job prospects in 10 years

[cfdavid]

Anyone care to speculate? I've read some of the sticky threads and JetPropilot shed some light on when he first entered the job market. This was when times weren't so good in the field. I know there's a lot of demand now, but what about 10 yrs from now? Any educated guessers??

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[Arctic Char]

all markets fluctuate.

 

[toughlife]

http://www.merritthawkins.com/pdf/2005_incentive_survey.pdf

"In addition, anesthesiology is one of the few medical specialties, where a significant amount of care can be provided by non-physicians, and in many cases, healthcare organizations are recruiting CRNAs in lieu of anesthesiologists"

 

[nitecap]

The article also mentions its clients had filled anesthesiology vacany the previous few years. Not to mention this is one firm and prob. not representative of the entire country.

 

[cfdavid]

Interesting article. This CRNA thing kind of worries me. It seems that if the AARP starts lobbying for lower healthcare costs (they will be an even bigger lobby than they are now), politicians may very well buckle. We're already seeing big names (Steve Case for one) investing in mini prompt-care facilities in Wal-Marts and Target's etc. You'll be seen by an NP for basic problems such as a sore throat etc. An increased interest in mid-levels seems to be a growing trend.

Then again, from what I here there is an increased interest in FM and IM, so perhaps it's not that simple. My biggest concern is in areas where they've previously hired CRNA's due to a lack of MD/DO availability or willingness to locate in a particular area. But, once that precedence is set, why would an organization pay for an MD/DO that suddenly becomes available. Why wouldn't they just save $150k and hire another CRNA if they can??

I know this has been discussed, but from an outsider's perspective, it seems that at the very least, MD/DO's should be very interested in supporting AA's whenever possible.

 

[Idiopathic]

But, once that precedence is set, why would an organization pay for an MD/DO that suddenly becomes available. Why wouldn't they just save $150k and hire another CRNA if they can??.

Liability.

 

[toughlife]

Liability.

With continued exposure to nothing but midlevels the public will eventually not know any different. New generations will grow up knowing the NP as their health care provider and will take it to be the standard of care. When that happens hospitals will be no more liable by having someone other than a MD/DO providing the care. It's all a matter of exposure and acquiescence by the public.

 

[bullard]

The public has nothing to do with it, dude. It's all about what makes good business sense for the hospital, and that's the anesthesia care team model. Not saying that's what's best for the patient but that's definitely the way to churn out the cases.

I'm not worried about my job prospects.

 

[curious1]

bullard hit the nail on the head. hospitals make money from surgeons who bring them cases. surgeons want a happy, stable, reliable anesthesia service of MDAs. it doesn't cost the surgeon any less money to operate with a CRNA than an MDA, of course they will prefer MDAs, and ultimately, surgeons run the show, especially in areas where they can take their business to another hospital or to an ambulatory surgical center. the public has no say.

 

[nitecap]

Actually the ACT has been deemed extremely safe benefiting both pt's, hospitals and providers and increasing access to anesthesia overall.

 

[nitecap]

Actually if you guys have ever studied any theory about what qualifies a person as a professional much of the criteria that qualifies someone as a professional is based on

1-Providing a needed service to the public
2-and being judged by the public

If you dont think the public has anything to do with a professionals practice you are fooled. Lawmakers that are elected by and lobbied by the public can make laws that effect your practice today if they desired.

 

[toughlife]

The public has nothing to do with it, dude. It's all about what makes good business sense for the hospital, and that's the anesthesia care team model. Not saying that's what's best for the patient but that's definitely the way to churn out the cases.

I'm not worried about my job prospects.

I am not worried either. Since you brought up the business topic, what happens if the hospital has no patients (the public)?

I think the public does have a say but they just don't know it. If they choose not to receive care at X hospital, it won't matter what X hospital has done that makes good business sense since they have no one to treat.

 

[bullard]

WTF are you talking about? Stop putting words in my mouth.

Actually if you guys have ever studied any theory about what qualifies a person as a professional much of the criteria that qualifies someone as a professional is based on

1-Providing a needed service to the public
2-and being judged by the public

If you dont think the public has anything to do with a professionals practice you are fooled. Lawmakers that are elected by and lobbied by the public can make laws that effect your practice today if they desired.

 

[ThinkFast007]

I am not worried either. Since you brought up the business topic, what happens if the hospital has no patients (the public)?

I think the public does have a say but they just don't know it. If they choose not to receive care at X hospital, it won't matter what X hospital has done that makes good business sense since they have no one to treat.

