Considering all the talk about CRNAs etc, would you attendings/residents still choose Anesthesiology as a specialty if you could go back in time?
Considering all the talk about CRNAs etc, would you attendings/residents still choose Anesthesiology as a specialty if you could go back in time?
yes, even with the turmoil and fear of the unknown.
now, would i choose medicine...thats another question, but one i like to think id answer yes to.
I would not choose anesthesiology again and it has nothing to do with the CRNAs and more to do with the inherent lack of autonomy with the specialty, the amount of call we take, the little respect.. but mostly the lack of autonomy. i would do diag radiology and would set up a reading room in my bedroom and never leave the house..
Then you better be willing to do it for 1/4 of the current salary, because you could very well be competing against a U.S. trained Indian dude who's doing the same thing from his mansion in Mumbai.....
I know you're speaking tongue-in-cheeck, but unless global economics changes drastically, if it can be out-sourced, it will be, eventually.
how many indian board cert us trained radiologists do you think there are living abroad enough to make a dent in the job market in the us. cmon.
I would not choose anesthesiology again and it has nothing to do with the CRNAs and more to do with the inherent lack of autonomy with the specialty, the amount of call we take, the little respect.. but mostly the lack of autonomy. i would do diag radiology and would set up a reading room in my bedroom and never leave the house..
Then you better be willing to do it for 1/4 of the current salary, because you could very well be competing against a U.S. trained Indian dude who's doing the same thing from his mansion in Mumbai.....
I know you're speaking tongue-in-cheeck, but unless global economics changes drastically, if it can be out-sourced, it will be, eventually.
My hospital now digitally transmits the imaging studies to another country on the other side of the planet. About 20 minutes later out spits a faxed report.
Here too. Australia reads an awful lot of midnight films and CTs done at the community hospital where I moonlight. Granted, Australia isn't India, and I don't think they're saving any money outsourcing it - there just aren't any American radiologists willing to move and work graveyard shift here.
Is it REALLY too far of a stretch to think that in 10 or 20 years that there will be both
a) a horde of radiologists able to read films in a basement in India
b) data showing that they do just as good a job ... or "good enough"
Radiology is cool, but there is no other specialty as vulnerable to technology as it is. I don't think they face a huge outsourcing threat within the next 20 years ... but then again this thread is about 'doing it over again' starting now.
the standard is bd certified radiologist. I doubt there are many of those in australia or india for that matter.. and of those that are there I doubt many of them will be willing to read those films.
The point is that outsourcing diagnostic radiology services to other countries is already happening and there's no reason to think it won't continue to happen.
You're full of doom & gloom about the looming CRNA takeover and destruction of the anesthesiology specialty by NURSES because they're "good enough" but somehow outsourced CT reads by DOCTORS won't ever be "good enough" also?
CRNAs are licensed to practice medicine in the US (as long as they call it nursing). Foreign doctors are NOT licensed to practice medicine in the US. How are they getting around this? Practicing medicine without a license is a felony. Sure they are not physically present in the US, but this isn't a case of medical tourism. The medical care is sought and received in the US. I wonder how the courts would treat the tele-docs with regard to practicing without a license and in malpractice suits.
..... Foreign doctors are NOT licensed to practice medicine in the US. How are they getting around this? Practicing medicine without a license is a felony. Sure they are not physically present in the US, but this isn't a case of medical tourism. The medical care is sought and received in the US. I wonder how the courts would treat the tele-docs with regard to practicing without a license and in malpractice suits.
Regarding liability and reimbursement: those are two other cans o' worms which I don't even want to begin contemplating.
Considering all the talk about CRNAs etc, would you attendings/residents still choose Anesthesiology as a specialty if you could go back in time?
No. My Board Scores and grades in Medical School allowed me many other options. In my day, the DNAP Solo CRNA was still fantasy. In 2015 it becomes reality for many CRNA programs.
Of Course, I wasn't seeking a lifestyle specialty like many of today's students.
I would look for a specialty without Advanced Practice Nurses and high economic earning potential.
Blade, good luck. Sure, mid-levels aren't doing nearly what they are in anesthesia but just wait. It seems every specialty is using them, from cards to neurosurg..... They may be more "tame" in other specialties NOW, but who knows what their position will be in 10 years. I'm already hearing random "chatter" coming from mid-levels in certain specialties like cards of all specialties.... This chatter is increasingly antagonistic.
