Michigan CRNA's set up Go Fund Me page to raise money for lawyers!

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Perrotfish said:
Their odds, of course, depend on the specific legalese of the contract, but my gut judgment here is that the hospital is on the wrong side of both ethics and the law.
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This is one of those fights where I'm just cheering for the lawyers.
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Perrotfish said:
Reading through this, it seems like the crux of the case is severance. Their contract guarantees a hefty severance package if they are fired, and breaking their contracts and forcing them to sign new ones for less money counts as firing them. The hospital, however, inserted a clause that if they are offered a new but 'equivalent' contract, and refuse to sign it, that doesn't count as firing them.

The hospital is arguing that since the base pay for their 40 hour week is the same under the new contract, this new contract is equivalent. The CRNAs are arguing, much more reasonably, that since the actual pay per CRNA under this contract will be reduced by up to 40% per employee, the contract is clearly not equivalent and that if they are terminated for not signing the contract they are owed severance.

Their odds, of course, depend on the specific legalese of the contract, but my gut judgment here is that the hospital is on the wrong side of both ethics and the law.
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Interesting. My understanding was that they were abusing the overtime system and that is why the hospital outsourced them. But if the severance deal like you say is the issue, then that changes things some. The hospital of course can do what it wants. And can be sued for it afterward. But I bet they feel like they are gonna win this one and aren't budging.

But we shall see in less than two weeks what happens.
 
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chocomorsel said:
Interesting. My understanding was that they were abusing the overtime system and that is why the hospital outsourced them. But if the severance deal like you say is the issue, then that changes things some. The hospital of course can do what it wants. And can be sued for it afterward. But I bet they feel like they are gonna win this one and aren't budging.

But we shall see in less than two weeks what happens.
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They always win....even if these CRNAs win this battle(not likely) they will lose the war. If Lago can't get this done, they will just call American, Northstar, or Sheridan and have it done next contract cycle. And if the compensation is truly $170,000 for 40 hours they won't get any better with one of those 3, and I can pretty much promise the contract terms will be just as oppressive.
 
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Man o War said:
They always win....even if these CRNAs win this battle(not likely) they will lose the war. If Lago can't get this done, they will just call American, Northstar, or Sheridan and have it done next contract cycle. And if the compensation is truly $170,000 for 40 hours they won't get any better with one of those 3, and I can pretty much promise the contract terms will be just as oppressive.
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I was thinking the same thing.
If they can't do it this round, they'll be out next year.
They probably screwed themselves with their nursing employment contract not thinking they would have to let them go.
Having said that, it seems like they're really taking advantage of their situation with overtime, etc. Our CRNAs get zero overtime. We properly staff, actively manage the ORs, and we will sit ourselves before we give them overtime.
Many bad things would have to be happening simultaneously to have us keep one of them late.
 
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Perrotfish said:
Reading through this, it seems like the crux of the case is severance. Their contract guarantees a hefty severance package if they are fired, and breaking their contracts and forcing them to sign new ones for less money counts as firing them. The hospital, however, inserted a clause that if they are offered a new but 'equivalent' contract, and refuse to sign it, that doesn't count as firing them.

The hospital is arguing that since the base pay for their 40 hour week is the same under the new contract, this new contract is equivalent. The CRNAs are arguing, much more reasonably, that since the actual pay per CRNA under this contract will be reduced by up to 40% per employee, the contract is clearly not equivalent and that if they are terminated for not signing the contract they are owed severance.

Their odds, of course, depend on the specific legalese of the contract, but my gut judgment here is that the hospital is on the wrong side of both ethics and the law.
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...forcing them to sign new ones for less money counts as firing them... It does? They've been given adequate notice. Michigan is an employment-at-will state. Unless the hospital is violating a contract, which I doubt they are (and that would be the only grounds for a lawsuit), they're well within their rights. OT is OT and base salary is base salary. OT is not guaranteed.

Now - the new employer may find it very difficult to staff the OR's come January 1 - but I doubt they came into this blind.

Welcome to the NEW real world in anesthesia.
 
