Look what I ran into on my way home today!

[SigmaSRNA]

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Members don't see this ad.

This actually may be true. I am from a state where there is a lot of rural areas and hospitals. When I was a medical student and I was doing rural rotations, all the anesthesia was given by CRNA's tht practiced under the surgeons license. There were no anesthesiologists. The one anesthesiologist in one small town I knew of was doing pain and was not in the OR at all. He told me that he really wanted to be in the OR as well but the CRNA's had such a monopoly that the surgeons would not contract with him. This is scary stuff folks. I have said it over and over again, no one needs to bad mouth the CRNA's but I really do feel that the ASA should do more to point out the level of education between the two and discuss the differences. Then let the public decide who they want to deliver their anesthetic.

What is also frightening is the push by the American Association of Colleges of Nursing proposed conversion to "Doctor of Nursing Practice" by 2015. There is an article about this in the May 2006 ASA Newletter. If they get there way, CRNA's could be calling themselves doctor since they would be granted PhD status. Wouldn't that be fun to have to explain to patients. I find this outrageous and we all should be writing the AMA and ASA to stop this.

2 points. 1st one. I'll use texas as an example since I live here. Approximately 80% or more of the counties in this state don't have an anesthesiologist not because they got pushed out by CRNAs; its because THEY DON'T WANNA WORK IN BUM ******* Texas. You will find that in alot of the states with high rural populations. Second, the AANA is not in favor of the DNP because it would be confusing to patient. We have no need to call ourselves docs because we are who we are, NURSES and we're proud. Everyone just needs to play their position, relax, and give good anesthesia.
Side note. Its funny how I have to explain to people what I do because the general public perception is that anesthesiologists are the only ones who give anesthesia. I really doubt know if we are winning the public relations battle.

 

[SigmaSRNA]

2 points. 1st one. I'll use texas as an example since I live here. Approximately 80% or more of the counties in this state don't have an anesthesiologist not because they got pushed out by CRNAs; its because THEY DON'T WANNA WORK IN BUM ******* Texas. You will find that in alot of the states with high rural populations. Second, the AANA is not in favor of the DNP because it would be confusing to patient. We have no need to call ourselves docs because we are who we are, NURSES and we're proud. Everyone just needs to play their position, relax, and give good anesthesia.
Side note. Its funny how I have to explain to people what I do because the general public perception is that anesthesiologists are the only ones who give anesthesia. I really doubt know if we are winning the public relations battle.

My bad. Don't know 👍

 

[jwk]

2 points. 1st one. I'll use texas as an example since I live here. Approximately 80% or more of the counties in this state don't have an anesthesiologist not because they got pushed out by CRNAs; its because THEY DON'T WANNA WORK IN BUM ******* Texas. You will find that in alot of the states with high rural populations. Second, the AANA is not in favor of the DNP because it would be confusing to patient. We have no need to call ourselves docs because we are who we are, NURSES and we're proud. Everyone just needs to play their position, relax, and give good anesthesia.
Side note. Its funny how I have to explain to people what I do because the general public perception is that anesthesiologists are the only ones who give anesthesia. I really doubt know if we are winning the public relations battle.

But Sig, here's the problem - many of those counties that don't have an anesthesiologist don't even have a hospital!

 

[SleepIsGood]

I read the "CRNA vs MDA" threads in the FAQ and still don't understand. If CRNAs can practice without MD's, what is preventing them from making >250k +? Especially with this push for "PhD" degrees, patients woudn't know that their anesthesiologist went to nursing school right?

This doesn't bother any of you practicing anesthesiologists? They may be working for you now and helping you earn $$, but what about in 5-10 yrs? You guys have prob already made a good living, but what about the med students, interns, residents.... should they be concerned?

Great point you bring up my friend.

It's sad but unfortunate. Let's be completely open about this issue. When the smoke clears it will be the interns and residents that get hurt. Attendings etc that hire CRNAs are making really good $$$. CRNAs are a cheaper alternative. It makes great fiscal sense. However, in terms of the future...our future. Unless allopathic residency programs stop training CRNAs and attendings stop hiring CRNAs, we (the younger generation of anesthesiologists) are the ones that will be hurt the most. The older attendings have or are currently making good $$$. It's time for the younger generation to become proactive so that we have a job with good benefits 5-10yrs from now.

