We NEED to respond ASAP - 60 days

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the ASA could be doing something to make life better for their members like fighting MOCA. Oh right they make a bunch of money off that. Never mind.
That is a whole other battle.

The ASA/ABA/ABMS are in bed together screwing us.... that is for another long thread

AA legislation in every state.

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Submitted yesterday. To those residents out there reading these forums, you are irresponsible if you do not do your part and help spread the word. Peer pressure your co-residents into doing this (example: last one to send in a copy of their submission to the group text chain has to take next Saturday's SR call, buy the first round, volunteer for endo for a week, ect whatever).

In today's world, social media is king as people are tied to their devices....to all of you very well respected attendings with years of golden experiences please take this opportunity to create a twitter account, instagram account, facebook account, ect.

I hope this story gets picked up by national media. Hopefully somebody has a good friend or family member working for a major network....
 
A major hurdle is getting the general public to
Done.

But my gripe is why do we wait until the last minute to prevent legislation like this from going through? There should be a very public campaign highlighting the differences between an anesthesiologist and a crna. The public is completely unaware of this and that is our fault. They have no problem marketing themselves as "the future of anesthesia care today." I would even venture to say that people in the OR don't know the difference...especially in those 1:4 models where the anesthesiologist is relegated to preop monkey duties. This specialty is a sinking ship because we are afraid to market ourselves to both the public and hospital.

100% agree.
 
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Also, how would you respond if you're a resident in a place with a lot of CRNAs? I was very proactive about this on social media and no breaks from CRNA's came around the OR today. My attending broke me out for lunch (30 min total for a 12 hour day of back to back cases) saying the CRnA's were short. There were 5 CRnA's sitting in the lounge. So passive agressive. How would you respond?

In my opinion... As the saying goes: lions dont worry about the opinions of sheep. However, im not so sure us MDs are the lions at this point.
 
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Added line for us veteran types:

"My fellow veterans and I gave our best. Some gave to the point of their health and their lives. I would hope we would be worthy of care from a physician that has had TEN times the training leading the anesthesia team than an independent CRNA being the sole anesthesia provider."

Posted to both pages.
 
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Med student here. Family members who have served and or are currently. I sent my message.

Proud to do my part-- hopefully more if the opportunity should arise.
 
Also, how would you respond if you're a resident in a place with a lot of CRNAs? I was very proactive about this on social media and no breaks from CRNA's came around the OR today. My attending broke me out for lunch (30 min total for a 12 hour day of back to back cases) saying the CRnA's were short. There were 5 CRnA's sitting in the lounge. So passive agressive. How would you respond?

In my opinion... As the saying goes: lions dont worry about the opinions of sheep. However, im not so sure us MDs are the lions at this point.

How is that different than any other day...?
 
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Also, how would you respond if you're a resident in a place with a lot of CRNAs? I was very proactive about this on social media and no breaks from CRNA's came around the OR today. My attending broke me out for lunch (30 min total for a 12 hour day of back to back cases) saying the CRnA's were short. There were 5 CRnA's sitting in the lounge. So passive agressive. How would you respond?

In my opinion... As the saying goes: lions dont worry about the opinions of sheep. However, im not so sure us MDs are the lions at this point.

When it comes to advocating on behalf of your profession remember that you are supporting anesthesiology. This does not mean you are attacking CRNAs. If they choose not to respect that fact, then they are off track and I would not worry about what they think.

The fact is that in the end, you have every right to support and advocate for what you have worked very hard to accomplish. In fact, without advocacy, sadly, any industry/profession will be doomed to the opposition that DOES advocate. That is a fact of life in the U.S.

It's "business as usual". Constant, relentless, career-long need to advocate is NOT unique to medicine. Get used to it.

Do not apologize for supporting a career you have chosen and which will be your livelihood. And, remember, you are not attacking CRNA's. You are simply supporting physician led anesthesia within the VA. That's all. Be proud of your position on this issue. I know I am.
 
