Where's JWK?

[toughlife]

I think he'd like to hear this, if he doesn't already know about it.

ASA Newsletter April 2006
Volume 70 Number 4


Nation’s Capital Officially Licenses Anesthesiologist Assistants

http://www.asahq.org/Newsletters/2006/04-06/AAs04_06.html
--------------------------------------------------------------------------------

Another significant milestone has been accomplished by the anesthesiologist assistant (AA) profession. AAs are now officially licensed to work in the nation’s capital. In 2002 the D.C. Board of Medicine decided that it was appropriate for hospitals there to employ AAs, and it issued appropriate guidelines. The law creating AA licensure was passed by the D.C. Council in 2004, and the regulations were written last year. The actual licensing was approved this year.

So far, seven AAs work in D.C. Frederick Finelli, M.D., President of the Medical Staff of Washington Hospital Center and Chair of the D.C. Board of Medicine, says they will fill a major need.

“We have had a shortage of anesthesia providers for awhile,” Dr. Finelli said. “AAs are helping to alleviate that shortage.”

AAs are now licensed to work in 10 areas (nine states and the District of Columbia). They also can practice in six other states under “delegatory authority,” meaning they are specifically requested by hospitals or physician anesthesiologists.

“States are recognizing our value as health care providers,” according to Ellen Allinger, President of the American Academy of Anesthesiologist Assistants (AAAA) <www.anesthetist.org>. “This is because of our ability to fill the need for providers in a highly skilled manner as part of the Anesthesia Care Team. Our track record of safety speaks for itself as more states are welcoming us.”

AAAA is a nonprofit association of graduates from accredited training programs specializing in the science and clinical practice of anesthesiology. AAAA establishes and maintains professional standards fostering and encouraging continuing education and research to all graduate AAs and enrolled students of accredited programs.

---

Members don't see this ad.

 

[Idiopathic]

AAAA

Worst. acronym. ever.

 

[ThinkFast007]

Worst. acronym. ever.

nope, this is CRNA

 

[toughlife]

Worst. acronym. ever.

Right. What would you suggest they use?

 

[Idiopathic]

Right. What would you suggest they use?

No, it fits, just saying it is dorky. "Hi, Im president of the AAAAAAAAAA (was that enough A's?) AAAa..." you get the picture.

 

[Idiopathic]

nope, this is CRNA

Hey I dont know whether I hope NW has plenty of CRNA's so that you can face them everyday or that they have none, so you can see what its like to not have them. Either way, your pettiness grows tiresome.

 

[ThinkFast007]

Hey I dont know whether I hope NW has plenty of CRNA's so that you can face them everyday or that they have none, so you can see what its like to not have them. Either way, your pettiness grows tiresome.

ideally the latter.

but in all seriousness, the above was mean to be taken lightheartedly. So soften up mr. sour puss. My major issue with 'them' is primarily w/ the arrogant, pricks that are way out of line and think thye are docs...vast majority.

So let me ask you something. Why dont you think the AA wouldnt be just as good? Have you been exposed to AAs? I have.

most ppl's arguments are that why have an anesthesiologist availalbe if you can have someone sit there and write down vitals and do routine things. So why can't a AA do that? I've seen many of them do it quite well. Additionally, their national alliance (AAAA) isnt out there trying to take your livelihood away. Wake up buddy. That's reality. Go ahead be their B@#ch if you want to. wont find me there.

 

[nitecap]

You would prob. fall in the "arrogant prick" category yourself toughlife. Sorry, prick status isnt delineated by education or training levels.

 

[ThinkFast007]

hey nitey

you getting worried? what are you going to do when the new generation of anesthesiologists are going to use AAs instead of your arrogant a ss? how do you feel about that my friend? see what you and YOUR colleagues have done. I hope that AAs are able to practice in more states!

