Montana CRNA article

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"Most CRNAs hold a doctorate", said Joseph Rodriguez, spokesperson for American Association of Nurse Anesthesiologists (AANA).

“It is immoral to hold professionals back from providing excellent patient care."

Morality ceases to become an issue when it comes to lying, I guess....
 
drmwvr said:
"Most CRNAs hold a doctorate", said Joseph Rodriguez, spokesperson for American Association of Nurse Anesthesiologists (AANA).

“It is immoral to hold professionals back from providing excellent patient care."

Morality ceases to become an issue when it comes to lying, I guess....
Click to expand...
What is Nurse Rodriguez's opinion of the morality of holding back AA's? Just sayin...
 
...the moral high ground ain't so high.....
 
ASA should have a rebuttal: Only md/do doctorates mean something in healthcare.
Not your sham online book report phd. Not the chiropractor’s. Not the functional medicine colon cleanser’s. Not np dnp wtf dna lmao’s. Everyone and their mother has one of your sham doctorates nurse Rodriguez. Sorry you paid for your participation trophy.
 
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From the perspective of MD/DOs, CRNA only care in many situations is substandard care. So, it would be immoral, (from the perspective of MD/DOs) to allow patients to receive substandard care. That's also the reason why there isn't any MD/DO lead studies. Can you imagine getting that past IRB. We want to subject patients to what we believe is substandard care, to prove that there is substandard care? They claim to be equals, but when MD/DOs fight back, we are somehow punching down on them? That's BS.
 
drmwvr said:
"Most CRNAs hold a doctorate", said Joseph Rodriguez, spokesperson for American Association of Nurse Anesthesiologists (AANA).

“It is immoral to hold professionals back from providing excellent patient care."

Morality ceases to become an issue when it comes to lying, I guess....
Click to expand...
Talk about disingenuous. Joe ignores their own history and actual facts.

There are still thousands of CRNAs in clinical practice who have a nursing diploma (not a degree) and a nurse anesthesia certificate.

Community hospital nurse anesthesia programs granting nurse anesthesia certificates (not a degree) were quite common well into the 90's, often from the same nursing school that granted their nursing diploma. There was no requirement for "critical care nursing" experience (which I seem to recall that even to this day can be defined by individual programs) and many CRNAs went straight from their diploma program into the nurse anesthesia program. These programs often existed to feed their own hospitals with a steady supply of new-grad CRNAs every year. Graduates of those programs are likely in their mid-50s or later at this point.

Nurse anesthesia programs didn't require a bachelors degree for admission until 1986 and still for many years didn't grant a graduate degree, just a certificate.

The granting of a masters degree in nurse anesthesia wasn't required until 1998. Contrast that to the Emory AA program which was a master's degree from day one in 1971.

The requirement for a DNP as the entry level into nurse anesthesia doesn't actually take effect until 2025, although many are already up and running. There are quite a few master's to DNP bridge programs, usually done as an online setup. Of course that's helpful since one has to have doctorate-level faculty to offer a doctorate-level degree. No problem - just educate them yourself. There is no requirement or even attempt to offer additional clinical training in the bridge or most full length DNP programs. They are however plenty of QI, statistics, healthcare policy, nursing "ethics", yada, yada, yada, and of course intense graduate level coursework in CRNA politics.

Interestingly (and quite predictably) applications to the full length DNP programs has waned, as the length of the program is now 3 years, which means an additional year of tuition at a doctorate-degree granting university. More tuition = more student loans and three years of NOT working as nursing salaries go through the roof due to supply and demand economics. It's not higher math to figure out the time to recoup lost income plus tuition/student loans can be decades.
 
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drmwvr said:
"Most CRNAs hold a doctorate", said Joseph Rodriguez, spokesperson for American Association of Nurse Anesthesiologists (AANA).

“It is immoral to hold professionals back from providing excellent patient care."

Morality ceases to become an issue when it comes to lying, I guess....
Click to expand...
Why the AANA wants independence is beyond me. Not only will it increase legal liability, it will also negatively affect the job market. If all these CRNA’s are independent there is suddenly a large increase in supply of providers (the MD’s are not just gonna disappear). You are basically fighting for lower pay and increased liability. Why?
 
dannyboy1 said:
Why the AANA wants independence is beyond me. Not only will it increase legal liability, it will also negatively affect the job market. If all these CRNA’s are independent there is suddenly a large increase in supply of providers (the MD’s are not just gonna disappear). You are basically fighting for lower pay and increased liability. Why?
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IMO, I think it’s about making a statement (“We’re just as good!”) rather than actually wanting independence. They want to eat their cake (being able to practice independently) and have it too (not actually having to practice independently).

