Medical Students Considering Anesthesia

[ecCA1]

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The AANA has won the battle of perception.

CRNAs are climbing the ranks of the academic elites. With a PhD in "nursing studies" they are now being addressed as "doctor" in front of patients and during grand rounds meetings.

AANA advertises themselves as equal to MD/DO anesthesiologists in training.

The advertising campaign is working: the public increasingly considers attending anesthesiologists and CRNAs equivalent in skill and reliability.

In short, this field is currently in "pre-code" status.

Assuming you are in your final year of medical school, by the time you finish your residency (and fellowship, if you are wise), we'll have many thousands more CRNA/DNP title holders vying for YOUR job.

Chairs of big programs that make $$$ from training nurses (who go home at 3 PM while you take over their rooms) will continue to sell the profession out for their own gain. Rather than training more anesthesiologists, they will produce more nurse anesthetists.

The money will continue to diminish, but the responsibilities, patient co-morbidities, malpractice lawsuit threats, etc. will only increase as time goes by.

Sound bleak? Wish it wasn't, but it's true.

A few of the older docs who have self-respect won't work with CRNAs.

But most do, and they love to as they can just "sign the chart and occupy the couch."

Day after day that is what most "teaching attendings" do in this field.

We've been sold out by those who run the profession: more requirements to "distinguish ourselves from CRNAs."

Masterminds: they created a dilemma and then used it to generate huge amounts of money for themselves in its "solution."

But the solution is only temporary, as CRNAs are now getting doctorates and are also "doctors."

Don't get me wrong: I cannot see myself in any other field, but that's just me.

Maybe you're not so hard-headed.

Or you don't want to be pissed on a regular basis as you see nurses openly stating their "equality of training."

It's unlike anything else in medicine. Even the family docs (who make less than CRNAs) don't have this much trouble with NPs impersonating them.

Forgive the caps, but emphasis is needed here:

YOU MUST WANT TO BE AN ANESTHESIOLOGIST MORE THAN ANYTHING ELSE IN MEDICINE TO JUSTIFY ENTERING THIS FIELD.

 

[D P356]

The AANA has won the battle of perception.

CRNAs are climbing the ranks of the academic elites. With a PhD in "nursing studies" they are now being addressed as "doctor" in front of patients and during grand rounds meetings.

AANA advertises themselves as equal to MD/DO anesthesiologists in training.

The advertising campaign is working: the public increasingly considers attending anesthesiologists and CRNAs equivalent in skill and reliability.

In short, this field is currently in "pre-code" status.

Assuming you are in your final year of medical school, by the time you finish your residency (and fellowship, if you are wise), we'll have many thousands more CRNA/DNP title holders vying for YOUR job.

Chairs of big programs that make $$$ from training nurses (who go home at 3 PM while you take over their rooms) will continue to sell the profession out for their own gain. Rather than training more anesthesiologists, they will produce more nurse anesthetists.

The money will continue to diminish, but the responsibilities, patient co-morbidities, malpractice lawsuit threats, etc. will only increase as time goes by.

Sound bleak? Wish it wasn't, but it's true.

I trained at a big program. Did a fellowship at a big program. Work at a medium-sized place that pumps loads of CRNAs into the mix.

A few of the older docs who have self-respect won't work with CRNAs.

But most do, and they love to as they can just "sign the chart and occupy the couch."

Day after day that is what most "teaching attendings" do in this field.

We've been sold out by those who run the profession: more requirements to "distinguish ourselves from CRNAs."

Masterminds: they created a dilemma and then used it to generate huge amounts of money for themselves in its "solution."

But the solution is only temporary, as CRNAs are now getting doctorates and are also "doctors."

Don't get me wrong: I cannot see myself in any other field, but that's just me.

Maybe you're not so hard-headed.

Or you don't want to be pissed on a regular basis as you see nurses openly stating their "equality of training."

It's unlike anything else in medicine. Even the family docs (who make less than CRNAs) don't have this much trouble with NPs impersonating them.