 

[nitecap]

We will see when that time comes. First the AA's will have to grow from somewhere around 4000-5000 to 30,000 prob more to fill our spots. Graduating 150/year like they are now would take about 170yrs. Even if say in the next decade they increased output 2 fold to 450-500 it would still take 55yrs tough guy. By then you will be in the nursing home man hopefully with a new attitude towards the very nurses that will be redressing you when you decide to walk into the cafeteria for bingo Butt AS s naked.

 

[ThinkFast007]

.... By then you will be in the nursing home man hopefully with a new attitude towards the very nurses that will be redressing you when you decide to walk into the cafeteria for bingo Butt AS s naked.

got no probs with nurses doing this kinda work for me. actually iw ould appreciate it. So tell me, as a male nurse, how many as ses did you have clean? how many sponge baths did you give? also, as a guy...do you go around bars,etc telling chicks you are a nurse? doubt it. i bet your pathetic ego wouldnt allow that. you probably tell the chick at the bar "i'm an anesthesist" thus hiding the fact that you are a nurse. you hope that the chick thinks you are a doctor by means of the word anesthesist being uttered.

tool.

 

[lawdawg]

got no probs with nurses doing this kinda work for me. actually iw ould appreciate it. So tell me, as a male nurse, how many as ses did you have clean? how many sponge baths did you give? also, as a guy...do you go around bars,etc telling chicks you are a nurse? doubt it. i bet your pathetic ego wouldnt allow that. you probably tell the chick at the bar "i'm an anesthesist" thus hiding the fact that you are a nurse. you hope that the chick thinks you are a doctor by means of the word anesthesist being uttered.

tool.

I hope for your sake you can suppress some of your attitudes about CRNA's, nurses, DO's, IMG's etc in your residency, otherwise it may come back to bite you in the arse.

 

[nitecap]

got no probs with nurses doing this kinda work for me. actually iw ould appreciate it. So tell me, as a male nurse, how many as ses did you have clean? how many sponge baths did you give? also, as a guy...do you go around bars,etc telling chicks you are a nurse? doubt it. i bet your pathetic ego wouldnt allow that. you probably tell the chick at the bar "i'm an anesthesist" thus hiding the fact that you are a nurse. you hope that the chick thinks you are a doctor by means of the word anesthesist being uttered.

tool.

Nah dont need a title or profession to pull the fine women man, unlike many MD's. Hey making 60k as a new grad RN isnt to shabby. Especially comparing to many of my others friends starting salaries that had degrees in business, biology, chemistry, accounting, finance,even engineering. A RN in 2 yrs can be making 80K, add free rent on top of that if traveling and you can up that to 90k. Yes you will have to put in the hours but it will be no more than those salaried accountants, marketers, managers, researcher ect. Crazy that a RN 22years old with 2yrs exp can make 80k when many of the phd. educated researchers at my instituion barely if even make that and they spend freaking day and night in the lab putting in 70hrs a week sometimes.

Yes I cleaned a few pts n my day. Nothing to be ashamed of. Not a pussyy and scared to get dirty to help a pt out, thoough I admit id rathers slide head first thru a mix of piss, vomit and bld than shiznit. Depending on the facility you work at poop scooping and bathing has decreased a good bit due to hiring a ton on unlic. aids, PCA's ect. Though if the pt was extremely sick bilevel vent ect I woud rather be there for the bath so the assistants dont increase oxygen demand too much. You couldnt imagine the number of ICU pts that decompensate during a routine bath.

You forget though tough guy. That crapped out CAB pt on mega drips, bilevel vent, bleeding and you pushing epi and phenyl to get him to the unit is the same pt that I when in ICU cared for at night with no MD in site and possibly a NP or PA nearby. We didnt call to say mr. toughlife hard man what pressor should i go up on to optimize this train wreck you just brought me. Toughlife you may have great anesthesia experience but your countless OR hours have really not allowed you to learn how the rest of the hospitals practioners function.

 

[Gimlet]

Toughlife you may have great anesthesia experience but your countless OR hours have really not allowed you to learn how the rest of the hospitals practioners function.