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jwk said:
...forcing them to sign new ones for less money counts as firing them... It does? They've been given adequate notice. Michigan is an employment-at-will state. Unless the hospital is violating a contract, which I doubt they are (and that would be the only grounds for a lawsuit),.
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The nurses are, in fact, saying that the hospital is violating a contract. The contract says that nurses can be forced to accept 'equivalent' employment if the hospital wishes to restructure its management, but they cannot be forced to accept reduced pay without being offered severance as an alternative. The hospital says that because the base pay of the new contract is the same its equivalent. The nurses say that a complete change in benefits and OT pay that results in a practical pay cut of 40% is not equivalent, regardless of the base pay. No one is arguing the hospital has a right to fire them, but they are arguing (reasonably) that they are not 'quitting' by refusing to sign this contract and that if the hospital terminates them they have no right to withhold their severance.

It seems like a flimsy legal pretext on the hospital's part, and it feels like the hospital was assuming they wouldn't put up enough of a legal fight to challenge what was, actually, a breach of contract. We will see if they cave, or if this goes to court.
 
The free-market will ultimately settle this issue. If these CRNA's are in fact grossly overpaid, the hospital will have no problem eventually replacing them with cheaper providers. My impression is that the hospital got a slick sales presentation by PSJ and didn't put much thought into signing the bottom line. I also believe the hospital lawyers put some kind of "out" clause in the contract to deal with the possibility of PSJ not being able to provide adequate coverage.

I don't know all the details, but it strikes me as ballsy how a small group like PSJ could come in and dictate the terms like they have to these 68 CRNA's. If this was a huge AMC taking over a little "St. Elsewhere", they could move providers around the country and/or pay a locums ransom and swallow a loss for a year or two before reaching the ROI. Not the case here: the 68 CRNA's have all the leverage and they know it. The market is actually quite good for CRNA's despite the new grads because of all the retirements of the aging CRNA's.

I think the right compensation is probably somewhere between what the CRNA's are making now and what PSJ is proposing. I'm pulling for the CRNA's because a higher salary for them means a higher salary for me.
 
Perrotfish said:
The nurses are, in fact, saying that the hospital is violating a contract. The contract says that nurses can be forced to accept 'equivalent' employment if the hospital wishes to restructure its management, but they cannot be forced to accept reduced pay without being offered severance as an alternative. The hospital says that because the base pay of the new contract is the same its equivalent. The nurses say that a complete change in benefits and OT pay that results in a practical pay cut of 40% is not equivalent, regardless of the base pay. No one is arguing the hospital has a right to fire them, but they are arguing (reasonably) that they are not 'quitting' by refusing to sign this contract and that if the hospital terminates them they have no right to withhold their severance.

It seems like a flimsy legal pretext on the hospital's part, and it feels like the hospital was assuming they wouldn't put up enough of a legal fight to challenge what was, actually, a breach of contract. We will see if they cave, or if this goes to court.
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Again - base salary is base salary and OT is OT. It's one thing to say "we will pay you X dollars per hr of OT. It's quite another to say "we will guarantee you X number of hours of OT". The first might be in their contract - I assure you the second one is not. My group pays OT as well - a lot of it - but not a minute of it is guaranteed. That may be the message this new employer is trying to put forward - they control the schedule, including the OT. I doubt they're stupid enough to just send people home when they hit the 8hr mark and leave cases undone. But what they're saying, as an employer has every right to do, is that they will control the schedule. Reading several of these nurses posts, it seems like they had very lax controls on attendance and OT - they even rant about not being able to "self-schedule". Again, welcome to the real world. You don't get to just show up when you feel like it and leave whenever you want.
 
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gaspasser2004 said:
The free-market will ultimately settle this issue. If these CRNA's are in fact grossly overpaid, the hospital will have no problem eventually replacing them with cheaper providers. My impression is that the hospital got a slick sales presentation by PSJ and didn't put much thought into signing the bottom line. I also believe the hospital lawyers put some kind of "out" clause in the contract to deal with the possibility of PSJ not being able to provide adequate coverage.

I don't know all the details, but it strikes me as ballsy how a small group like PSJ could come in and dictate the terms like they have to these 68 CRNA's. If this was a huge AMC taking over a little "St. Elsewhere", they could move providers around the country and/or pay a locums ransom and swallow a loss for a year or two before reaching the ROI. Not the case here: the 68 CRNA's have all the leverage and they know it. The market is actually quite good for CRNA's despite the new grads because of all the retirements of the aging CRNA's.