They don’t want to go to the dance. They just want to be invited.

Our practice does both solo and supervision. We generally get along with the CRNAs, but make no mistake about it, even when we bail out multiple CRNAs every single day in our practice, there are still some who think our training is superfluous—that they could do it themselves but having us there is a luxury (and not a necessity).

Delusion is a means for self-preservation.
 
-It's about the choice... Even if AANA got everything that they wanted legislatively, Not every CRNA would want to work independently. Although lots of them would try to skim lots of the cream and cherry pick.

-AANA leadership is over represented with the most angry, passionate individuals.
 
Fpg1245 said:
This is the biggest claptrap nonsense. AANA looks for weak staffing hospitals and pedals this nonsense in various states.
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And not once do you ever see in these articles that rural pass-through CMS money only goes to CRNAs, not anesthesiologists.
 
vector2 said:
And not once do you ever see in these articles that rural pass-through CMS money only goes to CRNAs, not anesthesiologists.
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But But But they are so much more cost effective and there gonna save the health system!!
 
sevoflurane said:
The second largest group in our town just went from ACT to MD only. Nice reversal based on quality of care provided as well as all the headaches that encompass an ACT model.
Our part of the state is now 90% Md only,
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Place to be!
 
We have some critical access hospitals far outside the city and one “collaborative model” an hour out, but outside of that one GI center in town.

Good people running these groups.
 
sevoflurane said:
The second largest group in our town just went from ACT to MD only. Nice reversal based on quality of care provided as well as all the headaches that encompass an ACT model.
Our part of the state is now 90% Md only,
Click to expand...

California?
 
Dr. Rude said:
-AANA leadership is over represented with the most angry, passionate individuals.
Click to expand...
Just as ASA leadership is over represented with the most passive and weak individuals in our specialty.

A match made in ... well, somewhere.
 
dannyboy1 said:
Why the AANA wants independence is beyond me. Not only will it increase legal liability, it will also negatively affect the job market. If all these CRNA’s are independent there is suddenly a large increase in supply of providers (the MD’s are not just gonna disappear). You are basically fighting for lower pay and increased liability. Why?
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Actually, why physicians don’t push for this is infuriating. The CRNAs want it, let’s give it to them.

I know why the physicians don’t. I won’t say it out loud because I’m sure these greedy physicians get sick and tired of being called greedy (oops…I said it).
 
Actually,

After the whole COVID thing, I’m not sure why anyone would trust MDs. We can’t even decide on some very basic things.

We used to say, let the science rule the day. - but not anymore. RCTs proving a concept be damned. Let’s use expert opinion over higher quality evidence. Let us not demand higher quality studies. Let’s argue about these concepts even when high quality studies have existed and new ones exist. We will ignore those and go with our gut!

It is a wonder anyone would listen to a doctor again.
 
epidural man said:
Actually,

After the whole COVID thing, I’m not sure why anyone would trust MDs. We can’t even decide on some very basic things.

We used to say, let the science rule the day. - but not anymore. RCTs proving a concept be damned. Let’s use expert opinion over higher quality evidence. Let us not demand higher quality studies. Let’s argue about these concepts even when high quality studies have existed and new ones exist. We will ignore those and go with our gut!

It is a wonder anyone would listen to a doctor again.
Click to expand...

Yes let's trust chiropractors and naturopaths and diploma mill nurses instead.
 
epidural man said:
Actually,

After the whole COVID thing, I’m not sure why anyone would trust MDs. We can’t even decide on some very basic things.

We used to say, let the science rule the day. - but not anymore. RCTs proving a concept be damned. Let’s use expert opinion over higher quality evidence. Let us not demand higher quality studies. Let’s argue about these concepts even when high quality studies have existed and new ones exist. We will ignore those and go with our gut!

It is a wonder anyone would listen to a doctor again.
Click to expand...
Did you get hacked or is this sarcasm or are you being held against your will or something? Cause this doesn't seem like you?
 
epidural man said:
Actually,

After the whole COVID thing, I’m not sure why anyone would trust MDs. We can’t even decide on some very basic things.

We used to say, let the science rule the day. - but not anymore. RCTs proving a concept be damned. Let’s use expert opinion over higher quality evidence. Let us not demand higher quality studies. Let’s argue about these concepts even when high quality studies have existed and new ones exist. We will ignore those and go with our gut!

It is a wonder anyone would listen to a doctor again.
Click to expand...

What in the ivermectin and hcq are you blabbering on about? It was a novel freaking virus. We did the best we could given the science we had which was all being investigated as we went because…. it was a novel freaking virus.