Nitecap, I think you may be confusing Toughlife with Thinkfast007...Toughie has been very chill on the CRNA front recently.

 

[rn29306]

So tell me, as a male nurse, how many as ses did you have clean? how many sponge baths did you give? also, as a guy...do you go around bars,etc telling chicks you are a nurse? doubt it. i bet your pathetic ego wouldnt allow that. you probably tell the chick at the bar "i'm an anesthesist" thus hiding the fact that you are a nurse. you hope that the chick thinks you are a doctor by means of the word anesthesist being uttered.

As a male nurse I did lots of s hit, including cleaning it on occasion. You however are a piece of s hit for putting down someone's profession such as this, though I'm sure with your winning attitude you've been told this before.

Chicks don't seem to mind the title. Not that I flaunt around like Focker, but I ain't got nothing to be ashamed of. Did hospital and pre-hospital (as in EMS and flight). Cool job, but ain't going back. Stripper I dated in Atlanta was most impressed, until her friends started hitting me up for fentanyl and I hit the road.
Why the h-e-l-l would I tell someone "I'm an anesthetist". You forgot the part of nurse, which i include. First off, why would i expect someone to be impressed that I am an AA? That's what they call themselves despite the fact that AA stands for Anesthesiologist Assistant. Guess trying to pick up chicks with 'assistant' in your name just isn't as kewl. Anesthetist happens to be in my title. Go figure. Second, most people know what nurse anesthetist are and they think it is a cool job.

Your kung-fu is weak.

 

[toughlife]

You would prob. fall in the "arrogant prick" category yourself toughlife. Sorry, prick status isnt delineated by education or training levels.

What did I do to draw such a hostile attitude?

 

[toughlife]

Nah dont need a title or profession to pull the fine women man, unlike many MD's. Hey making 60k as a new grad RN isnt to shabby. Especially comparing to many of my others friends starting salaries that had degrees in business, biology, chemistry, accounting, finance,even engineering. A RN in 2 yrs can be making 80K, add free rent on top of that if traveling and you can up that to 90k. Yes you will have to put in the hours but it will be no more than those salaried accountants, marketers, managers, researcher ect. Crazy that a RN 22years old with 2yrs exp can make 80k when many of the phd. educated researchers at my instituion barely if even make that and they spend freaking day and night in the lab putting in 70hrs a week sometimes.

Yes I cleaned a few pts n my day. Nothing to be ashamed of. Not a pussyy and scared to get dirty to help a pt out, thoough I admit id rathers slide head first thru a mix of piss, vomit and bld than shiznit. Depending on the facility you work at poop scooping and bathing has decreased a good bit due to hiring a ton on unlic. aids, PCA's ect. Though if the pt was extremely sick bilevel vent ect I woud rather be there for the bath so the assistants dont increase oxygen demand too much. You couldnt imagine the number of ICU pts that decompensate during a routine bath.

You forget though tough guy. That crapped out CAB pt on mega drips, bilevel vent, bleeding and you pushing epi and phenyl to get him to the unit is the same pt that I when in ICU cared for at night with no MD in site and possibly a NP or PA nearby. We didnt call to say mr. toughlife hard man what pressor should i go up on to optimize this train wreck you just brought me. Toughlife you may have great anesthesia experience but your countless OR hours have really not allowed you to learn how the rest of the hospitals practioners function.

Dude I think you may have a crush on me given how you always mention my screenname when addressing thinkfast007. . Sorry dude but I like women

 

[Idiopathic]

ideally the latter.

but in all seriousness, the above was mean to be taken lightheartedly. So soften up mr. sour puss. My major issue with 'them' is primarily w/ the arrogant, pricks that are way out of line and think thye are docs...vast majority.

So let me ask you something. Why dont you think the AA wouldnt be just as good? Have you been exposed to AAs? I have.

most ppl's arguments are that why have an anesthesiologist availalbe if you can have someone sit there and write down vitals and do routine things. So why can't a AA do that? I've seen many of them do it quite well. Additionally, their national alliance (AAAA) isnt out there trying to take your livelihood away. Wake up buddy. That's reality. Go ahead be their B@#ch if you want to. wont find me there.

