ProRealDoc

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Dear Colleagues,
ASA has become aware of a decision by the Department of Veterans Affairs (VA) on April 21 to remove physician supervision of nurse anesthetists, citing the COVID-19 pandemic. It is unclear from the document if this is a temporary or permanent action. I am extremely disappointed by this decision, which unnecessarily puts the health and lives of our Veterans at risk and also ignores the two public rule-making processes of 2017 that reaffirmed the importance of safe, physician-led anesthesia care for our nation’s Veterans.

According to the memo by VA Under Secretary for Health Richard Stone, M.D. (PDF), this directive urges VA medical facilities to “amend medical facility by-laws to allow CRNAs to have full practice authority to the extent that is within the full scope of their license.” ASA is aware that VA made unsuccessful attempts to effectuate this change through the regulatory and legislative processes before Dr. Stone unilaterally overturned the final VA APRN rule by memo. I have been in communication with VA about the patient safety risks of this change.

Throughout this public health emergency, ASA has been closely tracking anesthesia services and is not aware of any shortage of anesthesia providers that would necessitate this change. In fact, many VA anesthesiologists have been encouraged to deploy in support of critical care services because VA operating rooms, like those throughout the nation, have been under capacity.
It is unworthy of the Department of Veterans Affairs, or any entity for that matter, to ask physicians to deploy in the care of COVID-19 patients with the intention of displacing them from their jobs upon their return.

The demands of the current crisis do not require these changes to the care team model, and, in fact, the current National Anesthesia Service Directive provides sufficient flexibility to meet the demands of the breadth of patient care during the pandemic. ASA will soon execute a strong response, and we will continue to maintain open lines of communication with VA and the Administration.

In the meantime, I urge you to CONTACT YOUR LAWMAKER about the dangers of this unilateral change within VA and continue to monitor AANA activities disrupting the physician-led, team-based anesthesia care team in your state. In 2017, we successfully fought to preserve physician-led anesthesia care for our nation’s Veterans, and I call on you to renew this effort today. Most importantly, we need to continue to work closely with our nurse anesthetist and anesthesiologist assistant colleagues on our care teams to deliver the care our patients deserve.
Thank you for your leadership on the front line of this pandemic and on the front line of ensuring safe, high-quality care for our Veterans.
 
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Newtwo

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Not all bad ?
No one is making money off crna's anyway for a long time.
Plus guys will stop training them, stop bailing them out. And then after a few more rex meekers this thing will be put to bed
 
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AdmiralChz

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The timing is strange. The curve is on the way down just about everywhere, even in NYC hospitalizations are heading down. No shortage of docs anywhere, no surgeries being held up due to lack of anesthesia. Why this now??
 
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Ronin786

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The timing is strange. The curve is on the way down just about everywhere, even in NYC hospitalizations are heading down. No shortage of docs anywhere, no surgeries being held up due to lack of anesthesia. Why this now??
Because it's not temporary.
 
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Splenda88

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This is from a CRNA:

"I never understood how any country could afford NOT to have CRNA's. Paying anesthesiologists do do the CRNA's job is inefficient and wasteful."

Lol...
 
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FFP

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Because it's not temporary.
I bow to your wisdom. :=|:-):

I would almost bet my money that you're 100% right. They are trying to push this through while everybody is busy taking care of Covid-19 patients and surviving. They know there aren't many anesthesiologist jobs out there during the pandemic, so they are betting that VA anesthesiologists (who may have quit before) will just roll over this time.

It's like when Congress passed that monstrous Patriot Act after 9/11. They had had it in their minds for a long time, I am sure (the powerful always want more power), but they couldn't have passed it before.

This has been done many times in history, when people are not looking, or are already so used to crap that another pile won't matter. It's also predictive of even worse things to come.
 
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ProRealDoc

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Do what? Write my representative?! Whatevs dog...whatever's gonna happen is gonna happen. A stack of whiny letters from anesthesiologists who brought this upon themselves won't make any difference.

Do it anyways
 
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ProRealDoc

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This is from a CRNA:

"I never understood how any country could afford NOT to have CRNA's. Paying anesthesiologists do do the CRNA's job is inefficient and wasteful."

Lol...

Other countries, including poor ones, actually know better.
 
