"Uh-oh" has officially arrived.

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
So what does this mean for the future of Anesthesia? What can her and Obama realistically do? Isn't most regulation/restriction done at the state level?
 
So what does this mean for the future of Anesthesia? What can her and Obama realistically do? Isn't most regulation/restriction done at the state level?


The worst case scenario is National Opt-Out. But, that hasn't happened yet and the Federal Government would be forced to mandate state health care policies. Again, an unlikely situation.

Who knows what she will do? Perhaps, she might take the AANA up on the "we are much cheaper" propoganda slogan of theirs. Why is the Federal Government reimbursing Anesthesia Nurses at Physician wages?
It makes no fiscal sense.
 
Sebelius Biography

Governor of Kansas (2003-present)
Kansas insurance commissioner (1995-2003)
Kansas House (1987-1994)
Executive director, Kansas Trial Lawyers Association (1978-1986)
Special assistant, Kansas secretary of corrections (1975-78)
Daughter of former Ohio Gov. John Gilligan
Undergraduate degree from Trinity College, M.P.A. University of Kansas
Undergraduate degree from Biola University, M.B.A. from University of South Dakota
Age 60

So we have a former director of the Trial Lawyers Assn as our HHS secretary, this doesn't make sense to me.
 
Last edited:
As a fourth year med student who just submitted my rank-list for anesthesiology, I'm extremely concerned about the changes that are going to happen in anesthesia care in the near future. Where can I go to get more info on the changes that are currently being proposed by various groups and on what the ASA is doing on our behalf?
 
nuclear-explosion.jpg
 
It was a good run guys. Hopefully most of you made enough money during the golden age.
 
It was a good run guys. Hopefully most of you made enough money during the golden age.

Do you think health care in the USA can be changed on a dime? It will take years for effective change to work its way through our system.

Obama may decrease Medicare Payments by 10% over the next four years but that hardly destroys our system. The destruction occurs over the next 10 years as private insurance companies can no longer compete against government run health insurance. Then, the reimbursement rates go through the floor as there are no private insurance companies to make up the difference.

Surgeons will suffer as well although to a lesser degree. Eventually, the AMA will demand Socialized Medicine so our work load decreases along with the pay.
 
Now does everyone see why voting Republican in 2010 for congress/senate is so important?


oh sure. voting republican is the answer. Ok sure. have you been sleeping for the past 8 years?
 
The destruction occurs over the next 10 years as private insurance companies can no longer compete against government run health insurance. Then, the reimbursement rates go through the floor as there are no private insurance companies to make up the difference.

and then maybe we can have a single-payer system in which for-profit insurance companies are no longer siphoning off health care spending without actually providing health care. and with health care spending being more affordable for consumers, doctors may once again be a political lobbying force for good salaries.

of course, many on this thread would prefer to stay on the sinking ship, trying to defend both an inefficient, costly, three-party reimbursement system and higher physician salaries. we're going to take a hit one way or another. why would you still want to share a slice of the the smaller reimbursement pie with ceos, actuaries, lawyers, and medical billers? why do our patients need to pay these people so that we can provide them care?
 
of course, many on this thread would prefer to stay on the sinking ship, trying to defend both an inefficient, costly, three-party reimbursement system and higher physician salaries. we're going to take a hit one way or another. why would you still want to share a slice of the the smaller reimbursement pie with ceos, actuaries, lawyers, and medical billers? why do our patients need to pay these people so that we can provide them care?

I understand your sentiment. But man, I want to make decent money. I'm going to have 200K in loans, a family, and will need a place to live when I'm done with training. It sucks. Seems like there is no easy solution. Well, I mean, the easy solution would be provide med school for free, but that is never going to happen.
 
I understand your sentiment. But man, I want to make decent money. I'm going to have 200K in loans, a family, and will need a place to live when I'm done with training. It sucks. Seems like there is no easy solution. Well, I mean, the easy solution would be provide med school for free, but that is never going to happen.

It should. It isn't fair or equitable that a socialized health care system straddles you with bills while an IMG/FMG from Germany/Sweden/France etc. gets a free ride and then earns the exact same fee from Medicare.

