How do residents curb CRNA training?

[ecCA1]

Most of us residents attend training programs where there are significant numbers of SRNAs who come through, often getting better schedules than we get. In some cases, people have had to stay late to do their pre-ops, supposedly because it is a "doctor's" job (per the attendings)!

It does seem that the older generation of docs is indeed selling the profession out, given that CRNAs only seem to be increasing the amount of practice opportunities that they have at their disposal. Some people REALLY don't want to have to do a critical care fellowship in order to be viewed competitively in the future.

The issue is: what can we do?

---

Members don't see this ad.

 

[Planktonmd]

As a resident, unfortunately, there isn't much you can do.
Actually the best thing you can do is to learn how to work with CRNA's and eventually to lead them.

 

[Lizard1]

as residents - there si something you can do. become active in your state's anesthesia society. encourage others to be active.

CRNAs have gotten where they are today because of political fighting - it damn sure isn't because of their skills

 

[johankriek]

as residents - there si something you can do. become active in your state's anesthesia society. encourage others to be active.

CRNAs have gotten where they are today because of political fighting - it damn sure isn't because of their skills

the people who can really effect change are the chairman at the academic programs who have crnas working there and a srna program. The asa officers also have to lobby congress constantly. Its a constant battle. Another thing is hospital credentialing. IF you allow CRnas the same priveleges as the anesthesiologist. There is NO difference in thehospitals mind. . So there should be a line of distinction as to what a crna is allowed to do and what not to do. and furthemore, inever thought i would say this, vote Republican.

and everychance you get,. email the chairmen and the asa leaders. those email addresses should be easy to obtain.

 

[CremeSickle]

In case you didnt know


The incomming ASA president works at a hospital where he supervises and trains CRNAs.

 

[johankriek]

In case you didnt know


The incomming ASA president works at a hospital where he supervises and trains CRNAs.

Pretty much they all do! what is your point?

 

[toughlife]

In case you didnt know


The incomming ASA president works at a hospital where he supervises and trains CRNAs.

www.allnurses.com is that way ------>

 

[CremeSickle]

No point really, just noticed it today myself.

 

[CremeSickle]

well hello kiddie.

If you are a representation of the future of anesthesiology the battle is already lost. You are disrespectful, ignorant and uncouth. It is only a matter of time before that destroys your reputation in real practice. Stupid people tend to learn the hard way.

www.allnurses.com is that way ------>

 

[somedumbDO]

well hello kiddie.

If you are a representation of the future of anesthesiology the battle is already lost. You are disrespectful, ignorant and uncouth. It is only a matter of time before that destroys your reputation in real practice. Stupid people tend to learn the hard way.

kinda sensitive arent we??

 

[johankriek]

No point really, just noticed it today myself.

they all do. the current asa president also works with crnas.. What is your point?

this is coming from a guy who finds anesthesia 90 percent boring..

i with toughlife,, i think you are a crna in disguise... i think you are nitecap.. Im sure that guy is still lurking around this forum

 

[toughlife]

well hello kiddie.

If you are a representation of the future of anesthesiology the battle is already lost. You are disrespectful, ignorant and uncouth. It is only a matter of time before that destroys your reputation in real practice. Stupid people tend to learn the hard way.

So how does being a chief SRNA compare to being a chief resident?

 

[gogogas]