 

[wrx]

Great point you bring up my friend.

It's sad but unfortunate. Let's be completely open about this issue. When the smoke clears it will be the interns and residents that get hurt. Attendings etc that hire CRNAs are making really good $$$. CRNAs are a cheaper alternative. It makes great fiscal sense. However, in terms of the future...our future. Unless allopathic residency programs stop training CRNAs and attendings stop hiring CRNAs, we (the younger generation of anesthesiologists) are the ones that will be hurt the most. The older attendings have or are currently making good $$$. It's time for the younger generation to become proactive so that we have a job with good benefits 5-10yrs from now.

Any comments from the practicing anesthesiologists, Jet/Mil/Noyac? Let's say today, you were magically transformed into a student/resident. Knowing what you know now, you would have absolutely NO concerns? (Please PM me if you like, as I want your honest opinion).

So I shouldn't be pissed-off that "advanced" nurses are inching towards taking the whole damn pie, rather than a slice? I've read several posts here as well as at allnurses.com and have formed my own opinion: the ASA needs to grow some damn testicles...

 

[militarymd]

Any comments from the practicing anesthesiologists, Jet/Mil/Noyac? Let's say today, you were magically transformed into a student/resident. Knowing what you know now, you would have absolutely NO concerns? (Please PM me if you like, as I want your honest opinion).

So I shouldn't be pissed-off that "advanced" nurses are inching towards taking the whole damn pie, rather than a slice? I've read several posts here as well as at allnurses.com and have formed my own opinion: the ASA needs to grow some damn testicles...

Here's what I think about this and many other subjects.

You can only do what you can do.....Don't waste your time worrying about what everyone else is doing.

MD/nurse politics have been around forever. If nurses can really do doctors jobs....then why shouldn't they ?.....and if it is really a job that a nurse can do....then why would you want to do it?

Bottomline....be a doctor....be well-trained....don't be what I would say most anesthesiologists are out there right now.....lazy, poorly read, insecure schmucks.

 

[Monty Python]

Here's what I think about this and many other subjects.

You can only do what you can do.....Don't waste your time worrying about what everyone else is doing.

MD/nurse politics have been around forever. If nurses can really do doctors jobs....then why shouldn't they ?.....and if it is really a job that a nurse can do....then why would you want to do it?

Bottomline....be a doctor....be well-trained....don't be what I would say most anesthesiologists are out there right now.....lazy, poorly read, insecure schmucks.

(Current anesthesiologist/CRNA/AA graduation rate) - (current retirement rates) x (current demand for service) x (percentage rise in over-65 population as the baby boomers age) = jobs everywhere for decades to come.

 

[Monty Python]

(Current anesthesiologist/CRNA/AA graduation rate) - (current retirement rates) x (current demand for service) x (percentage rise in over-65 population as the baby boomers age) = jobs everywhere for decades to come.

Recalling that only a small portion of job openings are publicly advertised, no one's going to go hungry:

http://www.anesthesia.cc/
http://www.fastgas.com/index.shtml
http://www.easteranesthesia.com/index.html
http://www.gasjobs.com/
http://www.gaswork.com/
http://www.globalanesthesia.com/

And that's only A-G in my little black book. H-Z is equally as full.

 

[deleted50478]

Here's what I think about this and many other subjects.

You can only do what you can do.....Don't waste your time worrying about what everyone else is doing.

MD/nurse politics have been around forever. If nurses can really do doctors jobs....then why shouldn't they ?.....and if it is really a job that a nurse can do....then why would you want to do it?

Bottomline....be a doctor....be well-trained....don't be what I would say most anesthesiologists are out there right now.....lazy, poorly read, insecure schmucks.

It's not all about being able to do the job. A veteran anesthesiologist from the UK does not have the right to practice anesthesiology in the US because he hasn't done the training here. They are far more qualified than a CRNA and many anesthesiologists, but don't have the right to practice medicine in the US. Nurses also don't have the right to practice medicine in the US though they think they can bribe their way in. Proving difference in outcomes is beside the point. To practice medicine you have to go to medical school and residency. Anything else is cheating the system.

 

[Monty Python]

............. A veteran anesthesiologist from the UK does not have the right to practice anesthesiology in the US because he hasn't done the training here.................. .

Wouldn't that be a function of examination and licensure, and not a function strictly of training location?

