've effectively taken over the field. Why train them? I can't wrap my head around it.

train them to do what?

I don't train them to do TEEs or put in CVPs or do peripheral nerve blocks. Train them how to intubate? The whole world already knows how to do that. I train them to work with anesthesiologists.

We don't have enough anesthesiologists in this country to meet the demand for anesthesia services so CRNAs and AAs are necessary.

 

[Man o War]

They've effectively taken over the field. Why train them? I can't wrap my head around it.

“They’ve effectively taken over the field”
According to who and give some examples. They haven’t even come close to taking over the field.

 

[Gas you down]

Because it's a job requirement. At least, at my job, SRNAs are trained by the CRNAs (and all I have to do is protect my patients).

Unfortunately, it's too late to stop training them. That ship has sailed. They really don't need us for training. Monkey see monkey do. All I do is point out major mistakes, so they won't hurt future patients. It's definitely a different level of teaching than what I offer to the residents (if only they were smart enough to listen).

I've been telling everybody on this forum not to go into anesthesia. Already corporate departmental politics are dictated by CRNAs, they have a say in the hiring (and firing) of anesthesiologists; this is only going to get worse in the future, especially as PPs disappear. While a large number of practices are still MD-only, the number is decreasing exponentially every year. This specialty will be eaten up by the midlevels, with the docs as firefighters. At least, in other specialties, one can open one's own practice, if one is really good. In anesthesia, one will be stuck with a job that's the lesser of the evils in the area, which may include teaching one's replacements. Welcome to the dusk of medicine.

Basically the same situation for me. But I’m adamant...no blocks, spinals, epidurals, central lines. They ask, but I say nope.
And I don’t bother discussing the plan with them, just the crna if it’s necessary.
But I’m not mean to ‘em or anything, they’re people too.

 

[AdmiralChz]

Because it's a job requirement. At least, at my job, SRNAs are trained by the CRNAs (and all I have to do is protect my patients).

Yep, the hospital sort of forces us to do it given the CRNA school in town.

I don't train them to do TEEs or put in CVPs or do peripheral nerve blocks. Train them how to intubate? The whole world already knows how to do that. I train them to work with anesthesiologists.

Also this. My interactions with the SRNAs are minimal at best. We and our nurses emphasize patient-centered, physician-led care. Somewhere else (like in a totally different region) they go and get regional and CVL experience apparently. Hard pass on us allowing them to do anything beyond intubations, a-lines and spinals. I suspect those groups that do more face major pressure from administration to do so (and aren’t in a position to negotiate).

They also are not in the room alone except for morning breaks and lunches, if they are near graduation. NEVER have their own room.

 

[DrZzZz]

Basically the same situation for me. But I’m adamant...no blocks, spinals, epidurals, central lines. They ask, but I say nope.
And I don’t bother discussing the plan with them, just the crna if it’s necessary.
But I’m not mean to ‘em or anything, they’re people too.

Same here. Some of my colleagues allow them to practice neuraxial, but it's a hard no from me. And like FFP said, the only teaching I do is if I see/hear something egregious that could harm my patient. Anything else comes from whichever CRNA is supervising them.

 

[deleted171991]

Terrible. And your organization does nothing?

My organization is training midlevels left and right.

 

[Mman]

Somewhere else (like in a totally different region) they go and get regional and CVL experience apparently. Hard pass on us allowing them to do anything beyond intubations, a-lines and spinals. I suspect those groups that do more face major pressure from administration to do so (and aren’t in a position to negotiate).

They also are not in the room alone except for morning breaks and lunches, if they are near graduation. NEVER have their own room.

They are not required to do any peripheral nerve blocks or central lines to graduate. Spinals count for all the "regional" they need and they can count experiences on a simulator for central lines. Which is why I chuckle when they want to argue for independent practice. Because they are all so awesome except the actual things their colleagues need to do to graduate are quite minimal.

 

[Man o War]

They are not required to do any peripheral nerve blocks or central lines to graduate. Spinals count for all the "regional" they need and they can count experiences on a simulator for central lines. Which is why I chuckle when they want to argue for independent practice. Because they are all so awesome except the actual things their colleagues need to do to graduate are quite minimal.

I believe the requirement at the local school is 5 cardiac cases, and my understanding is they can observe.
What a joke.