It just gets old. How many CRNA's have you met? What wouldnt you like about working with them...I guess when as a CA-1 resident you are doing eyeballs and eardrums and Im getting relieved to do transplants and cranis, then we'll see, but a strong CRNA presence was actually something I looked for in a training program. There are obviously arguments to be made regarding practice limitations, etc, but I hear more from med students re: evil CRNA's than I do from people that actually work with them/employ them. So, you can have them cover your OR's for you in practice and increase your checkbook or you can run them out of town and work that much harder.

 

[Cap'nOblivious]

This thread's a real winner.

Since I'm a male nurse, and the topic's been brought up, I'll share. A lot of my buddies can't resist the "wipe" jokes, and it sucks when you can't win a smack-talk session without a "Yeah, but at least I don't bathe cottons for a living" comment. And everyone laughs. But for the most part, chicks are cool with it, more of a looks and personality thing with them, ya know? Especially when you're hung like Mandingo (no not me, just especially).

Toughlife and Thinkfast: Congrats on matching. Try to stop assuming all CRNAs want to destroy your livelihood, how bout it?

 

[drRumi]

So tell me, as a male nurse, how many as ses did you have clean? how many sponge baths did you give? also, as a guy...do you go around bars,etc telling chicks you are a nurse? doubt it. i bet your pathetic ego wouldnt allow that.

tool.

dude, how shallow are you? it's almost painful to read your comments. it's incredibly sad that you define your self-worth by your profession. you must be the typical fcking tool we see in bars that tries to impress women with the "yea baby, im a doc" line. usually thats all your kind has to offer to women. grow up man. all this talk about mds, crnas, aas is all good and fine. Why do you have to resort to disrespecting male nurses? as a future doc, i would hate to have a numbnut like you in my ranks.

by the way, that nurse might be cleaning up ur shi t one day. so if i were you, i would stfu unless you like to sleep in your shi t, my friend.

 

[ThinkFast007]

got hella respect for nurses. I've got plenty of close family that's in nursing. However, none of them are like nitecap. they respect doctors and do not believe that they are better than them. They realize their role (which is VERY important) but dont try to overpass their boundaries. they do their job willingly and with a smile on their face. Soo...the above post was actually just aimed at nitecap. the dude clearly doesnt recognize his place.

to idio- actually you havent mentioned to me why you dont think AAs are just as good as CRNAs? nice try at sidestepping the question, but it still remains.

also idio, you talk about yoru checkbook. So let me ask you. have you checked gasworks.com ? you are not going to be able to find a job in a major metropolitan city as a higher paying anesthesiologist. are youw illing to move to podunk to get paid more? cuz that's where you are going to find a job that pays well. so you talk about lifestyle etc. What kind of lifestyle is it when you have to work in podunk to be able to fund that car, house, education for that little girl of yours (not to mention the fact that you may miss a few soccer games etc)? yes, you prolly can mk 200-250K in a major metro city NOW. but think about it in like 5-10yrs. Factor in inflation and increased cost of living, your 200k isnt gonna end up to much my friend.

think again

 

[bullard]

I wouldn't necessarily take gaswork.com to be a barometer of the market at large. There's all kinds of sweet jobs out there that never get advertised. (Hence the importance of a good alumni network s/p residency). Ever look in the back of Anesthesiology magazine? If you judged the market based on those classifieds you'd think anesthesiologists were all working in 4 OR hospitals in Idaho for crap pay.

 

[ThinkFast007]

dude, .. tries to impress women with the "yea baby, im a doc" line. usually thats all your kind has to offer to women. grow up man. ....

actually never used that line....really couldnt, cuz i wasnt a doc yet. always just told them "i'm in school"...never told them medical school, just school.

so whatcha got to say now?

 

[Sugar72]

This thread's a real winner.