I know many foreign-born and/or foreign-educated physicians currently practicing anesthesiology in the US.

 

[wrx]

I understand your response Mil/Trin, and I'm going into anesthesiology regardless. However, I like to live by priciples, and this is just plain WRONG. Perhaps they should be required to take USMLEs, and the anesthesiology boards. Heck, if CRNA schools dissapeared tomorrow, how many prospective SNRAs would even apply and survive med school/residency? Very few. If you want to be an anesthesiologist, go to med school- don't take the cheap road around this.

Enough ranting- just wished the ASA had some balls to do something about this long time ago. Oh well....

 

[deleted50478]

Wouldn't that be a function of examination and licensure, and not a function strictly of training location?

I know many foreign-born and/or foreign-educated physicians currently practicing anesthesiology in the US.

They have to do residency training here even if they are already excellent anesthesiologists. Anyway, you're ignoring my point which is that lots of people could safely provide anesthesia and don't have the right to.

Mil asked, " If nurses can really do doctors jobs....then why shouldn't they?" The answer is that they shouldn't be able to because they are not doctors.

I could be a paralegal and learn everything about the law, but it wouldn't make me a lawyer. Only going to law school would do that. I can't just set up the American Paralegal Bar Exams and have my paralegal organization grant me the right to practice law. It undermines the intergrity of the profession. It's not just about knowledge, it's about doing things the right way.

 

[militarymd]

That's all politics....I believe I have stated my views on that...find them in my posts if you can.


Don't let politics tainted how you interact with your co-workers.....Give money to your PACS and professional organizations if you feel strongly about your politics....don't bring them to work.

 

[toughlife]

Sounds like a lot of people have a lot of time on thier hands. Why are you people so threatened by CRNAs???? My father and a relative are both CRNAs. They are both two of the smartest people I know, even though they are not doctors!! I am a physician in surgical residency...and still think they are 2 of the most intellegent well rounded poeple i know. But thats besides the point. You people that cause so much comotion are making it back fire on you. Most of the surgeons i work with enjoy the CRNAs and get frustrated with all the political crap that the Anethesiologist through in. And to the person that commented on using AAs.....give me a break. WHAT A JOKE!! I would much rathert work with a CRNA!!!! In order to get accepted to CRNA school these nurses have to have 2 years of ICU experience, AAs g have a degree in just about anything!!..... no medica/hospitall experience needed to get in to AA school. If i were a patient i would want a nurse anethetist not a AA, and i think the general public agrees, thats why there are but only a few schools. AAs will never be what a CRNA is!!! Surgeons that i work with would go to battle for the CRNA. Sorry if thats disapointing to some of you out there. I suggest working on realationships between CRNas and Anesthesiologist. Both are here to stay. I know there are some radical CRNAs but its not the majority!!!! The CRNAs i work with like to have anesthesiologist to work with, rather than doing the anesthesia all alone. If you take the time to take a picture off the side of the road of a billboard, maybe you should reconsider anesthesia and work in some other tyep of medicine where you dont feel so threatened.

Surgery resident? You're probably the only one here who believes that.

Why don't you concentrate in your CRNA schoolwork and stop trollling in here?

 

[deleted50478]

2 points. 1st one. I'll use texas as an example since I live here. Approximately 80% or more of the counties in this state don't have an anesthesiologist not because they got pushed out by CRNAs; its because THEY DON'T WANNA WORK IN BUM ******* Texas. You will find that in alot of the states with high rural populations. Second, the AANA is not in favor of the DNP because it would be confusing to patient. We have no need to call ourselves docs because we are who we are, NURSES and we're proud. Everyone just needs to play their position, relax, and give good anesthesia.
Side note. Its funny how I have to explain to people what I do because the general public perception is that anesthesiologists are the only ones who give anesthesia. I really doubt know if we are winning the public relations battle.

That statement about Texas is totally misleading. Most of the counties without an anesthesiologist also don't have a nurse. Even the crna site shows it: http://www.txana.org/
Very few counties have only crnas. There are many Texas counties with no anesthesia coverage at all. Why are there so many crnas in Houston and Dallas when about 90 counties don't have any anesthesia? Don't go spreading your nurse propaganda around here.

 

[Mike MacKinnon]

Ugh

What a sad discussion this has become (and is on a regular basis).

