- Joined
- Dec 1, 2005
- Messages
- 89
- Reaction score
- 0
I understand what you're saying, but I am not and never will be a "glorified CRNA" which is what you keep trying to perpetuate we are percieved as by a piece of paper.
The fact that I have a piece of paper stating I am a graduate of an American allopathic medical school and that I have a piece of paper stating completion of preliminary internal medicine internship AUTOMATICALLY garners the legality of worth. Furthermore, the certificates provided to CRNA's are not the same as those from an physician anesthesia residency.
The bottom line is attaining board certification. There are only two fellowships within anesthesia which will allow for extra "distinction", those being pain management and Critical Care.
As a physician I am allowed all the rights of a physician in this country including doing surgery if a patient was willing to let me do it. Would anyone let me without proper credentials? Doubtful, which is how I see your original point. The extra-credentialling will not protect our jobs, informing patients will. Furthermore, it is a poor mindset in my opinion. By stating that we need further distinction, we are essentially agreeing that we and CRNA's are the same. We are perioperative physicians. Surgeons do not consult CRNA's to diagnose and manage post-op patients.
It is the ASA/AMA's lack of a unified plan, physicians unwilling to work in underserved areas, and the initial Medicare reform disaster with its current forms (pay for performance) which has allowed the medical field (not just anesthesia) to slip. All of the documentation and red tape that we waste our time practicing defensive medicine has further allowed the increased scope and number of mid-level providers.
Mid-levels have effective lobbying powers because they are taught about the importance of such political actions during their training. Most residencies are not, and that is perpetuated in part by a large amount of lazy attendings who are not active themselves and have already "made" their money.
Furthermore, the mid-levels work significantly less hours, have significant income to donate with (which they do), all of which give them more time and vested interest in learning about and carrying out their efforts.
We as physicians have let patients start to feel some sort of entitlement to health care. It is not a right. Nowhere in our constitution does it say so.
Patients get in the habit of thinking medical bills cost a "co-pay". The mid-levels have always been supervised by physicians, or are employees of a hospital. This means they have never had to worry about overhead, collections, etc. They are actually screwing themselves and the people in America by trying to claim an equal level of care as a physician.
They are behind the erosion of health care with us helping by not paying attention for far too long. There is a place for CRNA's just like there is a place for PA's doing the saphenous vein harvest on a CABG, or a Nurse pratitioner doing a well-woman exam. The problem is that the general public has no idea of their role and scope of practice and knowledge base.
I personally feel we need to simplify it for people who are not involved with health care. It is as simple as wearing a long white coat.
What? A long white coat? That's stupid you say? How many people in the hospital do you see wearing a long white coat? I see tons of them. Hell, we've got PA's, NP's, phlebotomists, dieticians, pharmacists, ECHO techs, physicians, physical therapists, occupational therapists. You name it. Meanwhile, John Doe from anytown USA sees so many people during his hospital stay he has no idea who the doctor was and wasn't. Furthermore, most people in the health field that I've seen don' t even introduce themselves properly. Just because we know they aren't physicians doesn't mean most people assume they are not doctors. I've seen it countless times myself. I've been fooled myself tons of times by someone who is my elder in a long white coat walking around all proud on the floor. It's not until you get up close to them to see their title hidden behind the pens in their pocket, or in tiny print on a picture ID that you need to be within 1.5 feet to read. Meanwhile, someone in scrubs in the ER is talking with a patient, and educating them about their complaint and the patient thinks this is doctor's orders, and potentially leaves the ER without ever having a physician lay eyes on them.
This is one of the reasons for the new Bill being introduced to legislation concerning this misconception perpetuated by non-physicians charading around as one. Why can't we get back to simplicity. No one working in a hospital/clinic should be allowed to wear a long white coat except physicians.
Then a patient can decide which physician they are talking to and there is less confusion. It may sound silly to some on this board, but uniforms are important. You go to Best Buy and you know someone in a blue shirt with Best Buy on it works there.
Hell, if it is not such a big deal to wear the coat then why are medical students required to wear coats, or short coats at that? For IDENTIFICATION.
There needs to be a MAJOR education of the public concerning the personnel in healthcare. It does not need to come across as physicians are all important and mid-levels are worthless. It needs to be done in the same way and with the same care that we educate patients about their illnesses. That is by placing the patient's best interest first.
If it is done any other way, we will be percieved as greedy, pompous, and selfish. We became physicians to help people, be respected, and make money for our sacrifices, education and HARD WORK. We are the ones who need to fight for our patients now. We must unite under this premise which includes all specialties, because there is no way we lose the fight with this approach. If we keep trying to put out fires by winning small battles regarding reimbursement, and malpractice we will continue to perpetuate the wrong impressions.
We need to reinforce the doctor patient relationship and put the patient back in control of his/her own care. They need to be able to have more choice in whether they are seen by an MD/DO instead of being told to by an HMO, or Medicare. Once we reinforce this and educate the public about the quality of care they are becoming limited to our stock will rise again. It is at this point when we can stand up to being told how to practice medicine by CEOs and other non-medically trained money hounds.