Since I'm a male nurse, and the topic's been brought up, I'll share. A lot of my buddies can't resist the "wipe" jokes, and it sucks when you can't win a smack-talk session without a "Yeah, but at least I don't bathe cottons for a living" comment. And everyone laughs. But for the most part, chicks are cool with it, more of a looks and personality thing with them, ya know? Especially when you're hung like Mandingo (no not me, just especially).

Toughlife and Thinkfast: Congrats on matching. Try to stop assuming all CRNAs want to destroy your livelihood, how bout it?

As a chick, I would have no problem dating a male nurse..I have met several I would like to date...my husband really wouldn't be on board with that. I just wanted to pipe in since some people seem to be a little too wrapped up in self-importance and really outdated gender roles.

 

[Idiopathic]

actually never used that line....really couldnt, cuz i wasnt a doc yet. always just told them "i'm in school"...never told them medical school, just school.

so whatcha got to say now?

You are still a dork. Did you tell them your were in dork school? Or that you already have your PhD?

 

[ThinkFast007]

As a chick, I would have no problem dating a male nurse..I have met several I would like to date...my husband really wouldn't be on board with that. I just wanted to pipe in since some people seem to be a little too wrapped up in self-importance and really outdated gender roles.

what is this SDNdating ?

this could become a profitable business.

 

[stephend7799]

what is this SDNdating ?

this could become a profitable business.

th inkfast you need to clean out your message box.. i sent you a message like yesterday and it said your message center was full

 

[jwk]

I think he'd like to hear this, if he doesn't already know about it.

ASA Newsletter April 2006
Volume 70 Number 4


Nation’s Capital Officially Licenses Anesthesiologist Assistants

http://www.asahq.org/Newsletters/2006/04-06/AAs04_06.html
--------------------------------------------------------------------------------

.

Gee tough, I didn't know you missed me so much. I've been at the AAAA meeting at Hilton Head, so was a little out of touch. Besides that, I've been honing my debating skills on "the other website", practicing up for talking with some legislators in some soon-to-have AA states. Sorry nitecap.

We indeed have full licensure in DC - huge win for our side.

More big AA news - the 5th AA program has been formally announced at UMKC, the first program west of the Mississippi and the first at a public university. The Missouri Society of Anesthesiologists was instrumental in getting this program moving.

As far as the AAAA or Quad A, it's 17 syllables less than saying American Academy of Anesthesiologist Assistants. What can I say?

 

[Idiopathic]

to idio- actually you havent mentioned to me why you dont think AAs are just as good as CRNAs? nice try at sidestepping the question, but it still remains.

also idio, you talk about yoru checkbook. So let me ask you. have you checked gasworks.com ? you are not going to be able to find a job in a major metropolitan city as a higher paying anesthesiologist. are youw illing to move to podunk to get paid more? cuz that's where you are going to find a job that pays well. so you talk about lifestyle etc. What kind of lifestyle is it when you have to work in podunk to be able to fund that car, house, education for that little girl of yours (not to mention the fact that you may miss a few soccer games etc)? yes, you prolly can mk 200-250K in a major metro city NOW. but think about it in like 5-10yrs. Factor in inflation and increased cost of living, your 200k isnt gonna end up to much my friend.

think again

As far as AA vs CRNA, I have no opinion, because I have never worked with an AA. I honestly dont know what they can/cant do and what their training is. My humorous commentary about their acronym had to do with the fact that it could be read as "Ahhhhhh", etc. You see, its funny. I can understand why docs like them, especially if they are cheaper and arent asking for solo practice rights.

And Im not on board with CRNA's being unsupervised, Ive never made that comment. But to say that they dont benefit you in your medical training and further is probably a little short-sighted. I guess I choose to think that there are MUCH bigger fish to fry out there. Since Im interested in niche anesthesiology, Im probably just not as worried as someone looking to get out and practice in a general setting. I also think that you, as a fourth year med student, probably know about as much as I do regarding the future of medicine and our specialty, which is very little. So do me a favor, and unless you are going to educate me on 'how to match' or 'how to get drunk' (both strong topics BTW), refrain from doing any teaching.