Forgive the caps, but emphasis is needed here:

YOU MUST WANT TO BE AN ANESTHESIOLOGIST MORE THAN ANYTHING ELSE IN MEDICINE TO JUSTIFY ENTERING THIS FIELD.

I enjoyed reading the thread about anesthesia being paged to the ER. UTSouthwestern told about how he treated a pt who had a large object fall on his neck. When anesthesia was paged, I'm guessing a physician went to the ER, and I think there is a reason for that.

I'm just a student, and I couldn't even imagine the stress with that situation. But my hat is off to you folks who deal with these things quasi routinely.

If you have to compare yourself to the boss, you're not the boss. I can shoot a basketball well around the key; I'm just as good as Shaq (at least at free throws), OR NOT.

 

[topscorer]

was wondering if anybody could comment on this. does a money/salary pov matter at all if the cuts are across the entire medical spectrum? (meaning all fields more or less)

as for the last several years in my limited experience, all fields continuously stress how within a few years there salaries will be gone

but something always comes up, some new niche, or new way to make money to mantain previous salaries.

how much do you think ansth salary could possibly fall

and in any case, even if it falls, as far as comparing to other medical fields, wont they all be falling, and thus ansth still be same ranking relatively. so doesnt it all balance out anyway

 

[yappy]

Good question. Bump.

I wonder too - about compensating going down. What if they were dropped and most physicians simply refused to take medicare/caid? For example, a dentist friend I know only takes select insurances and none of the others that he doesnt feel pays him correctly. Why would physicians not be able to do this?

was wondering if anybody could comment on this. does a money/salary pov matter at all if the cuts are across the entire medical spectrum? (meaning all fields more or less)

as for the last several years in my limited experience, all fields continuously stress how within a few years there salaries will be gone

but something always comes up, some new niche, or new way to make money to mantain previous salaries.

how much do you think ansth salary could possibly fall

and in any case, even if it falls, as far as comparing to other medical fields, wont they all be falling, and thus ansth still be same ranking relatively. so doesnt it all balance out anyway

 

[copes]

This bad?

 

[medigull]

Bump


I would love anesthesia but am concerned about the CRNA issue. I recently looked and found out that Iowa was the first state to opt out in 2001. I then looked at gaswork and saw that there are plenty of MD anesthesiologist jobs there at competitive reimbursement, AND the openings outnumbered the amount of CRNA openings. This should imply that the tide has subsided no? If they were really going to take over the profession then the first state that would fall would be Iowa but it appears that all is well.

ETA: I have no intention to practice in Iowa but I figured it would be the best representation of the future for this issue

 

[saratoga733]

Bump


I would love anesthesia but am concerned about the CRNA issue. I recently looked and found out that Iowa was the first state to opt out in 2001. I then looked at gaswork and saw that there are plenty of MD anesthesiologist jobs there at competitive reimbursement, AND the openings outnumbered the amount of CRNA openings. This should imply that the tide has subsided no? If they were really going to take over the profession then the first state that would fall would be Iowa but it appears that all is well.

ETA: I have no intention to practice in Iowa but I figured it would be the best representation of the future for this issue

I had the same concerns a few years back when I started residency. Now that I am 3+ years out I don't regret my decision one bit. Reasonable lifestyle while commanding a nice salary (comparative to MOST other specialties). I earn MULTIPLES more than my Internist school buddies. CRNAs are around because there are simply not enough Anesthesiologists to cover all the surgical cases in this country. With the population getting older, ASCs/Endoscopy centers popping up all over, the need for Anesthesiologists will always be there. As a whole, we are more intelligent, better trained, and will always be THE "provider." When given a choice, the overwhelming majority of patients/surgeons prefer a MD over a nurse. Although I don't work in an opt out state, I am actively doing my small part to address the problem: I support my local PAC, refuse to teach CRNAs, lobby against hiring nurses in my group, and stay abreast of any new legislation that may effect scope of practice.