What fellowship has to deal with less CRNA

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Allergy/immunology
Cardiology
GI (unless you use them for your office propofol screening colon mill)
Rheum
family med
Sports
ob/gyn
REI
Rads/IR
Surgery (vascular, cardiac, neuro, ortho, uro, ent, plastics unless you use them for your office $$$ procedures)
Psych
Neurology

dentistry. Orthodontics.

Oh, Anesthesia you say? East coast? Pain and pain only if you wanna get real.
 
Last edited:
Said it before and again. We don’t need fellowships to provide physician level care. We need unions and lobbying power on the physician front. Look at the primary care and Er docs. It is a sheet show and ultimately patients will suffer. More studies will be ordered, more sick patients will die, and this is an overall win for the powers that be that indirectly benefit from this. $$$
 
Mid-level encroachment is ubiquitous in almost every speciality of medicine (except surgery i guess). I’m very happy to not be a surgeon and I’m sure my wife is too. We just gotta learn to live with it, as pessimistic as that sounds. CRNAs/PAs/NPs won’t magically disappear and realistically we won’t all lose our jobs. The landscape of medicine is changing for the worst in my opinion and it just is what it is.

When your loved ones will inevitably get sick, use your medical knowledge to protect them from reckless/lazy/dumb providers (this includes shoddy doctors).
 
Fellowship would not shield you from CRNAs. Your job selection and salary compromise might shield you. DO what you like and enjoy in the field of anesthesia. 1:4 ratio would shave decades off you , even some might say otherwise. At my academic shop, depending on case complexity, usually 1 or solo (40%) and 2(60%) supervision. Depending on the CRNA , an easy day on paper might be rough because of their cavalier attitude.
 
Propofool123 said:
Mid-level encroachment is ubiquitous in almost every speciality of medicine (except surgery i guess). I’m very happy to not be a surgeon and I’m sure my wife is too. We just gotta learn to live with it, as pessimistic as that sounds. CRNAs/PAs/NPs won’t magically disappear and realistically we won’t all lose our jobs. The landscape of medicine is changing for the worst in my opinion and it just is what it is.

When your loved ones will inevitably get sick, use your medical knowledge to protect them from reckless/lazy/dumb providers (this includes shoddy doctors).
Click to expand...
they will if you STOP TRAINING THEM. they cannot train themselves to do anything besides politically pander. grow a pair
 
Falconslick said:
they will if you STOP TRAINING THEM. they cannot train themselves to do anything besides politically pander. grow a pair
Click to expand...
Unfortunately, money talks in this country. Screw ethics. “Pay me and I will do your bidding no matter how detrimental it is to our profession”

There’s always someone willing to sell out for money.
 
Falconslick said:
they will if you STOP TRAINING THEM. they cannot train themselves to do anything besides politically pander. grow a pair
Click to expand...

its all good talking the talk , until the crna schools hire Docs at 800k a year to train crnas for 45 hours a week total, i doubt anyone here will be a matyr for their profession.....until PE starts demanding a bigger share of the pie
 
Falconslick said:
they will if you STOP TRAINING THEM. they cannot train themselves to do anything besides politically pander. grow a pair
Click to expand...
CRNAs are being trained largely by other CRNAs. Even a magical united front of anesthesiologists holding hands and singing songs and waving a battle flag with a laryngoscope on it couldn't plug their training pipeline.

If that's the battle you want to fight you'd be better off using their own arguments against them and working to expand the number of states where AAs can practice. And then fire CRNAs and hire AAs as you're able. That won't work either but at least it's a plan grounded in some semblance of reality.
 
The SRNAs I’ve encountered at my institution (they’re only here at night and are paired with the overnight CRNA) are actually reluctant to learn from physicians. Tried to give one of them a talk about physiology one night and she didn’t seem to care at all even though it was relevant to the case she was doing.
 
Propofool123 said:
The SRNAs I’ve encountered at my institution (they’re only here at night and are paired with the overnight CRNA) are actually reluctant to learn from physicians. Tried to give one of them a talk about physiology one night and she didn’t seem to care at all even though it was relevant to the case she was doing.
Click to expand...
Honestly she probably didn’t understand what you were saying.
Resident vs nurse teaching is a world of difference for sure.
I’ve found most of them to have a huge knowledge gap when you attempt to discuss physician level physiology or other such concepts. Their DNP is largely nursing fluff and it shows.
 
Man o War said:
Honestly she probably didn’t understand what you were saying.
Resident vs nurse teaching is a world of difference for sure.
I’ve found most of them to have a huge knowledge gap when you attempt to discuss physician level physiology or other such concepts. Their DNP is largely nursing fluff and it shows.
Click to expand...

Most of their education is ultimately boiled down to one-liners with no real deeper understanding below the surface.

