PAs and Anesthesiology?

[PharmBoy90]

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I'm currently working toward my Bachelor's in Biology, and from there I will decide if I want to go to Pharmacy school or PA school. I've been debating about it for a long time.

However, if I go the PA route, I'd like to do something in Anesthesiology, but I'm not sure if they have PAs that specialize in that field. One of my parents' friends is a RN, and she told me to look into a nursing programs and from there I can try to become a Nurse Anesthetist after I graduate. Is there anything similar to that career in the world of a Physician Assistant, or is that specifically a nursing thing?

 

[deleted6669]

pa's can work in anesthesiology but most do pre-screening, etc and not intraoperative anesthesia. a few old guys do OR anesthesia but it is hard to do that path as a pa.
there is another career (AA) which does o.r. anesthesia. see this link for an example of the program at Emory:
http://www.med.emory.edu/education/aa_program/
AA's and crna's do the same job in the o.r. and are used interchangeably at practices that use both. PM JWK here at sdn if interested as he is chief anesthetist at his group and is an AA.

 

[Denatured]

Be careful of choosing AA. They can only work with an anesthesiologist in the building, at least per my state (not that it should be that way), which will limit you to mostly major medical centers. They also only have practice rights in 18 states last I read. They are constantly trying to expand that number though. Also, they are not used in the military if you are interested in that.

Great job, just restrictive as far as location to practice and more restrictive laws than those that govern CRNAs or PAs. I just suggest researching it very well to make sure you are okay with where you can practice and being more restricted than other PAs.

 

[deleted6669]

Be careful of choosing AA. They can only work with an anesthesiologist in the building, at least per my state (not that it should be that way), which will limit you to mostly major medical centers. They also only have practice rights in 18 states last I read. They are constantly trying to expand that number though. Also, they are not used in the military if you are interested in that.

Great job, just restrictive as far as location to practice and more restrictive laws than those that govern CRNAs or PAs. I just suggest researching it very well to make sure you are okay with where you can practice and being more restricted than other PAs.

the thing in their favor is that they are part of md lead groups and not competition for docs. for this reason they are rapidly becoming the anesthetist of choice by anesthesiologists in states in which they practice. there are several new aa schools now and they are picking up a few states every few years. ask any anesthesiologist who they would rather hire given a choice.

I agree that if you want to do SOLO anesthesia AND not go to med school that crna offers that ability at the present time and AA does not. many feel that anesthesia is a field that always should have some degree of md oversight. I am not an AA and not planning on becoming one. just passing along information.

 

[Denatured]

the thing in their favor is that they are part of md lead groups and not competition for docs. for this reason they are rapidly becoming the anesthetist of choice by anesthesiologists in states in which they practice. there are several new aa schools now and they are picking up a few states every few years. ask any anesthesiologist who they would rather hire given a choice.

I agree that if you want to do SOLO anesthesia AND not go to med school that crna offers that ability at the present time and AA does not. many feel that anesthesia is a field that always should have some degree of md oversight. I am not an AA and not planning on becoming one. just passing along information.

Agree with all of that, except maybe the fine details on anesthetist of choice. What you say is likely very true in large urban centers that have an anesthesiologist in house 24 hours. Really though, it is mainly a facility and group dependent matter. What works for one does not work for all.

There are some anesthesia groups with CRNA owners, and most rural hospitals have few or no anesthesiologist. Mine being one.

If anesthesiologists really want to make AA the anesthetist of choice, they should help push legislation to call the anesthesiology associates 😉 but seriously, give them collaborative agreements so they can work in smaller facilities that have anesthesiologist, just maybe not 24 hour coverage.

 

[PrinceVersed]

If anesthesiologists really want to make AA the anesthetist of choice, they should help push legislation to call the anesthesiology associates 😉 but seriously, give them collaborative agreements so they can work in smaller facilities that have anesthesiologist, just maybe not 24 hour coverage.

Hey hey buddy, slow it down! Don't be giving my competition any ideas!

 

[jwk]

Agree with all of that, except maybe the fine details on anesthetist of choice. What you say is likely very true in large urban centers that have an anesthesiologist in house 24 hours. Really though, it is mainly a facility and group dependent matter. What works for one does not work for all.

There are some anesthesia groups with CRNA owners, and most rural hospitals have few or no anesthesiologist. Mine being one.

If anesthesiologists really want to make AA the anesthetist of choice, they should help push legislation to call the anesthesiology associates 😉 but seriously, give them collaborative agreements so they can work in smaller facilities that have anesthesiologist, just maybe not 24 hour coverage.

The "anesthetist of choice" is an interesting comment from E. He's saying that because he is aware of the current political climate / debate / friction between anesthesiologists and CRNA's. AA's work with anesthesiologists, not against them. It's not surprising that anesthesiologists might prefer to work with those who don't try to stab them in the back and pretend to have parity to a physician with twice the education.

Denatured - let me clarify this for you a little.

