if CRNAs didn't exist, would it make Anaesthetics more attractive?

[ALTorGT]

Just wondering...
from your experiences, if there was no such thing as a CRNA...Only MDs were allowed to practice anaesthesia, would anaesthesia be more competitive?

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[ThatManVan]

Is a frog's tail watertight?

Just wondering...
from your experiences, if there was no such thing as a CRNA...Only MDs were allowed to practice anaesthesia, would anaesthesia be more competitive?

 

[Skip Intro]

More competitive? Or, more attractive?

CRNAs have been and always will be around. Perhaps you meant to suggest that, if they were not, anesthesiology would be more lucrative, therefore more competitive and more attractive... right?

Wrong.

CRNAs are, actually, what has made the field more lucrative. The "problem" is that they are a much larger group and have much squeakier wheels when it comes to scope of practice, at least in recent years. Couple that with the fact that there has been (and will continue to be, at least for a while) a shortage of anesthesiologists... and you've pretty much touched the lit matchstick to the dynamite's fuse.

No, I think anesthesiology is attractive already, as was proven this year, and will continue to be. What we need are the right people going into the field: bright, motivated, intelligent, and definitely not passive. I can't imagine it being any more attractive than it is right now. It may seem counterintuitive, but less CRNAs actually make the field less attractive. The issue has more to do with what will ultimately be determination of appropriate levels of "scope of practice" within and between these two groups. The CRNAs are current the vocal majority, and this is why you (perhaps) perceive the field as being not "attractive".

-Skip

 

[JAMMAN]

I think what the OP is getting at is whether or not CRNAs will impact the 'lifestyle' or anesthesiologists. Meaning that with the growing number of CRNAs and their increasing independence, will it affect salary, job satisfaction and job availability of anesthesiologists in the future.

Add to the fire, the increasing competitiveness of anesthesia programs and a possible decrease in reimbursement and the question gets even more interesting.

What is the answer? I don't really know. This question has existed for more than 10 years. An important article appeared in the New York Times back then that scared alot of people. It predicted a bleak future for anesthesiologists and it scared alot of my classmates away from anesthesia.

As an example, anesthesia was so undesirable when I was applying for residency, that my classmates could easily secure prestigous spots outside of the match. Some programs would even pay travel costs for candidates and a few even gave stipends just for interviewing. Compare that with todays experience.

Well, I am not an anesthesiologist, but I am happy to say that those predictions never panned out. I have several classmates who are now enjoying careers in anesthesia. They are very happy with their choice.

 

[impetigo]

Can a puma challenge a lion for the rule of the jungle?

 

[cchoukal]

This is an answerable question, I think. There are places where there are no CRNAs, or at least very few of them. Stanford and UCSF come to mind. It would be interesting to know if the percentage of medical graduates of those programs choosing anesthesiology as a career is significantly higher or lower than at other programs. This would be a pretty sloppy way to look at it, but it might be a start. I get the impression that one reason private practice anesthesiologists make so much money is because, with the help of CRNAs, they can monitor (and, therefore, bill for) 2-3 cases at a time. It just seems logical that if you're billing for 3 cases, you're making more than if you're billing for one. If that's what the OP meant by "more attractive," then I guess CRNAs should make it more attractive.

That said, I know of a couple graduates taking jobs in MD-only practices who quote income figures comparable to the private practice salaries in MD-CRNA practices here in Mpls, so who knows.

 

[nitecap]

I guess the CRNA factor just depends on the size of the practice and volume that practice has. For instance if there are 12MDA's and 30-40 CRNA's that group can do 5-8 times maybe more cases if indeed they have that case load. They branch out and cover many hosiptials, OP surgery centers ect. But say they have 30crna's then the mda's must shell out about 4 million in salary plus retirement and malpractice insurance for the CRNA's. If in the end they make more from doing the extra case load after paying all that, then I guess it is indeed worth it huh.