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CyclonusMD

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I’m looking for some data pertaining to employment of anesthesiologists, and was hoping some of you folks could point me in the right direction. Or, if you know these numbers off the top of your head and wouldn’t mind sharing, that’d be great too.

Specifically, I was hoping to get some data regarding the distribution of anesthesiologists among the various types and sizes of hospitals (e.g. small vs. large, teaching vs. non-teaching, major medical centers vs. smaller community hospitals, tertiary care facilities, etc.) and the percentages of the various types of these health care facilities that have anesthesiologists on their staff.


Any input would be much appreciated.
 

IlDestriero

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I’m looking for some data pertaining to employment of anesthesiologists, and was hoping some of you folks could point me in the right direction. Or, if you know these numbers off the top of your head and wouldn’t mind sharing, that’d be great too.

Specifically, I was hoping to get some data regarding the distribution of anesthesiologists among the various types and sizes of hospitals (e.g. small vs. large, teaching vs. non-teaching, major medical centers vs. smaller community hospitals, tertiary care facilities, etc.) and the percentages of the various types of these health care facilities that have anesthesiologists on their staff.


Any input would be much appreciated.
Generally people requesting information take the time to introduce themselves, and explain why they want the info. Common courtesy, it's a lost art.
Off the top of my head, I would say that nearly 100% of hospitals outside of really rural America have anesthesiologists on staff or contracted to work in their ORs, ICUs and ASCs.
 
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karizma098

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Generally people requesting information take the time to introduce themselves, and explain why they want the info. Common courtesy, it's a lost art.
Off the top of my head, I would say that nearly 100% of hospitals outside of really rural America have anesthesiologists on staff or contracted to work in their ORs, ICUs and ASCs.
yup..

and those hospitals or clinics in rural america that don't have anesthesiologists would usually kill to have one; they are typically just somewhere that is a big enough craphole that no MD/DO would go there..that's typically where you'll find a militant style CRNA running the show.
 
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CyclonusMD

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yup..

and those hospitals or clinics in rural america that don't have anesthesiologists would usually kill to have one; they are typically just somewhere that is a big enough craphole that no MD/DO would go there..that's typically where you'll find a militant style CRNA running the show.
Sorry folks. This is my first time posting on SDN and I’m not familiar with the etiquette around here. Mea culpa. My name is Michael (forgive me if I pass on providing my last name).

The very reason I’m asking about this is because of a debate I’m having with a CRNA, who claims that there are studies showing that CRNAs autonomously handle high-risk / high acuity patients as well as anesthesiologists do.

I haven’t read any of these studies yet but I have a hard time believing that any of them could be valid, specifically because I can’t imagine that such a scenario (i.e. where CRNAs handle risky cases completely without an anesthesiologist around as a safety net) occurs frequently enough for a study to be conducted.

Hence, I’d like to know just how many hospitals there are in this country that do not have anesthesiologists on staff and treat high-risk patients in their ORs.
 

karizma098

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Sorry folks. This is my first time posting on SDN and I’m not familiar with the etiquette around here. Mea culpa. My name is Michael (forgive me if I pass on providing my last name).

The very reason I’m asking about this is because of a debate I’m having with a CRNA, who claims that there are studies showing that CRNAs autonomously handle high-risk / high acuity patients as well as anesthesiologists do.

I haven’t read any of these studies yet but I have a hard time believing that any of them could be valid, specifically because I can’t imagine that such a scenario (i.e. where CRNAs handle risky cases completely without an anesthesiologist around as a safety net) occurs frequently enough for a study to be conducted.

Hence, I’d like to know just how many hospitals there are in this country that do not have anesthesiologists on staff and treat high-risk patients in their ORs.
well, what do you expect? the AANA and CRNAs are depending on these 'studies' ( many which they fund directly or indirectly ) to allow them to practice independently and bring in more $$. They want autonomy, they want to do interventional pain; they want to make more money. They want to be a physician with half the training and knowledge. In rural areas where you dont have physicians you may see a CRNA handling these types of cases - doesn't mean they should be. It's a debate that is going to come to a boiling point in the next 10 years for sure.

Their endgoal is to take over the MD's job in the OR...they will continue to make bogus claims about how they are equivalent providers until that happens. It's not just CRNAs - NP's and DNP's are killing family practitioners, there are DERM PA's making a killing out there; and it's not long before you start seeing nurses trying to get in on some of the ophtho, cardio, GI action. will that happen? i dont know. It's a scary thought, but it's our forefather's fault for not protecting the profession. hopefully our generation of docs ( and after the DNP degree, i use this term likely ) changes things.
 

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Have you read the Health Affairs paper? Despite its considerable flaws, it gives a little perspective on what cases might be done from an acuity standpoint.
 

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Dude, the nurse is a nurse. Are you a doctor? If so, the discussion shouldn't be that hard....you went to med school, he didn't.

Just like we don't need studies to show that parachutes work to save lives, we don't need studies to show that doctors practice medicine, and that nurses cannot do so. THERE IS ONE TRUTH.