***However, as other specialists begin to see the downside of using (misusing is really the key word) mid-levels, physicians will band together. I'm already seeing this in my training, and even cards fellows complaining about mid-level providers and "substandard" care.
And, the motives are similar. A mix of supply/demand mismatch as well as profit motive. The procedural specialties can make more cash while mid-level "extenders" manage their patients in the ICU's and on the floors. This is happening across almost all subspecialties that do procedures. And, that's the key. You don't (at least I haven't) seen this in Rheumatology or ID......
I don't need the "luck" as my career path is set. Anesthesiology has been great to me. However, the future does not look nearly as good for you. With militant DNAP CRNAs just around the corner and opt-out coming to a state near you I wish you the best of luck.
Mississippi CRNA
Meridian, MS
Reply »
|
Report Abuse |
Judge it! |
#91 Jan 13, 2010
Judged:
1![]()
1![]()
1![]()
I am a practicing CRNA for in Mississippi. I trained at Wake Forest Baptist MEdical Center in Winton-Salem, NC. right along-side anesthesia residents. I sit every type of case. Heads, Hearts,Peds, OB.... you name , I sit it. I have a really big problem with the views of some MDAs. I work with 20 CRNAs and 4 MDAs. I think it is imperative to maintain a professional collegial attitude towards each other. No, I dont think it is right for MDAs to walk the halls and peek in every couple of hours to see if things are okay, and tell the pateints they put them to sleep. I always tell every patient that I am a CRNA and that I will be administering the anesthesia.
The MDAs know they have got it good for now, but in the town where I work, the change is coming. The movement from supervised to unsupervised cases is a happening thing. Our MDAs are worried about it, so worried that they will not let any CRNAs place any blocks (SAB, EPidurals, Ax block, ISB, etc) because "if the CRNA does the blocks, it will reinforce to the surgeons and to hospital administrators that the MDAs are not needed." It is a territory and money thing. This is word-for-word what our MDAs tell us, but what doesn't make sense is why we as CRNAs can induce a patient under general anesthesia place an ET airway, and maintain stable vitals for a 3-4 hour AAA, placing all invasive monitors by OURSELVES, but not any blocks..... Hmmmmmm. I don't understand... MDAs are getting desparate. And with ObamaCARE in the air, DO you think hospitals are going to keep paying 500k MDAs when they can employ 2 CRNAs to do more work which turns more revenue? You answer that...
As CRNAs, we do have it good, but we have also earned our keep in the OR, ER, ICU....
And who do you want to intubate you?
Some one who does it everyday 5-10 times/day, or someone who just stands at the door looks in and leaves, but takes all the credit?
Personally, I'll take the CRNA.
Mississippi CRNA
Meridian, MS
Reply »
|
Report Abuse |
Judge it! |
#91 Jan 13, 2010
Judged:
1![]()
1![]()
1![]()
I am a practicing CRNA for in Mississippi. I trained at Wake Forest Baptist MEdical Center in Winton-Salem, NC. right along-side anesthesia residents. I sit every type of case. Heads, Hearts,Peds, OB.... you name , I sit it. I have a really big problem with the views of some MDAs. I work with 20 CRNAs and 4 MDAs. I think it is imperative to maintain a professional collegial attitude towards each other. No, I dont think it is right for MDAs to walk the halls and peek in every couple of hours to see if things are okay, and tell the pateints they put them to sleep. I always tell every patient that I am a CRNA and that I will be administering the anesthesia.
The MDAs know they have got it good for now, but in the town where I work, the change is coming. The movement from supervised to unsupervised cases is a happening thing. Our MDAs are worried about it, so worried that they will not let any CRNAs place any blocks (SAB, EPidurals, Ax block, ISB, etc) because "if the CRNA does the blocks, it will reinforce to the surgeons and to hospital administrators that the MDAs are not needed." It is a territory and money thing. This is word-for-word what our MDAs tell us, but what doesn't make sense is why we as CRNAs can induce a patient under general anesthesia place an ET airway, and maintain stable vitals for a 3-4 hour AAA, placing all invasive monitors by OURSELVES, but not any blocks..... Hmmmmmm. I don't understand... MDAs are getting desparate. And with ObamaCARE in the air, DO you think hospitals are going to keep paying 500k MDAs when they can employ 2 CRNAs to do more work which turns more revenue? You answer that...
As CRNAs, we do have it good, but we have also earned our keep in the OR, ER, ICU....
And who do you want to intubate you?
Some one who does it everyday 5-10 times/day, or someone who just stands at the door looks in and leaves, but takes all the credit?
