More CRAP from the AANA....

[fval28]

Trinity--

First, I really cant believe your story because, no matter what country you graduated from you can't just come over to the US and start 'practicing'.

ON the otherhand there are folks that went to US med schools,etc that finished their residency in anesthesiology. These ppl may not all be board certified. Until recently being board certified was just a 'prestige'. No one cared if you were board certified or not. Times have changed. Nevertheless, any physician that finished an AMERICAN residency is day and night more qualified than any CRNA out there regardless of his board certification. Even now, getting board certified just makes you more marketable, it's not a necessity.

As someone pointed out above...a nurse can simply finish about 2 yrs of college (at a community college), then go into nursing schools 1.5-2 yrs (even at a community college)..then take an exam where they only have to get 72 questions right and then is automatically a RN. Sorry, but I dont know any community college type medical schools or residencies in the US. A physician goes 4 yrs college, 4 yrs med school (competitive), 4 yrs residency (competitive). Do the math..there's no comparison.

I think Trin answered in one of his previous posts that he recognizes the difference in education b/t MD/DO's and CRNA's- So you might want to reread his post before teeing off.

BTW...certification in what? So a group of nurses get together and decide they want to create a certification process? So they have an exam which one passes and then is automatically a "certified nurse". The "certified" part in the certified nurse anesthesist is just a guise to make themselves "sound" mroe official.

Just to fill you in on something. A physician needs to pass about three national exams....USMLE 1,2,3. So if you're referring to the ability to pass a national exam to become "certified", then by all means all physicians are "certified"...infact "triple certified". And by the way are exams have about 300-900 questions per exam ..............

Realize this. A nurse's role is to work UNDER the supervision of a Physician regardless of whether he is board certified in anesthesiology or not since they have completed an anesthesiology residency. IF you or your colleagues are soo eager to work independently there is an easy solution....medical school

Isn't this just the double standard that Trinity was talking about- just b/c a bunch of doc's decide to create a certification process doesn't make it any more or less legitimate does it?

Also if I understand his position correctly he is questioning the supervision of CRNAs by non-boarded PHYSICIANS, not necessarily an MDA... and I also have seen NON-anesthesia trained physicians cause near catastrophes in the OR and other places because of their unfamiliarity with and lack of respect for the substances and procedures we deal with every day. Fortunately most BOARDED, non-anesthesia trained docs know their area of expertise well and tend to be content with practicing within their purview.

The kneejerk response to defend a doc just because he/she is a doc is a losing position. Traching someone because you are too ignorant to know, or too lazy to learn what an LMA is is malpractice and negligence and NOT in any patient's best interest- the fact that someone that inept is in possession of a medical license, hell a DRIVER's license, is a bigger issue than whether or not it's illegal to call yourself board certified.

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Members don't see this ad.

 

[Monty Python]

.....I believe there is a role for Mid-level Providers in Anesthesia under the direction of an MDA.....

As to my previous post of double standards:

I'm in a Navy medical unit, specifically assigned to support the Marines on the front lines. When deployed I'm not in a cozy fixed-base hospital many miles behind the lines, nor on a hospital ship, nor at a state-side hospital.

How is it that Uncle Sam has no problem putting me out there as the only anesthesia provider handling critically-wounded grunts which would make an ASA 4E pale in comparison?

How is it that Uncle Sam had no problem with my previous assignment, where I was the entire anesthesia department on an aircraft carrier hundreds of miles away from land? The senior medical officer was an occupational physician who never came into the OR, and who point-blank told me that he didn't have a clue as to anesthesia.

 

[OffPiste]

Trinity, with all due respect, what Uncle Sam does is not a model from which we should base what is best. In fact, I know of at least one Ob/Gyn called upon by Uncle Sam to treat trauma patients because that was what was available at the time. I think all would agree this is far from ideal, did he muscle through it, sure.
Furthermore, penetrating trauma on young, otherwise healthy males does not make an ASA 4E pale in comparison, with multiple comorbidities, etc.

 

[SleepIsGood]

Trinity--

First, I really cant believe your story because, no matter what country you graduated from you can't just come over to the US and start 'practicing'.

ON the otherhand there are folks that went to US med schools,etc that finished their residency in anesthesiology. These ppl may not all be board certified. Until recently being board certified was just a 'prestige'. No one cared if you were board certified or not. Times have changed. Nevertheless, any physician that finished an AMERICAN residency is day and night more qualified than any CRNA out there regardless of his board certification. Even now, getting board certified just makes you more marketable, it's not a necessity.

As someone pointed out above...a nurse can simply finish about 2 yrs of college (at a community college), then go into nursing schools 1.5-2 yrs (even at a community college)..then take an exam where they only have to get 72 questions right and then is automatically a RN. Sorry, but I dont know any community college type medical schools or residencies in the US. A physician goes 4 yrs college, 4 yrs med school (competitive), 4 yrs residency (competitive). Do the math..there's no comparison.

I think Trin answered in one of his previous posts that he recognizes the difference in education b/t MD/DO's and CRNA's- So you might want to reread his post before teeing off.

BTW...certification in what? So a group of nurses get together and decide they want to create a certification process? So they have an exam which one passes and then is automatically a "certified nurse". The "certified" part in the certified nurse anesthesist is just a guise to make themselves "sound" mroe official.

Just to fill you in on something. A physician needs to pass about three national exams....USMLE 1,2,3. So if you're referring to the ability to pass a national exam to become "certified", then by all means all physicians are "certified"...infact "triple certified". And by the way are exams have about 300-900 questions per exam ..............

Realize this. A nurse's role is to work UNDER the supervision of a Physician regardless of whether he is board certified in anesthesiology or not since they have completed an anesthesiology residency. IF you or your colleagues are soo eager to work independently there is an easy solution....medical school

Isn't this just the double standard that Trinity was talking about- just b/c a bunch of doc's decide to create a certification process doesn't make it any more or less legitimate does it?

