How many of your attendings have sold their souls for CRNAs?

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YOu know who I'm talking about. The big hot shot academic MDA attending who supervises no less than 10 CRNAs. He never ever watches what they are doing. He gives a cursory signature to everything they do without really checking on it in depth. He's in another hospital on the other side of the city while his CRNAs laboriously go thru case after case with zero supervision.

We all know lots of attendings who fit this profile. They make a ****load of money by getting a cut into the CRNA reimbursement.

The CRNAs for the most part are happy, but they are also brooding.

The MDA never supervises them, he just signs cursory paperwork and says "go at it."

Eventually (and this is already happening) these happy little CRNAs arent going to be happy working for the big hotshot MDA anymore.

And this is what they are going to do.

They are going to quietly gather their cases together. They are quietly gathering outcome data. They are quietly gathering documentation to show how little supervision they get.

Then they are going to Congress and state legislatures. They are going to tell representatives that they have years of data that their outcomes were similar to hotshot MDA. They are going to have years of data showing sham supervision in which the hotshot MDA was never in the OR supervising.

MDAs are losing the war to CRNAs because these "hotshot" MDAs are selling the profession for a temporary pot of gold. Of course the hotshot MDA attending will realize one day that he no longer has slave labor to extract his 2.5 million dollar income. But that will be years down the line. He will have already made his money. He will be ready to cash out.

Unfortunately for the young MDAs coming up, this guy's actions will have resulted in a price bidding war with CRNAs who were granted independent scope by Congress and state legislatures. Oh sure, they'll always be able to find jobs, but these jobs will be wage suppressed and functionally equivalent to what a CRNA does.

CRNAs like money just as much as anybody else, but when push comes to shove they would happily take a 60k or 70k per year salary. Where else are they going to make that kind of money with a nursing education?

When that happens, MDA salaries will slowly drop to match CRNAs.

It wont happen overnight, but its coming unless MDAs take back the field.

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