Dude the problem is that the ASA needs to run adds in the paper or in airports (like the orthopods do), saying:

"Do you know who is behind the curtain when you're asleep? Find out, be informed. " -this is a message from the ASA, physicians concerned about your care. Ask your doctor now, who will be providing anesthesia for you during the surgery.

Guarantee you, if the public was more informed by means of something like that, it would be a totally different story. As it is now, these nurses go to the preop area, do their little rant, etc. The patient hasnt the fondest clue if it's a nurse or a MD (most of them will just say, i'm an anesthesist...which to the patient means "ANESTHESIOLOGIST")

p.s. dude you guys should really check out this allnurses.com . All this time I thought Jet was making that website up. That thing is for real. Look at their forum and see the threads aimed against Doctors/Surgeons. I think it's one thing for a anesthesiologist (which on that forum they refer to as a 'ologist') to bitch out a surgeon...but a CRNA to do that, that's just insubordination!

ridiculous

 

[ThinkFast007]

Folks...it's cuz of guys like NITECAP...I strongly believe that EACH AND EVERY ONE OF US in this forum who are future anesthesiologists should become active in the ASA .

If we as FUTURE physicians do not come together on this issue, the cause will be lost. THere are approximately 35,000 CRNAs and only 40,000 anesthesiologists..if we do not act now, and become politically active, this will be a lost cause.

Write to the ASA. DEMAND that they do something. Ask them what their stance is on the subject, and ask them what steps they are taking to resolve this issue. Demand this folks!

As bullard (I think) mentioned, to the hospitals it's all about the $$$. If they can get CRNAs to do the work cheaper, they will. As I PMd ppl who have PMd me about this. Yes, there was a worry in the 90's about CRNAs taking over, that never happened (as some will tell you). However, in this era of managed care, it's the hospitals 'bottom line' that needs to be met, if they can use CRNAs instead they will. Dont believe me, look at what managed care has done to our primary care colleagues' field.

Medicine is a BUSINESS. unfortunately since Docs in the past did not stand up, these 'paper pushers' (non-docs) are the one's running hospitals and mking policy for the most part.

We can't just sit around and be passive any longer. Do something. Get answers! Just joining the ASA is not enough. DEMAND answers. Write, etc.

 

[MacGyver]

You guys continue to hide your heads in the sand. Dont come back crying 20 years from now when it turns out your income is the same then as it is now due to wage suppression from CRNAs.

I'm sick and tired of hearing this BS about CRNAs bringing increased liability.

I've got a homework assignment for you boys and girls. Bring me an article about a CRNA getting sued for malpractice. Have fun hunting.

 

[nitecap]

Dude the problem is that the ASA needs to run adds in the paper or in airports (like the orthopods do), saying:

"Do you know who is behind the curtain when you're asleep? Find out, be informed. " -this is a message from the ASA, physicians concerned about your care. Ask your doctor now, who will be providing anesthesia for you during the surgery.

Guarantee you, if the public was more informed by means of something like that, it would be a totally different story. As it is now, these nurses go to the preop area, do their little rant, etc. The patient hasnt the fondest clue if it's a nurse or a MD (most of them will just say, i'm an anesthesist...which to the patient means "ANESTHESIOLOGIST")

p.s. dude you guys should really check out this allnurses.com . All this time I thought Jet was making that website up. That thing is for real. Look at their forum and see the threads aimed against Doctors/Surgeons. I think it's one thing for a anesthesiologist (which on that forum they refer to as a 'ologist') to bitch out a surgeon...but a CRNA to do that, that's just insubordination!

ridiculous

Actually I have worked at several facilities that informaly refer to anesthesiologists as ologist. Its all just short hand, same as when someone says call cardio, or when is surg getting here to start, or where the helll is opto.

Get over it man, you are the biggest cry baby I have ever seen on this forum. Please spend your money on advertisment while others spend that money on lobbying or others put out their own ads. You are nieve man, its pitiful.

As far the allnurses.com site, whats wrong with it. I guess MD's should be the only profession that is allowed to use forums huh.

And usually its AA vs CRNA debated there and not to much MD bashing though there is ASA bashing. ITs nothing different than how you guys bask on here and talk crap though any visitors or out numbered of course, similarly to how I am here. Hey I encourage you to post their. Use your same screen name too so I can know who you are there as well. Jwk and a few are freq posters their.

As for surgeon bashing youi are mistaken besides maybe a crna discussing mistreatment or a case. And an anesthesiologist bitchingggg out a surgeon, I have seen very few cases of such. Its usually the other way around, surg bitcchhing anesthesia all together and anesthesia defending their stance. Again you lack of real OR experience shinning thru the clouds that you float on, gotta come down one day player. Its time to wake up.