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MS4 here--


"As a someone who has worked inside the VA system, I am very concerned about the proposal to allow nurse anesthetists to be solely responsible for the patient's safety during major operations without physician anesthesiologist guidance.

Despite what the nursing lobby will claim, there is no such equivalency between an M.D. Physician Anesthesiologist, with 4 years of undergraduate training, 4 years of medical school, and 4 years of additional residency training, who has proved their clinical competence via board-certification exams, vs. a nurse with 4 years of undergraduate and 2 years of CRNA training, who has taken an entirely different nursing exam. Our VA patients are often the most medically demanding cases, with multiple comorbidities. There have been no reliable studies that compare the outcomes of sick patients under a Physician Anesthesiologist's care vs. a Nurse's care, because it would be unethical to conduct such a study.

Under this proposal there is the likelihood that new CRNA graduates, using the VA as a stepping stone to better careers, will be learning-by-doing while in the most precarious operations, all at the expense of Veterans' safety and outcomes. Even resident physician anesthesiologists, who have already completed 4 years of medical school and have obtained M.D. status, conduct their training at the VA under the direct supervision and guidance of a seasoned, board-certified Anesthesiologist.

If nurses would like to practice at the same level of responsibility as a physician, they should prove their competence and decision-making ability by passing the same series of board certification exams that are required of a physician. However, this is not the case, and the nursing lobby vehemently opposes any measure that require nurse anesthetists to pass such exams. If this measure takes effect, I will encourage my veteran family members and friends to avoid the VA for any surgical interventions, because I know that their lives would be put at risk in the care of nurses practicing as doctors. "
 
What doing you guys/gals think of this? Is it too long or too long on detail?

Hello, this proposed rule change would have considerable negative impact on anesthesia care at the Veterans Administration Hospitals as well as more broadly by impacting the training of future anesthesiologists. First and foremost, CRNAs (the anesthesia trained APRNs) have considerably less training than Anesthesiologists (physicians trained in anesthesiology), their schooling is a bachelors of nursing followed by 18 months of clinical training, approximately 1600 hours while a physician anesthesiologists spend 12 to 14 years in school and between 12,000 and 16,000 hours in clinical training to specialize in anesthesia and pain control, compared to about half the schooling and 2,500 hours of clinical training required for a nurse anesthetist. There is quite simply no comparison between the two when it comes to medical knowledge or experience. The depth of knowledge is incomparable. Nurses have a superficial understanding of medical issues and disease as well as medications used in the treatment of disease. Physicians on the other hand have in depth knowledge and the basis to understand and work through even rare and complicated disease states. This is particularly important in the acute care surgical arena where potentially life threatening events may occur leaving the anesthesia provider with only seconds to correct. Veterans have been documented in multiple studies to be more chronically and critically ill than the rest of the civilian surgical population. These medical illnesses are not left at the door when a patient enters the operating room for a surgical procedure however "simple or low risk" the actual surgery procedure is viewed as. This is where the expansive medical training of a physician comes into play, anesthesiologists have a background in internal medicine, surgery, and critical care (which is EXACTLY what intraoperative anesthesia is, critical care WHILE undergoing dangerous surgical procedures). The nurses claim to have critical care training but in reality it is time spent following the orders of their physician supervisors. But somehow their lack of knowledge leads them to believe they are the ones actually treating the patients. This is the flaw in their reasoning. They believe carrying out orders is equivalent to actually managing and treating patients. The surgical arena is no different where they follow protocols and manage stable situations until a greater level of expertise is needed. However, when the physician intervenes they don't understand the nuances needed to resolve the issue.
This proposed rule change is aimed at filling a void in the primary care of veterans, there has been documented shortages of primary care within the VA, most notably at the Phoenix VA. However, in the VA's own internal assessment of care shortfalls, anesthesiology was not even listed as an at risk area. There simply is no shortage of Anesthesiologist (physician) anesthesia care in the VA system, this IS NOT an access issue. Please understand, that physicians NEED to be involved in the delivery of anesthesia care for our veterans. The inclusion of CRNAs (certified registered nurse anesthetists) in the broadly defined APRN grouping is inappropriate and incongruent with the intent of this legislation. This proposed change would remove the most highly trained and experienced anesthesia provider from the care of veterans, leading to a decrease in the standard of care delivered. Please keep physician anesthesiologists involved, do not support or authorize the categorization of APRNs as fully independent practitioners, our veterans deserve our best.