I think the right compensation is probably somewhere between what the CRNA's are making now and what PSJ is proposing. I'm pulling for the CRNA's because a higher salary for them means a higher salary for me.
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How does a higher salary for them mean a higher one for you?
 
chocomorsel said:
How does a higher salary for them mean a higher one for you?
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Like it or not, but anesthesia has become a commodity. If the CRNA's in Michigan are willing to roll over and swallow a 33% pay cut, what's stopping hospitals/employers from expecting the same from MD's?
 
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gaspasser2004 said:
Like it or not, but anesthesia has become a commodity. If the CRNA's in Michigan are willing to roll over and swallow a 33% pay cut, what's stopping hospitals/employers from expecting the same from MD's?
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Almost everything has become a commodity. Honestly, surgery is becoming a commodity the way the general public views things. Maybe LESS so, but still being commoditized, like many many things in our economy. It doesn't mean total doom and gloom, but I agree it's better not to be commoditized.... We're not alone though...
 
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MomDoctor4 said:
YES!!! I wanted to be a CRNA up until maybe 6 months ago. Nope, not anymore. I never wanted to be a nurse anyway so it works out. I recently started looking into being an AA. That schooling is WAY more intense than that of a CRNA program. I am sorry, but it is. Plus, I have to have a strong science degree and take the MCAT. Why don't they get paid the same? I am also looking into a D.O. program as well, but due to time restrictions, the AA route seems more feasible.
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No offense, but I think you're both misinformed, and uninformed. Please reference these vast differences in education between a CRNA and an AA.
And many, if not all, places pay similar among each CRNA and AA. And since scope of practice is broader as a CRNA, it is not uncommon for CRNAs to be a little higher.
 
deansrv72 said:
No offense, but I think you're both misinformed, and uninformed. Please reference these vast differences in education between a CRNA and an AA.
And many, if not all, places pay similar among each CRNA and AA. And since scope of practice is broader as a CRNA, it is not uncommon for CRNAs to be a little higher.
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Why is the scope of practice broader as a CRNA, especially in an ACT model?
 
nycitygas said:
I love the pro-CRNA comments on that article. PSJ and the hospital must have some arrangement with a CRNA staffing company for the transition.
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Most definitely. They had things lined up BEFORE they even broached the subject. These guys are savvy; they're not just gonna cross their fingers and hope for the best.
 
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Consigliere said:
Most definitely. They had things lined up BEFORE they even broached the subject. These guys are savvy; they're not just gonna cross their fingers and hope for the best.
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I have learned never to underestimate the stupidity of administrators. I would bet that there are administrative as well as CRNA jobs on the line this weekend.
 
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Man o War said:
Very interesting the they only made second offers to 37 of the CRNAs.
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Whatever the outcome, they'll probably want to take advantage of an opportunity to cut away the problem people (low performers and/or ones who are difficult to work with).

It's hard to outright fire people who are basically competent but kinda suck, or are merely unpleasant to work with. Easier to simply not hire them again after a contract change.
 
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The Pro-CRNA, Anti-Anesthesiologist talk in the comments on that article are toxic.

Someone mentioned that CMS was going to be cutting midlevel (non-physician) payments?

Thoughts on this?
 
FFP said:
Why is the scope of practice broader as a CRNA, especially in an ACT model?
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Within an ACT model, that would be an incorrect statement. The scope of practice is the same. There is nothing in law giving CRNA's a wider scope of practice than AA's. As with many things, "all healthcare is local", and scope of practice and privileges, in the end, are determined at the hospital level, just as they are with physicians.
 
pgg said:
Whatever the outcome, they'll probably want to take advantage of an opportunity to cut away the problem people (low performers and/or ones who are difficult to work with).

It's hard to outright fire people who are basically competent but kinda suck, or are merely unpleasant to work with. Easier to simply not hire them again after a contract change.
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This is EXACTLY what we have done when we take over services at another hospital. Administration lets us know who the ass_hats are and they are not offered a contract.
 