 

[Mman]

I believe the requirement at the local school is 5 cardiac cases, and my understanding is they can observe.
What a joke.

I just read through their national requirements and chuckle. Individual schools can have higher minimums for their graduates, but the minimums are what they are.

100 ASA 3 and 4 patients
50 patients age 65+
25 patients from age 2-12
10 patients under 2
10 c-sections
10 labor epidurals
20 prone cases
5 cranis
5 hearts
5 lungs
10 vascular
350 general anesthetics
10 mask inductions
10 TIVAs
25 total spinals + epidurals + PNBs
25 art lines
5 CVPs (can count simulation)
5 fiberoptic intubations (can count simulation)


And that is who they want to argue is just as good as a board certified anesthesiologist. Yes, please take that 2 kg preemie and anesthetize him with your grand total of 10 cases under the age of 2, all of which were BMTs. Or float that PA cath on a patient when you have never actually placed a CVP in a real live human.

 

[2Fast2Des]

One of the jobs I interviewed at trained SRNAs and had to teach them, it was PP (AMC) no residents. They used the excuse that they want to make sure they have good CRNAs when they hire more so... One of their docs said we should respect their ability, license and let them do everything they can, and another said she loved to teach so she imparts all her knowledge to them. Was a friendly place overall but I noped out asap, aside from the ****ty package they were offering.

Doing my own cases is infinitely more gratifying than having to teach my replacements how to be better than me. I'll take a mild paycut to not have to deal with that and sell my soul. I don't know how you guys can stomach\live with yourselves selling out your field, doesn't rest will with me.

 

[Man o War]

I just read through their national requirements and chuckle. Individual schools can have higher minimums for their graduates, but the minimums are what they are.

100 ASA 3 and 4 patients
50 patients age 65+
25 patients from age 2-12
10 patients under 2
10 c-sections
10 labor epidurals
20 prone cases
5 cranis
5 hearts
5 lungs
10 vascular
350 general anesthetics
10 mask inductions
10 TIVAs
25 total spinals + epidurals + PNBs
25 art lines
5 CVPs (can count simulation)
5 fiberoptic intubations (can count simulation)


And that is who they want to argue is just as good as a board certified anesthesiologist. Yes, please take that 2 kg preemie and anesthetize him with your grand total of 10 cases under the age of 2, all of which were BMTs. Or float that PA cath on a patient when you have never actually placed a CVP in a real live human.

And there is some question whether or not they actually DO these cases. What is the point of watching?
The problem with all mid level education is the lack of breadth, depth, and standardization. They can’t even agree whether or not they should be allowed to count observed cases/procedures.

 

[kidthor]

One of the jobs I interviewed at trained SRNAs and had to teach them, it was PP (AMC) no residents. They used the excuse that they want to make sure they have good CRNAs when they hire more so... One of their docs said we should respect their ability, license and let them do everything they can, and another said she loved to teach so she imparts all her knowledge to them. Was a friendly place overall but I noped out asap, aside from the ****ty package they were offering.

I interviewed at an AMC that tried to sell teaching SRNAs as a benefit (as I told them I wanted to have some academic engagement). I didn't take the job. I work in academia and we do have SRNAs rotating through but I teach them nothing (the CRNAs do that). But they are always asking to do regional and neuraxial because they "need their numbers". I always say no, but some of my colleagues actually do teach them.

During residency at one site we were treated as fungible equals with SRNAs - the room staffing would be an attending with an SRNA in one room and a resident in another. No CRNAs worked there. The SRNAs would leave toward the end of the day for protected teaching time and the residents would then have to take over the SRNA rooms eventually (of course we had no protected teaching time). When the SRNAs went to their mandatory DC lobbying against anesthesiologists days, we then had to work overtime to cover their shifts. Absurdity. Crazy how badly "we" exploit our own while promoting our replacements.

 

[abolt18]

I interviewed at an AMC that tried to sell teaching SRNAs as a benefit (as I told them I wanted to have some academic engagement). I didn't take the job. I work in academia and we do have SRNAs rotating through but I teach them nothing (the CRNAs do that). But they are always asking to do regional and neuraxial because they "need their numbers". I always say no, but some of my colleagues actually do teach them.