Also these forums are public man, anyone and their grandma can biatch and complain about anyone or who they want. Grow up man. AS long as you follow the rules anyones a$$ is fair game no matter who or what you are.

Was on a politcal forum the other day and some people there were bad mouthing the president. I mean I can see a legislator doing that but just a regular old citizen " thats just insubordination". No rather its called freedom of speech you insecure teacup poodle.

 

[Idiopathic]

I'm sick and tired of hearing this BS about CRNAs bringing increased liability..

My point isnt about increased liability due to CRNA's, but rather, who assumes the liability? The hospital? The practice? After the hospital fronts the $$$ to pay the CRNA are they gonna pay the malpractice hickey too? What about when the amount it takes to hire a CRNA really isnt that far off from what it takes to pay an MD/DO, who comes with more versatility (i.e. ASA 4 cases?) and more training?

And like it or not, the decreased time spent in the OR/on rotations is definitely represented in the knowledge base. The basic CRNA knows what to give, but they dont always know why, and I dont feel comfortable with someone who doesnt know the intricacies of the physiologic mechanism planning an anesthetic. Some are easy, cookie-cutter types, but there are plenty of cases that need the extra schooling/training.

Any monkey can throw in a line and tube, right?

 

[nitecap]

You guys continue to hide your heads in the sand. Dont come back crying 20 years from now when it turns out your income is the same then as it is now due to wage suppression from CRNAs.

I'm sick and tired of hearing this BS about CRNAs bringing increased liability.

I've got a homework assignment for you boys and girls. Bring me an article about a CRNA getting sued for malpractice. Have fun hunting.

Dude you have no clue. I know CRNA's personally that have been sued. Why would CRNA's require malpractice policies if they wouldnt get sued. Whether the lawyer decides to go for the partner MD in the medical directed practice with the deeper pockets is another thing. Just googled and found many examples check yourself or at least do your research b/f you pen your mouth to vomit nonsense.

 

[cfdavid]

Dude the problem is that the ASA needs to run adds in the paper or in airports (like the orthopods do), saying:

"Do you know who is behind the curtain when you're asleep? Find out, be informed. " -this is a message from the ASA, physicians concerned about your care. Ask your doctor now, who will be providing anesthesia for you during the surgery.

Actually, good idea. If it comes to that, it should be done. I guarantee most people assume there will be an MD/DO anestheSIOLOGIST caring for them.

Don't get me wrong, I think that care team is a great idea. But, the prospect of mid-levels needing less and less doctor supervision will not bode well for us.

 

[nitecap]

My point isnt about increased liability due to CRNA's, but rather, who assumes the liability? The hospital? The practice? After the hospital fronts the $$$ to pay the CRNA are they gonna pay the malpractice hickey too? What about when the amount it takes to hire a CRNA really isnt that far off from what it takes to pay an MD/DO, who comes with more versatility (i.e. ASA 4 cases?) and more training?

And like it or not, the decreased time spent in the OR/on rotations is definitely represented in the knowledge base. The basic CRNA knows what to give, but they dont always know why, and I dont feel comfortable with someone who doesnt know the intricacies of the physiologic mechanism planning an anesthetic. Some are easy, cookie-cutter types, but there are plenty of cases that need the extra schooling/training.

Any monkey can throw in a line and tube, right?

Come on Ido CRNA's not doing ASA 4's. Your are kidding yourself man. I know CRNA's in podunct McAllen Tx, and Brownsville that do tons of ASA 4's daily with no MD anesthesia provider what so ever involved in the care. Again misconceptions.

 

[bullard]

You picked out one item in his post and ignored the rest (which were valid arguments, IMHO). You also cited a couple of people you know out of the thousands of CRNAs out there. Nice tactics. You should run for office.

But while we're talking about ASA 4's...what kind of outcomes do those CRNAs in McAllen have? Nobody knows, right? The only (not very good) study out there shows that CRNAs working alone have lousier outcomes than ACT or anesthesiologists alone. Right? So do you have a point here or are you just trying to pick a fight?

 

[bullard]

Never mind. You're just trying to pick a fight. No more posts from me on this thread.

 

[ThinkFast007]

Come on Ido CRNA's not doing ASA 4's. Your are kidding yourself man. I know CRNA's in podunct McAllen Tx, and Brownsville that do tons of ASA 4's daily with no MD anesthesia provider what so ever involved in the care. Again misconceptions.