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codeb1ue said:
http://www.wxyz.com/news/region/oak...t-john-providence-instead-of-being-outsourced

I can't believe the level of support they are receiving for this. Can you imagine the public outcry if physicians abandoned patients and walked off over a labor dispute.
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I think you're right about public reaction to two different situations

but walking is the only real "trump card" the CRNAs have....good for them for having guts, even if it doesn't/shouldnt' work. (I have no idea if the new contract is fair). But that's how contracts get decided. Both sides push for stuff and if one pushes too hard the only way to force the issue is to walk. It's the true determinant of value. How much will you pay me to not walk out that door. If the hospital's # isn't enough in their mind, they walk and don't owe anyone an apology. If the CRNAs are wrong about their value, they'll make less than they demand when they finally find a new job somewhere else. If the hospital is wrong, the CRNAs will find a bunch of amazing contracts to walk into at other locations. It sounds like the CRNAs just had the gravy train end and that's why they are stomping their feet.

The most true thing people are saying though is the "leaders" will never get to put ink on that new contract though....they will be blacklisted
 
http://www.wxyz.com/news/region/oak...t-john-providence-instead-of-being-outsourced

Reading the comments in this latest article, it makes me kind of sick that my fellow anesthesiologists took the time and exercised the necessary patience to train these CRNAs that now have this level of disrespect for our profession....and, these comments are linked through Facebook so they have absolutely zero shame spewing this stuff online in a public forum with their names attached. Crazy. So many of them so quickly forget where they came from.
 
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jwk said:
Within an ACT model, that would be an incorrect statement. The scope of practice is the same. There is nothing in law giving CRNA's a wider scope of practice than AA's. As with many things, "all healthcare is local", and scope of practice and privileges, in the end, are determined at the hospital level, just as they are with physicians.
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I didn't specify ACT environment. CRNAs do not need to be medially directed. Anywhere. And the fact that CRNAs can practice in any setting in any state performing any procedure is definition enough to say scope is broader. I'm not trying to argue or anything, just saying.
 
Just because somebody has a broad legal scope of practice it does not mean that the person is competent to practice that broadly. For example, my license is of a physician-surgeon, but I would never imagine myself performing surgery alone. True professionals know the limits of their competency.

CRNAs may be allowed to practice independently in most states, but the fact that they actually don't speaks volumes about how competent they are. Which is probably about the same as AAs, since they do the same jobs.

Most independent CRNAs are in rural settings, and that's not the result of free market competition with anesthesiologists, or AAs, but of a political arrangement where Medicare subsidizes only CRNA salaries. And we all know how good outcomes are for those hospitals, if anybody ever bothers to measure them.

I have zero problems with a free market where we let all midlevels go loose, no supervision, no help, no safety net, medical ethics be damned. That would only make us better physicians, and also show patients who the truly competent people are. I am fed up with not being able to tell my patients how the wonderful CRNA ****ed up their care, just because my name is on the same chart, or we have the same employer who wouldn't appreciate the liability risk.

Militant nurses of all kinds need to remember that the reason physicians don't do their job is not because we couldn't, but because there are many better uses of our time. In many countries, medical students are allowed to moonlight on wards as nurses. And advanced practice nursing education is not the same as medical education, when comparing depth, breadth, intensity or responsibility. When the **** hits the fan, they all call for a physician, at least to serve as an escape goat.
 
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sb247 said:
I think you're right about public reaction to two different situations

but walking is the only real "trump card" the CRNAs have....good for them for having guts, even if it doesn't/shouldnt' work. (I have no idea if the new contract is fair). But that's how contracts get decided. Both sides push for stuff and if one pushes too hard the only way to force the issue is to walk. It's the true determinant of value. How much will you pay me to not walk out that door. If the hospital's # isn't enough in their mind, they walk and don't owe anyone an apology. If the CRNAs are wrong about their value, they'll make less than they demand when they finally find a new job somewhere else. If the hospital is wrong, the CRNAs will find a bunch of amazing contracts to walk into at other locations. It sounds like the CRNAs just had the gravy train end and that's why they are stomping their feet.

The most true thing people are saying though is the "leaders" will never get to put ink on that new contract though....they will be blacklisted
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I wouldn't hire any of them if I had other even remotely viable alternatives. Now more than ever it's vital that anesthesia groups mind public relations Ps and Qs. Between the go fund me account, social media posts, and media interviews they are giving, this is a s@@t show. My 91
Year old grandma who lives in Michigan called to ask me about this. Anesthesia communities there are small....career suicide and extremely short sighted if these folks want to stay in the metro area. The hospital will get rid of them after this fiasco at their earliest opportunity if they somehow get to come back this time.
 