Fantastic.

I see/hear many arguments out there about the hours and years of training between CRNA and Anesthesiologist. The highlighted portion of Noy's letter point's out an incredibly important difference in QUALITY (not just quantity) of training.

The time spent training to become a CRNA is geared towards being able to EXECUTE a prescribed plan/orders/protocols.

The time spent training to become an anesthesiologist is geared toward DEVELOPING and EXECUTING a prescribed plan/orders/protocols.

In my opinion, DEVELOPING (and knowing how and when the plan should be changed) the care plan is where the major difference lies in our training. It requires an in-depth understanding of medicine and application of critical thinking. EXECUTION of a plan does not (superficial at most).

DEVELOPING a plan for a complicated patient (such as those at the VA), requires a solid foundation and in-depth understanding of medicine. Understanding when and how that plan should should change along the way relies on the solid foundation of medical knowledge and high QUALITY of training built throughout medical school and residency. This is lacking in the current training of CRNA's. This is why it is unsafe for CRNA's to care for complicated patients with acute surgical conditions without the direction of an anesthesiologist.

Argue about years of ICU training, hours of classroom work, board exams all you want.....We need QUALITY when it comes to taking care of complicated sick patients.

If you have not yet submitted your letter or response, I think this point is worth highlighting.

over the course of 8 years.....
John builds a brick house on a solid foundation.
Bob builds a straw house without a foundation.

John and Bob paint their houses the same color, have the same front door, same landscaping, same curb appeal.

When the inevitable storm comes around, which house do you and your loved ones want to be in?

Sally and Sue start a marathon. It's 9am and Sally and Sue have BOTH been running for an hour pushing their upper limit of fitness. How in the world is Sally 4 miles ahead of Sue!?!?!?! Well, duhhhh, Sally is running a 6min pace and Sue is running a 10 min pace......
 
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i added a comment this morning.. so did my mom and 3 sisters, all my sisters husbands and their kids all posted on regulations.gov.. My six year old nephew wants to be an anesthesiologist and he commented as well. My six year old nephew's best friend Hubie also posted on the site.. Im making this thing roll.. THese kids aare against the idea of APRNs taking over... Even if the ASA has no sense.... these kids do!!
 
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I really enjoyed reading the other comments on here. Finally got around to posting my comments, it took a while because unlike a CRNA, I do not work 40 hours and then skip out the door, leaving a mess behind for the adults to clean up. It's been a busy week working 60+ hours in the hospital, taking home call, and preparing for basic boards. Those little butt-wipers' training is a joke.

I also contacted all of my congressional reps. As mentioned below, my dad is a vet and I am terrified of some CRNA killing him in the OR someday. We all need to be more involved politically. It takes time and money and effort and compared to how much we all invested in our training, getting involved is a bargain.

"My father is a US Army veteran and I am grateful and proud of the service that he has provided for our country, to keep us free and safe. I am thankful that we have a country filled with men and women who answered the call to serve in the armed forces and protect US interests in a dangerous and complex world. Surely these men and women deserve quality medical care through the Veterans Affairs health system. To remove the physician leader from their anesthesia team is an insult to them and the sacrifices they have made on our behalf.

I have seen what nurse-only anesthesia care looks like firsthand as a physician anesthesiologist and it is terrifying. I would not allow my father to go to the operating room with a mid-level provider as the individual tasked with keeping him alive. These are individuals who are not sufficiently trained in diagnosis and treatment of acute illness. Although they have some limited grasp of what to do in delivering a standard anesthetic, their training leaves them unable to create and carry out an individualized anesthesia plan for a person with complex pathophysiology. For example, heart failure, decompensated cirrhosis, end stage renal disease, uncontrolled diabetes, and chronic obstructive pulmonary disease are prevalent among our aging veterans. These diseases and many others are often simultaneously altering the normal functions of the body and the end result is increased risk in going for surgery and the need for a thoughtful and customized plan, not the one-size-fits-all model that nurse anesthesia schools produce.