Also if I understand his position correctly he is questioning the supervision of CRNAs by non-boarded PHYSICIANS, not necessarily an MDA... and I also have seen NON-anesthesia trained physicians cause near catastrophes in the OR and other places because of their unfamiliarity with and lack of respect for the substances and procedures we deal with every day. Fortunately most BOARDED, non-anesthesia trained docs know their area of expertise well and tend to be content with practicing within their purview.

The kneejerk response to defend a doc just because he/she is a doc is a losing position. Traching someone because you are too ignorant to know, or too lazy to learn what an LMA is is malpractice and negligence and NOT in any patient's best interest- the fact that someone that inept is in possession of a medical license, hell a DRIVER's license, is a bigger issue than whether or not it's illegal to call yourself board certified.

With all due respect, someone like a Trinity trying to undermine anesthesiologists by using a made up scenario is just that fluff. I find it hard to believe that ANY anesthesiologist in the United States that is practicing...board certified or not would nto know what an LMA is. I really do need that individuals name and group name to verify that.

Secondly, let it be known again that a CRNA calling themselves 'certified' does not mean they are 'board certified'. Again CRNAs mislead the general public by using words that blur the perception of the public by using words like "certified" and "anesthesist". Why can't they simply tell the public what they are...a nurse. On two distinctive occassions I've had a Nurse Practioner (a male) tell me that he wasnt a nurse, rather a "Nurse Practionner".

Whether a group wants to hire a board certified or not anesthesiologist is up to the group. A physician does an "anesthesiology" residency to become an anesthesiologist. Whether they get boarded or not has nothing to do with whether they are an anesthesiologist or not. Bottom line. The knowledge base, physiology, and science that a physician has is far more in depth than what a nurse has.

This is not to undermine nurses, but their training is different and is to assume a different role. Again, you want to be commander and chief...go to medical school.

 

[Gasboy07]

Now for a real study in a real journal - go here


Consequences of running more operating theatres than anaesthetists to staff them: a stochastic simulation study

Sorry - if you want pictures I'll post up the whole article somewhere or you'll need to have access to BJA

 

[johankriek]

How is it that Uncle Sam had no problem with my previous assignment, where I was the entire anesthesia department on an aircraft carrier hundreds of miles away from land? .

stevie wonder can drive too.. doesnt make it a good idea


get a life If i remember correcly you are a crna who was unfhappy with your station so you went to medical school. What happened? did you drop out? too difficult for you.. too rigorous.. you dont have the discipline to committ to the rigorous education and training? I know it is much easier coming on this board and bad mouth doctors... I dont understand why you cant go to your nursing forum and bad mouth us.. MURSE

 

[dogbone65]

Amazing....too bad the general public doesn't know about this forum. I'm sure they'd love to see how the almighty MD acts. With a couple of exceptions, I wouldn't let you guys rub EMLA cream on my dog's ass. I'm sure someone will post soon to prove my point.

 

[CremeSickle]

The level of professionalism on this forum is dismal. I fear for the future of my chosen specialty (luckily you all represent the fringe extremist minority of anesthesiologists). Also, I find the outright ignorance displayed by many of you as to what it means to be an RN and go through nursing school distasteful. As i said, my mother was an RN -> CRNA -> MD and I am an RN -> DO in my late 30s. You know nothing about anything in medical school or internship (and the greater part of residency for that matter) yet you all speak as if you've been doing it for years. Being self righteous cocky asses will do little more than seal your fate.

This trinity fellow is just enlightening you ingrates as to REALITY (something which you are obviously ignorant of) and all you do is attack and bash him/her. How deplorable and shameful. Does it make you feel like a bigger and better doctor? Does it make up for that time when that bully beat the crap out of you in the school yard?

The fact is the VAST majority of FMGs (other than UK and CAN) are rarely capable of speaking more than broken english. They simply come and write the USMLEs (which they can do from their country of origin) and then apply for residency (and some dont have to do one). Ive seen NUMEROUS FMG "anesthesiologists" who cant identify an LMA, never heard of an ILMA and think if intubation is impossible cric is the next step. They arent suited to supervise the janitors let alone CRNAs who are far and away better trained and more knowledgeable about anesthesia than they could ever hope to be. So while i agree that we are vastly superior training wise (in the USA/UK/AU/CA at least), that dosent translate to anesthesia (you wouldn't want a derm doing your anesthetic over a CRNA would you?)

It would do well to remember who runs hospitals. Nurses. Who YOU rely on to inform you when the **** hits the fan and be the 'hands on' person doing the clinical assessment and treating the critical pt when your not there. If you want a short career, alienate all the nurses by degrading them the way you are here. Ask any attending who has been working in a REAL medical environment (read: Hospital) for a long time, they will clue you in. Believe me, it wont be long before you are no longer insurable let alone employable.

Get a grip on your egos or they will be the end of you and anesthesiology.

 

[rn29306]

Boy where is JPP on this. He's worked with Trin and they've been in the anesthesia biz for a LONG time.

Its really sad to see the level of maturity on here when he indeed had a valid question and you guys start teeing off on him.

Congrats on being tools. Man if JPP was here...he'd be busting on all you guys.

 

[johankriek]

The level of professionalism on this forum is dismal. Being self righteous cocky asses will do little more than seal your fate.

This trinity fellow is just enlightening you ingrates as to REALITY (something which you are obviously ignorant of) and all you do is attack and bash him/her. How deplorable and shameful. Does it make you feel like a bigger and better doctor? Does it make up for that time when that bully beat the crap out of you in the school yard?

The fact is the VAST majority of FMGs (other than UK and CAN) are rarely capable of speaking more than broken english. They simply come and write the USMLEs (which they can do from their country of origin) and then apply for residency (and some dont have to do one). Ive seen NUMEROUS FMG "anesthesiologists" who cant identify an LMA, never heard of an ILMA and think if intubation is impossible cric is the next step. They arent suited to supervise the janitors let alone CRNAs who are far and away better trained and more knowledgeable about anesthesia than they could ever hope to be. So while i agree that we are vastly superior training wise (in the USA/UK/AU/CA at least), that dosent translate to anesthesia (you wouldn't want a derm doing your anesthetic over a CRNA would you?)