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I suspect that the admin is inking a contract with one or more of the big AMCs for 6 months worth of temp CRNA coverage right now. Then the 68 will all be begging to sign any contract. They can lose money upfront and make it back later. The AMCs do that for breakfast. As long as the hospital isn't bankrupt, they can do it.
 
IlDestriero said:
I suspect that the admin is inking a contract with one or more of the big AMCs for 6 months worth of temp CRNA coverage right now. Then the 68 will all be begging to sign any contract. They can lose money upfront and make it back later. The AMCs do that for breakfast. As long as the hospital isn't bankrupt, they can do it.
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I agree with you and manowar.....making the fight public is going to cost them any chance of staying at that hospital. Threat of leaving might have worked, embarassin the company will cause the hospital/group to retaliate in kind
 
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deansrv72 said:
I didn't specify ACT environment. CRNAs do not need to be medially directed. Anywhere. And the fact that CRNAs can practice in any setting in any state performing any procedure is definition enough to say scope is broader. I'm not trying to argue or anything, just saying.
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AAs can't take call without an anesthesiologist also coming in with them, which is probably the biggest difference overall. That alone is a huge reason to bring CRNAs onboard before AAs in non-supervision states.
 
All I can say is that I am glad that I currently don't supervise. I swear, those CRNA schools must be teaching them to come out hating on doctors. All they want to keep spewing about is that they are just as good and more cost effective than doctors.
But the truth is, they are neither. And it seems like we are all in the lounge looking up our stocks while they do all the work. Where is all this coming from? Sure there are some of us that are lazy, just like there are lazy nurses. Sure there are some of older anesthesiologists who supervised 6 nurses or more in the old days and just signed charts, followed the stock market game and made money. But for the majority of us, either in ACT model or in Physician only model, we are busting our tail supervising up to four rooms, managing pre-op, post op, ER, OB, doing blocks and have minimal time to look at our stock portfolios. I know when I supervised, on most days I ran around like a chicken with my head cut off. On slow days, I would spend most of my free time in PACU making sure I was available for any post operative complications since many of the cases we did were routine.

I don't get the hatred. How are 3 to 4 times cheaper if they get paid overtime? I don't think most of us are running around here making 600-800K like these nurses keep reporting. THAT would be 3-4 times cheaper. Sure there are a minority who make that, but I bet it isn't on a 40 hour week. What's the average amount of hours that anesthesiologists work? 50-55 hours? Hourly pay in some places is pretty comparable.

I will say that I don't go into a new job of being hateful and holding a chip on my shoulder when it comes to nurses, because there are some good, competent ones out there. I suspect most of us go in this way. But it seems that the majority of CRNA's are on some bull about the equality, and us making money off them, and we being overpaid.

I really think there must be a class in their school that teaches them this. Why are so many of them so hateful? I have a couple of CRNA friends that I need to ask.

I do have to add, that I have met lots of pompous, arrogant docs who are quite rude and demeaning to the OR staff, and nurses so could those jerks be turning CRNAs against us? I think there is more to it than that quite frankly. I have also met a few pompous jerk CRNAs who put us docs off too in my short career and am glad I don't have to deal with them now.

Since most of us have to work together, why can't we just learn to develop a healthy mutual respect for each other? While understanding our roles in the ACT model. And leave independent practice alone? Hell, encourage pompous-know-it-all-don't-need-overpaid-docs covering-me to go work somewhere else independently so that you are left with the ones who truly want to work in an ACT model. All this whining on the board about how many of these nurses are incompetent? Why keep trying to be responsible for them? Let the American people have the "low cost alternative" they seem to want!!!! You know, the ones that care!!
 