Idio and I have had our differences, but...when it comes to an ASA4 or any 'sick' patient, dude you must be kidding to think I'd want a CRNA doing anything.

If that was my MOM or even yours in the OR, dude, there's no way I would trust her in a nurse's hand. The knowledge is simply not there.

Anyways, folks, before this nitecap guy gets this thread closed.....Please refer to my posts earlier in this thread about us coming together and becoming more active with the ASA. Also, I think we definitely need to take steps asking the ASA to mk the general public aware of these issue.

 

[leopold stotch]

Come on Ido CRNA's not doing ASA 4's. Your are kidding yourself man. I know CRNA's in podunct McAllen Tx, and Brownsville that do tons of ASA 4's daily with no MD anesthesia provider what so ever involved in the care. Again misconceptions.

i'm glad you guys have it under control....sweet, more time for coffee.

 

[nitecap]

My point was that CRNA's carry malpractice policies as well and are liable when they fuq up. In the AANA standards or care, in the Nurse Practice act and in the Medical Practice act it clearly states that MD's are not liable for CRNA's, PA's, NP's if that practioner makes an independent decision as long as the MD in the medically directed practice claims that that CRNA is competent to be in that situation and that incompetence is not suspected. The CRNA is then liable for their screw up and whatever damages come along with it.

And please refering to totally biased and flawed studies funded by the ASA or Departments of Anesthesiology are useless b/c all have or can be refute with ease. Dont they teach you guys in med school how to break down an article and pick out the biases? Or are MD's the only people in the world that can pick out biased articles?

 

[nitecap]

Idio and I have had our differences, but...when it comes to an ASA4 or any 'sick' patient, dude you must be kidding to think I'd want a CRNA doing anything.

If that was my MOM or even yours in the OR, dude, there's no way I would trust her in a nurse's hand. The knowledge is simply not there.

Anyways, folks, before this nitecap guy gets this thread closed.....Please refer to my posts earlier in this thread about us coming together and becoming more active with the ASA. Also, I think we definitely need to take steps asking the ASA to mk the general public aware of these issue.

Thinkfast off the top of your head can you even tell me what characteristics qualify a pt as a ASA 4. Probrably not b/c my grandma that has had a good bit of surgeries in her day now at 88yo has more total OR time than you. So please quit acting like you know things man. You are a joke.

Why do you think I freq these forums man. To find out your game plans, mentality, and weaknesses. Its all about knowing your competition better than you know your inlaws, understanding how they think so you can expect their every move. Dont hate the player man, hate the game. This thread shouldnt get closed unless peeps start cursing each other. A good debate has closed very few threads as long as it doesnt get out of hand. Can you guys handle that?

 

[ThinkFast007]

Thinkfast off the top of your head can you even tell me what characteristics qualify a pt as a ASA 4. Probrably not b/c my grandma that has had a good bit of surgeries in her day now at 88yo has more total OR time than you. So please quit acting like you know things man. You are a joke.

Why do you think I freq these forums man. To find out your game plans, mentality, and weaknesses so I can use them against you when my times comes to lead ny profession to future advancements. Its all about knowing your competition better than you know your inlaws, understanding how they think so you can expect their every move. Dont hate the player man, hate the game. This thread shouldnt get closed unless peeps start cursing each other. A good debate has closed very few threads as long as it doesnt get out of hand. Can you guys handle that?

the bolded truly shows this guys intent on here. JetPro (i know you will get into this convo sooner or later...so take a quick read about my previous comments on this thread), I know you have been quite partial to him lately. But as you can see, his true colors come out.

I'm telling you, these CRNAs put up this 'front' about wanting to be apart of the team. Once they learn the trade, they want to be the boss. Folks, it's common sense. Who wants to be a subordinate for the rest of their lives. No one. Do you really think that these CRNAs are any different?

As i stated earlier, these nurses (CRNA), all try to 'act nice to the anesthesiologist" just to learn the craft. their true intent is elucidated by what Nitecap has just said above. They'll stab you in the back as soon as they can find a place to practice independently or for greater pay. Seriously, we should just cut this thread and send it to the ASA.

p.s. yo nite, the day I answer a nurse's pimp quesiton will be teh day. if you dont knwo what an ASA 4 is, try baby miller.

 

[leopold stotch]

Thinkfast off the top of your head can you even tell me what characteristics qualify a pt as a ASA 4. Probrably not b/c my grandma that has had a good bit of surgeries in her day now at 88yo has more total OR time than you. So please quit acting like you know things man. You are a joke.