The stark reality is that CRNAs and Anesthesiologists work togeather everyday. Amazingly, the propoganda seen here only exists on forums like these. Anesthesiologists and CRNAs goto each others kids birthday parties, social events and enjoy a collegiate atmosphere clearly non-existant here.

The young cocky attitudes displayed here by nurse/physician anesthesia students, non-physicians, residents and the like are a total display of immaturity and simple ignorance of the reality of anesthesia practice.

The truth is that anesthesia needs both Anesthesiologists and CRNAs. It has been that way long enough that the system is totally dependant on both provider groups to function.

Let it go.

 

[DreamMachine]

Word.

CRNAs are awesome to have in residency right now. Without them, we would have to do a lot of boring cases in which we learn little. Instead, residents get assigned to difficult cases that attendings expect us to learn from. They also allow for us to have a lighter call schedule, academic time, and less weekends. Some of them are pretty cute too. I agree, we all end up friends on the job. Especially, when surgeons and the OR staff is pissing you both off, as is many times the case.

 

[jwk]

Ugh

What a sad discussion this has become (and is on a regular basis).

The stark reality is that CRNAs and Anesthesiologists work togeather everyday. Amazingly, the propoganda seen here only exists on forums like these. Anesthesiologists and CRNAs goto each others kids birthday parties, social events and enjoy a collegiate atmosphere clearly non-existant here.

The young cocky attitudes displayed here by nurse/physician anesthesia students, non-physicians, residents and the like are a total display of immaturity and simple ignorance of the reality of anesthesia practice.

The truth is that anesthesia needs both Anesthesiologists and CRNAs. It has been that way long enough that the system is totally dependant on both provider groups to function.

Let it go.

Mike, I agree with much of what you say, but lets remember almost identical discussions occur on the allnurses board as well.

And dreammachine - is that cute girls or cute guys?

 

[jwk]

That statement about Texas is totally misleading. Most of the counties without an anesthesiologist also don't have a nurse. Even the crna site shows it: http://www.txana.org/
Very few counties have only crnas. There are many Texas counties with no anesthesia coverage at all. Why are there so many crnas in Houston and Dallas when about 90 counties don't have any anesthesia? Don't go spreading your nurse propaganda around here.

Gee, I thought I already said that. 😉

Interesting how the map shows counties with both CRNA's and MD's as "sole providers" in the same county.

 

[Mike MacKinnon]

I agree jwk

That board is as guilty.

Mike, I agree with much of what you say, but lets remember almost identical discussions occur on the allnurses board as well.

And dreammachine - is that cute girls or cute guys?

 

[deleted50478]

I agree jwk

That board is as guilty.

I'm all for crna's continuing in their jobs and practicing safe nursing by following a protocol in an OR setting. A united team is the best right? However, srna's like SigmaSRNA should at least look at the information they're quoting before they spread it. Not just swallowing whatever line you hear is good policy in any setting. It's tough when the questionable info is complementary like crna society's (mis)info is to srna's, but try to think critically anyway. 'Lies, damn lies, and statistics' - Benjamin Disraeli

Maybe there should be an anesthesia provider branch of the forum, then all these threads could be moved there. It'd be easier to avoid for people who are sick of it, and this forum could regain the focus that some think it has lost.

 

[Mike MacKinnon]

Ah see Nolagas you ruined it.

You pretend in the post like the ASA isnt just as guilty of questionable tactics both legislative and otherwise, which is simply not true. They are playing the game, which is all it is.

Without skipping a beat, you insult an entire profession by suggesting that CRNAs have to follow protocols in an OR setting. This isnt true and clearly derrogatory. CRNAs practice independantly based on clinical knowledge and education.

Now, this shouldnt be surprising based on your previous posts in this thread alone. However, reviewing your profile it is clear you have only been a resident for 1 year orso. Your perception of real practice and what CRNAs do and how they work in ACT practices (or otherwise) is as mis-informed as you suggested Sigs comment about texas was.

In anycase, this just proves my point. I wont bother to post anymore.

 

[CRNA01]

That sums up why when I am done with residency my billboard will read

"Now hiring AA's to provide anesthesia in the team care model"

I encourage all to help promote AA schools so that we have the chance to employ quality people who want to work in the team care model

I just hope that by the time I am an attending/mba making the choices there are enough AA schools to provide me the personel to staff a hospital with MDAs and AAs.