If you think MDs are deservedly being questioned these days then guess what, it may be because YouTube and social media are filled with MD crack pipes and conspiracy theorists spouting off about crap everyone with a brain knows won’t work, all to get a following, get some clicks, and get some dollars.

Just last week a fellow MD came to this board full of MDs and posted that a NFL player with commotio cordis needed CPR because of the COVID vaccine. You really aren’t seeing the problem ?
 
Southpaw said:
What in the ivermectin and hcq are you blabbering on about? It was a novel freaking virus. We did the best we could given the science we had which was all being investigated as we went because…. it was a novel freaking virus.

If you think MDs are deservedly being questioned these days then guess what, it may be because YouTube and social media are filled with MD crack pipes and conspiracy theorists spouting off about crap everyone with a brain knows won’t work, all to get a following, get some clicks, and get some dollars.

Just last week a fellow MD came to this board full of MDs and posted that a NFL player with commotio cordis needed CPR because of the COVID vaccine. You really aren’t seeing the problem ?
Click to expand...
Any physician with a brain knows that the "science" behind masks, boosters, etc. was tenuous and perhaps even willfully unexplored (should the results be contrary to what we told the public..). This might be tolerable if these things weren't mandated on people. When you threaten people's jobs and their ability to use public transport and other social services, you better damn well have have demonstrated mortality benefit for their specific risk pool (eg, young healthy adults/children). Treating everyone the same as nursing home grandmas and the obese made them lose their trust. Telling people that they must get the vaccine to prevent transmission when everyone was observing the contrary lost their trust. Confidently telling people that "natural immunity" played no role in Covid made them lose their trust. The elite gallivanting about at the Obama's in Martha's Vineyard and the Met Gala while making the help perform mask theater definitely lost the people's trust. Depriving children of in-person education and socialization for 1-2 years absolutely destroyed the trust in public health. I really don't think any of this was the "best we could have done". You were absolutely vilified for questioning any aspect of the COVID response, and there was no attempt to back any of this up with evidence. Instead you were screeched at to "trust the science" as if "science" was merely a religion that demanded our faith.

And to be honest, I don't really understand why the same physicians on this board who were smart enough to criticize the AORN and their inane rules about bouffants somehow accepted performative COVID edicts without question.
 
nimbus said:
All threads converge to a final common
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MirrorTodd said:
Did you get hacked or is this sarcasm or are you being held against your will or something? Cause this doesn't seem like you?
Click to expand...
I’m just saying, COVID messed us up, not just the nation, but the medical community.

I’m just saying, trust has been significantly degraded.
 
gunnershow said:
Any physician with a brain knows that the "science" behind masks, boosters, etc. was tenuous and perhaps even willfully unexplored (should the results be contrary to what we told the public..). This might be tolerable if these things weren't mandated on people. When you threaten people's jobs and their ability to use public transport and other social services, you better damn well have have demonstrated mortality benefit for their specific risk pool (eg, young healthy adults/children). Treating everyone the same as nursing home grandmas and the obese made them lose their trust. Telling people that they must get the vaccine to prevent transmission when everyone was observing the contrary lost their trust. Confidently telling people that "natural immunity" played no role in Covid made them lose their trust. The elite gallivanting about at the Obama's in Martha's Vineyard and the Met Gala while making the help perform mask theater definitely lost the people's trust. Depriving children of in-person education and socialization for 1-2 years absolutely destroyed the trust in public health. I really don't think any of this was the "best we could have done". You were absolutely vilified for questioning any aspect of the COVID response, and there was no attempt to back any of this up with evidence. Instead you were screeched at to "trust the science" as if "science" was merely a religion that demanded our faith.

And to be honest, I don't really understand why the same physicians on this board who were smart enough to criticize the AORN and their inane rules about bouffants somehow accepted performative COVID edicts without question.
Click to expand...

The bell curve of this post spans from 5% deceptive spin on vaguely true things to 95% outright falsehoods/misinformation.
 
We can get back to bashing CRNA militant political mumbo jumbo (a very worthy cause I might add).

I’m just pointing out the COVID years may have degraded trust in physicians. I think it is a valid point.
 
Rcts don't prove anything. Plenty of times when a study shows one thing and subsequent studies don't agree
 
epidural man said:
I’m just saying, COVID messed us up, not just the nation, but the medical community.

I’m just saying, trust has been significantly degraded.
Click to expand...

Why did the COVID years degrade trust in physicians? You keep vaguely dancing around a point you seem to want to make. Be a man and just come right out and say it.
 
