Is extent of CRNA takeover of anesthesia dependent purely on number of CRNAs?

[Money Moniker]

I've been following the CRNA related discussions on this forum for a while. Based on these conversations, it would seem as if the degree to which anesthesia is being overrun with CRNAs is a function of a multifactorial calculus: surgeon preference, hospital policies, AMC staffing models, insurance reimbursement policies, etc.

But isn't it really a lot more simple than that? As far as I know, there aren't any unemployed or underemployed CRNAs out there, which means that the demand for CRNAs exceeds their supply. In this light, one could make the argument that the ratio of anesthesiologists to CRNAs is dictated purely by the number of active CRNAs. If you were to increase the supply of CRNAs, then the ratio would shrink, independent of any policy or political changes.

In other words, the extent of the CRNA threat facing anesthesia can be quantified by a simple number rather than a complex interplay of the aforementioned factors: the growth of the CRNA supply. If the number of CRNAs doesn't grow, then even giving them full scope would not damage anesthesiologists too badly, since the CRNAs are already cranking out as much "anesthesia product" as they have the capacity for. Policy changes would not magically give them powers to increase their throughput. Likewise, the market has shown there is currently unmet demand for CRNAs and so growth in their number would lead to a decrease in the doctor:CRNA ratio even absent the removal of restrictions on their scope. So, to see how badly anesthesia is screwed, just look at how quickly they're cranking out CRNAs.


Agree? Disagree?

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[GA8314]

I think that the CRNA oversupply will simply drive down demand for CRNA's. This will eventually lead to decreased hourly rates for CRNA's.

What happens to our profession will be dictated by what we achieve politically and the extent to which anesthesiologists maintain leadership positions within the hospital system. I do not think we are going to be "taken over" by CRNA's.

 

[Consigliere]

To answer your original question, no....it is/was based on that most basic human quality: greed.

 

[anbuitachi]

I've been following the CRNA related discussions on this forum for a while. Based on these conversations, it would seem as if the degree to which anesthesia is being overrun with CRNAs is a function of a multifactorial calculus: surgeon preference, hospital policies, AMC staffing models, insurance reimbursement policies, etc.

But isn't it really a lot more simple than that? As far as I know, there aren't any unemployed or underemployed CRNAs out there, which means that the demand for CRNAs exceeds their supply. In this light, one could make the argument that the ratio of anesthesiologists to CRNAs is dictated purely by the number of active CRNAs. If you were to increase the supply of CRNAs, then the ratio would shrink, independent of any policy or political changes.

In other words, the extent of the CRNA threat facing anesthesia can be quantified by a simple number rather than a complex interplay of the aforementioned factors: the growth of the CRNA supply. If the number of CRNAs doesn't grow, then even giving them full scope would not damage anesthesiologists too badly, since the CRNAs are already cranking out as much "anesthesia product" as they have the capacity for. Policy changes would not magically give them powers to increase their throughput. Likewise, the market has shown there is currently unmet demand for CRNAs and so growth in their number would lead to a decrease in the doctor:CRNA ratio even absent the removal of restrictions on their scope. So, to see how badly anesthesia is screwed, just look at how quickly they're cranking out CRNAs.


Agree? Disagree?

Nah that just affects hourly pay.

 

[Man o War]

I've been following the CRNA related discussions on this forum for a while. Based on these conversations, it would seem as if the degree to which anesthesia is being overrun with CRNAs is a function of a multifactorial calculus: surgeon preference, hospital policies, AMC staffing models, insurance reimbursement policies, etc.

But isn't it really a lot more simple than that? As far as I know, there aren't any unemployed or underemployed CRNAs out there, which means that the demand for CRNAs exceeds their supply. In this light, one could make the argument that the ratio of anesthesiologists to CRNAs is dictated purely by the number of active CRNAs. If you were to increase the supply of CRNAs, then the ratio would shrink, independent of any policy or political changes.

In other words, the extent of the CRNA threat facing anesthesia can be quantified by a simple number rather than a complex interplay of the aforementioned factors: the growth of the CRNA supply. If the number of CRNAs doesn't grow, then even giving them full scope would not damage anesthesiologists too badly, since the CRNAs are already cranking out as much "anesthesia product" as they have the capacity for. Policy changes would not magically give them powers to increase their throughput. Likewise, the market has shown there is currently unmet demand for CRNAs and so growth in their number would lead to a decrease in the doctor:CRNA ratio even absent the removal of restrictions on their scope. So, to see how badly anesthesia is screwed, just look at how quickly they're cranking out CRNAs.


Agree? Disagree?

Look at how many places allow them to work without the supervision of an anesthesiologist, yet not many of them do, relatively speaking.
Oversupply of CRNAs+preferential hiring of and increased practice rights for AAs+ever increasing toxicity of their rhetoric= lower salaries for them.

 

[Stank811]

The large increase in SRNA positions will result in decreased salary as well as continue to decrease the quality of the graduating CRNA. But of course will make a lot of different people in different environments bank.

 

[anbuitachi]

Look at how many places allow them to work without the supervision of an anesthesiologist, yet not many of them do, relatively speaking.
Oversupply of CRNAs+preferential hiring of and increased practice rights for AAs+ever increasing toxicity of their rhetoric= lower salaries for them.

I think it will happen but i dont see it happening anytime soon. They still command a IM docs salary these days and its been going up near me. Demand has been sky high..
Meanwhile nurses have to go thru ICU to become CRNAs and I think if in the future salary drop enough so that it's not really more than working in ICU, supply will come down. It's kind of self regulating. It's not like medicine where you are kind of tied down by your 300k debt to keep going.

 

[GaseousClay]

they will not take over the field. what they are doing and will continue to do is marginalize the field so much that the physician "MDA" as they like to say and the CRNA are equal in the eyes of the public and everyone in the hospital. That is their game plan.

 

[Man o War]

they will not take over the field. what they are doing and will continue to do is marginalize the field so much that the physician "MDA" as they like to say and the CRNA are equal in the eyes of the public and everyone in the hospital. That is their game plan.

Yep. Their goal is side by side practice.
I am of the opinion if the Medicare pass through funds available to rural hospitals for hiring only CRNAs and not docs were removed, you would see even less independent Crna practice. Again, there really isn’t that much to begin with but there would likely be even less in that scenario.