Go JWK

I can tell you that most research done by CRNAs is done by SRNAs I know this from first hand experience. Such as: Neuroprotective effects of propofol (bench research), Beta-blockers and their role in postoperative pain (clinical research). Bench research on Neuroglobin (if you know what that is) etc. This is just a few from one school. Now, why is there so little research completed by CRNAs? Most research is completed at academic institutions that are run by MDs. In the majority of Mds eyes, CRNAs are a way to work less and bill for supervision. Most want to avoid being in a room at all costs. Come on residents you see it every day, look at your attendings. I do rotations with The residents and see it on a daily basis. Why do MDs feel threatened by CRNAs? well, its not an education issue, it is a pay issue. As CRNAs function more independent, MDs bill less and less. To get paid they have to provide anesthesia. Please keep in mind, I am not talking about all but there is a overwhelming percentage. AAs are great, they do not have the opportunity to function on an independent level and are completely dependent on you as MDAs. This works well for you doesnt it. I dont want to be an anesthesiologist nor do I pretend to be one. I only desire to provide a quality anesthesia service that MDAs do not have the numbers to do alone. The rural areas survive on CRNAs as most MD's high maintenance spouses cant part from the urban environment thus the rural area requires other options. In Missouri, 50% of the counties are served by CRNAs alone! Why? Because the MD doesnt want to. There is room for everyone, feeling threatened by the AANA is rediculous. The PAC funding is so obscenely imbalanced between the ASA and AANA. If you have been around any, you know that in government and polotics, money talks and gets things done. When you consider that the ASA also has support from the AMA it makes them almost untouchable.

One thing to think of: you feel that AAs are the answer? They will fight for their independence one day and their salaries match CRNAs today. AAs still require supervision therefore they will work predominately in the Urban area where you want to work....hmmmm maybe they are actually the threat to your survival and job security. When a group of MDs have the option to hire a new MD for 300,000+ versus 2-3 AAs that they can bill for what do you think they are going to do? It will always come to the bottom dollar. You continue to support them, the day will come when you see how they have taken your jobs using your money and support

Think about it. I am not the enemy. Maybe just maybe the AA is.

David

 

[jwk]

I can tell you that most research done by CRNAs is done by SRNAs I know this from first hand experience. Such as: Neuroprotective effects of propofol (bench research), Beta-blockers and their role in postoperative pain (clinical research). Bench research on Neuroglobin (if you know what that is) etc. This is just a few from one school. Now, why is there so little research completed by CRNAs? Most research is completed at academic institutions that are run by MDs. In the majority of Mds eyes, CRNAs are a way to work less and bill for supervision. Most want to avoid being in a room at all costs. Come on residents you see it every day, look at your attendings. I do rotations with The residents and see it on a daily basis. Why do MDs feel threatened by CRNAs? well, its not an education issue, it is a pay issue. As CRNAs function more independent, MDs bill less and less. To get paid they have to provide anesthesia. Please keep in mind, I am not talking about all but there is a overwhelming percentage. AAs are great, they do not have the opportunity to function on an independent level and are completely dependent on you as MDAs. This works well for you doesnt it. I dont want to be an anesthesiologist nor do I pretend to be one. I only desire to provide a quality anesthesia service that MDAs do not have the numbers to do alone. The rural areas survive on CRNAs as most MD's high maintenance spouses cant part from the urban environment thus the rural area requires other options. In Missouri, 50% of the counties are served by CRNAs alone! Why? Because the MD doesnt want to. There is room for everyone, feeling threatened by the AANA is rediculous. The PAC funding is so obscenely imbalanced between the ASA and AANA. If you have been around any, you know that in government and polotics, money talks and gets things done. When you consider that the ASA also has support from the AMA it makes them almost untouchable.

One thing to think of: you feel that AAs are the answer? They will fight for their independence one day and their salaries match CRNAs today. AAs still require supervision therefore they will work predominately in the Urban area where you want to work....hmmmm maybe they are actually the threat to your survival and job security. When a group of MDs have the option to hire a new MD for 300,000+ versus 2-3 AAs that they can bill for what do you think they are going to do? It will always come to the bottom dollar. You continue to support them, the day will come when you see how they have taken your jobs using your money and support

Think about it. I am not the enemy. Maybe just maybe the AA is.

David

Sorry David, you really don't know what you're talking about with AA's. We have always been and always will be part of the anesthesia care team.