Why do you think I freq these forums man. To find out your game plans, mentality, and weaknesses so I can use them against you when my times comes to lead ny profession to future advancements. Its all about knowing your competition better than you know your inlaws, understanding how they think so you can expect their every move. Dont hate the player man, hate the game. This thread shouldnt get closed unless peeps start cursing each other. A good debate has closed very few threads as long as it doesnt get out of hand. Can you guys handle that?

if crnas take over...i'll do a residency in ER...and after 3 years, still make more money than...

can't we all just get along? of course not.

 

[August_Bier]

Choose a specialty because you love the work it involves and nothing else. If you like what you do, you will be good at it. There always will be work for good people.

May sound simple but that is all there is to it.

 

[toughlife]

Thinkfast off the top of your head can you even tell me what characteristics qualify a pt as a ASA 4. Probrably not b/c my grandma that has had a good bit of surgeries in her day now at 88yo has more total OR time than you. So please quit acting like you know things man. You are a joke.

Why do you think I freq these forums man. To find out your game plans, mentality, and weaknesses so I can use them against you when my times comes to lead ny profession to future advancements. Its all about knowing your competition better than you know your inlaws, understanding how they think so you can expect their every move. Dont hate the player man, hate the game. This thread shouldnt get closed unless peeps start cursing each other. A good debate has closed very few threads as long as it doesnt get out of hand. Can you guys handle that?

I am not surprised.......and ditto.

 

[miamidc]

Thinkfast off the top of your head can you even tell me what characteristics qualify a pt as a ASA 4. Probrably not b/c my grandma that has had a good bit of surgeries in her day now at 88yo has more total OR time than you. So please quit acting like you know things man. You are a joke.

Why do you think I freq these forums man. To find out your game plans, mentality, and weaknesses so I can use them against you when my times comes to lead ny profession to future advancements. Its all about knowing your competition better than you know your inlaws, understanding how they think so you can expect their every move. Dont hate the player man, hate the game. This thread shouldnt get closed unless peeps start cursing each other. A good debate has closed very few threads as long as it doesnt get out of hand. Can you guys handle that?

Your nothing but a nurse nitecap. Deal with THAT for the rest of your life. Im sure you get some looks when you tell people that, huh? Your a nurse playing wanna be doctor. You should just swollow that pride boy... that stinging feeling you feel when you're in the OR, its pride f*cking wit cha...Nurse Nightcap.

 

[nitecap]

the bolded truly shows this guys intent on here. JetPro (i know you will get into this convo sooner or later...so take a quick read about my previous comments on this thread), I know you have been quite partial to him lately. But as you can see, his true colors come out.

I'm telling you, these CRNAs put up this 'front' about wanting to be apart of the team. Once they learn the trade, they want to be the boss. Folks, it's common sense. Who wants to be a subordinate for the rest of their lives. No one. Do you really think that these CRNAs are any different?

As i stated earlier, these nurses (CRNA), all try to 'act nice to the anesthesiologist" just to learn the craft. their true intent is elucidated by what Nitecap has just said above. They'll stab you in the back as soon as they can find a place to practice independently or for greater pay. Seriously, we should just cut this thread and send it to the ASA.

p.s. yo nite, the day I answer a nurse's pimp quesiton will be teh day. if you dont knwo what an ASA 4 is, try baby miller.

CRNA's and Anesthesiologists get along fine minus all the political mumbo jumbo that they will never agree upon. Face it George Bush and Ted Kennedy will never agree but in public are cordial to one another.

Baby Miller? Nah Im a Big Miller Kinda guy man. You will make the investment one day man, its ok dont be scared. Thanks for spinning your lack of knowing what an ASA 4 is to a Nurse vs MD thing. Typical, to proud to admit you dont know.

You feel stabbed in the back by us, we feel stabbed in the back by you, thats pretty much how it goes, yet still work well together, deliver safe care and make great money. really work relationships all depend on the people and mgmt. As JWK has stated within his practice there are AA's, MD's, and CRNA's and all get along. It is happening man, just b/c you have no clue believe me it happens. All you know is what people vent about on this board man. Yes Jet, millitary and all those cats have valuable info that assists everyone on here but they have been around and you havent. Thats why I I will strike down upon thee with great vengeance and furious anger those who would attempt to poison and destroy my brothers. And you will know my name is the nitecap when I lay my vengeance upon thee. Samuel L Jackson, pulp fiction.