Once our system becomes a single payer over the next ten years the government should pick up the cost of your college and medical school education. I know it won't happen but in every Obama Socialistic Country he aspires to be like that is the way it works: Free College and Medical School. Not only do these Socialistic Countries provide a free education the individual is not even obligated to remain/work in that country.
 
oh sure. voting republican is the answer. Ok sure. have you been sleeping for the past 8 years?

It is not just about voting for republicans as many republicans are responsible for the problems of today ( in addition to virtually all democrats). It is voting for the responsible politicians (who are mostly republican) and voting these other crooks out of office.
 
It always amazes me how Republican and alarmist this board is. Oh no, the sky is falling, the big bad government and the AANA are going to take away all of our money and freedom.... Aaaaaaaahhhhhhh (runs away screaming with tail between legs).

Our world as we know it is not going anywhere. We will likely make less money, but so will our colleagues. There will always be good paying jobs for anesthesiologists. I have never met or even heard of the militant CRNAs that are constantly brought up as the whipping boy on this board, although I don't disagree that they exist and are a threat. I'm just saying it is not like everywhere there are these power-hungry, militant CRNAs as is so often portrayed on this board. And I don't think that Sebelius is going to throw down the gauntlet and specifically gut anesthesiologists (over any other specialty) in order to further an AANA agenda, and I would love to see some actual, verified and non-speculative information to the contrary.
 
It is not just about voting for republicans as many republicans are responsible for the problems of today ( in addition to virtually all democrats). It is voting for the responsible politicians (who are mostly republican) and voting these other crooks out of office.

The Republican party let the USA down. Low taxes plus big government doesn't work. You can't be a hypocrite and expect people to vote for you.

Obama believes in high taxes and big government for a socialistic America.
The bottom 60% won't pay much if anything in terms of taxes. Obama will soak the upper middle class until they scream murder. Even then he still needs more tax revenue.

The "average" American is a moderate. There is a good chance he/she will reject Obama's vision of American in the next election cycle. Our economy is unlikely to prosper in such a high tax enviroment so a prolongled recession is likely.

My hope is the Bill Clinton tax code returns in 2011.
 
It always amazes me how Republican and alarmist this board is. Oh no, the sky is falling, the big bad government and the AANA are going to take away all of our money and freedom.... Aaaaaaaahhhhhhh (runs away screaming with tail between legs).

Our world as we know it is not going anywhere. We will likely make less money, but so will our colleagues. There will always be good paying jobs for anesthesiologists. I have never met or even heard of the militant CRNAs that are constantly brought up as the whipping boy on this board, although I don't disagree that they exist and are a threat. I'm just saying it is not like everywhere there are these power-hungry, militant CRNAs as is so often portrayed on this board. And I don't think that Sebelius is going to throw down the gauntlet and specifically gut anesthesiologists (over any other specialty) in order to further an AANA agenda, and I would love to see some actual, verified and non-speculative information to the contrary.
Spoken like a true medical student. Give us a call after you've left the protective confines of spring break, Christmas vacation, and amsa lunches.
 
Spoken like a true medical student. Give us a call after you've left the protective confines of spring break, Christmas vacation, and amsa lunches.

I'm a realist - the world will not change overnight just because Sebelius has been tapped as the new HHS. There are more pressing issues than chopping off anesthesiologists at the knees so that CRNAs can get a leg up.

The chicken little attitude on this board is almost laughable.
 
Still waiting on one of these brilliant med students to explain why its economically a good idea to selectively raise taxes on people that contribute to charity and pay their mortgages on time... Or explain why you would build an anti-keynesian medicare surplus while in a recession.
 
you have not idea what you're talking about. you're not out there looking for jobs this year. you have no idea JUST HOW MUCH salaries have already dropped. how partnership tracks have disappeared. and now more taxes?

once you actually DO something (sitting in your room and reading med school physiology doesn't count) - once you WORK in the real world and have YOUR CASH taken away from you. and have NURSES say that they are just as good as you at your job in PUBLIC political statements and pay their lobbies to change laws so they DON't need our supervision anymore, you won't be so smug.

real information? look at any of the statements released by the AANA. look at the statements released by their current president.

the world will not change overnight. but, this is my career. for the next 30 years. and the world will certainly change by then.