Nurses are excellent mid level providers of care; however, they do not have the training or experience to guide each and every sick patient safely through the perioperative continuum of care. In fact, to expect them to do so is reckless and unfair to nurses.

Due to physician efforts in research and work to improve safety and quality in anesthesia over the past several decades, there is a false perception among non-providers that anesthesia is safe and easy and that anyone can do it equally well. This is simply not true.

In certain healthy patient populations such as active duty service men and women who tend to be young and healthy, the value of a physician-led anesthesia team may be difficult to discern. Unfortunately, the difference in quality will become very apparent if nurses are left as the sole providers for aging veterans with complex medical conditions.

Anyone who is naive enough to carry out this proposed change in policy is enabling the death and suffering of every ill veteran who is denied access to a fully trained and competent physician anesthesiologist. Nurses are excellent at caring for people, but their training does not focus on differential diagnosis and real time clinical decision making.

There is no data to suggest that reducing the standard of care for veterans (who already have issues obtaining quality care) will decrease spending. It is likely that due to increased complications and wrongful death lawsuits that funding the VA system could become more unsustainable. I believe in fiscal responsibility and I support creative measures to reduce government spending; however, removing physicians from veterans' anesthesia team is a recipe for higher costs and worse outcomes.

I support America's veterans, including those in my own family: they put their lives on the line in service to our country, and I believe they deserve the best possible medical care. I oppose any mandate that would force the best trained physicians out of the operating room. I urge the VA to preserve physician-led, team-based surgical anesthesia care. My father and the rest of our veterans need us to stand up to politically motivated posturing by nursing organizations, lawyers, and politicians. They are sacrificing the health of our fathers, mothers, brothers, and sisters in order to advance their self-serving agendas. I urge you to stand up and be accountable to veterans and remove any and all barriers that would prevent a veteran from having a physician anesthesiologist as the leader of their anesthesia team."
 
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Why don't you all tell stories when you had to save a CRNA's butt, or prevent a patient from being harmed?
 
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I commented, and forwarded this link to friends, family, and colleagues.
 
Can someone who has a modicum of writing ability submit a piece to the New York Times Op-Ed section? That would seriously boost publicity.

Yes, every CRNA would ferociously turn on you for writing this. It is best suited for someone who has previously supervised CRNAs and is now comfortably working in an MD-only practice. I would do this myself, but no one is going to listen to someone who just received their MD degree three days ago.
 
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The latest propaganda from the AANA:

http://www.aana.com/newsandjournal/...e-No-Impact-on-Anesthesia-Patient-Safety.aspx

“It’s interesting that the same doctors who argue that they need to be involved in the care of our military veterans don’t insist on being assigned to the front lines during military actions to care for soldiers horribly injured during battle, leaving this up to CRNAs to handle,” said Quintana

(vomit). Pretty sure my friends who were deployed as anesthesiologists would take offense to this. AND apparently the group that did this "study" is funded by united healthcare.
 
What happened with that crna turned anesthesiologist asa president? Why did nothing happen with her? That was the ultimate trump card
 
I modified @i2passgas' post. Here is what I submitted:

Veterans deserve the best and exceptional care in return for the exceptional service to our nation. The proposed policy changes to the VA Nursing Handbook recommend that all Advanced Practice Registered Nurses (APRNs) practice independently to their full practice authority.

One of the most critical times for health care occurs in the operating room. Potentially life threatening events may occur during operations, leaving the anesthesia provider only seconds to correct the problem. A proven model exists within the current health care system; the anesthesia care team. In the care team model, CRNAs work together with physicians to provide optimal care to the patient, with the physician anesthesiologist overseeing and guiding the care of CRNAs.