For the record, no studies have been done to show CRNA superiority or equality in any way...

Sorry folks. This is my first time posting on SDN and I’m not familiar with the etiquette around here. Mea culpa. My name is Michael (forgive me if I pass on providing my last name).

The very reason I’m asking about this is because of a debate I’m having with a CRNA, who claims that there are studies showing that CRNAs autonomously handle high-risk / high acuity patients as well as anesthesiologists do.

I haven’t read any of these studies yet but I have a hard time believing that any of them could be valid, specifically because I can’t imagine that such a scenario (i.e. where CRNAs handle risky cases completely without an anesthesiologist around as a safety net) occurs frequently enough for a study to be conducted.

Hence, I’d like to know just how many hospitals there are in this country that do not have anesthesiologists on staff and treat high-risk patients in their ORs.
 
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CyclonusMD

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Dude, the nurse is a nurse. Are you a doctor? If so, the discussion shouldn't be that hard....you went to med school, he didn't.

Just like we don't need studies to show that parachutes work to save lives, we don't need studies to show that doctors practice medicine, and that nurses cannot do so. THERE IS ONE TRUTH.

For the record, no studies have been done to show CRNA superiority or equality in any way...

Well, dude, I am a doctor - an anesthesiologist, in fact. And the discussion is indeed that hard. Even some of our colleagues here disagree with you on this matter. CRNAs are using these studies to cut into our profession -- and having some success at it -- so I’d say it behooves us to make some sort of effort to expose them as flawed. Simply saying that we know more than they do isn’t cutting it, obviously.
 

Coastie

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Well, dude, I am a doctor - an anesthesiologist, in fact. And the discussion is indeed that hard. Even some of our colleagues here disagree with you on this matter. CRNAs are using these studies to cut into our profession -- and having some success at it -- so I’d say it behooves us to make some sort of effort to expose them as flawed. Simply saying that we know more than they do isn’t cutting it, obviously.
So, some of our colleagues disagree with me that CRNAs are nurses, not doctors, and can't practice medicine? They disagree that there is only one truth, and that being noctors are not doctors?

You smell like a decently covered troll, but try harder next time, dude.
 
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CyclonusMD

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So, some of our colleagues disagree with me that CRNAs are nurses, not doctors, and can't practice medicine? They disagree that there is only one truth, and that being noctors are not doctors?

You smell like a decently covered troll, but try harder next time, dude.

Wow, that has to be world record speed with which someone posting on a forum for the first time has been labeled as a “troll”.

Obviously I know that we are more qualified than CRNAs, as does everyone else here on this message board. But that doesn’t seem to be a convincing enough argument for the people who make health policy. That’s my point. I have a hard time understanding how you’re not seeing the practicality of addressing the very material that the AANA uses to promote their claim that CRNAs are just as safe.
 

Coastie

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Wow, that has to be world record speed with which someone posting on a forum for the first time has been labeled as a “troll”.

Obviously I know that we are more qualified than CRNAs, as does everyone else here on this message board. But that doesn’t seem to be a convincing enough argument for the people who make health policy. That’s my point. I have a hard time understanding how you’re not seeing the practicality of addressing the very material that the AANA uses to promote their claim that CRNAs are just as safe.
Stop whining because people are questioning your intentions.

Check out old threads on this.
 

pgg

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Wow, that has to be world record speed with which someone posting on a forum for the first time has been labeled as a “troll”.

Obviously I know that we are more qualified than CRNAs, as does everyone else here on this message board. But that doesn’t seem to be a convincing enough argument for the people who make health policy. That’s my point. I have a hard time understanding how you’re not seeing the practicality of addressing the very material that the AANA uses to promote their claim that CRNAs are just as safe.
Welcome to the forum. :)

We have a long and inglorious history of being assaulted by nurses creating new accounts and pretending to be doctors, reporters, or innocent researchers looking for data comparing CRNAs to anesthesiologists. We're generally not interested in feeding their delusions or helping them hone their talking points. The threads typically degenerate. We ban them as fast as we can but it's like playing whackamole, except less satisfying because there's no actual punching involved.

Don't take the suspicious welcome personally.
 

countingdays

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CRNAs don't do studies. They do advertising in no-standard nursing throw aways. Their audience is too ignorant of the scientific method to understand how flawed their press releases in nursing journals and newspapers are. You don't counter advertising with research. You counter advertising with better advertising. Physicians have not sunk to nurses' level so far because we have professional standards, but it may come to that in time. I don't want us to lose our standards like the trial lawyers- destroying the respectibility of law, but the nurses will lie cheat and steal to sneak their way into practicing medicine without licenses.
 
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CyclonusMD

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CRNAs don't do studies. They do advertising in no-standard nursing throw aways. Their audience is too ignorant of the scientific method to understand how flawed their press releases in nursing journals and newspapers are. You don't counter advertising with research. You counter advertising with better advertising. Physicians have not sunk to nurses' level so far because we have professional standards, but it may come to that in time. I don't want us to lose our standards like the trial lawyers- destroying the respectibility of law, but the nurses will lie cheat and steal to sneak their way into practicing medicine without licenses.
I agree with you completely that these studies are likely invalid, however, it seems to be these very studies that are being used to successfully further their cause.