It would do well to remember who runs hospitals. Nurses. Who YOU rely on to inform you when the **** hits the fan and be the 'hands on' person doing the clinical assessment and treating the critical pt when your not there. If you want a short career, alienate all the nurses by degrading them the way you are here. Ask any attending who has been working in a REAL medical environment (read: Hospital) for a long time, they will clue you in. Believe me, it wont be long before you are no longer insurable let alone employable.

Get a grip on your egos or they will be the end of you and anesthesiology.

yeah this post is really professional. It actually is bordering on prejudicial against foreign physicians.
Dont defend trinity. He is the one who came on this thread bashing physicians. bashing the board certification process and bashing foreign physicians. All I am saying is that if you want to bash and bad mouth physicians dont do it on our board. BUt if you do it here, you will hear it from me. Do it on your own board. Geez, have some common courtesy.

Most nurses all they care about is their 8 or 10 hour shift and going home. How professional is that.? and you keep thinking nurses run the hospital.. Sure thing buddy. You are delusional nitecap. And I know you are nitecap.

 

[CremeSickle]

Ah yes

When you have nothing to backup what you say, attack me personally and make accusations. Yup, highly professional. All you did johan, is prove my point about both your ignorance and unprofessionalism.

yeah this post is really professional. It actually is bordering on prejudicial against foreign physicians.

It isnt stereotyping when its true. But since you have little real experience with them, you dont know (ignorance)

Dont defend trinity. He is the one who came on this thread bashing physicians. bashing the board certification process and bashing foreign physicians.

Didn't do well in reading comprehension did you? He didnt bash anyone just pointed out OBVIOUS truths that people with experience already know. Yet you attack him personally. (ignorance & unprofessional)

Most nurses all they care about is their 8 or 10 hour shift and going home. How professional is that.?

Oh yah, Doctors NEVER do this? BWHAHAHAHA You are a fool. (ignorance & living in fairy tale land)

and you keep thinking nurses run the hospital.. Sure thing buddy.

Clear ignorance. The vast majority of hospitals are managed by RNs. They are the single largest workforce in healthcare (remember i was apart of it so i an NOT ignorant about them YOU are) and when they want a doctor fired, they are gone *poof*. (ignorance again)

You are delusional nitecap. And I know you are nitecap

Actually, no, im not nitecap or a CRNA, im a physician. (Ignorance, personal attacks and ABSOLUTE unprofessionalism)

Yup, clearly your the consummate professional. What a joke.

yeah this post is really professional. It actually is bordering on prejudicial against foreign physicians.
Dont defend trinity. He is the one who came on this thread bashing physicians. bashing the board certification process and bashing foreign physicians. All I am saying is that if you want to bash and bad mouth physicians dont do it on our board. BUt if you do it here, you will hear it from me. Do it on your own board. Geez, have some common courtesy.

Most nurses all they care about is their 8 or 10 hour shift and going home. How professional is that.? and you keep thinking nurses run the hospital.. Sure thing buddy. You are delusional nitecap. And I know you are nitecap.

 

[Stimulate]

I would have no problem with being required to be board certified prior to practicing, however, the current ABA examination process makes this task impossible because of timing issues.

We take our written boards in July, get the results in September (huge delay, much longer than the CRNA result waiting period). Even when we pass writtens we are still not "certified".

Next, we have to wait to schedule our Oral board exam which is in April or October of the FOLLOWING YEAR plus wait for those results to come back. Therefore, waiting for board certification prior to practicing is completely impractical. This would mean joining the ranks of unemployment for approximately 1.5 years after graduation from residency.

 

[The_Sensei]

Amazing....too bad the general public doesn't know about this forum. I'm sure they'd love to see how the almighty MD acts. With a couple of exceptions, I wouldn't let you guys rub EMLA cream on my dog's ass. I'm sure someone will post soon to prove my point.

I certainly would never do this either.......however, I would SUPERVISE you while you did it.

 

[VolatileAgent]

The level of professionalism on this forum is dismal. I fear for the future of my chosen specialty (luckily you all represent the fringe extremist minority of anesthesiologists). Also, I find the outright ignorance displayed by many of you as to what it means to be an RN and go through nursing school distasteful. As i said, my mother was an RN -> CRNA -> MD and I am an RN -> DO in my late 30s. You know nothing about anything in medical school or internship (and the greater part of residency for that matter) yet you all speak as if you've been doing it for years. Being self righteous cocky asses will do little more than seal your fate.

did anyone else catch the blatant hypocrisy of this statement? pot, meet kettle. you're so cute, cremesickle. such an angry little self-righteous sweetie with an adorably untameable superiority complex.

Get a grip on your egos or they will be the end of you and anesthesiology.

i like this idea, maybe it'll catch on:

http://www.njleg.state.nj.us/2006/Bills/A1500/1327_I1.HTM

many of you wouldn't be quite so tough if everyone knew who you were.

 

[militarymd]

many of you wouldn't be quite so tough if everyone knew who you were.

yep........and it is surprising how easy it is to find out who people are....internet search, phone calls, data bases....

before you know it....you have their picture, home address, etc.

It is quite amazing.

 

[VolatileAgent]

yep........and it is surprising how easy it is to find out who people are....internet search, phone calls, data bases....

before you know it....you have their picture, home address, etc.

It is quite amazing.

yeah, i'm waiting...

 

[militarymd]

yeah, i'm waiting...

What are you waiting for ???

Something like your walking papers 2 months before you make partner????

 

[badgas]

Wow. This thread is horrible. Mods... please close??