I am a CA 1 and am thoroughly enjoying my life as a resident. I work in a University Hospital where there are both CRNAs and AAs(Anesthesiology Assistants). In our hospital, there is no difference between CRNAs and AAs. I think that AAs are the answer to this CRNA vs MD problem. We should encourage the proliferation of AAs because they can do pretty much the same things as CRNAs yet, by the very nature of their profession, they are assistants and should therefore always be supervised - which is how CRNAs were intended to be. So even if their heads start to swell up after doing years and years of "anesthesia" and they start to see, feel and think that they are "doctors," there will never be in issue of competition because they are - as their title states - anesthesia ASSISTANTS. We have AA's doing cardiac cases and who are more competent than CRNAs. Bottomline is, there is no difference between the two and there should be no difference in their job description. In our program, CRNAs and AAs are lumped together as "Anesthetists" and have to be supervised - just like the residents. Residents always take priority over these "anesthetists" and even something as simple as our department pager list goes in the following order: attendings, residents, anesthestists (AA/CRNA), students (MSA/SRNA), finally techs and support staff. Some of our attendings refer to us as Dr. so and so in front of these anesthetists who then address us as Dr. so and so. Journal clubs are exclusive to residents even if these anesthestists have often expressed interest in participating. Little things like this really puts anesthestists in their rightful place. Oh, and CRNAs hate the AAs and vice versa. You, as a resident, end up just being a spectator to their catfights and backstabbing. In conclusion, I think supporting initiatives of AAs to be recognized by all states is a good way for us to start ending this CRNA self-disillusionment of "doctorhood." I agree that most (not all) of the older generation of anesthesia docs have sold us out by allowing anesthetists to do more and more with less and less supervision. What do they care, they are close to retirement. But I do not think it is too late because anesthesia residency programs are now filling with competent, hard-working and intelligent medical school grads who will be the leaders of tomorrow. That's us, guys. We have to start being active and creative in finding ways to outsmart the CRNAs. I truly believe that having AAs will help to soften the blow of these militant CRNAs. The goal is to blur the distinction between the two because after all, they are what they are (assistants, NOT doctors) and they should function and work as part of the anesthesia care team which is run by MD/DO anesthesiologists.

 

[gogogas]

I am a CA 1 and am thoroughly enjoying my life as a resident. I work in a University Hospital where there are both CRNAs and AAs(Anesthesiology Assistants). In our hospital, there is no difference between CRNAs and AAs. I think that AAs are the answer to this CRNA vs MD problem. We should encourage the proliferation of AAs because they can do pretty much the same things as CRNAs yet, by the very nature of their profession, they are assistants and should therefore always be supervised - which is how CRNAs were intended to be. So even if their heads start to swell up after doing years and years of "anesthesia" and they start to see, feel and think that they are "doctors," there will never be in issue of competition because they are - as their title states - anesthesia ASSISTANTS. We have AA's doing cardiac cases and who are more competent than CRNAs. Bottomline is, there is no difference between the two and there should be no difference in their job description. In our program, CRNAs and AAs are lumped together as "Anesthetists" and have to be supervised - just like the residents. Residents always take priority over these "anesthetists" and even something as simple as our department pager list goes in the following order: attendings, residents, anesthestists (AA/CRNA), students (MSA/SRNA), finally techs and support staff. Some of our attendings refer to us as Dr. so and so in front of these anesthetists who then address us as Dr. so and so. Journal clubs are exclusive to residents even if these anesthestists have often expressed interest in participating. Little things like this really puts anesthestists in their rightful place. Oh, and CRNAs hate the AAs and vice versa. You, as a resident, end up just being a spectator to their catfights and backstabbing. In conclusion, I think supporting initiatives of AAs to be recognized by all states is a good way for us to start ending this CRNA self-disillusionment of "doctorhood." I agree that most (not all) of the older generation of anesthesia docs have sold us out by allowing anesthetists to do more and more with less and less supervision. What do they care, they are close to retirement. But I do not think it is too late because anesthesia residency programs are now filling with competent, hard-working and intelligent medical school grads who will be the leaders of tomorrow. That's us, guys. We have to start being active and creative in finding ways to outsmart the CRNAs. I truly believe that having AAs will help to soften the blow of these militant CRNAs. The goal is to blur the distinction between the two because after all, they are what they are (assistants, NOT doctors) and they should function and work as part of the anesthesia care team which is run by MD/DO anesthesiologists.

