New WSJ Article - VA debates MD vs CRNA, Interesting Comments

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I'm glad to see this is blowing up. Our vets deserve better.

Agreed, the only problem is it could totally go in the wrong direction. If they win this battle, many other hospital groups will follow. You kind of feel like only surgery is safe at this point.

Anesthesia to 220k? Wouldnt be surprised it obongocare pulls all MDs into the 220-250 range. Who knows
 
Interestingly, obama thought he was above the forces of the free market. When insurance companies cancelled plans of folks, he met with the companies and asked them to take their customers back. It is hilarious to see how out of touch and idealistic career politicians (democrat and republican) have become with the real world and economy/market, but that is what gets votes.
 
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...and you'd complain about that, too.
maybe. nothing's perfect, but controlling your own practice and not having to deal with insurance or cms sounds nice

you're so smart and knowledgeable, you should definitely do anesthesia
 
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Can't read the article without a subscription.
Do a Google search on the title of the article ("At VHA, Doctors, Nurses Clash on Oversight"), than click the link from there. Chances are you will be able to read it.

Last month, the VHA issued new guidelines for its 2,200 physician assistants, lifting some restrictions and letting individual PAs and their "collaborating physicians"—previously called "supervising physicians"—determine how much autonomy the PA should have. The American Academy of Physician Assistants hailed the new directive as a "model of flexibility."

The proposed nursing handbook is generating more opposition. As currently drafted, it would recognize the VHA's 6,135 advance-practice registered nurses—including nurse practitioners, nurse anesthetists, nurse midwives and clinical-nurse specialists—as independent practitioners authorized to care for patients without direction or supervision by a doctor. For nurse anesthetists, for instance, that includes administering anesthesia in surgeries, managing acute-pain services and being the lone anesthesia provider in some clinics.

VHA nursing officials say the proposed change follows a 2010 Institute of Medicine recommendation that nurses should practice to the full extent of their education and training. They note advanced-practice RNs, who have master's or doctoral degrees and pass national certification exams, have been operating independently in many VHA facilities and the armed forces for years. The proposed nursing handbook would standardize procedures throughout the system.
F_ck them! I wouldn't "collaborate". They can "collaborate" with each other, if they are so expert.

VA Secretary Eric Shinsekiwho credits a nurse with saving his foot when physicians wanted to amputate it in Vietnam—defended the proposed change in a letter to lawmakers last fall, saying it "will increase access to care and ensure continuation of the highest quality care for our nation's veterans."
Now we know where the wind is blowing from. This guy should have recused himself from this discussion.

These are the comments. The link might not be working: http://online.wsj.com/public/page/r...ration, doctors and nurses clash on oversight.
 
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Unfortunately the people who read WSJ are educated and conservative and already value the care of real doctors. Too bad this doesn't trickle down to more liberal newspapers.
 
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Do a Google search on the title of the article ("At VHA, Doctors, Nurses Clash on Oversight"), than click the link from there. Chances are you will be able to read it.


F_ck them! I wouldn't "collaborate". They can "collaborate" with each other, if they are so expert.


Now we know where the wind is blowing from. This guy should have recused himself from this discussion.

These are the comments. The link might not be working: http://online.wsj.com/public/page/reader-comments.html?baseDocId=SB10001424052702304856504579340603947983912&headline=At the Veterans Health Administration, doctors and nurses clash on oversight.

LOVE the comment about there should be a University of Phoenix medical school "since the demand is there" It's like HEY these people want to be doctors and engineers, the demand is there so we must make all these people experts in these fields thru U of P!

Good grief
 
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LOVE the comment about there should be a University of Phoenix medical school "since the demand is there" It's like HEY these people want to be doctors and engineers, the demand is there so we must make all these people experts in these fields thru U of P!

Good grief

There already is. It's in the carribean somewhere.
 
Can't read the article without a subscription.
Search the article title on Google and click the link. You can read WSJ articles for free if the URL referral is from Google.

edit: His post is from months ago, whatever.
 
I'm glad to see this is blowing up. Our vets deserve better.
And now with this VA deaths fiasco and Shinseki, I hope your ASA is smart enough to strike while it's still hot.
 