 

[SleepIsGood]

The level of professionalism on this forum is dismal. I fear for the future of my chosen specialty (luckily you all represent the fringe extremist minority of anesthesiologists). Also, I find the outright ignorance displayed by many of you as to what it means to be an RN and go through nursing school distasteful. As i said, my mother was an RN -> CRNA -> MD and I am an RN -> DO in my late 30s. You know nothing about anything in medical school or internship (and the greater part of residency for that matter) yet you all speak as if you've been doing it for years. Being self righteous cocky asses will do little more than seal your fate.

This trinity fellow is just enlightening you ingrates as to REALITY (something which you are obviously ignorant of) and all you do is attack and bash him/her. How deplorable and shameful. Does it make you feel like a bigger and better doctor? Does it make up for that time when that bully beat the crap out of you in the school yard?

The fact is the VAST majority of FMGs (other than UK and CAN) are rarely capable of speaking more than broken english. They simply come and write the USMLEs (which they can do from their country of origin) and then apply for residency (and some dont have to do one). Ive seen NUMEROUS FMG "anesthesiologists" who cant identify an LMA, never heard of an ILMA and think if intubation is impossible cric is the next step. They arent suited to supervise the janitors let alone CRNAs who are far and away better trained and more knowledgeable about anesthesia than they could ever hope to be. So while i agree that we are vastly superior training wise (in the USA/UK/AU/CA at least), that dosent translate to anesthesia (you wouldn't want a derm doing your anesthetic over a CRNA would you?)

It would do well to remember who runs hospitals. Nurses. Who YOU rely on to inform you when the **** hits the fan and be the 'hands on' person doing the clinical assessment and treating the critical pt when your not there. If you want a short career, alienate all the nurses by degrading them the way you are here. Ask any attending who has been working in a REAL medical environment (read: Hospital) for a long time, they will clue you in. Believe me, it wont be long before you are no longer insurable let alone employable.

Get a grip on your egos or they will be the end of you and anesthesiology.

What are you talking about?

go back and read my posts. I believe regular nurses (ie not CRNAs) have a role in the hospital. however, when nurses desire to become more than what they are and begin to take on physician roles then i have a problem with that. CRNAs need to be supervised and the public needs to be aware of that. I dont get it? Are you desiring the downfall of your own profession?

next, what Trinity is posing is next to an impossible situation. Yes, I agree, perhaps FMGs can come from X country and not know what a LMA is...similar to a med student who doesnt know what a LMA is. HOWEVER, when you become an attending, it's guaranteed that one went through a US residency program in anesthesiology. As such, everyone who's an attending must know what a LMA is because they trained in the US. During residency we use LMAs all the time. .

 

[johankriek]

Ah yes

When you have nothing to backup what you say, attack me personally and make accusations. Yup, highly professional. All you did johan, is prove my point about both your ignorance and unprofessionalism.



It isnt stereotyping when its true. But since you have little real experience with them, you dont know (ignorance)



Didn't do well in reading comprehension did you? He didnt bash anyone just pointed out OBVIOUS truths that people with experience already know. Yet you attack him personally. (ignorance & unprofessional)



Oh yah, Doctors NEVER do this? BWHAHAHAHA You are a fool. (ignorance & living in fairy tale land)



Clear ignorance. The vast majority of hospitals are managed by RNs. They are the single largest workforce in healthcare (remember i was apart of it so i an NOT ignorant about them YOU are) and when they want a doctor fired, they are gone *poof*. (ignorance again)



Actually, no, im not nitecap or a CRNA, im a physician. (Ignorance, personal attacks and ABSOLUTE unprofessionalism)

Yup, clearly your the consummate professional. What a joke.

Ok nitecap.. sure thing buddy. trinity started the bashing.. go back on the thread.. And he never answered my question. Wasnt he/she the one who decided to go to medical school because he/she was so unhappy with their station as a crna? What happened? couldnt hack the committment? couldnt hack the rigors of real schooling? tell me trinity? what happened

 

[toughlife]

The level of professionalism on this forum is dismal. I fear for the future of my chosen specialty CRNA training is not a specialty is a trade. (luckily you all represent the fringe extremist minority of anesthesiologists). Also, I find the outright ignorance displayed by many of you as to what it means to be an RN and go through nursing school distasteful. As i said, my mother was an RN -> CRNA -> MD and I am an RN -> DO in my late 30s. You know nothing about anything in medical school or internship Hey genius, all of us have been to medical school(and the greater part of residency for that matter) [/B] many here are attendings, senior residentsyet you all speak as if you've been doing it for years. Being self righteous cocky asses will do little more than seal your fate.

This trinity fellow is just enlightening you ingrates as to REALITY (something which you are obviously ignorant of) and all you do is attack and bash him/her. How deplorable and shameful. Does it make you feel like a bigger and better doctor? Does it make up for that time when that bully beat the crap out of you in the school yard?

The fact is the VAST majority of FMGs (other than UK and CAN) are rarely capable of speaking more than broken english. Yet they are intelligent enough to be tested and pass exams written in your language. Can you pass your certification exams written in french, Hindi, or any other language? I doubt it. Many of the foreign attendings you are bashings are very accomplished people. Yet, you with a 2-yr community college degree (which only required a pencil (to fill out the application) to get admitted into, have an idea you are superior because you speak english better than them

They simply come and write (in the US we say "take". Are you canadian? the USMLEs (which they can do from their country of origin) and then apply for residency (and some dont have to do one). Ive seen NUMEROUS FMG "anesthesiologists" who cant identify an LMA, never heard of an ILMA and think if intubation is impossible cric is the next step. They arent suited to supervise the janitors let alone CRNAs who are far and away better trained and more knowledgeable about anesthesia than they could ever hope to be. So while i agree that we are vastly superior training wise You mean your bosses the physicians have vastly superior training than you (in the USA/UK/AU/CA at least), that dosent translate to anesthesia (you wouldn't want a derm doing your anesthetic over a CRNA would you?)

It would do well to remember who runs hospitals. Nurses. Who YOU rely on to inform you when the **** hits the fan and be the 'hands on' person doing the clinical assessment and treating the critical pt when your not there. If you want a short career, alienate all the nurses by degrading them the way you are here.