Thanks.

 

[Idiopathic]

Gee tough, I didn't know you missed me so much. I've been at the AAAA meeting at Hilton Head, so was a little out of touch. Besides that, I've been honing my debating skills on "the other website", practicing up for talking with some legislators in some soon-to-have AA states. Sorry nitecap.

We indeed have full licensure in DC - huge win for our side.

More big AA news - the 5th AA program has been formally announced at UMKC, the first program west of the Mississippi and the first at a public university. The Missouri Society of Anesthesiologists was instrumental in getting this program moving.

As far as the AAAA or Quad A, it's 17 syllables less than saying American Academy of Anesthesiologist Assistants. What can I say?

I can just picture the national meeting: "Everyone say aahhhhhhh"



j/k man, I aint a hater.

 

[jetproppilot]

As a chick, I would have no problem dating a male nurse..I have met several I would like to date...my husband really wouldn't be on board with that. I just wanted to pipe in since some people seem to be a little too wrapped up in self-importance and really outdated gender roles.

Gotta respect a chick that refers to herself as a chick...i.e. not caught up in gender/racial issues.

You'll be chief resident someday.

 

[ThinkFast007]

You are still a dork. Did you tell them your were in dork school? Or that you already have your PhD?

guess hot gals love dorks then, cuz i'm marrying one ...SUCKA

 

[ThinkFast007]

th inkfast you need to clean out your message box.. i sent you a message like yesterday and it said your message center was full

erased a few for ya...PM me again if u wish

 

[Idiopathic]

guess hot gals love dorks then, cuz i'm marrying one ...SUCKA

Damn, dude. Stop making my point for me.

 

[bullard]

Word. As a dude, I would have no problem dating a female surgeon. That's an untapped resource right there.

As a chick, I would have no problem dating a male nurse..I have met several I would like to date...my husband really wouldn't be on board with that. I just wanted to pipe in since some people seem to be a little too wrapped up in self-importance and really outdated gender roles.

 

[nitecap]

Dude I think you may have a crush on me given how you always mention my screenname when addressing thinkfast007. . Sorry dude but I like women

Maybe I have been refering to your name but meaning thinkfast007. My bad if so. Sleep is rare these days. Your name is tighter too. No, dont have a crush on you fool, your not that lucky of a faggg.

 

[ThinkFast007]

....
And Im not on board with CRNA's being unsupervised, Ive never made that comment. But to say that they dont benefit you in your medical training and further is probably a little short-sighted. I guess I choose to think that there are MUCH bigger fish to fry out there. Since Im interested in niche anesthesiology, Im probably just not as worried as someone looking to get out and practice in a general setting. I also think that you, as a fourth year med student, probably know about as much as I do regarding the future of medicine and our specialty, which is very little. So do me a favor, and unless you are going to educate me on 'how to match' or 'how to get drunk' (both strong topics BTW), refrain from doing any teaching.

Thanks.

idiot-
so you're absolutely right, i'm an MSIV. very true. I didnt know much about managed care, how hosp adminstration works,etc. What did i do? Or shall is say what have I been doing? I'll tell you. For teh last month or so i've been working with the CEO and VP of medical affairs doing an elective with them. True I cant learn everything about the business aspects of medicine...but i do ask them questions and they give me pretty truthful answers. Dude told me straight up....hospitals love foreign medical grads, why? Easy labor. True they have to pay them the same, but hey he said...if a US grad has a problem with our hospital or a doc doesnt want to work...we'll have a PA or FMG take his place anytime for the same rate.

so..goes to show you...medicine IS A BUSINESS. to a lot of administrators it's just about mking revenue, at the cheapest way possible. you'll see maybe next year, but these administrators are usually NON-MD's just trying to mk bank. so you are replacable!

you talk about niche? dude, this isnt friggin internal med. Anesthesiology for the most part has the OR stuff, Pain, CV, peds, and OB. it's not like there's anesthesia for 35,000 feet above sea level or something (despite what Jet wuld like you to think ). specialties or niches are very hard to find outside of those.