During residency at one site we were treated as fungible equals with SRNAs - the room staffing would be an attending with an SRNA in one room and a resident in another. No CRNAs worked there. The SRNAs would leave toward the end of the day for protected teaching time and the residents would then have to take over the SRNA rooms eventually (of course we had no protected teaching time). When the SRNAs went to their mandatory DC lobbying against anesthesiologists days, we then had to work overtime to cover their shifts. Absurdity. Crazy how badly "we" exploit our own while promoting our replacements.

Where in the world was this place and is it still this way???

 

[dannyboy1]

And that is who they want to argue is just as good as a board certified anesthesiologist. Yes, please take that 2 kg preemie and anesthetize him with your grand total of 10 cases under the age of 2, all of which were BMTs. Or float that PA cath on a patient when you have never actually placed a CVP in a real live human.

Sorry but those cases aren’t being done by a general anesthesiologist either. That stuff is cardiac and peds. The real danger is that they gain independence for bread and butter stuff ....

 

[GandalfTheWhite]

One of the jobs I interviewed at trained SRNAs and had to teach them, it was PP (AMC) no residents. They used the excuse that they want to make sure they have good CRNAs when they hire more so... One of their docs said we should respect their ability, license and let them do everything they can, and another said she loved to teach so she imparts all her knowledge to them. Was a friendly place overall but I noped out asap, aside from the ****ty package they were offering.

Doing my own cases is infinitely more gratifying than having to teach my replacements how to be better than me. I'll take a mild paycut to not have to deal with that and sell my soul. I don't know how you guys can stomach\live with yourselves selling out your field, doesn't rest will with me.

QFT.

 

[leaverus]

Basically the same situation for me. But I’m adamant...no blocks, spinals, epidurals, central lines. They ask, but I say nope.
And I don’t bother discussing the plan with them, just the crna if it’s necessary.
But I’m not mean to ‘em or anything, they’re people too.

I admire your desire to protect our field but there are too many others who are either too lazy or too greedy or both and will give them free rein. I don't do hearts where I am but the crnas have told me that many times the doc will maybe peek in a couple of times to see how they're doing but meanwhile the crna will have put in the aline, swan and tee. I've read others here refer to those as just "monkey" skills but that's just making excuses.

 

[GA8314]

They are not required to do any peripheral nerve blocks or central lines to graduate. Spinals count for all the "regional" they need and they can count experiences on a simulator for central lines. Which is why I chuckle when they want to argue for independent practice. Because they are all so awesome except the actual things their colleagues need to do to graduate are quite minimal.

Yes, but we could all see a day when they begin to "require" such things in order to graduate. Invariably some group will capitulate and allow them to do these things. Then, that is an "out" rotation for them, and they will acquire their numbers. Even if it means traveling 1 hour for said out rotation.

We don't allow them CVP, A-lines, Peripheral blocks, Epidurals, but we do allow the occasional spinal. Same for our CRNA's, but they will get a very rare A-line. Yes, some will make the argument that these are monkey skills but I say f.ck that thought process. You need to protect some things. So, we do.

If your group covers a hospital with a SRNA program, you will deal with SRNA's as a matter of course. For us, there is some advantage that we can get to know some of them for recruiting purposes. However, because we don't allow them to do "hot shot" stuff, I'm not sure we are looked upon as favorably by the wanna-be's. Probably this is a very good self selection process for our practice.

We do offer a nice employment environment, but if you are a CRNA wanna-be doc then it's not the place.

 

[deleted126335]

There is a difference between training/allowing CRNAs/SRNAs-correcting them to keep a patient safe and training them to work as part of an anesthesiologist directed practice vs training residents to function as independent practitioners- explaining rationale in detail, showing tips, tricks, and clinical pearls. I do the former to protect myself. I do the latter because it is the right thing to do.

 

[Twiggidy]

It all comes down to supply and demand.

There is a large demand of anesthesia services and a short supply of physicians to cover. Its the rare moment where I will say that we don't graduate enough residents. I use to think the field was saturated but there's a reason why some areas of the country ALWAYS have jobs available and there's a recruiter emailing and calling everyday with a locums gig.

It also comes down to money. All the places that have physicians covering 1:2 or 1:4 could just as well have a physician sitting the stool in all of those rooms but that is going to cost someone some money, whether it's the organization itself or decrease in what I'm able to "kill to eat".

This is a service industry and there's just too large a demand for service and lack of physicians to cover the service.

I'm sure someone will say I'm wrong and that will probably prove a better discussion than "why are you killing your own field?"