Allowing independent practice would have considerable negative impact on anesthesia care at the Veterans Administration Hospitals. Veterans have been documented in multiple studies to be more chronically and critical ill than the rest of the civilian surgical population. These medical illnesses do not disappear when the patient enters the operating room for a surgical procedure, however simple or low risk the actual surgical procedure may be viewed.

Physician anesthesiologists train considerably longer and more in depth in order to optimize and take care of individuals during an operation, a time period of critical care. Physician anesthesiologists complete a bachelors degree, a 4 year medical medical doctorate, and a minimum of 4 years of specialized anesthesiology residency training. During this time frame it is estimated that they receive 15-16,000 hours of clinical training beyond their medical doctorate education.

Contrast this to the training of CRNAs which the American Association of Nurse Anesthetists estimates receive approximately 2500 hours of clinical training and complete 2-3 years of anesthesia training (depending on the program) after a bachelors degree.

In sum, the proposed change would remove the most highly trained and experienced anesthesia provider from the care of veterans, leading to a decrease in the standard of care delivered.

The proposed VA Handbook change is aimed at filling a void in the primary care services of veterans. There have been documented shortages of primary care within the VA system. However, in the VA’s own internal assessment of care shortfalls, anesthesiology was not listed as an at risk area. There is no shortage of physician anesthesiologists in the VA system, the is not an access issue. Please understand that physicians need to be involved in the delivery of anesthesia care for our veterans. Please keep physician anesthesiologists involved and do not support or authorize the categorization of APRNs as fully independent practitioners.
 
I modified @i2passgas' post. Here is what I submitted:

Veterans deserve the best and exceptional care in return for the exceptional service to our nation. The proposed policy changes to the VA Nursing Handbook recommend that all Advanced Practice Registered Nurses (APRNs) practice independently to their full practice authority.

One of the most critical times for health care occurs in the operating room. Potentially life threatening events may occur during operations, leaving the anesthesia provider only seconds to correct the problem. A proven model exists within the current health care system; the anesthesia care team. In the care team model, CRNAs work together with physicians to provide optimal care to the patient, with the physician anesthesiologist overseeing and guiding the care of CRNAs.

Allowing independent practice would have considerable negative impact on anesthesia care at the Veterans Administration Hospitals. Veterans have been documented in multiple studies to be more chronically and critical ill than the rest of the civilian surgical population. These medical illnesses do not disappear when the patient enters the operating room for a surgical procedure, however simple or low risk the actual surgical procedure may be viewed.

Physician anesthesiologists train considerably longer and more in depth in order to optimize and take care of individuals during an operation, a time period of critical care. Physician anesthesiologists complete a bachelors degree, a 4 year medical medical doctorate, and a minimum of 4 years of specialized anesthesiology residency training. During this time frame it is estimated that they receive 15-16,000 hours of clinical training beyond their medical doctorate education.

Contrast this to the training of CRNAs which the American Association of Nurse Anesthetists estimates receive approximately 2500 hours of clinical training and complete 2-3 years of anesthesia training (depending on the program) after a bachelors degree.

In sum, the proposed change would remove the most highly trained and experienced anesthesia provider from the care of veterans, leading to a decrease in the standard of care delivered.

The proposed VA Handbook change is aimed at filling a void in the primary care services of veterans. There have been documented shortages of primary care within the VA system. However, in the VA’s own internal assessment of care shortfalls, anesthesiology was not listed as an at risk area. There is no shortage of physician anesthesiologists in the VA system, the is not an access issue. Please understand that physicians need to be involved in the delivery of anesthesia care for our veterans. Please keep physician anesthesiologists involved and do not support or authorize the categorization of APRNs as fully independent practitioners.

PS I'm a medical student and my department is whistling past the graveyard on this. Our staff ratio is about 4:1 CRNA:MD, fwiw.
 
Can someone who has a modicum of writing ability submit a piece to the New York Times Op-Ed section? That would seriously boost publicity.

Yes, every CRNA would ferociously turn on you for writing this. It is best suited for someone who has previously supervised CRNAs and is now comfortably working in an MD-only practice. I would do this myself, but no one is going to listen to someone who just received their MD degree three days ago.