as i see it, physicians in this country will begin to occupy the same socioeconomic strata as european physicians (you know, the very best of whom are coming here against unbelievable difficulty cause practicing in their countries sucks). salaries will drop to 100-150ish for all, at best.
the wealthy who are wiling to pay cash and not wait or not have the underqualified, lower intelligence people who will fill the profession (as the best and brightest go for more financially rewarding professions) will have their own class of physicians. i predict this will keep about 5% of our ranks well compensated.

this will not happen overnight. or in 5 years. but, it will happen. as an inevitability of attempting to socialize a country which has lost it's economic edge in the world, has a massive population of undereducated and entitled, tens of millions of illegals siphoning public services, a superwealthy class that gets out of paying most of what they earn (many made their money by STEALING through the ponzi scheme that is our stock market). i'm not talking about the professionals making 252k/yr. i'm talking about the multimillionarres. and now, obama is going to get 3 trillion dollars out of nowhere and give it out to the people (while taking even more from the most productive individuals in society and companies). this will produce a disincentive to the people who want to produce real goods/svc and make real money. at the same time it will produce an incentive for people who don't want to work or produce anything. companies will leave the US at an even greater rate than they are jumping ship now (as we have the largest corporate tax burden in the world) due to the clean energy taxes.

i kind of feel badly for everyone in med school now. especially M1s. by the time you're out, you will have 250k in debt at 7% rates. your salaries will be 50% lower than what they are now. by that time the tax and spend will spread to all classes and your taxes will be massive. you will buy a ****ty 3 bedroom 1 bath house and drive 10 year old hondas. you will vacation once a year, for 1 week at the jersey shore. your children will go to mediocre public schools (obama will take education money and make really bad schools into mediocre ones at best). you will have crappy government medical care (you won't be able to afford the best care, which will be reserved for the wealthy). SS will be bankrupt and you will not see a penny of what you put in.
on the bright side, you will always have a job. and will always be able to pay for food. and have indoor plumbing. ahh, the american dream.



I'm a realist - the world will not change overnight just because Sebelius has been tapped as the new HHS. There are more pressing issues than chopping off anesthesiologists at the knees so that CRNAs can get a leg up.

The chicken little attitude on this board is almost laughable.
 
How come it is always Med students who come out and say, oh it will be okay, you guys are worried over little CRNA's and Medicare cuts for no reason... I never see residents saying that. Maybe these are the rich med students who have their parents helping them. I sure as hell am worried about my debt and interest racking up, while my future earning potential is being chopped down.
 
She will not have the power to change/create federal legislation allowing CRNAs to practice independently.

83% of the hospitals in Kansas rely exclusively on CRNAs for anesthesia?? It sounds like they're implying that 83% of hospitals in Kansas have NO ANESTHESIOLOGISTS and the CRNAs are in independent practice. Is this true?
 
83% of the hospitals in Kansas rely exclusively on CRNAs for anesthesia?? It sounds like they're implying that 83% of hospitals in Kansas have NO ANESTHESIOLOGISTS and the CRNAs are in independent practice. Is this true?

I have no idea.
 
http://www.aana.com/WorkArea/showcontent.aspx?id=19142

"Kansas Governor Kathleen Sebelius has proclaimed the week of January 25-31, 2009 as Nurse Anesthetist Week."

They're having a party over at the nurse anesthesia boards.

They should save their cash - If we get reimbursement cuts the crnas will feel it too. Most crnas don't care that much about independence - they appreciate working with good anesthesiologists. The AANA is not doing them any favors, independence will lead to much longer hours, higher risks, and less pay for them.
 
Now does everyone see why voting Republican in 2010 for congress/senate is so important?

freakin' hilarious!! :laugh:

why the heck do people vote along party lines for a single issue? sure you need to protect your pockets, but the world DOES NOT revolve around your wallet. wars, health care, taxes, economy, education, and did i mention WARS also serve important topics to consider.

greed is what destroys. vote for the BEST candidate, not because he/she has an R or D (or I) after their name.

PS: Georgie's politics brought up interest rates...so now i get to pay back a good chunk of my $200,000 school loans at 6.5% (and some at 8.5%) Thank you!
 
Last edited:
83% of the hospitals in Kansas rely exclusively on CRNAs for anesthesia?? It sounds like they're implying that 83% of hospitals in Kansas have NO ANESTHESIOLOGISTS and the CRNAs are in independent practice. Is this true?