And if you don't think the AANA is a threat to the ASA (and AA's), you're either clueless or lying through your teeth. Is that the best you can do for your first post?

 

[CRNA01]

Sorry David, you really don't know what you're talking about with AA's. We have always been and always will be part of the anesthesia care team.

And if you don't think the AANA is a threat to the ASA (and AA's), you're either clueless or lying through your teeth. Is that the best you can do for your first post?

JWK
I know you from the allnurses forum also. Yes, AAs will always be a part of The MD anesthesia care team, no question. What I am saying is that AAs will be competing for the same jobs as MDs. I am aware of the ratio rules and dont think that MD run groups will not exploit that and hire 2 AAs rather than one MD. Why pay more for the same care? Do you know what a PAC is? Money is huge in the ASA and AMA in comparison with the AANA. Most of the action of the AANA is defensive just trying to protect themselves and their survival. Yes I know that some legislation has passed allowing for OPT-OUT states. This was an absolute necessity to provide care in those anesthesiologist abandoned regions. I have no dreams of complete independence. I desire adequate compensation (not equal), a pleasant work environment with a collegial feel and a respect that goes both ways. I dont know what the future holds for AAs but I believe that with anesthesia and its condition today, there is adequate work for everyone. I would be interested to hear your true view on billing for supervision when you know better than me the lack of supervision that there really is. Tell me that most MDs just want to bill for supervision and not provide it. We know that most of this is supervision is a facade for financial gain.

 

[DreamMachine]

Cute girls.

 

[jwk]

JWK
I know you from the allnurses forum also. Yes, AAs will always be a part of The MD anesthesia care team, no question. What I am saying is that AAs will be competing for the same jobs as MDs. I am aware of the ratio rules and dont think that MD run groups will not exploit that and hire 2 AAs rather than one MD. Why pay more for the same care? Do you know what a PAC is? Money is huge in the ASA and AMA in comparison with the AANA. Most of the action of the AANA is defensive just trying to protect themselves and their survival. Yes I know that some legislation has passed allowing for OPT-OUT states. This was an absolute necessity to provide care in those anesthesiologist abandoned regions. I have no dreams of complete independence. I desire adequate compensation (not equal), a pleasant work environment with a collegial feel and a respect that goes both ways. I dont know what the future holds for AAs but I believe that with anesthesia and its condition today, there is adequate work for everyone. I would be interested to hear your true view on billing for supervision when you know better than me the lack of supervision that there really is. Tell me that most MDs just want to bill for supervision and not provide it. We know that most of this is supervision is a facade for financial gain.

Ah, you must use a different name over there.

Numerous problems with your post. One, AA's aren't competing for MD jobs. We don't post MD positions hoping an AA will come along and fill it.

I understand perfectly how a true anesthesia care team operates, and the concept of medical direction and supervision, within or outside the realm of the TEFRA requirements. My group of over 100 providers (MD, AA, and CRNA) operates strictly within those requirements, and attests in writing to that fact on every single case. We perform more than 38,000 procedures a year, with strict adherence to both the legal and ethical requirements of an anesthesia care team.

Opt-out was not a necessity for anyone. You're fooling yourself. It is simply a way for a nurse to claim they function "independent" of a physician - nothing more, nothing less. In the 35 non-opt-out states, things are as they always were. A physician of some flavor (or dentist or podiatrist) provides "supervision" or "collaboration" or whatever the current PC term is. It's not like surgery was going to stop in the opt-out states if the system hadn't changed. See the other current thread about rural pass-through's and Medicare reimbursement for anesthesiologists. There is a financial dis-incentive for hospitals in rural areas to utilize anesthesiologists.

You're also fooling yourself (or lying to us, not sure which) if you think the AANA doesn't pour TONS of money into it's own PAC. And if you're going to lump the ASA and AMA together, then again, let's be honest about it and lump the AANA and ANA together.

Your claim that the AANA's actions are purely defensive is laughable, but in line with your other naive, uninformed, or misleading comments.

I know, we all just want to get along. But when the AANA stabs the ASA in the back during the ThoughtBridge fiasco, and then seeks to limit funding for anesthesia residencies and block legislation to prevent misrepresentation of healthcare providers to patients, and then try to block legislation dealing with Medicare pass-throughs (and lets not forget blocking AA-enabling legislation in every state possible) your pleas that this is all about your "survival" fall on deaf ears. Defensive my ass - the AANA is offensive as it gets.