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chocomorsel said:
All I can say is that I am glad that I currently don't supervise. I swear, those CRNA schools must be teaching them to come out hating on doctors. All they want to keep spewing about is that they are just as good and more cost effective than doctors.
But the truth is, they are neither. And it seems like we are all in the lounge looking up our stocks while they do all the work. Where is all this coming from? Sure there are some of us that are lazy, just like there are lazy nurses. Sure there are some of older anesthesiologists who supervised 6 nurses or more in the old days and just signed charts, followed the stock market game and made money. But for the majority of us, either in ACT model or in Physician only model, we are busting our tail supervising up to four rooms, managing pre-op, post op, ER, OB, doing blocks and have minimal time to look at our stock portfolios. I know when I supervised, on most days I ran around like a chicken with my head cut off. On slow days, I would spend most of my free time in PACU making sure I was available for any post operative complications since many of the cases we did were routine.

I don't get the hatred. How are 3 to 4 times cheaper if they get paid overtime? I don't think most of us are running around here making 600-800K like these nurses keep reporting. THAT would be 3-4 times cheaper. Sure there are a minority who make that, but I bet it isn't on a 40 hour week. What's the average amount of hours that anesthesiologists work? 50-55 hours? Hourly pay in some places is pretty comparable.

I will say that I don't go into a new job of being hateful and holding a chip on my shoulder when it comes to nurses, because there are some good, competent ones out there. I suspect most of us go in this way. But it seems that the majority of CRNA's are on some bull about the equality, and us making money off them, and we being overpaid.

I really think there must be a class in their school that teaches them this. Why are so many of them so hateful? I have a couple of CRNA friends that I need to ask.

I do have to add, that I have met lots of pompous, arrogant docs who are quite rude and demeaning to the OR staff, and nurses so could those jerks be turning CRNAs against us? I think there is more to it than that quite frankly. I have also met a few pompous jerk CRNAs who put us docs off too in my short career and am glad I don't have to deal with them now.

Since most of us have to work together, why can't we just learn to develop a healthy mutual respect for each other? While understanding our roles in the ACT model. And leave independent practice alone? Hell, encourage pompous-know-it-all-don't-need-overpaid-docs covering-me to go work somewhere else independently so that you are left with the ones who truly want to work in an ACT model. All this whining on the board about how many of these nurses are incompetent? Why keep trying to be responsible for them? Let the American people have the "low cost alternative" they seem to want!!!! You know, the ones that care!!
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I get really fired up about the independent practice thing because I can't even count the number of patients that would be seriously injured or dead today had a CRNA had no back up from an anesthesiologist. I know it for a fact despite what their "studies" show.
 
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chocomorsel said:
All I can say is that I am glad that I currently don't supervise. I swear, those CRNA schools must be teaching them to come out hating on doctors. All they want to keep spewing about is that they are just as good and more cost effective than doctors.
But the truth is, they are neither. And it seems like we are all in the lounge looking up our stocks while they do all the work. Where is all this coming from? Sure there are some of us that are lazy, just like there are lazy nurses. Sure there are some of older anesthesiologists who supervised 6 nurses or more in the old days and just signed charts, followed the stock market game and made money. But for the majority of us, either in ACT model or in Physician only model, we are busting our tail supervising up to four rooms, managing pre-op, post op, ER, OB, doing blocks and have minimal time to look at our stock portfolios. I know when I supervised, on most days I ran around like a chicken with my head cut off. On slow days, I would spend most of my free time in PACU making sure I was available for any post operative complications since many of the cases we did were routine.

I don't get the hatred. How are 3 to 4 times cheaper if they get paid overtime? I don't think most of us are running around here making 600-800K like these nurses keep reporting. THAT would be 3-4 times cheaper. Sure there are a minority who make that, but I bet it isn't on a 40 hour week. What's the average amount of hours that anesthesiologists work? 50-55 hours? Hourly pay in some places is pretty comparable.

I will say that I don't go into a new job of being hateful and holding a chip on my shoulder when it comes to nurses, because there are some good, competent ones out there. I suspect most of us go in this way. But it seems that the majority of CRNA's are on some bull about the equality, and us making money off them, and we being overpaid.

I really think there must be a class in their school that teaches them this. Why are so many of them so hateful? I have a couple of CRNA friends that I need to ask.

I do have to add, that I have met lots of pompous, arrogant docs who are quite rude and demeaning to the OR staff, and nurses so could those jerks be turning CRNAs against us? I think there is more to it than that quite frankly. I have also met a few pompous jerk CRNAs who put us docs off too in my short career and am glad I don't have to deal with them now.