This is true to some extent. There are anesthesiologists but there are a whole hell of alot more CRNAs. If you don't believe me look under Kansas on gasworks and you will see that they only jobs listed are locums. It is very difficult to get a job in Kansas unless you are in one of the bigger cities (even then, the market is very tough). You can forget about practicing in the rural areas (there are exceptions) because most of these areas are dominated by CRNA's who do not have to be supervised. It is not good people. Our specialty is in alot of trouble. And anyone who doesn't believe it should look at gasworks. There are very few respectable jobs out there anymore. It sucks to be job hunting right now.
 
They should save their cash - If we get reimbursement cuts the crnas will feel it too. Most crnas don't care that much about independence - they appreciate working with good anesthesiologists. The AANA is not doing them any favors, independence will lead to much longer hours, higher risks, and less pay for them.

I disagree that most CRNA's don't care much about independence (maybe the ones you work with don't because they are happy), but if you goto many of the midwestern and more rural areas, you will think differently. Also, take a look at the AANA's website and letters to Obama. The whole goal of the AANA is to get complete independence from anesthesiologists. And most CRNA's are members of the AANA. It is really stupid because they are shooting themselves in the foot. Once total independence is had, all wages will be lowered.
 
freakin' hilarious!! :laugh:

PS: Georgie's politics brought up interest rates...so now i get to pay back a good chunk of my $200,000 school loans at 6.5% (and some at 8.5%) Thank you!
You still don't understand economics. You have $200,000 in debt because the fed govt made student loans very cheap with cheap interest rates. When the govt decided it was a bad idea to falsely inflate the price of education via student loans, you complained.

People should pay market rates on their student loans. If your education isn't worth 200k, then so be it.
 
I disagree that most CRNA's don't care much about independence (maybe the ones you work with don't because they are happy), but if you goto many of the midwestern and more rural areas, you will think differently. Also, take a look at the AANA's website and letters to Obama. The whole goal of the AANA is to get complete independence from anesthesiologists. And most CRNA's are members of the AANA. It is really stupid because they are shooting themselves in the foot. Once total independence is had, all wages will be lowered.

I'd say maybe 10% of the crnas where I am would like to be independent. The others just simply aren't good enough/or are too nervous/ or lazy. And crnas (and srnas) are required to be aana members. They don't have a choice. And I'm with you, I do believe we are in trouble. I just think that the crnas don't know what a good thing they have. If and when they finally do gain full independence they will cease to be reimbursed like physicians and will be forced to accept nursing reimbursement. I also don't know too many crnas willing to work as hard as I do. They are happy to leave at 3, etc or work their one 24 and one 12 a week.
 
Lots of good recognition of the problems on this thread.

We have far less power, as physicians, than most of the public realizes for the following three reasons:

(1) We cannot collectively bargain (against the FTC rules).

(2) We rely on those who can collectively bargain to pay us fairly (e.g. insurance companies).

(3) We spend way too much time fighting amongst ourselves (on the wards, in meetings with administration, etc.) instead of developing solidarity.

Until these things change either by individual and/or collective will, or by some judicial act, other people who don't really understand the ins-and-outs of our jobs and the incredible challenges we face on a daily basis will continue to make decisions for us.

We've identified the problems. It's time to start being part of the solution, instead of letting someone else force what they perceive to be the "right course of action" on us.

It starts by walking off the job the day one day a week when this "single fee per occurrence" stuff gets passed. Putting your bleeding hearts aside. Do it. Remember to "treat yourself" first. This is something most physicians are both loathe to do and terrible at understanding.

-copro
 
Last edited:
(1) We cannot collectively bargain (against the FTC rules).
why can't we collectively bargain and nurses can? IM not sure that makes sense
 
People should pay market rates on their student loans. If your education isn't worth 200k, then so be it.

I can assure you my education won't be worth 250K (which is what I owe) on top of market rate interest.

Especially if I end up in primary care scrapping for 100K annually.
 
The Pearson report assumes accurate reporting and integrity of the National Practitioner Data Bank (NPDB) to make its claims

The problem is that NP's are underreporting their adverse events to the NPDB.

The Pearson report uses flawed data to make its case. Yet, that won't stop the nurses from pushing this analysis on lawmakers and the public to advance their agenda. Again, nursing uses propaganda and lies as its tools to get what it wants. When will somebody in medicine stand up to this crap and say enough is enough?!
 
Top