Your lack of knowledge and big mouth makes you an easy target man, dont take it personal, you will understand one day. Its all about survival of the fitest. The same threats you feel toward us that make you feel uneasy, are the same threats we feel toward you that make us feel uneasy.

 

[ThinkFast007]

Your nothing but a nurse nitecap. Deal with THAT for the rest of your life. Im sure you get some looks when you tell people that, huh? Your a nurse playing wanna be doctor. You should just swollow that pride boy... that stinging feeling you feel when you're in the OR, its pride f*cking wit cha...Nurse Nightcap.

Nurse Nitecap. Kinda nice dont ya think.

Anyone else hear this "blah blah" kinda ringing noise when Nurse Nitecap posts?

 

[lvspro]

Yo
Looking around at this board, and seeing the caliber of students that applied anesthesia this year leads me to believe that a CRNA takeover would be difficult, to say the least. The slacker anesthesiologists of yesteryear are gone, and a new breed of hard-working, politically involved, willing to spend some of their hard earned $$$ guys are moving in. I don't have any studies to support what I just said, but I do have the ability to look around me and see the legions of like-minded people. Don't be surprised when you start to see ASA approved billboards as was stated by think. I think the general public may start to wonder who is, in fact, monitoring them from above the curtain. I know who I'd want monitoring me.

 

[nitecap]

Your nothing but a nurse nitecap. Deal with THAT for the rest of your life. Im sure you get some looks when you tell people that, huh? Your a nurse playing wanna be doctor. You should just swollow that pride boy... that stinging feeling you feel when you're in the OR, its pride f*cking wit cha...Nurse Nightcap.

Nah I made the most financially sensible decision for me. I can post my case study on gross earning comparisons of the CRNA and Anesthesiologists over a 30 yr period post graduation but that may start another fire here so Ill hold off.

I

 

[lvspro]

I will strike down upon thee with great vengeance and furious anger those who would attempt to poison and destroy my brothers. And you will know my name is the nitecap when I lay my vengeance upon thee. Samuel L Jackson, pulp fiction.

Your lack of knowledge and big mouth makes you an easy target man, dont take it personal, you will understand one day.

I believe it was God who originally said that.

I'm sorry for interrupting, were you saying something about a lack of knowledge, and big mouths?

 

[miamidc]

Nah I made the most financially sensible decision for me. I can post my case study on gross earning comparisons of the CRNA and Anesthesiologists over a 30 yr period post graduation but that may start another fire here so Ill hold off.

I

like I said its just pride f*cking wit cha homey

 

[nitecap]

I believe it was God who originally said that.

I'm sorry for interrupting, were you saying something about a lack of knowledge, and big mouths?

Maybe so, but saw a little of pulp fiction today. Great movie.

 

[leopold stotch]

Nah I made the most financially sensible decision for me. I can post my case study on gross earning comparisons of the CRNA and Anesthesiologists over a 30 yr period post graduation but that may start another fire here so Ill hold off.
I

case study! that sounds like some powerful research. please don't hold this back from us. i'm dying to see this.

 

[norgeringerike]

Think about our society right now. Extremely litigious. You have one hospital move to all CRNAs, and an adverse outcome occurs. Whether it was the CRNA's fault or not, the family is going to sue purely for the fact that an anesthesiologist was not available at that hospital when there are plenty of them to be hired around town. With a typical "bleeding heart" jury, they will win as well. This is not arguing whether it is right or wrong, just a reality check on how our jobs will always be safe. It does not matter to a jury of lay people what statistics show. A hospital won't take that kind of liability. Can you imagine the settlements a hospital would pay out for morbidity/mortality from a PA acting alone without physician oversight in an ER?? Even if it was only acute care, you might as well start adding zero's after that first digit.

In a sense we have moved from the "practice" of medicine to the "business" of medicine. For hospitals to proctect the bottom line, they NEED anesthesiologists around.

 

[ThinkFast007]

....In a sense we have moved from the "practice" of medicine to the "business" of medicine. ....

this is somethign me and many on here have been saying. medicine is a business. Although hospitals going COMPLETELY CRNA is never going to happen, increasing their presence is almost definite if DOCTORS do nothing. As you and I pointed out on here, hospitals and the 'paper pushers from above' really just care about the bottom line.

money being the motivation in healthcare to the hosp administrators (sorry to crack your bubbles all you philanthropists), the 'cheaper' route will always be attempted (ie outsourcing xrays,etc to australia, etc).

public knowledge and surgeon knoweldge (who are our customers) to be increased. CRNAs, like nurse nitecap, and their AANA lobbying group is extremely active. we need to ask the same of our ASA, if they cant do the job, vote them out.