The nurse gestapo will post a poorly written emotional "article" about you on their website if you do. Just go look at the front page. Lord knows how else they might bully someone. IIRC they also bully residents but I can't find that "article" anymore, so be careful where you tread. It's like an organization of Donald Trumps.
 
As a 4th year medical student about to start the residency application process, is this something that I should be highly concerned about? If this passes, will it have a snowball effect as far as more widespread CRNA independence and reduced job opportunities for anesthesiologists in the future ?


I really enjoyed my anesthesia rotation, but with news like this coming down the pipeline, I find myself thinking more and more about applying IM and going for Pulm/CC instead.
 
The latest propaganda from the AANA:

http://www.aana.com/newsandjournal/...e-No-Impact-on-Anesthesia-Patient-Safety.aspx

“It’s interesting that the same doctors who argue that they need to be involved in the care of our military veterans don’t insist on being assigned to the front lines during military actions to care for soldiers horribly injured during battle, leaving this up to CRNAs to handle,” said Quintana

(vomit). Pretty sure my friends who were deployed as anesthesiologists would take offense to this. AND apparently the group that did this "study" is funded by united healthcare.
Hmm, that's funny, our anesthesia dept at Kandahar was all physician. Guess she didn't get the memo.

I honestly don't get offended by AANA lies any more. You can't fault the scorpion for being a scorpion.
 
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Hmm, that's funny, our anesthesia dept at Kandahar was all physician. Guess she didn't get the memo.

I honestly don't get offended by AANA lies any more. You can't fault the scorpion for being a scorpion.

Yeah but the public reads the propaganda. If you say something enough times, people start to believe you even when it makes no sense.
 
I practice a different specialty but I felt motivated to say it's downright alarming that there are only two pages to this thread. What's even more alarming is that there are not threads of outrage about this on every specialty subforum. And where the f&@$ are all the attendings? Half the posts are med students. (If you're reading this you're probably not who I'm referring to - all the apathetic short sided lazy politically inactive *****ic docs out there.)

Anesthesia not the only field at risk here... Before long the NPs will be fixing hernias and causing coronary dissections on heart caths. (Sort of kidding. Not really though.)
 
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I practice a different specialty but I felt motivated to say it's downright alarming that there are only two pages to this thread. What's even more alarming is that there are not threads of outrage about this on every specialty subforum. And where the f&@$ are all the attendings? Half the posts are med students. (If you're reading this you're probably not who I'm referring to - all the apathetic short sided lazy politically inactive *****ic docs out there.)

Anesthesia not the only field at risk here... Before long the NPs will be fixing hernias and causing coronary dissections on heart caths. (Sort of kidding. Not really though.)

The attendings or generations before us have a severe entitlement problem. They think they had it so much worse during residency and are owed something. Now they are selling the profession down the river for a few extra bucks. They created this monster but are completely spineless to stand up against it.
 
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Hmm, that's funny, our anesthesia dept at Kandahar was all physician. Guess she didn't get the memo.

I honestly don't get offended by AANA lies any more. You can't fault the scorpion for being a scorpion.
They also seem to leave out that most FSTs are bypassed for the CSH (where the anesthesiologists are), and that nearly all CRNAs that I know who deployed in the last few years spent six months downrange, and did very little (most of them said maybe a hernia or two in a month). But, you know, the troops.

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I practice a different specialty but I felt motivated to say it's downright alarming that there are only two pages to this thread.
Yeah, but 1/3 of the threads on the forum are about mid levels taking over. There are only so many different ways we can express our outrage and discuss what to do about it.
 
The attendings or generations before us have a severe entitlement problem. They think they had it so much worse during residency and are owed something. Now they are selling the profession down the river for a few extra bucks. They created this monster but are completely spineless to stand up against it.

I practice a different specialty but I felt motivated to say it's downright alarming that there are only two pages to this thread. What's even more alarming is that there are not threads of outrage about this on every specialty subforum. And where the f&@$ are all the attendings? Half the posts are med students. (If you're reading this you're probably not who I'm referring to - all the apathetic short sided lazy politically inactive *****ic docs out there.)