 

[johankriek]

I am a CA 1 and am thoroughly enjoying my life as a resident. I work in a University Hospital where there are both CRNAs and AAs(Anesthesiology Assistants). In our hospital, there is no difference between CRNAs and AAs. I think that AAs are the answer to this CRNA vs MD problem. We should encourage the proliferation of AAs because they can do pretty much the same things as CRNAs yet, by the very nature of their profession, they are assistants and should therefore always be supervised - which is how CRNAs were intended to be. So even if their heads start to swell up after doing years and years of "anesthesia" and they start to see, feel and think that they are "doctors," there will never be in issue of competition because they are - as their title states - anesthesia ASSISTANTS. We have AA's doing cardiac cases and who are more competent than CRNAs. Bottomline is, there is no difference between the two and there should be no difference in their job description. In our program, CRNAs and AAs are lumped together as "Anesthetists" and have to be supervised - just like the residents. Residents always take priority over these "anesthetists" and even something as simple as our department pager list goes in the following order: attendings, residents, anesthestists (AA/CRNA), students (MSA/SRNA), finally techs and support staff. Some of our attendings refer to us as Dr. so and so in front of these anesthetists who then address us as Dr. so and so. Journal clubs are exclusive to residents even if these anesthestists have often expressed interest in participating. Little things like this really puts anesthestists in their rightful place. Oh, and CRNAs hate the AAs and vice versa. You, as a resident, end up just being a spectator to their catfights and backstabbing. In conclusion, I think supporting initiatives of AAs to be recognized by all states is a good way for us to start ending this CRNA self-disillusionment of "doctorhood." I agree that most (not all) of the older generation of anesthesia docs have sold us out by allowing anesthetists to do more and more with less and less supervision. What do they care, they are close to retirement. But I do not think it is too late because anesthesia residency programs are now filling with competent, hard-working and intelligent medical school grads who will be the leaders of tomorrow. That's us, guys. We have to start being active and creative in finding ways to outsmart the CRNAs. I truly believe that having AAs will help to soften the blow of these militant CRNAs. The goal is to blur the distinction between the two because after all, they are what they are (assistants, NOT doctors) and they should function and work as part of the anesthesia care team which is run by MD/DO anesthesiologists.

really excellent post and I would whole heartedly support and back legislation to have AAs licensed in every state in the union.. I just wish the ASA would start the ball rolling. These guys have jello for a spine. and like i said im afraid the guy or guys in the pipeline arent any better. we need a voice and many voices concerning this issue. We dont wanna work with CRNAs who want our jobs. They wont take any of OURS but the future is what we are protecting. We need to stop the hemmorhaging. If it means militarymd needs to start doing cases and stop posting on here all day then so be it.. too bad its about time he did something.

I noticed you joined in 05 but only have 4 posts.. I certainly hope you post here more often and let everybody know how you are doing in residency.

 

[MacGyver]

Pretty much they all do! what is your point?

So let me get this straight. The ASA president uses CRNAs, and has the AUDACITY to suggest that future MDAs will have to compete critical care fellowships to stay competitive against the CRNAs?

He's speaking with double tongue, selling out your profession to unqualified underlings while at the same time having the nerve to tell you that you have to take yet MORE training to compete against the people he's selling you out for.

 

[MacGyver]

The real reason guys like hte ASA president use CRNAs is because of greed, NOT because their hands are tied. There is no law requiring him to supervise CRNAs and hospitals dont require it either. If a hospital hires a CRNA, they have no power to force the MDA to supervise them.

What it comes down to is money. Just goddamn money. By working solo and not using CRNAs, you can clear a nice 275k easy. But no, thats not enough for the bigshot ASA guy. So he has to sell out hte future of hte profession so he can make 375k by "supervising" CRNAs.

This mess came about because of the greed of MDAs, nothing more. They opened the door to this nonsense because they wanted to make an extra 100-200k per year, despite the fact that they were already making a killing.

 

[toughlife]

Some of the excuses I have heard about not fighting for more AAs to join the anesthesia care team is that anesthesiologists don't want to hand their skills to yet another group who will then try to screw them later.