 

[deleted50478]

jwk,

 

[johankriek]

Word.

Without them, we would have to do a lot of boring cases in which we learn little. .

please retract this. Please.. You can learn a wealth in every single case doesnt matter what you do. A MAC case has tremendous learning value. You have to find that learning value.. DOnt let other people find it for you. If you do this, you will be running circles around everyone by your ca3 year.

 

[johankriek]

Ugh


The stark reality is that CRNAs and Anesthesiologists work togeather everyday. Amazingly, the propoganda seen here only exists on forums like these. Anesthesiologists and CRNAs goto each others kids birthday parties, social events and enjoy a collegiate atmosphere clearly non-existant here.

The young cocky attitudes displayed here by nurse/physician anesthesia students, non-physicians, residents and the like are a total display of immaturity and simple ignorance of the reality of anesthesia practice.

The truth is that anesthesia needs both Anesthesiologists and CRNAs. It has been that way long enough that the system is totally dependant on both provider groups to function.

Let it go.

I dont work with crnas,, im out here in LA doing independent stuff for a while now. So nice. I worked with crnas for about 6 months.. Did not like it. They were very arrogant, disrespectful and passive aggresive in my opinion. I did not like it at all. its part of their curriculum to think they know it all and phsyicians dont know anything.. thats how they are trained in school So i looked for something where i did not have to do it and I came out here and worked out great. If anyone says you need crnas.. you dont.. Maybe you do becuase of the shortage but clinically you can do it all on your own. Peace out..

right jet?

 

[Mike MacKinnon]

Clearly, your not arrogant or disrespectful eh?

Guess you havent been keeping up on Jets posts.

Let me paste it here for you:

For the record, EVERY institution I've worked at, even during my residency days, I enjoyed a cordial relationship with CRNAs. I think there are political beefs between the ASA and the AANA that need to be continually addressed. But what my young colleagues don't realize here is that in the "real world", where we are out here making a living, its different. Teamwork. Social interaction. The same feelings were present when I emerged from residency in 1996. I've yet to feel threatened.

 

[threepeas]

Here's what I think about this and many other subjects.

You can only do what you can do.....Don't waste your time worrying about what everyone else is doing.

MD/nurse politics have been around forever. If nurses can really do doctors jobs....then why shouldn't they ?.....and if it is really a job that a nurse can do....then why would you want to do it?

Bottomline....be a doctor....be well-trained....don't be what I would say most anesthesiologists are out there right now.....lazy, poorly read, insecure schmucks.

the problem is the system is not designed for nurses to practice medicine independently. some or maybe most can sit on the stools, but can ALL CRNA new grads operate at a level the public expects their clinicians to practice autonomously. maybe anesthesiologists are slightly overtrained for what they have to do day in and day out, and maybe CRNAs are slightly undertrained to earn the autonomy physicians enjoy but that is the system. the most important thing is public awareness and education. the only way to say all CRNAs should practice independently is to do a random controlled trial of new grads from CRNA schools and physicians from doctor residency programs and see what the stats are. present that to the public and let them decide via their congressmen and senators what the standard of care should be.

most peeps are pissed off because of the subversive nature of the AANA.

 

[Monty Python]

........CRNAs are awesome to have in residency right now. Without them, we would have to do a lot of boring cases in which we learn little...........

When you're expecting to encounter bear, and are loaded for bear, things usually go smoothly.

It's when you think you have an "auto-pilot" type of case that unexpected excitement can catch you with your pants down.

All of these events happened to me while doing "boring" cases.

-- during an EGD, the 2nd year surgery resident (without attending in the room) decided to biopsy the "gastric wall" - unbeknownst to him, he was looking at the aorta through a gastric erosion.

-- during a laparoscopic tubal ligation, the initial trocar goes through the full bladder (forgot to void pre-op, forgot the in/out foley) and into the iliac.

-- experienced CV surgeon clamps the aorta on the wrong side of the bypass cannula. Ignores my strongly-worded observations; ignores similar observations from the perfusionist. Never seen an anesthesia circuit fill up with blood like that before.

You'll learn more, and be challenged periodically more strenously, by unanticipated events during a "boring, routine" anesthetic.