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Not all bad ?
No one is making money off crna's anyway for a long time.
Plus guys will stop training them, stop bailing them out. And then after a few more rex meekers this thing will be put to bed

The biggest difference maker will be coverage, $$$, and outcomes. If CRNAs provide the same amount of coverage with equal outcomes, for less $$$, while filling the admin needs of the institution they win and it's time to start looking for a new career. If, as other states with opt-outs have demonstrated, that the coverage is lacking, outcomes leave much to be desired, admin roles are unfilled, and the $$$ savings are minimal if even there, then a continuation of physician care will continue.

I always think of California when this comes up. Cali is the most progressive state in the union and is usually an indicator of what is to come. The docs out there seem to be doing ok. I suspect the rest of us will be too.
 

46Long

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Even in third world country the standard is a formal medical education to make MEDICAL decisions.. Except in USA.. We are gonna sell this country to the lowest bidder. Who else wants independent practice? The Nursing assistants? Butch, the orderly wants to be called a doctor? Lets make him independent..
 
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46Long

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Even in third world countries the standard is formal medical education to make MEDICAL decisions.. Except in USA.. We are gonna sell this country to the lowest bidder. Who else wants independent practice? The Nursing assistants? Butch, the orderly wants to be called a doctor? Lets make him independent..
There is zero leadership in our profession. Either that or the leadership is silently selling us out.
Seriously, i hope they do cancel student loans for us since weve been sold BS
 

46Long

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That letter is to Alex Azar. LOL!! After reading the front page of today's Wall Street Journal I doubt that letter will even be read and even if it is read it will be used as toilet paper because Alex Azar is ****ting in his pants right about now because he is the first guy Trump will be FIring once he gets a handle on the coronavirus. That is pretty much a guarantee and he even knows it. The nasty agenda of wanna be CRNAS without a formal medical education is the last thing on his mind.

Have a look for yourself.
 
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nimbus

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That letter is to Alex Azar. LOL!! After reading the front page of today's Wall Street Journal I doubt that letter will even be read and even if it is read it will be used as toilet paper because Alex Azar is ****ting in his pants right about now because he is the first guy Trump will be FIring once he gets a handle on the coronavirus. That is pretty much a guarantee and he even knows it. The nasty agenda of wanna be CRNAS without a formal medical education is the last thing on his mind.

Have a look for yourself.


“Mr. Azar relied heavily on his chief of staff, Brian Harrison, who worked in the office of the deputy HHS secretary in the George W. Bush administration. Before returning to the agency in 2018, Mr. Harrison ran businesses in Texas building homes and breeding labradoodles. “I am proud of my time working in family businesses before I was recruited back to government,” Mr. Harrison said.”

Is this a joke??
 

46Long

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“Mr. Azar relied heavily on his chief of staff, Brian Harrison, who worked in the office of the deputy HHS secretary in the George W. Bush administration. Before returning to the agency in 2018, Mr. Harrison ran businesses in Texas building homes and breeding labradoodles. “I am proud of my time working in family businesses before I was recruited back to government,” Mr. Harrison said.”

Is this a joke??
Sadly, it is not a joke which is precisely why i said Mr Azar's priority right now is not nurses without any medical education demanding removal of physicians. MR Azar is doing damage control to save his federal career..
 

dr doze

To be able to forget means to sanity
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“Mr. Azar relied heavily on his chief of staff, Brian Harrison, who worked in the office of the deputy HHS secretary in the George W. Bush administration. Before returning to the agency in 2018, Mr. Harrison ran businesses in Texas building homes and breeding labradoodles. “I am proud of my time working in family businesses before I was recruited back to government,” Mr. Harrison said.”

Is this a joke??

Absolutely Nothing Matters.




Sent from my iPhone using SDN mobile
 
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vector2

It's not what you know, it's what you can prove.
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“Mr. Azar relied heavily on his chief of staff, Brian Harrison, who worked in the office of the deputy HHS secretary in the George W. Bush administration. Before returning to the agency in 2018, Mr. Harrison ran businesses in Texas building homes and breeding labradoodles. “I am proud of my time working in family businesses before I was recruited back to government,” Mr. Harrison said.”

Is this a joke??


“In eight years alone—2010–2018—the DOE’s National Nuclear Security Administration collected enough material to make 160 nuclear bombs. The department trains every international atomic-energy inspector; if nuclear power plants around the world are not producing weapons-grade material on the sly by reprocessing spent fuel rods and recovering plutonium, it’s because of these people.”


This is the department of which Trump put Rick "I got a 'D' in a Texas A&M class called 'Meats'" Perry in charge. I'm not sure why you were expecting HHS employees to know anything about healthcare.
 
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