To Gas or Not to Gas: That is the question

[hans19]

Yes, the field of medicine is facing a number of challenges, both externally and within its own ranks. But you seem to have spent a lot of time and energy in blowing things way out of proportion. I find your portrayal of the situation alarmist at best. If you are so pessimistic about the our profession why do you even bother with medical school? Why not cut your losses and pursue nursing and become a NP or CRNA, since you feel that they will be supplanting MDs in the future? I commend the fact that you are not naive to the less desireable aspects of medicine, but I think you've gone off the deep end.

Relax, man. The sky is NOT falling!

-Hans.

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[bgreet]

You should pay attention to the time stamps, mac hasn't been here since march.

Woops! Didn't realize this was a resurfaced thread.

 

[MacGyver]

Yes, the field of medicine is facing a number of challenges, both externally and within its own ranks. But you seem to have spent a lot of time and energy in blowing things way out of proportion. I find your portrayal of the situation alarmist at best. If you are so pessimistic about the our profession why do you even bother with medical school? Why not cut your losses and pursue nursing and become a NP or CRNA, since you feel that they will be supplanting MDs in the future? I commend the fact that you are not naive to the less desireable aspects of medicine, but I think you've gone off the deep end.

Relax, man. The sky is NOT falling!

-Hans.

Your attitude is exactly why MDAs got into this mess to begin with. They naively assumed that CRNAs would NEVER EVER try to increase their scope, try to work independently, or otherwise pose a threat.

Of course, that theory has been proven wrong over and over again. Its time to wake up.

Besides, I never said that CRNAs would replace all MDAs. Reality is more complex than that. MDAs will always be able to find a job, the REAL question is what salary/income will they make.

I'm telling you right now that market forces WILL NOT SUPPORT an MDA making 300k per year that only performs marginally more work than a CRNA. If a CRNA makes 100k doing 90% of what an MDA does, market forces will drive the MDA salary down long term.

Most of the current MDAs dont give a **** one way or the other. If I could take them to the future 30 years from now and show them that CRNAs have caused MDA salaries and market share to plummet, they'd shrug their shoulders and say something to the effect of "well I'll be retired by then, so I really dont care. As long as I cash out first, I dont give a flip about the future of the profession."

This incredibly myopic viewpoint is what kills the MDA profession. Its the MDAs that are currently in practice that are selling out the future of gas down the river so they can hire extra CRNAs and make extra $$$. Why do they care if their actions result in increased scope of practice for CRNAs? Why do they care if CRNAs are able to drive down market share for MDAs? They will have already cashed out and be retired on their yacht by the time that happens. These scoundrels are the plague of the medical profession.

I can see I struck a nerve here with all the hateful posts. Keep em coming guys, its about time I opened your naive MDA residents' eyes. Dont buy the party line BS your program is selling you. Your department chairman doesnt give a flip about CRNAs, he will be long gone by the time they really start putting a hurt on the profession, and he has every motivation in the world to sell you a sack of lies about how they are not really a threat.

 

[MacGyver]

Hey Macguyver,

Still haven't answered my question. Or are you afraid of something? Who are you, what do you do, and how do you have so much time to look up all that crap you do?

Got something to hide?

Why is ANY of that relevant?

If a homeless guy tells you on the street that propofol has a painful burn associated with rapid infusion, does that make his claim about propofol any more or less true?

What if its the gas department chairman?

 

[jwk]

Good: Patient advocacy and comfort are job #1. You keep the surgeons and other docs from killing people.

Bad: The surgeons take all the credit or blame you when they screw up. The surgeons treat you like a nurse.

Ah yes, very important concept:

always remember that anesthesia keeps the patient alive in spite of the surgeon's best efforts to do otherwise!

And a corollary to this - to be used when the surgeon (for the 5th time) tells you the relaxation is inadequate:

Anesthesia makes surgery possible, NOT EASY!

 

[zoolander]

Hey, MacGyver, sounds like you've found your calling...

How about lobbying for the medical profession or developing policy/legal changes?

The amount of time + energy you've devoted to researching this sounds enormous. Since you're obviously passionate about scope of practice issues, sure the AMA/ASA could find a way for you to take advantage of it. Be that guy that you think the ASA hasn't done.

Re: past lobbying you're right that it was hard for the ASA to compete with the nurse lobby under Clinton. His mother was a nurse anesthetist with a life-ling wish that they could one day widen their scope of practice. Hard to out-lobby that- maybe you could do it.

 

[gaslady]

Actually the source of information is extremely important in interpreting it's validity. Every analysis of medical literature is incomplete without looking at who wrote it, where they are from, and where the funding came from. At your level of education (whatever that is) I would have thought you would know by know that just because you see something in print does not necessarily mean it is true. It's all about the source.

Macgyver, once you get to residency you will quickly come to realize that everything you are told by others that appears to be the truth and fact is not. Looking at the source of the information is essential.