 

[deleted171991]

This is a service industry and there's just too large a demand for service and lack of physicians to cover the service.

That's such a nice and dumb excuse. There may be a lack of physicians in BFE, but not elsewhere (on the contrary). And the reason for that is lack of incentives. Everybody wants to be in certain areas, so, if one wants docs in the rural areas, one should compensate them accordingly. "Show me the money!".

The hospital industry is brainwashing the American people into thinking that we have too few doctors so they can use cheaper (and less educated) replacements. The sad part is that they have managed to brainwash physicians into thinking the same. Even if it were true, there are more than enough foreign physicians who would immigrate, some already board-certified in their native developed countries, and would be way better than midlevels, so this is not about access, this is about money.

 

[Mman]

That's such a nice and dumb excuse. There may be a lack of physicians in BFE, but not elsewhere (on the contrary). And the reason for that is lack of incentives. Everybody wants to be in certain areas, so, if one wants docs in the rural areas, one should compensate them accordingly. "Show me the money!".

The hospital industry is brainwashing the American people into thinking that we have too few doctors so they can use cheaper (and less educated) replacements. The sad part is that they have managed to brainwash physicians into thinking the same. Even if it were true, there are more than enough foreign physicians who would immigrate, some already board-certified in their native developed countries, and would be way better than midlevels, so this is not about access, this is about money.

there are not enough BC anesthesiologists in our country to take care of every anesthetic needed. That isn't even up for debate. If you wanted to argue that we could suck up all of them from other countries if we offered enough money, well I kinda doubt we could meet the demand that way.

 

[Mman]

Sorry but those cases aren’t being done by a general anesthesiologist either. That stuff is cardiac and peds. The real danger is that they gain independence for bread and butter stuff ....

I do not have a pediatric fellowship and yet I have anesthetized plenty of tiny babies in the last 12 months. Did I take care of them for their TE fistula? No, but they have other more benign things done as well.

 

[deleted126335]

If we started graduating lots of extra residents, they wouldn’t be displacing CRNAs. Their existence would ratchet down salaries for all docs instead.

 

[Twiggidy]

That's such a nice and dumb excuse. There may be a lack of physicians in BFE, but not elsewhere (on the contrary). And the reason for that is lack of incentives. Everybody wants to be in certain areas, so, if one wants docs in the rural areas, one should compensate them accordingly. "Show me the money!".

The hospital industry is brainwashing the American people into thinking that we have too few doctors so they can use cheaper (and less educated) replacements. The sad part is that they have managed to brainwash physicians into thinking the same. Even if it were true, there are more than enough foreign physicians who would immigrate, some already board-certified in their native developed countries, and would be way better than midlevels, so this is not about access, this is about money.

But I argue.....what do you think the unemployment rate is currently for a board certified anesthesiologists? I agree with you that money is the main issue but that won’t change in rural areas where on top of being places is young hipsters don’t really want to practice, but also the payor mix is bad. So you say “Show me the money” and some hospital admin will say “Fine, show me some patients with insurance”

California is a good example where you have a rural and warm climate but still have shortages in a state where people constantly asking “how do I get into CA?” I mean you can get it but it won’t be where you want and all you patients are poor folks on Medicare/Medical......hello 20/unit. Yeah, good luck recruiting an anesthesiologist. Then want happens is an AMC takes over just to get some coverage and they send CRNAs and whatever doc is willing to go out there and still pay peanuts

 

[Twiggidy]

If we started graduating lots of extra residents, they wouldn’t be displacing CRNAs. Their existence would ratchet down salaries for all docs instead.

That’s why I said it would come down to money. If you want less CRNAs and all MD practices all across the country then prepare to take a pay cut almost down to Gen Peds levels

 

[Mman]

That’s why I said it would come down to money. If you want less CRNAs and all MD practices all across the country then prepare to take a pay cut almost down to Gen Peds levels

well if we get single payer healthcare based on medicare rates and then you add all physician solo anesthesia care, well let's just say you'd make more money as an electrician or plumber.

 

[Twiggidy]

well if we get single payer healthcare based on medicare rates and then you add all physician solo anesthesia care, well let's just say you'd make more money as an electrician or plumber.