Ask any attending who has been working in a REAL medical environment (read: Hospital) for a long time, they will clue you in. Believe me, it wont be long before you are no longer insurable let alone employable. What are you Nostradamus now?

Get a grip on your egos or they will be the end of you and anesthesiology. Stop pretending you are something you are notQUOTE]

 

[Planktonmd]

Without meaning to cast dispersions on different cultures ......

This is where I'm coming from. On more than one occasion I've worked locums where the IMG/FMG physician(s) working as anesthesiologist(s) were from a foreign country with an accent so thick they couldn't be understood. Some hadn't completed an anesthesia residency. Others had completed a residency of dubious quality (in some country) but never "bothered" to take their boards. These folks couldn't intubate their way out of a wet paper bag, didn't know what an LMA was, etc, the list goes on. Yet they're qualified to supervise my anesthetic simply because they have MD/DO/MBBS after their name ???

One physician's first day in XYZ Hospital's OR was my first day there as a locums. This person honest-to-God didn't have a clue as to what an LMA was. We had an unexpected difficult airway, impossible to intubate, I reached for the LMA in my bag and I was FORBIDDEN to insert because Dr. ABC had never seen one and didn't trust it. The patient received a very ugly trach by an extremely irritated surgeon.

I have no problem recognizing the educational differences between CRNA and anesthesiologist. I likewise have no problem working with a properly trained BE/BC anesthesiologist. But I have a real problem working with generic MD/DO supervising me simply because of their academic degree, who may (or may not) have done an anesthesia residency, and who might be unable to pass their boards and never do.

How would you feel if your loved one was about to be slept by an "anesthesiologist" who continually was unable to pass boards? Would the simple fact that they possessed an MD degree pacify you? After all, what do they call the person who graduates last in their class from their med school? "Doctor."

The above derogatory comments are not intended to throw stones at physicians, but at double standards.

OK,
So you are saying that in some places where you worked there are foreign physicians, who did not finish an Anesthesiology residency in the US, practicing anesthesia.
Can you kindly give us the names of these hospitals? because I want to verify these doctors credentials, and if what you said is correct, I promise you I would escalate it to the highest level, because obviously these hospitals are breaking the law.
On the other hand, if these statements are incorrect, this means you are just doing cheap propaganda, and attempting to gain support by being a racist.
It's a very common phenomenon that people tend to blame their failures on foreigners, it happens all over the world, and it is directly proportional to the degree of ignorance in a society.

 

[fakin' the funk]

On the other hand, if these statements are incorrect, this means you are just doing cheap propaganda, and attempting to gain support by being a racist.
It's a very common phenomenon that people tend to blame their failures on foreigners, it happens all over the world, and it is directly proportional to the degree of ignorance in a society.

What is that, like 3 assumptions you're making there?

 

[jwk]

OK,
So you are saying that in some places where you worked there are foreign physicians, who did not finish an Anesthesiology residency in the US, practicing anesthesia.
Can you kindly give us the names of these hospitals? because I want to verify these doctors credentials, and if what you said is correct, I promise you I would escalate it to the highest level, because obviously these hospitals are breaking the law.
On the other hand, if these statements are incorrect, this means you are just doing cheap propaganda, and attempting to gain support by being a racist.
It's a very common phenomenon that people tend to blame their failures on foreigners, it happens all over the world, and it is directly proportional to the degree of ignorance in a society.

Puhleeeeeeze.

Either some of you haven't worked in the real world yet, or else you're incredibly naive.

1) There are in fact physicians (and nurses, and dentists, and physical therapists, etc.) that are incompetent. Simple fact. Have you not ever worked with a surgeon that you wouldn't let touch your dog, or even your neighbor's dog?

2) There are in fact physicians (and nurses et al) that do not have a good command of the English language, and not all were foreign born either. That's not racist - again, it's a simple fact.

3) Hospitals are not required to use board certified physicians in any specialty. There are plenty of hospitals in small towns that would like to have ANY physician, board-certified or not. In addition, there are plenty of older physicians around that practice excellent medicine who never passed their boards.

 

[CremeSickle]

Ah I see the pinnacle of professionalism "toughlife the pimply faced kid" spoke. Sadly, i didn't bother reading it.
http://www.njleg.state.nj.us/2006/Bills/A1500/1327_I1.HTM

many of you wouldn't be quite so tough if everyone knew who you were.

So true. You should consider this yourself.

Those of you who don't believe what i said, fill your boots. You will find out soon enough when your no longer sheltered by the veil of residency and academia.

As for my personal stance on CRNA independence, im pro-ACT and anesthesiologist supervision in large hospitals when this is available. I am pro-CRNA independence in rural areas where there would not be anesthesia services otherwise.

Really, the argument is hilarious. 94% of CRNAs are working in ACT practices. Now here we are, facing severe reimbursement cuts and you all are up in arms about 6% (like 3-5 K) CRNA who work in areas you never would. Don't bother to concern yourselves with trivial things such as medicare cuts, intensivists taking over perioperative medicine and changing the negative perception of other physicians about anesthesiology. Afterall, those are the major issues and hey, its important to put those nurses in their place dammit, even if it means the entire specialty falling apart to do it! Cant see the Forrest for the trees.

 

[Planktonmd]

Puhleeeeeeze.

Either some of you haven't worked in the real world yet, or else you're incredibly naive.

1) There are in fact physicians (and nurses, and dentists, and physical therapists, etc.) that are incompetent. Simple fact. Have you not ever worked with a surgeon that you wouldn't let touch your dog, or even your neighbor's dog?

2) There are in fact physicians (and nurses et al) that do not have a good command of the English language, and not all were foreign born either. That's not racist - again, it's a simple fact.

3) Hospitals are not required to use board certified physicians in any specialty. There are plenty of hospitals in small towns that would like to have ANY physician, board-certified or not. In addition, there are plenty of older physicians around that practice excellent medicine who never passed their boards.

I work in the real world and supervise people like you all day.