I think this is a flawed view and in reality, the only way this ignorance and non-sense will end when the old geezers who have been selling out our specialty retire and the new generation takes over.

The leadership of the ASA is not doing the current and future residents a favor by not being aggressive in the AA issue. I am now beginning to understand why so many here are against supporting the ASA.

Despite this disadvantage, I believe the next generation of anesthesiologists can and needs to take charge of our own future.

 

[johankriek]

So let me get this straight. The ASA president uses CRNAs, and has the AUDACITY to suggest that future MDAs will have to compete critical care fellowships to stay competitive against the CRNAs?

He's speaking with double tongue, selling out your profession to unqualified underlings while at the same time having the nerve to tell you that you have to take yet MORE training to compete against the people he's selling you out for.

Hey macgyver.. I know you are a CRNA who thinks he/she is a doctor and you are trying to get a rise out of me, but it wont happen my friend.

I do happen to agree with your post, I do not think i have to do any FELLOWSHIP to compete with a crna. I am a physician, what i bring to the OR the CRNAs cannot even come close to what a 2 year trained vocationally trained nurse brings. Most of the CRNAs have NO backround in basic science.. They dont have a foundation.
ETHER MD will say do 2 year fellowship. waster more time and more money. I SAY NO. A four year residency is excellent training .

Now go back to the nursing forum and stop posting on here, MURSE

 

[VolatileAgent]

... the only way this ignorance and non-sense will end when the old geezers who have been selling out our specialty retire and the new generation takes over.
...
I am now beginning to understand why so many here are against supporting the ASA.

Despite this disadvantage, I believe the next generation of anesthesiologists can and needs to take charge of our own future.

with all due respect, what are you doing about it? you, yourself, personally. aside from bitching on an anonymous internet forum, that is.

now, you may be able to argue that you are looking towards the current shepherds of your future career for guidance and leadership, to fight the battles you are currently too busy to fight. and, you'd be right, in part. they've already succeeded where you are going to soon tread.

however, it is that "they need to do this" mentality that will likely carry into your life post-residency. you will continue to sit back and bitch about the problem. if you perceive yourself as being able to do nothing now - if you are not getting involved with the ASA and your state society - then you are really doing nothing, and have no one else to blame but yourself when you don't have a true voice other than an anonymous internet forum.

so, i'd suggest to you that you channel some of that bottled-up rage you have and make it work towards positive change. unless you are going to go out and start your own advocacy group, you can start doing that, at the very least, by contributing to one of those groups. even a pittance portion of a pittance residence salary is appreciated.

i would love to read on this forum, just one time, something like this:

-i identified a problem
-i made people aware of it
-i did (this) positively and constructively to help change that problem

it's clear we all understand the future challenges facing our profession. you need to take it to the next level now. figure out an effective way to do that. i suggest you start by getting involved in your state society, and you can start by doing that this week.

don't be one of those guys who sits back and complains all the time expecting everyone else to fix the problem. that's how we got into this "mess" in the first place.

 

[toughlife]

with all due respect, what are you doing about it? you, yourself, personally. aside from bitching on an anonymous internet forum, that is.

now, you may be able to argue that you are looking towards the current shepherds of your future career for guidance and leadership, to fight the battles you are currently too busy to fight. and, you'd be right, in part. they've already succeeded where you are going to soon tread.

however, it is that "they need to do this" mentality that will likely carry into your life post-residency. you will continue to sit back and bitch about the problem. if you perceive yourself as being able to do nothing now - if you are not getting involved with the ASA and your state society - then you are really doing nothing, and have no one else to blame but yourself when you don't have a true voice other than an anonymous internet forum.

so, i'd suggest to you that you channel some of that bottled-up rage you have and make it work towards positive change. unless you are going to go out and start your own advocacy group, you can start doing that, at the very least, by contributing to one of those groups. even a pittance portion of a pittance residence salary is appreciated.

i would love to read on this forum, just one time, something like this:

-i identified a problem
-i made people aware of it
-i did (this) positively and constructively to help change that problem

it's clear we all understand the future challenges facing our profession. you need to take it to the next level now. figure out an effective way to do that. i suggest you start by getting involved in your state society, and you can start by doing that this week.

don't be one of those guys who sits back and complains all the time expecting everyone else to fix the problem. that's how we got into this "mess" in the first place.

where do you want me to begin?