 

[nitecap]

Think about our society right now. Extremely litigious. You have one hospital move to all CRNAs, and an adverse outcome occurs. Whether it was the CRNA's fault or not, the family is going to sue purely for the fact that an anesthesiologist was not available at that hospital when there are plenty of them to be hired around town. With a typical "bleeding heart" jury, they will win as well. This is not arguing whether it is right or wrong, just a reality check on how our jobs will always be safe. It does not matter to a jury of lay people what statistics show. A hospital won't take that kind of liability. Can you imagine the settlements a hospital would pay out for morbidity/mortality from a PA acting alone without physician oversight in an ER?? Even if it was only acute care, you might as well start adding zero's after that first digit.

In a sense we have moved from the "practice" of medicine to the "business" of medicine. For hospitals to proctect the bottom line, they NEED anesthesiologists around.

There are many podunct hospitals with pure CRNA coverage.

 

[cloud9]

Nah I made the most financially sensible decision for me. I can post my case study on gross earning comparisons of the CRNA and Anesthesiologists over a 30 yr period post graduation but that may start another fire here so Ill hold off.

I

Ya know, up until this point I had maintained a patient outlook on these tirades Nite as you could sometimes give some interesting clinical outlooks and perspectives, but I'm really tired of it. I'm about to make the best move I've made today.

Oh, and it must really get you riled up to know that even though you make a good paycheck (as quoted), you will have to address Thinkfast and whomever else you dislike as "Sir" and "Boss" and have to do as you're told.

So you enjoy those paychecks.

And now to place you on ignore. Goodbye.

 

[cloud9]

This message is hidden because nitecap is on your ignore list.

Ah, life can be a beautiful thing.

Oh and no offense to you, Think, in the previous post, just wanted to make a point.

 

[norgeringerike]

There are many podunct hospitals with pure CRNA coverage.

Thank you nurse nitecap. As usual, you have educated us all with your wit and knowledge. I must now recant my blasphemy that anesthesiologists jobs are safe. Truly we are doomed if CRNAs can do the just as good a job as us but cost less. Well, I guess I could always go back to nursing school....

 

[toughlife]

this is somethign me and many on here have been saying. medicine is a business. Although hospitals going COMPLETELY CRNA is never going to happen, increasing their presence is almost definite if DOCTORS do nothing. As you and I pointed out on here, hospitals and the 'paper pushers from above' really just care about the bottom line.

money being the motivation in healthcare to the hosp administrators (sorry to crack your bubbles all you philanthropists), the 'cheaper' route will always be attempted (ie outsourcing xrays,etc to australia, etc).

public knowledge and surgeon knoweldge (who are our customers) to be increased. CRNAs, like nurse nitecap, and their AANA lobbying group is extremely active. we need to ask the same of our ASA, if they cant do the job, vote them out.

I think the ASA does try to make inroads on this issue but what needs to happen is a conscientious effort by the individual physician to correct the problem. By that I mean, you have to want to do your job.

You have to believe that your job IS sitting on that stool, charting vitals and dumping pee or whatever you want to call it. Many aneshesiologists we have seen here feel that is beneath them to do their job and that allows a hungrier and willing NA to move in and take over.

I, for one, will LOVE to have a chance to sit on that stool, chart the vitals, dump the pee, move the patient, suction the oral cavity, etc, etc etc. Take pride and ownership of your job.

All of us newbies need to get as far away from that lazy anesthesiologist attitude, who all he/she wants to do is drink coffee and chat in the lounge while the NA or student NA does the case. Forget about that.
What do you think is earning the mexicans points with american employers? That's right, strong work ethic.

Along with that, we need increased lobbying by the ASA, advertising could help a lot. Nothing wrong with promoting the good physicians do for patients along with their skills to carry out such taks. Also, networking with the surgeons is a good idea as well.

All in all, we need to be diligent, dedicated and relentless in the pursuit of perfection. OK that last part is from a Lexus commercial but you get the point.

As far as people like nitecap go, well, he has already demonstrated to everyone his goal is to "learn our game" and use it against us. My response to that is, we'll see you on the court!

The way you beat clowns like him is to be hungrier, more agressive and more willing than he is to do the job. Call it "gunning for your job".

 

[nitecap]

Ya know, up until this point I had maintained a patient outlook on these tirades Nite as you could sometimes give some interesting clinical outlooks and perspectives, but I'm really tired of it. I'm about to make the best move I've made today.