I asked that CRNA a specific question: "Do you know of physicians practicing anesthesia without going through US residency"
I did not mention board certification, so before you make defensive statements read the question.

 

[johankriek]

I guess trinity backed off when he found out what he was posting was BS. Whats the matter trinity.. come out of you hole and answer my question

 

[CremeSickle]

plank is correct

the book "state lisencing requirements and statistics 2005" from AMA provides info which clearly states you cannot practice medicine in the USA without a residency.

However, the residency can be from 1-4 years (all states are different) and while one may be boarded in internal med or family practice they can (and do) practice anesthesia without an anesthesia residency legally. This is state specific but a good example is florida. In FL ANY physician can practice surgery and there has been a significantly documented string of litigation vs physicians with no residency training in any surgery practicing in surgi-centers and the like.

 

[VolatileAgent]

What are you waiting for ???

Something like your walking papers 2 months before you make partner????

yeah, just as i thought and per usual you don't know s***.

 

[Monty Python]

get a life If i remember correcly you are a crna who was unfhappy with your station so you went to medical school. What happened? did you drop out? too difficult for you.. too rigorous.. you dont have the discipline to committ to the rigorous education and training? I know it is much easier coming on this board and bad mouth doctors... I dont understand why you cant go to your nursing forum and bad mouth us.. MURSE

Quite interesting how my straight-forward and purely academic question (at least it was my intent) has kicked the ant hill. Without meaning to stir up needless bandwidth wastage of "whose is bigger" I simply wanted to hear other's opinions on a BC requirement for attendings versus just being an option. CRNAs have to pass boards ... would the same mandatory requirement for attendings be feasible/desirable/overkill, etc?

[to reply to another question about the CRNA boards: there is an anesthesiologist on the question writer panel. I personally know his predecesor: he's an MD/PhD pediatric anesthesiologist. I think the CRNA certification exam would challenge a new med school grad, even if they did a clerkship in anesthesia. It's not the cakewalk fluff alluded to by others]

I have seen anesthesiologists whose talents truly ranged from A to Z. Most are talented physicians who I would let put me to sleep at any time. On the other hand, I've seen some who fail to make the grade. So, would a BC requirement have demonstratable benefits from perspectives of patient care (and job opportunity/job security) for anesthesiologists? Would it be just another piece of academic paper hanging on the wall, with no direct correlation to quality of patient care?

To be objective, there are also CRNAs out there who I wouldn't let put my dog to sleep.

Why ask the question? Simply because I enjoy knowing what others think because I don't know everything, never will, and enjoy learning from others. I enjoy the intellectual stimulation of educated conversation (on any topic) and the tangents it can take to other areas also worth exploring. And because there are no anesthesiologists in my local Mensa chapter with whom to chat.

Which is why I also applied to med school last year. I didn't need the money, didn't need ego-stoking, but pursued it for intellectual reasons and desire for broader clinical challenges with the licensure to address them. I was accepted with full all-expenses-paid scholarship. I declined to matriculate after more discussion with my wife. Losing the chance to continue my education was not worth losing my wife/family. (interesting is how ~90% of physician friends have privately told me I did the right thing).

I'm 50. I don't need to work anymore, financially speaking. I have no axes to grind with anyone - I'm so far beyond that I can't even see it in my rear-view mirror. If you wish to say the sky is green, I'll just smile, nod my head at you, and continue on my way.

What sickens me is the continuing political nastiness, lack of transparent honesty (from all camps) and pursuit of the almighty dollar in the anesthesia profession. I guarantee you if nationalized healthcare came into being (and everyone was straight salary) all of the current hostility would disappear overnight.

At some level in your conscious or sub-conscious mind, and if pressed, almost every person on this forum would admit all the debates boil down to one thing: political power --> control --> money and/or job security.

If the ASA truly felt CRNAs were not qualified to give anesthesia, they would have put the profession out of business decades ago and seen to it that anesthesiologist-only practice was the law of the land. But they didn't. Could it be due to financial benefits? One wonders.

I applaud some members' obvious efforts to remain civil while in the midst of a contentious debate. I feel sorry for others who lack this ability, for it predicts a rocky road in the private practice world. This particular ability will be needed on a regular basis. I also have no personal need to recognize other's lack of decorum with similarly undignified replies.

 

[SleepIsGood]

Puhleeeeeeze.

Either some of you haven't worked in the real world yet, or else you're incredibly naive.

1) There are in fact physicians (and nurses, and dentists, and physical therapists, etc.) that are incompetent. Simple fact. Have you not ever worked with a surgeon that you wouldn't let touch your dog, or even your neighbor's dog?

2) There are in fact physicians (and nurses et al) that do not have a good command of the English language, and not all were foreign born either. That's not racist - again, it's a simple fact.

3) Hospitals are not required to use board certified physicians in any specialty. There are plenty of hospitals in small towns that would like to have ANY physician, board-certified or not. In addition, there are plenty of older physicians around that practice excellent medicine who never passed their boards.

Listen of course there are going to be ppl with accents...no argument there. However, when someone like Trinity tries to throw sand in our faces by saying there's a ANESTHESIOLOGIST that doesnt know what a LMA is...that's just a CRNA trying to doctor bash. PERIOD. Yes, perhaps in a small city a person can go and practice int/general medicine maybe...if they passed USMLE step3. HOwever, with a specialty like anesthesiology, you can't just go to some village in AMERICA and start working as an anesthesiologist at a hospital. Again, TRINITY...please provide us with a name of the hospital and the anesthesiology dept chair's name. Or else we're calling you out on this one.

 

[militarymd]

many of you wouldn't be quite so tough if everyone knew who you were.

yep........and it is surprising how easy it is to find out who people are....internet search, phone calls, data bases....

before you know it....you have their picture, home address, etc.

It is quite amazing.

yeah, i'm waiting...

What are you waiting for ???

Something like your walking papers 2 months before you make partner????

yeah, just as i thought and per usual you don't know s***.

ooohhhhh.....cussing....