"CHF pts need etomidate inductions and never need any fluid"

"A pump case is a pump case"

"Pt has history of DMII so needs an RSI for gastroparesis"

"200 mcgs of neo didn't work so I guess time to give vasopressin"

"HR is 45 and pt is normotensive. Let's give glyco"

"Let me set the tidal volume to 675 so I can pop the lungs open"
 
Propofool123 said:
The SRNAs I’ve encountered at my institution (they’re only here at night and are paired with the overnight CRNA) are actually reluctant to learn from physicians. Tried to give one of them a talk about physiology one night and she didn’t seem to care at all even though it was relevant to the case she was doing.
Click to expand...

These nurses only do CRNA etc. for the money, so what did you expect. They all of a sudden developed a sudden "passion" for anesthesia while in nursing school? Give me a break.
 
pgg said:
If that's the battle you want to fight you'd be better off using their own arguments against them and working to expand the number of states where AAs can practice. And then fire CRNAs and hire AAs as you're able. That won't work either but at least it's a plan grounded in some semblance of reality.
Click to expand...
This idea that creating more mid levels (AA) will solve the CRNA problem is bizarre. CRNA, MD, AA we are all anesthesia “providers” to our employers. Increase the supply and keep demand the same and you know what happens...
Quite honestly this profession is fu(ked. While I don’t see complete CRNA independence I think you will see supervision ratios increase and of course our salaries will decrease with less demand. Hopefully this scenario will take a while so I can get mine before the sky falls in....
 
Propofool123 said:
The SRNAs I’ve encountered at my institution (they’re only here at night and are paired with the overnight CRNA) are actually reluctant to learn from physicians. Tried to give one of them a talk about physiology one night and she didn’t seem to care at all even though it was relevant to the case she was doing.
Click to expand...
Stop teaching them. She’s there to learn from the CRNA not you.

Her attitude showed it and she wasn’t interested in what you were saying. Nor could she probably understand it anyway.

You are also training your replacement by teaching them.
Stop it.
 
chocomorsel said:
Stop teaching them. She’s there to learn from the CRNA not you.

Her attitude showed it and she wasn’t interested in what you were saying. Nor could she probably understand it anyway.

You are also training your replacement by teaching them.
Stop it.
Click to expand...

I get that. The truth is CRNAs aren’t going anywhere and they will be out there caring for patients. If someone is genuinely curious and willing to learn, I’m happy to teach them if it’s within the scope of what I believe they should know.

Will I teach them physiology to help them make more wise decisions about fluids and pressors in the OR? Or why LR is not contraindicated in patients with CKD/ESRD? Yes.

Will I teach them how to do TEE or nerve blocks? No.
 
Another Q. If assuming 5 years for anesthesia + fellowship, would you guys go back and do anesthesia again? Or would you say do 6 years of IM + fellow, or Rads, etc. 2 things that are generally the same competitiveness. Not going to say surgery because that's an sizable increase in competitiveness.
 
scoopdaboop said:
Another Q. If assuming 5 years for anesthesia + fellowship, would you guys go back and do anesthesia again? Or would you say do 6 years of IM + fellow, or Rads, etc. 2 things that are generally the same competitiveness. Not going to say surgery because that's an sizable increase in competitiveness.
Click to expand...
For me yea. I don’t plan on living in America forever and outside of the US, Anaesthetists are the intensivists. So it’s exciting for me.
In America, being an anesthesiologist one makes good money but there are so much politics with CRNAs, and there is lack of respect from other fields and surgeons that can be a problem. But the disrespect is not that rampant, but it’s there.
I am queen in the ICU. Not the princess.
 
chocomorsel said:
For me yea. I don’t plan on living in America forever and outside of the US, Anaesthetists are the intensivists. So it’s exciting for me.
In America, being an anesthesiologist one makes good money but there are so much politics with CRNAs, and there is lack of respect from other fields and surgeons that can be a problem. But the disrespect is not that rampant, but it’s there.
I am queen in the ICU. Not the princess.
Click to expand...

The idea of physicians disrespecting others always bugs me. We say follow what interests you yet some docs will judge others for doing just that. Sad.
 
You must log in or register to reply here.

Similar threads

L
Whats the deal with crnas giving every drug in the pyxis??
2
Replies
73
Views
7K
coffeebythelake
coffeebythelake
GaseousClay
Super creepy crna loses license
Replies
10
Views
2K
FiremedicMike
F
A
Crna “independent” practice massive lawsuit judgment in Conn
Replies
35
Views
3K
NPJR
N
A
Bcbs cuts crna reimbursement
Replies
49
Views
5K
Howard888
H
coffeebythelake
CRNA wearing white coat administers fatal treatment
2
Replies
69
Views
14K
psycho-matic
P
Top