Re: MDA's not protecting their profession ....
is a load of BS. You will see this clearly if you look at the fact that there was a shortage of anesthesia providers. What was ASA going to do, let surgeries not be able to happen because there wasn't anyone to run the gas. Well, I suppose you would say that we should have enrolled more people in residency to fill the spots. Well med students didn't want to go into gas because there were predictions about not needing as many anesthesiologist, just like there have been workforce predictions for every other field that have generally been wrong.
In addition, many would argue that CRNA's have in fact worse public relations and advocacy than MDA's. By being adversarial with MDA's politically there are many MDA's who won't even work with CRNA's. Yet, there are not the same feelings for anesthesia assistants who support the team approach. Some of these are large groups who are deeply imbedded in particular geographic areas. There simply are not enough CRNA's to overtake the MDA groups like you seem to insist will happen. In addition, although recruitment to nursing school has improved, there is still a vast shortage of nurses and specifically critical care nurses (who are the applicant pool to CRNA school).

One thing that amazes me about this CRNA argument and the fact that MacGyver keeps bringing it up repeatedly (in addition to stopping interested parties from getting info that they want by hijacking threads) is that there are other instances of this that are just as real in other specialties, psycologists with prescribing powers, optometrists doing laser surgery. Yet for some reason MacGyver overlooks these, just as he overlooks many things.

 

[bgreet]

I once again revert to my previous statement.

MacGyver go away

 

[gaslady]

I think I found out why Mac has so much steam to burn, he's worried about paying off all his debt.... Here's some of his posts...



credit card debt consolidation

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I have about 15k in credit card debt that I want to consolidate into a low interest loan.

I dont have a mortgage, or own property; I just rent an apartment.

Does that disqualify me? Is it an absolute must to own property in order to consolidate debt?



I am thinking about applying in both rad onc and radiology. I am definitely not going to apply to 2 different specialties at the same institution; I realize that this would be pretty foolish.



Finishing in the bottom 1/2 of the class...

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OK so given the following facts what residency choices will I have?

1) Finishing in bottom 1/2 of class at a top 10 school
2) Average clinical recommendations
3) Average Step I score
4) MD/PhD graduate with several relevant publications

So I realize that I wont be matching at Harvard Mass General, but what specialties do I still have a shot at in a community program?
__________________

 

[MacGyver]

there are other instances of this that are just as real in other specialties, psycologists with prescribing powers, optometrists doing laser surgery. Yet for some reason MacGyver overlooks these, just as he overlooks many things.

You are ****ing kidding me right? You havent been paying attention. Go read those other forums and you will find many areas where I chastise them as well.

However, for the most part htey have controlled their turf MUCH better than MDAs have. Opthos compete against a small group of ODs who hold doctoral level educations, just as psych competes against a small group of people who hold PHDs.

MDAs on the other hand, are wrapped up in a battle with TENS OF THOUSANDS of people who barely have any education past college. Thats MUCH WORSE than the other specialties.

 

[MacGyver]

Re: past lobbying you're right that it was hard for the ASA to compete with the nurse lobby under Clinton. His mother was a nurse anesthetist with a life-ling wish that they could one day widen their scope of practice. Hard to out-lobby that- maybe you could do it.

Sure, Clinton's influence helped but you do realize that CRNAs have also made substantial gains during Bush's tenure and previous administrations before Clintons.

They have steadily advanced their turf over the past 20 years.

 

[gaslady]

It's hard to pay attention when you go on and on endlessly. I don't deny that there are issues with CRNA's but you repeatedly twist the argument and use misinformation to support your ideas. You often use ancedotal evidence which is insignificant, unreliable and makes your arguments sound more persuasive than is reality. I met a physcian the other day who did Burr holes, appendectomies and C sections while practicing as a general practitioner. I guess we don't need neurosurgeons, general surgeons, and ob/gyns anymore. Oops, the info I left out is that this was when he worked in a northern desolate area,these cases happened when he was snowed in, and the patients would have died had he not tried.

How can you honestly know what it's really like out there for all the "docs fighting off the physician extenders and other health care professionals" as you make it seem? The fact that you are the self appointed expert of "the fight against CRNA's" is absurd when you aren't even out of medical school yet? Have you even done your clinical rotations? I don't deny that MDA's need a strong unified front and a strong ASA that lobbys on our behalfs, but give it a rest already. You continually take over threads from users that have nothing to do with your crusade.

BYW, in regards to CRNAs having little schooling after college....they may only go to school for a few years after college, but many of them go to college for nursing to get a bachelors. So their 4 years of college isn't useless knowledge that has nothing to do with healthcare like it is for many MDs. They are also required to have ICU nursing experience, which may not be a formal educational program with credits, but is significant. There education isn't equivalent to an MDA's but it's not as inadequate as you make it seem.