Maybe if the CRNAs killed them they may have had some traction.
I think the opposite will happen. The NPs organization(s), with the AANA tagging along, will use this disaster to show how they need more pseudo independent NPs, and CRNAs, to manage the volume there and free up the MDs to be able to manage the sickest patients. (Which they will say they can manage as well, but all those overpaid MDs have to do something.)
 
Shinseki gets shi_canned.
Does it matter? The guy is 71 years old with full govt pension?

For once I would like to see some type of higher up (who's 2-3 years away from full govt pension) get fired. Of course that will never happen.
 
:thumbup: Ding Ding Ding! We have a winner!

Yeah well I work with a guy who went to American University of the Caribbean (also owned by Devry) and he is the best damn anesthesiologist in our group. He did his four year residency at a university program plus a fellowship in critical care. He passed all of his exams and boards easily on the first try probably outscoring most of you guys. If I needed surgery I'd take him over most of my other partners - or any CRNA I've ever worked with. So be careful at whom you're casting stones.
 
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Maybe if the CRNAs killed them they may have had some traction.
I think the opposite will happen. The NPs organization(s), with the AANA tagging along, will use this disaster to show how they need more pseudo independent NPs, and CRNAs, to manage the volume there and free up the MDs to be able to manage the sickest patients. (Which they will say they can manage as well, but all those overpaid MDs have to do something.)

I predict this exact thing will happen. Guaranteed.
 
I predict this exact thing will happen. Guaranteed.

We lack again in the PR department. I have yet to see/hear a physician speak out on what they believe will be best for the VA. It's a grand opportunity to show we are the true leaders of a well ran healthcare system.
 
Yeah well I work with a guy who went to American University of the Caribbean (also owned by Devry) and he is the best damn anesthesiologist in our group. He did his four year residency at a university program plus a fellowship in critical care. He passed all of his exams and boards easily on the first try probably outscoring most of you guys. If I needed surgery I'd take him over most of my other partners - or any CRNA I've ever worked with. So be careful at whom you're casting stones.

Hey, I was talking about the school in general, not about those who graduate from said school.

FWIW, I'm sure there are a couple incompetent snobs who get their MD from Harvard each year... but that's way off topic.
 
Hey, I was talking about the school in general, not about those who graduate from said school.

FWIW, I'm sure there are a couple incompetent snobs who get their MD from Harvard each year... but that's way off topic.

No problem.

[Offtopic]

I just think that once you get into the real world the distinctions between those who are accomplished no matter their pathway begin to stand out. I've worked with relative *****s who trained at some of the most prestigious of institutions in the U.S. and whom I wouldn't feel comfortable letting them operate on an actual guinea pig. And I've also worked with some from medical schools you've never heard of in India, eastern Europe, Africa and, yes, even the Caribbean (to name only a few) who are some of the smartest, most gifted, insightful physicians you'll ever have the great fortune to work alongside.

I think any potentially disparaging remarks about the Caribbean or D.O. route or IMG (or whatever else) are best left for the pre-med forums. There the status anxiety can be left to freely flourish. And certainly the Caribbean has a far more cutthroat way of separating the wheat from the chaff. As my friend once told me, getting in and staying in are two entirely different concepts. Let alone succeeding in a competitive field that has incredibly high standards of safety and performance.

[/Offtopic]
 
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Unfortunately the people who read WSJ are educated and conservative and already value the care of real doctors. Too bad this doesn't trickle down to more liberal newspapers.

WSJ readers are well educated--56% are college grads (the same as the liberal NYT, a bit less than the liberal New Yorker, a bit more than the liberal NPR)--but they are not particularly conservative--only 20% of WSJ readers are Republicans and only 32% are conservative. The really conservative news sources are Hannity (78% conservative), Limbaugh (71% conservative), O'Reilly (69% conservative) and Fox News (60% conservative)--24% to 31% of the viewership of each of those outlets has a college degree. http://www.ibtimes.com/audience-pro...ches-fox-news-other-news-publications-1451828
 
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