You're hoping I don't know S HIT.....you can ask s23512345 whether I don't know S HIT or not....

 

[johankriek]

Which is why I also applied to med school last year. I didn't need the money, didn't need ego-stoking, but pursued it for intellectual reasons and desire for broader clinical challenges with the licensure to address them. I was accepted with full all-expenses-paid scholarship. I declined to matriculate after more discussion with my wife. Losing the chance to continue my education was not worth losing my wife/family. (interesting is how ~90% of physician friends have privately told me I did the right thing).

.

A HAH!! Which is why you are spewing all this CRap on tis board. You are nothing. you never will be anything. If you did get into medical school which i dont believe, and didnt matriculate after receiving a full scholarship, someone else could have gotten your spot. You wasted everyone's time including your own. People who pursue medicine dont lose thier families, quite the opposite. They are family oriented. so you are a disgruntled doctor wanna be. It is not our fault. You had your chance to become a doctor and you could not cut it. SO now all you have left is to come on here and bash docs.. I believe that you matriculated and saw the mountain of work that you would have to do and you backed off.. Why dont you just admit it...

 

[morpheus md]

This thread blows.

 

[Monty Python]

..... However, when someone like Trinity tries to throw sand in our faces by saying there's a ANESTHESIOLOGIST that doesnt know what a LMA is...that's just a CRNA trying to doctor bash. PERIOD.

1. I have no desire nor need to doctor-bash. And I'm not so dumb as to intentionally come on a physician forum and willfully spit in the forum's face. Why come here at all if I just wish to become banned? That flies in the face of logic.

2. I do get perturbed by subjective double standards.

3. When I initially posted the scenario of the anesthesiologist not knowing what an LMA was, I should have used the term "supervising physian" in lieu of "anesthesiologist."

To you (I think) it means a BE/BC graduate of an anesthesiology residency. To me it's a generic term, referring to the non-surgeon physician who is specifically supervising the CRNA who just may (or may not) be a BC anesthesiologist.

 

[johankriek]

What sickens me is the continuing political nastiness, lack of transparent honesty (from all camps) and pursuit of the almighty dollar in the anesthesia profession. I guarantee you if nationalized healthcare came into being (and everyone was straight salary) all of the current hostility would disappear overnight.

At some level in your conscious or sub-conscious mind, and if pressed, almost every person on this forum would admit all the debates boil down to one thing: political power --> control --> money and/or job security.

If the ASA truly felt CRNAs were not qualified to give anesthesia, they would have put the profession out of business decades ago and seen to it that anesthesiologist-only practice was the law of the land. But they didn't. Could it be due to financial benefits? One wonders.

.

The asa didnt put crnas out of business because they weremaking tons of money on you all. It had nothing to do with them thinking you were good. IF they were allowed they woud have put monkeys on all the stools and billed for their services. Now there is no benefit for physicians to supervise nurses anymore, more an dmore of us will start doing our own cases (which i have been doing).

ANd also trinity. WIth regard to my stance about CRNAs. It has nothing to do with political power or anyhing like that. I think it is MORALLY wrong for CRNAS to have independent practice right. I think the training is not sufficient and the education does not have enough breadth. ANd patients deserve better. the standard is board certificaion and if we change that what message are we sending? You may be the nicest guy in the world. i have nothing against you but you are obviously trying to advance your cause through politics what you COULD NOT do with education. You were not willing to make the sacrifice or you couldnt make the sacrifice. So why should you have the privilege of having independent practice rights my friend.. Iw ish you all the luck in your future.

 

[jwk]

Listen of course there are going to be ppl with accents...no argument there. However, when someone like Trinity tries to throw sand in our faces by saying there's a ANESTHESIOLOGIST that doesnt know what a LMA is...that's just a CRNA trying to doctor bash. PERIOD. Yes, perhaps in a small city a person can go and practice int/general medicine maybe...if they passed USMLE step3. HOwever, with a specialty like anesthesiology, you can't just go to some village in AMERICA and start working as an anesthesiologist at a hospital. Again, TRINITY...please provide us with a name of the hospital and the anesthesiology dept chair's name. Or else we're calling you out on this one.

There are still non-board certified physicians without formal anesthesia training (some old GP's) administering anesthesia in some small towns. Granted, they're few and far between, but they're out there.

Again, not all states, and not all hospitals, have the same licensing and credentialling requirements. Ideally everyone is residency-trained and board certified. That's not the real world. There are a lot of physicians out there doing procedures and practicing in specialties outside their own that they have no business practicing in, but are allowed to do so because physician licenses are largely unrestricted.

 

[Monty Python]

A HAH!! Which is why you are spewing all this CRap on tis board. You are nothing. you never will be anything. If you did get into medical school which i dont believe, and didnt matriculate after receiving a full scholarship, someone else could have gotten your spot. You wasted everyone's time including your own. People who pursue medicine dont lose thier families, quite the opposite. They are family oriented. so you are a disgruntled doctor wanna be. It is not our fault. You had your chance to become a doctor and you could not cut it. SO now all you have left is to come on here and bash docs.. I believe that you matriculated and saw the mountain of work that you would have to do and you backed off.. Why dont you just admit it...

Please provide your mailing address and I'll oblige with copies of my acceptance letters.

Someone else did get my spot. I intentionally declined to matriculate in plenty of time (April) so as to allow an alternate to get in. I can also provide the school's declination of my request for a refund of my seat deposit payment.

So glad you're fully informed as to the details of my family situation to make such a grandiose pronouncement.

 

[johankriek]

1. 2. I do get perturbed by subjective double standards.

.

You are like a kid. You dont know enough to make a statment about anything.
YOur double standard was. why do anesthesiologist get to practice when they are not board certified and Nurses cannot until they are certified.