Please forgive the long post.
The fact that I have a piece of paper stating I am a graduate of an American allopathic medical school and that I have a piece of paper stating completion of preliminary internal medicine internship AUTOMATICALLY garners the legality of worth. Furthermore, the certificates provided to CRNA's are not the same as those from an physician anesthesia residency.
The bottom line is attaining board certification. There are only two fellowships within anesthesia which will allow for extra "distinction", those being pain management and Critical Care.
As a physician I am allowed all the rights of a physician in this country including doing surgery if a patient was willing to let me do it. Would anyone let me without proper credentials? Doubtful, which is how I see your original point. The extra-credentialling will not protect our jobs, informing patients will. Furthermore, it is a poor mindset in my opinion. By stating that we need further distinction, we are essentially agreeing that we and CRNA's are the same. We are perioperative physicians. Surgeons do not consult CRNA's to diagnose and manage post-op patients.
It is the ASA/AMA's lack of a unified plan, physicians unwilling to work in underserved areas, and the initial Medicare reform disaster with its current forms (pay for performance) which has allowed the medical field (not just anesthesia) to slip. All of the documentation and red tape that we waste our time practicing defensive medicine has further allowed the increased scope and number of mid-level providers.
Mid-levels have effective lobbying powers because they are taught about the importance of such political actions during their training. Most residencies are not, and that is perpetuated in part by a large amount of lazy attendings who are not active themselves and have already "made" their money.
Furthermore, the mid-levels work significantly less hours, have significant income to donate with (which they do), all of which give them more time and vested interest in learning about and carrying out their efforts.
We as physicians have let patients start to feel some sort of entitlement to health care. It is not a right. Nowhere in our constitution does it say so.
Patients get in the habit of thinking medical bills cost a "co-pay". The mid-levels have always been supervised by physicians, or are employees of a hospital. This means they have never had to worry about overhead, collections, etc. They are actually screwing themselves and the people in America by trying to claim an equal level of care as a physician.
They are behind the erosion of health care with us helping by not paying attention for far too long. There is a place for CRNA's just like there is a place for PA's doing the saphenous vein harvest on a CABG, or a Nurse pratitioner doing a well-woman exam. The problem is that the general public has no idea of their role and scope of practice and knowledge base.
I personally feel we need to simplify it for people who are not involved with health care. It is as simple as wearing a long white coat.
What? A long white coat? That's stupid you say? How many people in the hospital do you see wearing a long white coat? I see tons of them. Hell, we've got PA's, NP's, phlebotomists, dieticians, pharmacists, ECHO techs, physicians, physical therapists, occupational therapists. You name it. Meanwhile, John Doe from anytown USA sees so many people during his hospital stay he has no idea who the doctor was and wasn't. Furthermore, most people in the health field that I've seen don' t even introduce themselves properly. Just because we know they aren't physicians doesn't mean most people assume they are not doctors. I've seen it countless times myself. I've been fooled myself tons of times by someone who is my elder in a long white coat walking around all proud on the floor. It's not until you get up close to them to see their title hidden behind the pens in their pocket, or in tiny print on a picture ID that you need to be within 1.5 feet to read. Meanwhile, someone in scrubs in the ER is talking with a patient, and educating them about their complaint and the patient thinks this is doctor's orders, and potentially leaves the ER without ever having a physician lay eyes on them.
This is one of the reasons for the new Bill being introduced to legislation concerning this misconception perpetuated by non-physicians charading around as one. Why can't we get back to simplicity. No one working in a hospital/clinic should be allowed to wear a long white coat except physicians.
Then a patient can decide which physician they are talking to and there is less confusion. It may sound silly to some on this board, but uniforms are important. You go to Best Buy and you know someone in a blue shirt with Best Buy on it works there.
Hell, if it is not such a big deal to wear the coat then why are medical students required to wear coats, or short coats at that? For IDENTIFICATION.
There needs to be a MAJOR education of the public concerning the personnel in healthcare. It does not need to come across as physicians are all important and mid-levels are worthless. It needs to be done in the same way and with the same care that we educate patients about their illnesses. That is by placing the patient's best interest first.
If it is done any other way, we will be percieved as greedy, pompous, and selfish. We became physicians to help people, be respected, and make money for our sacrifices, education and HARD WORK. We are the ones who need to fight for our patients now. We must unite under this premise which includes all specialties, because there is no way we lose the fight with this approach. If we keep trying to put out fires by winning small battles regarding reimbursement, and malpractice we will continue to perpetuate the wrong impressions.
We need to reinforce the doctor patient relationship and put the patient back in control of his/her own care. They need to be able to have more choice in whether they are seen by an MD/DO instead of being told to by an HMO, or Medicare. Once we reinforce this and educate the public about the quality of care they are becoming limited to our stock will rise again. It is at this point when we can stand up to being told how to practice medicine by CEOs and other non-medically trained money hounds.
Please forgive the long post.