An AA does indeed have to work with an anesthesiologist. We work in what is commonly referred to as an Anesthesia Care Team concept (ACT), where an anesthesiologist supervises or directs a number of AA's and/or CRNA's, often on a 1:3 or 1:4 ratio. If an anesthesiologist is present, AA's can work there. Most hospitals that have anesthesiologists have them present or available 24/7, and the larger and more urban the hospital, the higher the chances are that an anesthesiologist is in-house 24/7. So, if an anesthesiologist is in-house or comes in on call, it's perfectly legit for an AA to be there as well. However, it doesn't have to be a "large urban center" to have in-house anesthesiologist coverage. Probably any city with a population of >75k is likely to have such coverage because the hospital will be large enough to support that type of practice.

PharmBoy - feel free to PM me for more info. Also, check out www.anesthetist.org for more info about AA's.

 

[Denatured]

The "anesthetist of choice" is an interesting comment from E. He's saying that because he is aware of the current political climate / debate / friction between anesthesiologists and CRNA's. AA's work with anesthesiologists, not against them. It's not surprising that anesthesiologists might prefer to work with those who don't try to stab them in the back and pretend to have parity to a physician with twice the education.

Denatured - let me clarify this for you a little.

An AA does indeed have to work with an anesthesiologist. We work in what is commonly referred to as an Anesthesia Care Team concept (ACT), where an anesthesiologist supervises or directs a number of AA's and/or CRNA's, often on a 1:3 or 1:4 ratio. If an anesthesiologist is present, AA's can work there. Most hospitals that have anesthesiologists have them present or available 24/7, and the larger and more urban the hospital, the higher the chances are that an anesthesiologist is in-house 24/7. So, if an anesthesiologist is in-house or comes in on call, it's perfectly legit for an AA to be there as well. However, it doesn't have to be a "large urban center" to have in-house anesthesiologist coverage. Probably any city with a population of >75k is likely to have such coverage because the hospital will be large enough to support that type of practice.

PharmBoy - feel free to PM me for more info. Also, check out www.anesthetist.org for more info about AA's.

Thanks for the lesson JWK, but I'm well informed on these issues and TEFRA rules.

Not re-reading my posts as I'm tired, I may have not made it clear that there are always exceptions. However, in my area, only level one trauma centers tend to have an anesthesiologist on call 24/7. My personal hospital only has 5 CRNAs (mostly everything but neuro and hearts), though I have worked with AAs in the past and found them exceptionally well trained. So my hospital would not find an AA the provider of choice, nor would any of my surrounding hospitals that do not have 24/7 (most only 12 hour and some weekends) coverage with an anesthesiologist. Not to mention ACT groups that are owned by CRNAs, which I'm sure have a preference 😉 Like I was saying, it's all relative and that is just my locale. I know Atlanta is AA central. At least I cannot think of a place with a more dense population of AAs.

And please don't paint the picture that CRNAs are out to "stab them in the back." It simply isn't true. Maybe we should start a site like clinician one for NPs and PAs, only for CRNAs and AAs.

 

[jwk]

Thanks for the lesson JWK, but I'm well informed on these issues and TEFRA rules.

Not re-reading my posts as I'm tired, I may have not made it clear that there are always exceptions. However, in my area, only level one trauma centers tend to have an anesthesiologist on call 24/7. My personal hospital only has 5 CRNAs (mostly everything but neuro and hearts), though I have worked with AAs in the past and found them exceptionally well trained. So my hospital would not find an AA the provider of choice, nor would any of my surrounding hospitals that do not have 24/7 (most only 12 hour and some weekends) coverage with an anesthesiologist. Not to mention ACT groups that are owned by CRNAs, which I'm sure have a preference 😉 Like I was saying, it's all relative and that is just my locale. I know Atlanta is AA central. At least I cannot think of a place with a more dense population of AAs.

And please don't paint the picture that CRNAs are out to "stab them in the back." It simply isn't true. Maybe we should start a site like clinician one for NPs and PAs, only for CRNAs and AAs.

It's unfortunate that hospitals that have anesthesiologists on staff don't have them at least available on call 24/7. Those types of groups are doing their patients a dis-service. Regardless, if anesthesiologists are on staff, AA's can work there (assuming of course it's in an AA-friendly state).

An ACT group owned by CRNA's is an oxymoron. I've heard of CRNA groups that employ anesthesiologists. It doesn't really make sense to me except as an attempt to attach some sort of legitimacy to a CRNA group so they can say "look, we have an anesthesiologist too!".

 

[Denatured]

It's unfortunate that hospitals that have anesthesiologists on staff don't have them at least available on call 24/7. Those types of groups are doing their patients a dis-service. Regardless, if anesthesiologists are on staff, AA's can work there (assuming of course it's in an AA-friendly state).

An ACT group owned by CRNA's is an oxymoron. I've heard of CRNA groups that employ anesthesiologists. It doesn't really make sense to me except as an attempt to attach some sort of legitimacy to a CRNA group so they can say "look, we have an anesthesiologist too!".

Anesthesia is a business and the groups give the customers what they want. If they want an ACT, that's what they give them. Same with my hospital.

 

[nixonshead]

in theory could a PA operate as a AA if an MDA trained them? Shouldnt the PA be able to do what ever the SP allowed them to do under their own scope? I suppose billing would be an issue as well..