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The_Sensei

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Just curious how some of the other practicing studs are doing it......

I, for example, give this spiel when doing patient interviews:


"Hi, I'm Dr. ---- and I'll be your anesthesiologist. I'll be supervising your care today, making sure you get through your surgery safely and comfortably. (Name of CRNA) will be the anesthesia nurse in the room with you helping me out."
 

sallyjoe

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I was working a place where an Evil Management Company had been imposed upon CRNAs who had previously been practicing independently. The CRNAs usually got to the patient first and introduced the Doctor as by saying,

“Hi, I am John Smith and I will be giving you your anesthesia today, I will be in the room during the entire operation, Doctor Jones will only be in their for a minute at the beginning of your surgery, but will be sending you a very large bill for his services.”
 
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elinj

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i think this is an interesting topic....when i was in my anesthesia rotation it was a smaller hospital with many crnas. I had one attending that started making a huge deal during preop with intro's.

when the crna werent with him they would say that they were the anesthesist provider most patients didnt care. when he was around they said that they were the nurse anesthesist. I noticed that patients would tend to ask more questions or ask to met the doctor also.

The attending told me that something as simple as introduction...Dr vs CRNA is a small everyday process that can help open the publics eyes.
 

militarymd

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"I am Dr. Militarymd. Myself and a CRNA will be your anesthesia team today."
 

The_Sensei

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I was working a place where an Evil Management Company had been imposed upon CRNAs who had previously been practicing independently. The CRNAs usually got to the patient first and introduced the Doctor as by saying,

“Hi, I am John Smith and I will be giving you your anesthesia today, I will be in the room during the entire operation, Doctor Jones will only be in their for a minute at the beginning of your surgery, but will be sending you a very large bill for his services.”

This is a joke, right? If any nurse pulled that $hit here, I'd fire them on the spot.
 

sallyjoe

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This is a joke, right? If any nurse pulled that $hit here, I'd fire them on the spot.

No joke, I am sure you would be alarmed at what the CRNA are saying about you when you are not around.

The CRNAs worked for the hospital. The Evil Management Company didn't care and was not going to waste any effort on anything that wouldn't make them more money or tighten their grip in the hospital and hospital administration, so asking them to discipline their employees was not on the Evil Management Company's agenda.

I said something to my out of town absentee employer but getting paid my imaginary bonus, so I would be making more than the CRNAs was much higher on my agenda. I also was trying not to make any waves so I could get a decent recommendations so I could quit working for the Evil Management Company, ASAP.
 

The_Sensei

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No joke, I am sure you would be alarmed at what the CRNA are saying about you when you are not around.
.

Nope, I know exactly what they say behind my back (I've got a few moles). Like I said before, however......if I hear one of my nurses talking sh#t about me while I'm around, I hands them their walkin' papers!
 
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Stimulate

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I was working a place where an Evil Management Company had been imposed upon CRNAs who had previously been practicing independently. The CRNAs usually got to the patient first and introduced the Doctor as by saying,

“Hi, I am John Smith and I will be giving you your anesthesia today, I will be in the room during the entire operation, Doctor Jones will only be in their for a minute at the beginning of your surgery, but will be sending you a very large bill for his services.”

Where does the CRNA think their paychecks come from? Would they rather the patient not pay for their anesthetic care?
 

EtherMD

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Where does the CRNA think their paychecks come from? Would they rather the patient not pay for their anesthetic care?

Some CRNA's truly believe that MD Anesthesiologists are not needed. I overheard a conversation between CRNA's talking about the difference between an MDA and a CRNA. "What do you think the major difference is between the MDA's and us?" Response. "They make twice as much as we do and do half as much work."


This is how many of them feel. Is it true? Not in my practice. We see all the patients, write the pre-op note, evaluate the patient and formulate the anesthetic plan. We start every case, do 90% plus of the Regional and lines as well as deal with all the problems. We are in house 24/7 and always avail. for problems throughout the hospital. We help cover emergencies at night and on the weekend (MD only sometimes). We do cases ourselves about 30%of the time. We place central lines and intubate throughout the hospital when asked by any Physician staff member. We also average about 52 hours per week and supervise the "weak" CRNA's as well as the strong ones. This is not an easy job by any means but by staying involved with the patients, surgeons, CRNA's and hospital staff we earn the respect we need to keep our jobs. In other words, stay out of the lounge and do your job. Also, be involved with hospital committees and show why you are valuable to the administration.
 

sallyjoe

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Where does the CRNA think their paychecks come from? Would they rather the patient not pay for their anesthetic care?

The CRNA are hospital employees so their services are bundled with the hospitals bill, while the Evil Management Company billed the patients more than any other anesthesia group in the state and had very aggressive bill collectors to call the patients repeatedly until they paid. Since they are hospital employees the CRNAs did not care if the patient paid since it made no difference to them either way.
 

The_Sensei

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Some CRNA's truly believe that MD Anesthesiologists are not needed. I overheard a conversation between CRNA's talking about the difference between an MDA and a CRNA. "What do you think the major difference is between the MDA's and us?" Response. "They make twice as much as we do and do half as much work."