You can find my name on the list of donors to the ASA and that includes the resident section and the more than $20 donor section.
I have letters/emails from many a senator/congressperson including the one from my district whom I have contacted ad nauseum regarding medicare cuts to anesthesia. You can also find my name on comments submitted to the FDA regarding use of propofol by non-anesthesiologists. I attend my state anesthesia society meetings to stay abreast of the specialty, etc, etc.

I won't ask what you are doing but you are mistaken if you think all I do is complain. Complain and make CRNAs life miserable is my hobby.

 

[VolatileAgent]

where do you want me to begin?

You can find my name on the list of donors to the ASA and that includes the resident section and the more than $20 donor section.
I have letters/emails from many a senator/congressperson including the one from my district whom I have contacted ad nauseum regarding medicare cuts to anesthesia. You can also find my name on comments submitted to the FDA regarding use of propofol by non-anesthesiologists. I attend my state anesthesia society meetings to stay abreast of the specialty, etc, etc.

I won't ask what you are doing but you are mistaken if you think all I do is complain. Complain and make CRNAs life miserable is my hobby.

well, then... excellent! there are about 4,799 others, unlike you, who i wish would follow suit.

for myself, i vocalize here but am equally active at the state and local level. i'm regularly in contact with the president of our state's anesthesia society (both formally via meetings, email, etc. and informally). i have attended legislative sessions at the annual asa meetings (twice), and i am well-known among my local politicians.

i am concerned about the state i'm moving to when i finish in june, and have already contacted who will be my local state representative. i am moving to an opt-out state, but into an anesthesiologist-run private practice (as an associate anesthesiologist). they hired me, in part, because of my business background, but also strongly support the ACT model and have already suggested that i am freely able to get involved - even early in my private career - into the political process, provided it doesn't interfere with my clinical duties.

so, we'll see how things go. i applaud you, toughlife. i, too, am on that ASA-PAC contributors list. and, i intend to be for the rest of my career. i also intend to be personally, politically active.

keep up the great work. do what you can. you (and i) are the future.

 

[toughlife]

well, then... excellent! there are about 4,799 others, unlike you, who i wish would follow suit.

for myself, i vocalize here but am equally active at the state and local level. i'm regularly in contact with the president of our state's anesthesia society (both formally via meetings, email, etc. and informally). i have attended legislative sessions at the annual asa meetings (twice), and i am well-known among my local politicians.

i am concerned about the state i'm moving to when i finish in june, and have already contacted who will be my local state representative. i am moving to an opt-out state, but into an anesthesiologist-run private practice (as an associate anesthesiologist). they hired me, in part, because of my business background, but also strongly support the ACT model and have already suggested that i am freely able to get involved - even early in my private career - into the political process, provided it doesn't interfere with my clinical duties.

so, we'll see how things go. i applaud you, toughlife. i, too, am on that ASA-PAC contributors list. and, i intend to be for the rest of my career. i also intend to be personally, politically active.

keep up the great work. do what you can. you (and i) are the future.

I am trying and I echo your comments about getting involved regardless of level of training. It is never too early nor too late to get involved.

As a side note, I learned through my state society that respiratory therapists in my state were attempting to include sedation and placement of invasive lines for hemodynamic monitoring on patients with cardiorespiratory issues as being within their scope of practice.

Is that just crazy or what?

So far their efforts have been thwarted. It is issues like these that also need to be dealt with besides the CRNA issue.