It’s honestly the reason I find myself considering voting Republican more and more but it doesn’t matter in my state

 

[TXEMC344]

So Anesthesiologists are against mid-levels (CRNA's), yet the need exists in rural America. You know why? Money. You do not want to work in BFE, because of money, lifestyle, whatever. Yet ya'll complain when the CRNA's are working where ya'll refuse to.

 

[Twiggidy]

So Anesthesiologists are against mid-levels (CRNA's), yet the need exists in rural America. You know why? Money. You do not want to work in BFE, because of money, lifestyle, whatever. Yet ya'll complain when the CRNA's are working where ya'll refuse to.

Not necessarily true. Most on here don’t really care what happens in BFE. They care about the hospital where they work realizing there are CRNAs and begin undercutting salaries.

 

[Twiggidy]

So Anesthesiologists are against mid-levels (CRNA's), yet the need exists in rural America. You know why? Money. You do not want to work in BFE, because of money, lifestyle, whatever. Yet ya'll complain when the CRNA's are working where ya'll refuse to.

Now you might here me complain if there’s a heart institute in BFE using CRNAs but that’s unliked

 

[Mman]

So Anesthesiologists are against mid-levels (CRNA's), yet the need exists in rural America. You know why? Money. You do not want to work in BFE, because of money, lifestyle, whatever. Yet ya'll complain when the CRNA's are working where ya'll refuse to.

Anesthesiologists (the ASA) are against CRNAs arguing for independent practice. That is not the same thing as being "against mid-levels". CRNAs (and AAs) are an important part of the ACT model which is fully supported by the ASA. Anesthesia care in our country could not fully exist without the ACT model.

 

[TXEMC344]

That's my point. There are a lot of hospitals across this nation in BFE. And you proved my point. You do not care about BFE and it's all about your salary. Not patients.

 

[TXEMC344]

The brightest and most clinically proficient physicians in my 20 plus years of practice have been Anesthesiologists. We have full time General Surgery, Orthopedics, ENT, and GI. And NO Anesthesiologists. Have a 5 CRNA group. The reason why....money. No anesthesiologist wants to work here because of money. You want to complain about mid level encroachment, none of ya'll want to work here. What are we suppose to do?

 

[2Fast2Des]

I admire your desire to protect our field but there are too many others who are either too lazy or too greedy or both and will give them free rein. I don't do hearts where I am but the crnas have told me that many times the doc will maybe peek in a couple of times to see how they're doing but meanwhile the crna will have put in the aline, swan and tee. I've read others here refer to those as just "monkey" skills but that's just making excuses.

So what exactly are these docs doing that they can't be in the room doing the actual procedure(s) or actually, be there! And if they're just too busy sitting on their ass or shooting the **** then yeah they're a disgrace. It annoyed me to no end when in cardiac as the echo resident, I would watch the attending watch the crna\srna do all the lines and put in the echo probe, and then occasionally ask if they can do art line. I mean really?

 

[Twiggidy]

The brightest and most clinically proficient physicians in my 20 plus years of practice have been Anesthesiologists. We have full time General Surgery, Orthopedics, ENT, and GI. And NO Anesthesiologists. Have a 5 CRNA group. The reason why....money. No anesthesiologist wants to work here because of money. You want to complain about mid level encroachment, none of ya'll want to work here. What are we suppose to do?

To an extent you are correct. There are a good amount of anesthesiologists where their only motivation is money. But wouldn’t you say it’s a contribution to the problem when facilities say, “well, we can’t afford and MD so we’ll just take a nurse and all the risks that may come with it” It’s basically saying MD care isn’t worth the money. I bet anything those full time surgeons and GI docs are paid WELL compare to their urban counterparts but for some reason people always want to get cheap when it comes to anesthesiologists

 

[dannyboy1]

The brightest and most clinically proficient physicians in my 20 plus years of practice have been Anesthesiologists. We have full time General Surgery, Orthopedics, ENT, and GI. And NO Anesthesiologists. Have a 5 CRNA group. The reason why....money. No anesthesiologist wants to work here because of money. You want to complain about mid level encroachment, none of ya'll want to work here. What are we suppose to do?

Of course it’s about money. Anesthesia is my JOB. I do it for the money. And I like to make the most I can per hour worked. Just like everyone else in the workplace. No shame in that.