GravelRider said:
Why did the COVID years degrade trust in physicians? You keep vaguely dancing around a point you seem to want to make. Be a man and just come right out and say it.
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I’m not trying to be vague, and no specific point trying to be made. I thought it was pretty well established that trust has been degraded….lots of articles (not scientific…media stuff) written about it.
 
for the entirety of my career so far there's been dishonesty in the crna debate. dishonesty on their end, and on ours as well if we are honest about it. but this article doesn't touch on it, it's one sided, and frankly such articles that present only one side of an issue and don't even present that side fully are very dangerous when read by the general public. example, the AANA will never admit that there are plenty of CRNAs who are frankly dangerous and patient safety would absolutely be an issue were they allowed to practice independently. At the same time, the ASA will never admit that there are plenty of anesthesiologists who've done nothing but supervise CRNAs (even 'supervising' CRNAs as they do all of the labor epidurals for the hospital) their whole career and I find it commendable they are still able to tie their shoes each and every day. I certainly however wouldn't trust them to command an anesthetic. They are shielded by the CRNA and were they forced to do a case on their own they'd be no more safe than a lot of dangerous CRNAs. It's a sad but true statement and I'm tired from retreating from it. The ASA, and this field in general, has done its membership a disservice by allowing skill atrophy through not stating that each and every anesthesiologist should routinely do their own work. It's what we do in residency as we are crafting skills, and it should be no different after training when we are honing those skills.

The AANA will never admit that they are doing the exact same thing to AAs that they accuse anesthesiologists of doing to them. Truth. The AANA will never admit that they greatly, greatly benefit from stupid rural pass through legislation that effectively mandates CRNA independent practice in tiny hole in the wall places (the spots where morbidity and mortality are glossed over routinely because 'patient was sick...'). Of course that'll never stop them from flying the flag of 'we take care of all of rural America'. It's a very dishonest answer to a more complex issue that the general public has no understanding of.

All in all, I've come to the same conclusion as @epidural man. It is not my job to protect America. Just like every other physican in every other field of medicine out there, I can only take care of my patients. I can't control the rest of the world. It isn't my job to supervise CRNAs if they are making the claim they are equally trained as me and all of my extra years of training weren't necessary. It's not my job to be the gatekeeper of patient safety. If CRNAs want to work independently, then fine, let them. I don't care. Let me do my work and let me care for my patients in peace. But ASA, please for the love of god, just come clean in the debate on all of the issues. Both the skill atrophy problem amongst supervising anesthesiologists and the clear fact that a lot of CRNAs are not safe in any way whatsoever to practice independently (and often these exact CRNAs are the most difficult ones to work with).

Anyway, yet again, there's my 2 cents.
 
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GravelRider said:
Why did the COVID years degrade trust in physicians? You keep vaguely dancing around a point you seem to want to make. Be a man and just come right out and say it.
Click to expand...
This is not about COVID directly, but he makes my general point by talking about an another (but very important) subject.

 
GravelRider said:
Why did the COVID years degrade trust in physicians? You keep vaguely dancing around a
point you seem to want to make. Be a man and just come right out and say it.
Click to expand...

They collectively poked a hole in the condom and now are claiming all trust in prophylactics has been degraded.

But to be fair, one maybe, just maybe might take their protests about the COVID response a weee bit more seriously if conservatives didn't immediately downplay COVID from literally Jan 2020 onwards and then go on to claim we should prosecute Fauci and all liberals are freedom hating totalitarians who gleefully dance on the graves of dead antivaxxers. And the seriousness might've gained even more traction if freedom utopias like Florida didn't have the worst post-vaccine COVID death rates.
 
epidural man said:
I’m not trying to be vague, and no specific point trying to be made. I thought it was pretty well established that trust has been degraded….lots of articles (not scientific…media stuff) written about it.
Click to expand...

What is trust? What is the point of trust? We live in a world where you can literally create your own reality. Theoretically there could be the most knowledgeable human on the planet who knows everything there is to know regarding math and science and it won’t mean anything if some guy starts a YouTube channel to “debunk” everything this theoretical superhuman has to say.

The ability of humans to believe in things that aren’t real allowed our species to flourish and build society. It is that talent that is unique to our species that will also be our downfall. In a distant future when superhuman AI is utilizing the power of the cosmos, humans will still be listening to charlatans on YouTube argue about how flat the Earth really is. F—- trust, it’s overrated.
 
Is the ASA even doing anything about it other than trying to tell us how to sweet talk to our patients? Are they doing ANYthing real?
 
Even if they become fully legally independent everywhere , hospitals can still choose to have oversight if they want? But doubt assuming insurance will cover it that ?
 
jon stewart said:
Even if they become fully legally independent everywhere , hospitals can still choose to have oversight if they want? But doubt assuming insurance will cover it that ?
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Absolutely. The medical staff bylaws should be controlling within the hospital, including for CRNAs as they are members of the Anesthesia Department.
 
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