Bogus or not, I think we should address them and point out their flaws. One of the ways to do this is to see if such data that they claim to have is even feasible to obtain. Hence my original query.
 

IlDestriero

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Flaws in the recent study were discussed before. Perhaps in the private forum? Search away.
 

IlDestriero

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One flaw in all of these safety studies is that people do not report complications and near misses. My hospital belongs to a group of children's hospitals looking at peds complications, with the goal of benchmarking patient safety in pediatric surgery.
Looking at the prelim data, it's obvious that even the participating institutions are failing to enter all their data, either that or somehow all the problems are occurring at a couple of places. Unlikely.
These are leaders in peds medicine, who agreed to participate, and they're not entering their data in a timely manner.
Do you think rural CRNAs are reporting anything voluntarily to anyone? They may not even recognize that their practice contributed to bad outcomes.
 
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CyclonusMD

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One flaw in all of these safety studies is that people do not report complications and near misses. My hospital belongs to a group of children's hospitals looking at peds complications, with the goal of benchmarking patient safety in pediatric surgery.
Looking at the prelim data, it's obvious that even the participating institutions are failing to enter all their data, either that or somehow all the problems are occurring at a couple of places. Unlikely.
These are leaders in peds medicine, who agreed to participate, and they're not entering their data in a timely manner.
Do you think rural CRNAs are reporting anything voluntarily to anyone? They may not even recognize that their practice contributed to bad outcomes.
No, I highly doubt that rural CRNAs report problems. They have every reason not to. Hell, some of the CRNAs I supervise are hesitant to call for help when the need arises. I've been involved in two incidents already where, by sheer chance, I walked into the room during situations that should have warranted someone paging me. Unfortunately, these kinds of incidents (which are probably quite common) can't be proven to have taken place. Similarly, I don't know if anyone could prove that CRNAs working on their own aren't reporting complications as they should.

What I want to know is where in the hell they're getting any statistics at all? Where and when are they treating ASA 3's and 4's completely on their own, i.e. frequently enough for there to be "studies" showing that they're doing it as well as we are.
 

IlDestriero

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If you assassinate someone do you bill the family? Insurance? Medicaid? I wouldn't know. Maybe they comment on that in the article.
 

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one flaw in all of these safety studies is that people do not report complications and near misses.

Looking at the prelim data, it's obvious that even the participating institutions are failing to enter all their data, either that or somehow all the problems are occurring at a couple of places. Unlikely.

These are leaders in peds medicine, who agreed to participate, and they're not entering their data in a timely manner.
Do you think rural crnas are reporting anything voluntarily to anyone? They may not even recognize that their practice contributed to bad outcomes.
.....duh :) :) :)
 

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Jerry Cromwell who authored the Health Affairs article based everything on billing data. Billing data does not include ASA status, nor does it include intraoperative issues that were managed/treated, and morbidity/mortality during hospitalization. You may be asking yourself how you could conduct such a study and draw any conclusions with such important details completely missing. Good question.

Jerry Cromwell has been producing research aimed at making anesthesiologists look bad for a long time. Do a search. He's also been getting paid by the AANA for a long time. You may be asking yourself why so much attention was paid to research done with such obvious bias included, and missing such important details as mentioned above. Good question. You can only conclude that the media cares absolutely nothing for accuracy or validity of the research, and only cares for a good story. You'd be right.

These conversations are so old, they've been repeated here over and over, so it'd be so much easier if people just either did a search, or joined the private forum.

If you're really honestly concerned about your profession, join the private forum, contribute as much as you can to the ASAPAC, and become an advocate for our profession.
 
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CyclonusMD

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Jerry Cromwell who authored the Health Affairs article based everything on billing data. Billing data does not include ASA status, nor does it include intraoperative issues that were managed/treated, and morbidity/mortality during hospitalization. You may be asking yourself how you could conduct such a study and draw any conclusions with such important details completely missing. Good question.

Jerry Cromwell has been producing research aimed at making anesthesiologists look bad for a long time. Do a search. He's also been getting paid by the AANA for a long time. You may be asking yourself why so much attention was paid to research done with such obvious bias included, and missing such important details as mentioned above. Good question. You can only conclude that the media cares absolutely nothing for accuracy or validity of the research, and only cares for a good story. You'd be right.

These conversations are so old, they've been repeated here over and over, so it'd be so much easier if people just either did a search, or joined the private forum.

If you're really honestly concerned about your profession, join the private forum, contribute as much as you can to the ASAPAC, and become an advocate for our profession.
So how the hell are these CRNAs saying that these studies take acuity into account, and that CRNAs have the same outcomes treating high-risk patients as we do?

As I said before, it simply doesn’t seem plausible to me that such studies could exist, but I’m awfully curious to know what CRNAs are referring to.
 

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Whackatroll.

The OP is now banned and unless there is a huge objection I am closing this thread since it really has nowhere to go and these issues have been covered ad nauseum.
 
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