Anesthesia not the only field at risk here... Before long the NPs will be fixing hernias and causing coronary dissections on heart caths. (Sort of kidding. Not really though.)

Actually the real selling of Anesthesiology as a medical specialty is happening right now and it's being done by the ASA.
This probably applies to a lesser degree to other specialty associations, but the ASA had gone above and beyond.
The ASA a few years back decided that the best way is to kiss the AANA's behind and make peace with them, so they publically conceded that it is OK for a nurse anesthetist to be supervised by any physician, not necessarily an anesthesiologist!
This fatal mistake was the origin of all the disasters that followed including more states opting out of anesthesiologist supervision, and the current miserable state of this dying specialty.
Then when the AANA took the ASA's stupid and unjustified concession to the next level and started rallying politicians against anesthesiologists and against the ASA, the wise leadership at the ASA was under pressure to take some meaningful action, and the only thing they could come up with was to hand over the entire scope of intra-operative patient care to the nurses, and create instead this idiotic concept called the surgical home, where anesthesiologists are no longer anesthesiologists but some sort of glorified nurse practitioners applying protocols to peri-operative patients, and trying to compete with other physicians like internists and hospitalists.
If there is anyone to blame for what we are dealing with right now it is without any doubt the ASA!
 
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Actually the real selling of Anesthesiology as a medical specialty is happening right now and it's being done by the ASA.
This probably applies to a lesser degree to other specialty associations, but the ASA had gone above and beyond.
The ASA a few years back decided that the best way is to kiss the AANA's behind and make peace with them, so they publically conceded that it is OK for a nurse anesthetist to be supervised by any physician, not necessarily an anesthesiologist!
This fatal mistake was the origin of all the disasters that followed including more states opting out of anesthesiologist supervision, and the current miserable state of this dying specialty.
Then when the AANA took the ASA's stupid and unjustified concession to the next level and started rallying politicians against anesthesiologists and against the ASA, the wise leadership at the ASA was under pressure to take some meaningful action, and the only thing they could come up with was to hand over the entire scope of intra-operative patient care to the nurses, and create instead this idiotic concept called the surgical home, where anesthesiologists are no longer anesthesiologists but some sort of glorified nurse practitioners applying protocols to peri-operative patients, and trying to compete with other physicians like internists and hospitalists.
If there is anyone to blame for what we are dealing with right now it is without any doubt the ASA!

God those glossy newsletters they spam you with. What an embarrassment.
 
As a 4th year medical student about to start the residency application process, is this something that I should be highly concerned about? If this passes, will it have a snowball effect as far as more widespread CRNA independence and reduced job opportunities for anesthesiologists in the future ?


I really enjoyed my anesthesia rotation, but with news like this coming down the pipeline, I find myself thinking more and more about applying IM and going for Pulm/CC instead.

Yes, if this VA Bill passes allowing Independent CRNA practice how long until the AANA demands the same for the community hospital? The AANA/CRNA DNP wants your job and seeks to destroy the medical specialty of Anesthesiology as it now exists.
 
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Yes, if this VA Bill passes allowing Independent CRNA practice how long until the AANA demands the same for the community hospital? The AANA/CRNA DNP wants your job and seeks to destroy the medical specialty of Anesthesiology as it now exists.
Exactly! If it's good enough for our vets, why wouldn't people assume its good enough for the rest of society? It's only a matter of time before we're phased out altogether or transitioned to some ungodly "supervision" ratio. Save, and live below your means... or find a niche to keep you safe for a while.

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Yes, if this VA Bill passes allowing Independent CRNA practice how long until the AANA demands the same for the community hospital? The AANA/CRNA DNP wants your job and seeks to destroy the medical specialty of Anesthesiology as it now exists.
BLADE, what do you do my man? You post in the Anes forum, but speak like you aren't.
 
My day job due to multiple rooms of "supervision" covering know-it-all CRNAs:

fireman.jpg
 
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