What's up with the VA Spa?

[imfrankie]

Did I see correctly the VA system is moving to let nurses work independently?

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[aneftp]

Yes depends on VA.

Some places have CRNAs doing own cases and MDs doing own cases.

 

[sleepallday]

Nothing but the best for our vets.

 

[ph8]

and the link....

http://www.medpagetoday.com/Anesthesiology/Anesthesiology/41479

I don't know what others experience has been, but my VA experience was full of pretty hardcore ASA 3's and 4's. While it is pretty tough to knock off a vet (hell, they survived some of the craziest stuff in Vietnam, Korea, etc), this has the potential for a poor decision by the govt.

 

[TheKidCanRun]

More unsettling news. As a resident this is very scary stuff. It's tough to get through the day to day grind when you look around and see stuff like this, and it hits you that there may not be a job out there for you after all

 

[OB1🤙]

What's the difference between a VA nurse and a bullet?

You can fire the bullet.

What the other difference between a VA nurse and a bullet?

The bullet only kills once.

 

[zebalong]

What's the difference between a VA nurse and a bullet?

You can fire the bullet.

What the other difference between a VA nurse and a bullet?

The bullet only kills once.

lol this is one of the funniest things i've read for awhile.. and i did per diem as an RN at a VA awhile back.

 

[cchoukal]

The article read kind of funny. So there's a new "nursing handbook" that encourages NPs/CRNAs to seek independent practice. As someone who spends time in the VA system, I've learned the terminology is important. This doesn't sound like a VA directive or memorandum; it sounds like the usual pro-nursing (and, frankly, pro-systems) jargon on clinicians working to the maximum of their license. The ASA president-elect is the one using the terminology of it being a rule and a formal proposal. And we're still hiring doctors.

Of course, I'm not naive and there could be a bona fide policy initiative in the works somewhere, but the language of the linked article, by my read, falls short of suggesting that.

 

[aneftp]

The article read kind of funny. So there's a new "nursing handbook" that encourages NPs/CRNAs to seek independent practice. As someone who spends time in the VA system, I've learned the terminology is important. This doesn't sound like a VA directive or memorandum; it sounds like the usual pro-nursing (and, frankly, pro-systems) jargon on clinicians working to the maximum of their license. The ASA president-elect is the one using the terminology of it being a rule and a formal proposal. And we're still hiring doctors.

Of course, I'm not naive and there could be a bona fide policy initiative in the works somewhere, but the language of the linked article, by my read, falls short of suggesting that.

Working to the "maximum of their license".

Everyone wants to do more than they really are originally trained and licensed.

Surprised docs don't just take over the entire health system and demand only those with MDs can be heads of health systems and those without MD degrees can't run it.

Does a non JD run a court room?

 

[Reciprocity79]

What's the difference between a VA nurse and a bullet?

You can fire the bullet.

What the other difference between a VA nurse and a bullet?

The bullet only kills once.

A bullet can also draw blood.

 

[imfrankie]

Working to the "maximum of their license".

Everyone wants to do more than they really are originally trained and licensed.

Surprised docs don't just take over the entire health system and demand only those with MDs can be heads of health systems and those without MD degrees can't run it.

Does a non JD run a court room?

Plenty of M.D.s are heads of things. They quickly figure out they personally can make even more ching by replacing physicians with cheap labor.

 

[aneftp]

Plenty of M.D.s are heads of things. They quickly figure out they personally can make even more ching by replacing physicians with cheap labor.

Not many MDs head of hospital systems. I actually do not know any. Couple head of hospitals but none head of system.

Even those with executive MBAs. It's like the discriminate against having MD even though they know the systems in and out.

 

[Per4mer8]

A bullet can also draw blood.

Ahahahahaha.

 

[Per4mer8]

Not many MDs head of hospital systems. I actually do not know any. Couple head of hospitals but none head of system.

Even those with executive MBAs. It's like the discriminate against having MD even though they know the systems in and out.

Because the personality type that goes into medicine isn't the best business person. Success in medicine typically involves doing what's best for the patient not being the most black/white ruthless policy maker. Real business people optimize profit while physicians would optimize patient care etc. Physician heads of the hospital system would favor other physician interests which are typically not the same interests as the corporation/boardmembers. Also, those MDs that become corporate men are typically seen almost like Internal Affairs Officers of the PD......

 

[ambiturner]

Not many MDs head of hospital systems. I actually do not know any. Couple head of hospitals but none head of system.

Even those with executive MBAs. It's like the discriminate against having MD even though they know the systems in and out.

Gary Gottlieb, an MD, is the president and CEO of partners healthcare - the system that controls MGH and the Brigham, one of the most profitable and successful on the east coast. Granted he has an MBA and under his watch there has indeed been an influx of cheap labor (nps). It's also academic, I would assume docs have less influence in private practice hospitals.

 

[Teillard]

Working to the "maximum of their license".

Everyone wants to do more than they really are originally trained and licensed.

Surprised docs don't just take over the entire health system and demand only those with MDs can be heads of health systems and those without MD degrees can't run it.

Does a non JD run a court room?

Last I heard, the surgeons at the VA we're all docs...but the only docs complaining (that I've heard so far) are the anesthesiologists.

What do the surgeons have to say about the whole thing?

 

[VentdependenT]

Last I heard, the surgeons at the VA we're all docs...but the only docs complaining (that I've heard so far) are the anesthesiologists.

What do the surgeons have to say about the whole thing?

Wont affect them. as long as the pt gets anesthetized so the case can happen why would they care?

 

[Teillard]

Wont affect them. as long as the pt gets anesthetized so the case can happen why would they care?

Because they have more skin in the game than anyone else.