This is how many of them feel. Is it true? Not in my practice. We see all the patients, write the pre-op note, evaluate the patient and formulate the anesthetic plan. We start every case, do 90% plus of the Regional and lines as well as deal with all the problems. We are in house 24/7 and always avail. for problems throughout the hospital. We help cover emergencies at night and on the weekend (MD only sometimes). We do cases ourselves about 30%of the time. We place central lines and intubate throughout the hospital when asked by any Physician staff member. We also average about 52 hours per week and supervise the "weak" CRNA's as well as the strong ones. This is not an easy job by any means but by staying involved with the patients, surgeons, CRNA's and hospital staff we earn the respect we need to keep our jobs. In other words, stay out of the lounge and do your job. Also, be involved with hospital committees and show why you are valuable to the administration.

Ether,

Uncanny! This is EXACTLY how my practice is set up - the description is verbatim what I do. Eerie...:eek:
 

Stimulate

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The CRNA are hospital employees so their services are bundled with the hospitals bill, while the Evil Management Company billed the patients more than any other anesthesia group in the state and had very aggressive bill collectors to call the patients repeatedly until they paid. Since they are hospital employees the CRNAs they did not care if the patient paid since it made no difference to them either way.

I am still not understanding how the hospital is billing for the CRNA in addition to the Management group billing for the CRNA. It sounds like the patients are being billed twice for their anesthetic? Hospitals are usually paid by a DRG for a particular operation, and that reimbursement covers the hospital's expenses, but my understanding was that the anesthesia fee is always billed separately. Regardless of who is paying the CRNA, either the hospital or the Management company is billing for that anesthetic, not both. If I were a patient I would report this practice of double-billing to the State Insurance Commissioner, rather than make derogatory and insubordinate comments about superiors.
 

sallyjoe

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I am still not understanding how the hospital is billing for the CRNA in addition to the Management group billing for the CRNA. It sounds like the patients are being billed twice for their anesthetic? Hospitals are usually paid by a DRG for a particular operation, and that reimbursement covers the hospital's expenses, but my understanding was that the anesthesia fee is always billed separately. Regardless of who is paying the CRNA, either the hospital or the Management company is billing for that anesthetic, not both. If I were a patient I would report this practice of double-billing to the State Insurance Commissioner, rather than make derogatory and insubordinate comments about superiors.

I am not a billing expert but Anesthesia services with physicians and CRNAs can be billed different ways. 1) anesthesia group or hospital employees the CRNA and physicians and bills for both. 2) Hospital employs the CRNA and bills for them. Physicians work for an anesthesia group and bill for their own services. There are then two bills for anesthesia services one for the nursing services and the second for the physician services. Different companies will pay different amounts so it depends on the local payer mix as to which way will generate more revenue.
 

Stimulate

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Interesting. That must be confusing for the patients to get a bill for the CRNA and then another bill for the anesthesiologist.
 

EtherMD

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Interesting. That must be confusing for the patients to get a bill for the CRNA and then another bill for the anesthesiologist.

Volatile could introduce his CRNA's this way:

I am Dr. Volatile and this is my Nurse Anesthetist Mrs. Smith. I will be starting your case with her and she is my assistant. I am available at all times and she will make sure you are asleep during surgery. We work as a team.

OR, Volatile could go this way:

This is my [email protected] CRNA. She works for our Group and I am stuck with her. She is not a doctor but she thinks she can do everything without me. She didn't even sleep at a Holiday Inn Express last night! Her Schooling? I think she went to the local community college and bridged to her BSN. No Masters degree because at the time it wasn't required. But, don't worry because this Nurse hasn't lose any patients yet- I think. I told her to give me a call on my cell phone if you go into Cardiac Arrest or don't wake up. One last thing "relax because a Nurse is by your side." (official AANA slogan).:laugh:
 

Stimulate

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Volatile could introduce his CRNA's this way:

"relax because a Nurse is by your side." (official AANA slogan).:laugh:

we are all by their side at least during crani's. Otherwise I generally position myself at the patients head.

"Relax because a nurse is by your head, and if she gets into deep **** there is almost always back-up available" would be a more accurate slogan.
 

Gasboy07

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Relax because a nurse is giving you head... oops did I just say that?!
 

LostTommyGuns

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Volatile could introduce his CRNA's this way:
This is my [email protected] CRNA. She works for our Group and I am stuck with her. She is not a doctor but she thinks she can do everything without me. She didn't even sleep at a Holiday Inn Express last night! Her Schooling? I think she went to the local community college and bridged to her BSN. No Masters degree because at the time it wasn't required. But, don't worry because this Nurse hasn't lose any patients yet- I think. I told her to give me a call on my cell phone if you go into Cardiac Arrest or don't wake up. One last thing "relax because a Nurse is by your side." (official AANA slogan).:laugh:

ZING!!! :laugh: :laugh: :laugh:
 
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