Since most of us have to work together, why can't we just learn to develop a healthy mutual respect for each other? While understanding our roles in the ACT model. And leave independent practice alone? Hell, encourage pompous-know-it-all-don't-need-overpaid-docs covering-me to go work somewhere else independently so that you are left with the ones who truly want to work in an ACT model. All this whining on the board about how many of these nurses are incompetent? Why keep trying to be responsible for them? Let the American people have the "low cost alternative" they seem to want!!!! You know, the ones that care!!
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I think you are right on all counts. The only thing I have to add is that part of the problem is that the top 1% of CRNAs, the ones who practice independently, do everything from CVLs to PNBs, keep up with the literature, could have gotten to medical school but didn't for whatever reason; they think that all the CRNAs are like them. They are either intentionally or unintentionally ignorant of the fact that a significant number of their colleagues are blatantly incapable or uninterested in working independently.

Also, he coffee/stock market shtick gets old fast. Like you said, I don't doubt that those types did and do exist, but it's markedly less than the CRNA lobby wants you to believe. Plus, for every lazy anesthesiologist story we could all come up with an equal if not greater number of "checking Facebook/shopping on Amazon while the BP is in the toilet and I was lucky I just happened to Epic-stalk the case in between checking my other rooms and seeing pre-ops/post-ops" CRNA stories.

The problem is there are more of them than there are of us so they have more voices and are therefore louder. I would say the way to counter that is with information, but we know the American people don't want information, they want PR and shtick.
 
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Man o War said:
I get really fired up about the independent practice thing because I can't even count the number of patients that would be seriously injured or dead today had a CRNA had no back up from me or one of my partners. I know it for a fact despite what their "studies" show.
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However true this maybe, and I have been there myself, if we let them go practice independently, then their incompetence will sort itself out. Sadly to the detriment of some the public, but I am saying that I am at a point where I don't really care anymore. I don't want to be in charge of incompetent, arrogant people. Why does any one?

Maybe it sounds selfish, but for my family and friends I will of course encourage physician care or ACT care and hope they call in a physician before it is too late in case a complication arises. Because we all know this happens.

The public mostly just wants cheap care, not quality care, and since they identify with nurses, (more blue collar/working class) they stand by them way more than they stand by us overpaid, arrogant rich doctors. The AANA propaganda is way more reaching to the masses than the ASA. And some of that is our fault. Face it, we are way more individualistic than nurses are.

You know how many times I have been asked, "You need to be a doctor to do this job?" I hope never to have to supervise again, and if I do, I hope to work with competent, teachable, respectful CRNAs. They are out there. I know of three mysel. (Actually the third one is a combination of not-so-competent, but teachable and respectful and the last one is a competent but sometimes arrogant one) LOL.
 
sb247 said:
Is that a reflection of skill and legislation or just legislation? (Are the AAs as good?)
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At my previous job we could not have the AAs up on OB due to medical direction vs supervision. We checked into it and that is what the conclusion was....I wish we could've, our dedicated OB CRNAs were a pain in the butt in many ways. In my opinion AA=CRNA competency wise. There is no difference based on what I saw. My sample size was less than 10, so not a great representation probably, but the surgeons were happy with them and so were we.
 
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DrLight said:
Over $12 000 in donations to help pay for a lawyer to sue an Anesthesia company...wow and I thought Go Fund Me was to raise money for real causes....
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Meh...typical nursing trash, infecting this once great profession. Let them argue over 30-50k of pay.
 
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Man o War said:
http://www.wxyz.com/news/region/oak...t-john-providence-instead-of-being-outsourced

Reading the comments in this latest article, it makes me kind of sick that my fellow anesthesiologists took the time and exercised the necessary patience to train these CRNAs that now have this level of disrespect for our profession....and, these comments are linked through Facebook so they have absolutely zero shame spewing this stuff online in a public forum with their names attached. Crazy. So many of them so quickly forget where they came from.
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Really i don't get it, Most nurses I know hate doctors and the OPENLY do so, but at our school they are constantly telling us " love the nurses they are your best friends." I'm only a med student, but seems everybody wants the MDs head on a platter, and for some of them we constantly bend over backwards.
 
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I wouldn't be gloating too much. Those docs who are employed by hospitals, AMCs, or non partnership employees in private practices will be looking at being being squeezed as well.
 
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