 

[Lecithin5]

The brightest and most clinically proficient physicians in my 20 plus years of practice have been Anesthesiologists. We have full time General Surgery, Orthopedics, ENT, and GI. And NO Anesthesiologists. Have a 5 CRNA group. The reason why....money. No anesthesiologist wants to work here because of money. You want to complain about mid level encroachment, none of ya'll want to work here. What are we suppose to do?

It’s not that anesthesiologists don’t want to work in BFE, it’s that bfe hospitals will not hire them due to pass through legislation. These hospitals have government funding which is simply not allowed to be used for the hiring of anesthesiologists, but rather to hire crnas. And these crnas are being paid anesthesiologist-level salaries in many cases. This is a fact.

 

[Mman]

The brightest and most clinically proficient physicians in my 20 plus years of practice have been Anesthesiologists. We have full time General Surgery, Orthopedics, ENT, and GI. And NO Anesthesiologists. Have a 5 CRNA group. The reason why....money. No anesthesiologist wants to work here because of money. You want to complain about mid level encroachment, none of ya'll want to work here. What are we suppose to do?

Because the hospitals can use passthrough funds to pay for CRNAs but not anesthesiologists. That's a legislative problem that incentivizes rural hospitals to not have anesthesiologists. They will literally pay a CRNA more to be there than they will pay a doc.

 

[Man o War]

It’s not that anesthesiologists don’t want to work in BFE, it’s that bfe hospitals will not hire them due to pass through legislation. These hospitals have government funding which is simply not allowed to be used for the hiring of anesthesiologists, but rather to hire crnas. And these crnas are being paid anesthesiologist-level salaries in many cases. This is a fact.

CRNAs are just cost shifting from the hospital to taxpayers footing the bill for their salaries....and somehow they think that’s more acceptable I suppose.
Watch what happens when pass through legislation goes away.....

 

[deleted50478]

Because the hospitals can use passthrough funds to pay for CRNAs but not anesthesiologists. That's a legislative problem that incentivizes rural hospitals to not have anesthesiologists. They will literally pay a CRNA more to be there than they will pay a doc.

Hypocrite crnas. Lobby against pass through money for physicians then whine that docs won’t take rural jobs. Hypocrite crnas.

 

[deleted171991]

But I argue.....what do you think the unemployment rate is currently for a board certified anesthesiologists? I agree with you that money is the main issue but that won’t change in rural areas where on top of being places is young hipsters don’t really want to practice, but also the payor mix is bad. So you say “Show me the money” and some hospital admin will say “Fine, show me some patients with insurance”

California is a good example where you have a rural and warm climate but still have shortages in a state where people constantly asking “how do I get into CA?” I mean you can get it but it won’t be where you want and all you patients are poor folks on Medicare/Medical......hello 20/unit. Yeah, good luck recruiting an anesthesiologist. Then want happens is an AMC takes over just to get some coverage and they send CRNAs and whatever doc is willing to go out there and still pay peanuts

It would have been a fairer market if the federal government hadn't decided to replace rural physicians with midlevels (think Medicare passthrough funds).

The ship has sailed, that's correct. More anesthesiologist graduates now (would) hurt us even more. I was talking about what the solution should have been decades ago, especially because, back then, physicians were listened to in this country. And the solution should have been foreign specialists from selected countries, not midlevels.

 

[deleted171991]

So Anesthesiologists are against mid-levels (CRNA's), yet the need exists in rural America. You know why? Money. You do not want to work in BFE, because of money, lifestyle, whatever. Yet ya'll complain when the CRNA's are working where ya'll refuse to.

Rural Pass Through Legislation | American Society of Anesthesiologists (ASA)

 

[deleted171991]

Hypocrite crnas. Lobby against pass through money for physicians then whine that docs won’t take rural jobs. Hypocrite crnas.

Of course the AANA are hypocrites. That's an organization run by lowlifes, who want to take over anesthesiology in the US and make MONEY. Nothing less. Don't fool yourselves.

Also, don't confuse the average CRNA with the AANA (who may not even represent the former). There are a lot of decent CRNAs, who speak out against the AANA.

 

[Twiggidy]

Well.....it's not just us

Nurse practitioners in texas will be given the right to read CT, MRI, and such, oh gosh!!

 

[Twiggidy]

Well.....it's not just us

Nurse practitioners in texas will be given the right to read CT, MRI, and such, oh gosh!!

Medical Students.......go into a SURGICAL SPECIALTY