Oh, and it must really get you riled up to know that even though you make a good paycheck (as quoted), you will have to address Thinkfast and whomever else you dislike as "Sir" and "Boss" and have to do as you're told.

So you enjoy those paychecks.

And now to place you on ignore. Goodbye.

I have been real chill for the last few months though it only takes a few big mouthed hotheads to get my bigger mouth and ego a going. I have grown to show much more respect to attending and even knowledgable posters that freq here but when peeps that have no experience in dealing with, working with or even observing CRNA's practice bad mouth and fill public forums with inaccurate misconceptions and jargon then it is my duty to rebuke this inaccuracy and give another side of things. SOrry to piss the respectful peeps off, its nothing personal yet these are all very realistic issues and feelings that really need not be surpressed on anonomous public discussion boards.

And if my boss is a MD then of course they will get the utmost respect after all he is paying the bills. Dont get the misconception that I am a anesthesiologist hater b/c i strongly believe there is plenty enough business to go around yet when haters like thinkslow continue to push an agenda there has to be peeps like myself to point out fallacies and here say that lead to misconceptions just like thinkfast himself has.

For the most part he and I keep it above the belt so I have no problem with it though as long as he keeps pushing I will keep coming, sorry guys. Peace out.

 

[ThinkFast007]

I just Tivo'd Nurse Nitecap's post.

But going back to ToughLife's post. I think he makes an EXCELLENT post. Folks, what he stated about our profession is what this boils down to. We 'newbies' must come together on this issue. Take pride in the job and be good at it. All in all, we need to stop being lazy.

If we are solid and have our knowledge base down, AND have informed individuals assuming the role of negotiating on our behalf over at the ASA and ASAPC, our profession will continue to thrive. As long as managed care exists, the paper pushers will always want to find 'cheaper' labor to replace us. However, if the ASAPAC and ASA and of course us, stand together on this issue we can have enough leverage to control what goes on in hospitals. Managed care has definitely pushed the envelope and continues to do so, again...just look at what happened to primary care docs. We could be next.

Do you guys know what managed care hates? It hates unified physicians. They know docs dont congregate and that's why they prey on us. In fact, HMOs and other managed care orgs hate multispecialty groups because they usually contain MANY doctors.

I think a united front, with active ad campaigns,etc is what we need.

See my other thread on this forum about joining the ASAPAC and the resident component of the ASA.

 

[nitecap]

I think the ASA does try to make inroads on this issue but what needs to happen is a concientious effort by the individual physician to correct the problem. By that I mean, you have to want to do your job.

You have to believe that your job IS sitting on that stool, charting vitals and dumping pee or whatever you want to call it. Many aneshesiologists we have seen here feel that is beneath them to do their job and that allows a hungrier and willing NA to move in and take over.

I, for one, will LOVE to have a chance to sit on that stool, chart the vitals, dump the pee, move the patient, suction the oral cavity, etc, etc etc. Take pride and ownership of your job and own it.

All of us newbies need to get as far away from that lazy anesthesiologist attitude, who all he/she wants to do is drink coffee and chat in the lounge while the NA or student NA does the case. Forget about that.
What do you think is earning the mexicans points with american employers? That's right, strong work ethic.

Along with that, we need increased lobbying by the ASA, advertising could help a lot. Nothing wrong with promoting the good physicians do for patients along with their skills to carry out such taks. Also, networking with the surgeons is a good idea as well.

All in all, we need to be diligent, dedicated and relentless in the pursuit of perfection. OK that last part is from a Lexus commercial but you get the point.

As far as people like nitecap go, well, he has already demonstrated to everyone his goal is to "learn our game" and use it against us. My response to that is, we'll see you on the court!

The way you beat clowns like him is to be hungrier, more agressive and more willing than he is to do the job. Call it "gunning for your job".

Though we may disagree on most things at least you make sense man and arent foaming at the mouth like thinkslow.

quick question though. I really dont think that MD providers dont want to do their job as you claim. Many I have met are rather enthusiastic about their work. If you are a promoter of the ACT which has proven time and time again to be highly effective than many times you wont be dumping that pee. Thats just how things go. You will be rotating in and out of rooms, preoping, providing PACU care, maybe doing transplants or CABS. The MD's that are partners in the ACT are not only great clinicians but have to ensure smooth opertaion of the ENT suites across the street, OB on 3rd floor, that Outpt surg center across town. To have all this coverage which increases your gross revenue for your practice you have to have providers. Though are you willing to take a pay cut to get rid of all CRNA's and replace them with MD's, as far as earning AA's make the same so there is no difference there.