NUrses certification are a far far far far cry from BOARD CERTIFICATION

After graduation, one cannot be "Board certified" for minimum nine months.. and if u take the orals in the fall its over a year. do you propose that anesthesiologists sit at home unemplioyed because you want them to be board certified. And just to make it sit easier with you. In order to get a license in most states, physicians have to pass 3 national exams. Now its four national exams. which are very rigorous. and most states require a residency. thats a far cry from the 60 multiple choice exams that nurses take on the computer. each exam is extremely stressful. AND those who are board eligible have completed at least a four year residency. and those who are board certified have completed the above plus passed a written qualifying exam administered (once per year) by the American BOARD OF Anesthesiology and finished a certifying Oral exam given once per year. This is what is necessary for independent practice. Not 24 months of advanced nursing classes and on the job training.

 

[Monty Python]

The asa didnt put crnas out of business because they weremaking tons of money on you all. It had nothing to do with them thinking you were good. .

So what you're saying is that your national organization doesn't put patient safety as a number one priority?

 

[Monty Python]

YOur double standard was. why do anesthesiologist get to practice when they are not board certified and Nurses cannot until they are certified.

.

My subjective double standard complaint concerns CRNAs requiring supervision by a non-surgeon, non-BC generic physician (I won't use the term anesthesiologist).

 

[johankriek]

So glad you're fully informed as to the details of my family situation to make such a grandiose pronouncement.

I'm not making any pronouncement on your family situation. All I am saying is that you have not made the sacrifice for whatever reason. you may have gotten accepted into medical school but you DID not go or complete. the fact that you got accepted does not make you a better person or an authority on anything. you are still a NURSE. a MURSE.

And you have ruined it for other nurses who may wanna go to medical school They will think twice before they accept a MURSE.

Where did you get accepted anyway? prolly an osteopathic school ( no offense to my DO brothers and sisters)

 

[CremeSickle]

johankriek


Your posts here speak volumes about your character and professionalism.


BTW: as a DO, offense taken.

 

[mocdoc]

My subjective double standard complaint concerns CRNAs requiring supervision by a non-surgeon, non-BC generic physician (I won't use the term anesthesiologist).

It is not the boards alone that makes someone an anesthesiologist. I don't know why that is such a difficult sticking point.

Just as it is not the Bar alone that makes one a lawyer or the USMLE's that make one a physician, it is not the TEST that entitles one to call themselves an anesthesiologist. There may be restrictions on an individual's ability to practice or ability to obtain malpractice or insurance reimbursement or whatever. BUT you are still an anesthesiologist, or a lawyer, or an MD, or even a nurse upon completion your training program.

The minute I graduated medical school, I was a doctor, an MD. In either situation, JD or MD, there is a training component and a test component. Currently you have to get through both.

I feel like the issue of "grandfathered" physicians is a rather small one, and is becoming a thing of the past in rapid fashion. I know of several surgical residents that are truly world class foreign surgeons, that I would allow to cut on me or my family any day, who are re-doing their residency for the ability to practice in the US. This goes for several anesthesiology residents I have met as well.

I feel like you are splitting hairs to pick a fight, sure find one example of the worst of anyone in any given specialty and I am sure we would all be shocked by their actions. This goes for CRNAs also.

 

[johankriek]

johankriek


Your posts here speak volumes about your character and professionalism.


BTW: as a DO, offense taken.

I said no offense NITECAP..

 

[CremeSickle]

You said this

Where did you get accepted anyway? prolly an osteopathic school

Which is certainly a slight against DOs. Just b/c you cant figure out OMM dosent mean we are in anyway inferior. BTW saying "no offence to my DO brothers" dosen't make it OK.

Lastly, it appears you all hate this CRNA nitecap, I could care less.

 

[Monty Python]

It is not the boards alone that makes someone an anesthesiologist. I don't know why that is such a difficult sticking point.

Just as it is not the Bar alone that makes one a lawyer or the USMLE's that make one a physician, it is not the TEST that entitles one to call themselves an anesthesiologist. There may be restrictions on an individual's ability to practice or ability to obtain malpractice or insurance reimbursement or whatever. BUT you are still an anesthesiologist, or a lawyer, or an MD, or even a nurse upon completion your training program.

The minute I graduated medical school, I was a doctor, an MD. In either situation, JD or MD, there is a training component and a test component. Currently you have to get through both.

I feel like the issue of "grandfathered" physicians is a rather small one, and is becoming a thing of the past in rapid fashion. I know of several surgical residents that are truly world class foreign surgeons, that I would allow to cut on me or my family any day, who are re-doing their residency for the ability to practice in the US. This goes for several anesthesiology residents I have met as well.

I feel like you are splitting hairs to pick a fight, sure find one example of the worst of anyone in any given specialty and I am sure we would all be shocked by their actions. This goes for CRNAs also.

It was not my intent to pick a fight. I have no need nor desire for such a folly, especially on a forum where I am a guest.

I asked my question purely out of academic apolitical curiosity ..... asking myself, "hmmm, what do others think about xyz? Let's see."

If my verbalization of that question caused unwanted angst I apologize and will retire from this thread, before any more emotional currency is needlessly wasted.

 

[toughlife]

everyone wants to be captain of the ship without going through the proper training.

Laboratory workers want to be pathologists, radiology assistants want to be radiologists, etc. What is it with people? This is mind boggling. In no other country in the world do you see people trying to be something they are not.

Why is everyone so jealous of physicians that they are trying so hard to be just like them? If you want to be the boss, pay the price and go through the proper training, you lazy freaks.

http://www.aaom.info/qiunity/06/11/ama_resolution_904.pdf

 

[johankriek]

You said this



Which is certainly a slight against DOs. Just b/c you cant figure out OMM dosent mean we are in anyway inferior. BTW saying "no offence to my DO brothers" dosen't make it OK.

Lastly, it appears you all hate this CRNA nitecap, I could care less.

i have nothing against osteopaths..... they are physicians and they have made the academic sacrifice.. Not like you my friend.. You are A CRNA posing as a doc to post on here...

 

[dogbone65]

I wish I could get the 5 minutes of my life back I just wasted reading this drivel.....pitiful