Personally, I'll take the CRNA.
pas in anesthesia..!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Mississippi CRNA
Meridian, MS
Reply »
|
Report Abuse |
Judge it! |
#91 Jan 13, 2010
Judged:
1![]()
1![]()
1![]()
I am a practicing CRNA for in Mississippi. I trained at Wake Forest Baptist MEdical Center in Winton-Salem, NC. right along-side anesthesia residents. I sit every type of case. Heads, Hearts,Peds, OB.... you name , I sit it. I have a really big problem with the views of some MDAs. I work with 20 CRNAs and 4 MDAs. I think it is imperative to maintain a professional collegial attitude towards each other. No, I dont think it is right for MDAs to walk the halls and peek in every couple of hours to see if things are okay, and tell the pateints they put them to sleep. I always tell every patient that I am a CRNA and that I will be administering the anesthesia.
The MDAs know they have got it good for now, but in the town where I work, the change is coming. The movement from supervised to unsupervised cases is a happening thing. Our MDAs are worried about it, so worried that they will not let any CRNAs place any blocks (SAB, EPidurals, Ax block, ISB, etc) because "if the CRNA does the blocks, it will reinforce to the surgeons and to hospital administrators that the MDAs are not needed." It is a territory and money thing. This is word-for-word what our MDAs tell us, but what doesn't make sense is why we as CRNAs can induce a patient under general anesthesia place an ET airway, and maintain stable vitals for a 3-4 hour AAA, placing all invasive monitors by OURSELVES, but not any blocks..... Hmmmmmm. I don't understand... MDAs are getting desparate. And with ObamaCARE in the air, DO you think hospitals are going to keep paying 500k MDAs when they can employ 2 CRNAs to do more work which turns more revenue? You answer that...
As CRNAs, we do have it good, but we have also earned our keep in the OR, ER, ICU....
And who do you want to intubate you?
Some one who does it everyday 5-10 times/day, or someone who just stands at the door looks in and leaves, but takes all the credit?
Personally, I'll take the CRNA.
I would not to Anesthesia. I would pick a profession with less liability and more autonomy. Most hospitals I've been at, I've been at the beck and call of surgeons, because surgeons bring in money to the hospital and I don't.
Wanna know how much power you have,? how about all anesthesiologists in the country stop going to work for one day. Wanna know how many surgeries would take place (even if the surgeon is present and ready to operate)? NONE!
.
I think thats what needs to be done in colorado and any other states thinking about opting out..have the anesthesiologist get together and say.. None of us are coming to work ... ever.. if this bill comes into play. we will ALL leave the state.. we will all LEAVE THE hospital. we will all go work in other states. Risky move but I think would work if well executed..
Physician Assistants in ANESTHESIA
why can PAS open and close a chest with the cardiac surgeons not even in the room but cant be our assistants.. This is the way to go guys.. Anesthesiology Assistants are obscure. nothing against them. I fully support AAs.. so take it easy jwk. not many people know about them.. Every state has PAs.. WHy not have them train in anesthesia.. this is the way to go..
Considering all the talk about CRNAs etc, would you attendings/residents still choose Anesthesiology as a specialty if you could go back in time?
Honestly, if I could go back, I'd get my JD or MBA and try to work at CAA
http://en.wikipedia.org/wiki/Creative_Artists_Agency
or WME
http://en.wikipedia.org/wiki/William_Morris_Agency
but, to stay on the serious tip, I see other specialties taking phone calls at home, at sporting events, at the strip club, which sucks. Besides maybe ER, Radiology, or Derm, I think we as anesthesiologist have it pretty good (if you stay away from pain, but that's just my bias. i'm a cards fellow.)
Considering all the talk about CRNAs etc, would you attendings/residents still choose Anesthesiology as a specialty if you could go back in time?
Heck yeah! Rotating through other specialties in my first year, I realize now how totally awesome anesthesia is. I love physiology, pharmacology, procedures, cool toys in and out of the OR, chill attendings, even more chill residents - it's the perfect combination of what makes me happy. Also, the specialty puts some hair on your chest and makes a man outta ya! - whether in a code, the OR, or damn near anywhere else!
Plus, I kick my legs reflexively like a dog whenever I get that perfect view of the cords on Glidescope and/or fibeoptic - that's when you know you're doing what you're born to do.
LOVE IT! F- the CRNA's - they're not taking what I love away from me.
does anyone know the chairman at wake forest so we can send this over there