So this niche you speak about...interesting stuff...cuz aside from those 5 'specialties' of anesthesia, there's nto much out there. So basically you are telling me that cuz you want to be lazy in residency (ie want to be relieved by some CRNA) you are going to compromise your future job market. So you really think these CRNAs that sit on the bench while you want to have a lunch or take a sh it are just sitting there waiting for you to come back w/o an ambition of your own. You say you dont want unsupervised anesthesia, but let me tell ya, if go on with you lazy ways that's exactly what you're going to get.

What's a present day analogy. Look at the immigration problem that's on current events. Americans got a little too cushy and some woudl argue 'lazy' and now look...they're replaced with cheaper labor. albeit, some would say of dang good quality. Similarly, if you sit back and take it easy, i'd really like to find out what sorta niche your gonna find yourself in.

oh by the way, anytime...wnt advice on getting drunk i'll be your man.

 

[ThinkFast007]

Damn, dude. Stop making my point for me.

no peter north here...but hey I guess dorks get loving. so what was your wife's excuse for dating you chap?

 

[toughlife]

Maybe I have been refering to your name but meaning thinkfast007. My bad if so. Sleep is rare these days. Your name is tighter too. No, dont have a crush on you fool, your not that lucky of a faggg.

whew! Good to know cuz I was starting to worry there. Having girls say my name all the time is cool but a dude?!

 

[ThinkFast007]

whew! Good to know cuz I was starting to worry there. Having girls say my name all the time is cool but a dude?!

if u ask me...i think it's an unconscious thing for him man.

dude was trying to rip on me but thinking of your name....

he's got it bad for you bro.

 

[jetproppilot]

idiot-
so you're absolutely right, i'm an MSIV. very true. I didnt know much about managed care, how hosp adminstration works,etc. What did i do? Or shall is say what have I been doing? I'll tell you. For teh last month or so i've been working with the CEO and VP of medical affairs doing an elective with them. True I cant learn everything about the business aspects of medicine...but i do ask them questions and they give me pretty truthful answers. Dude told me straight up....hospitals love foreign medical grads, why? Easy labor. True they have to pay them the same, but hey he said...if a US grad has a problem with our hospital or a doc doesnt want to work...we'll have a PA or FMG take his place anytime for the same rate.

so..goes to show you...medicine IS A BUSINESS. to a lot of administrators it's just about mking revenue, at the cheapest way possible. you'll see maybe next year, but these administrators are usually NON-MD's just trying to mk bank. so you are replacable!

you talk about niche? dude, this isnt friggin internal med. Anesthesiology for the most part has the OR stuff, Pain, CV, peds, and OB. it's not like there's anesthesia for 35,000 feet above sea level or something (despite what Jet wuld like you to think ). specialties or niches are very hard to find outside of those.

So this niche you speak about...interesting stuff...cuz aside from those 5 'specialties' of anesthesia, there's nto much out there. So basically you are telling me that cuz you want to be lazy in residency (ie want to be relieved by some CRNA) you are going to compromise your future job market. So you really think these CRNAs that sit on the bench while you want to have a lunch or take a sh it are just sitting there waiting for you to come back w/o an ambition of your own. You say you dont want unsupervised anesthesia, but let me tell ya, if go on with you lazy ways that's exactly what you're going to get.

What's a present day analogy. Look at the immigration problem that's on current events. Americans got a little too cushy and some woudl argue 'lazy' and now look...they're replaced with cheaper labor. albeit, some would say of dang good quality. Similarly, if you sit back and take it easy, i'd really like to find out what sorta niche your gonna find yourself in.

oh by the way, anytime...wnt advice on getting drunk i'll be your man.

Along the same line,

one of my close (pilot) friends sets up acute-long-term-care-facilities, then manages them. His net worth= 20-30 mil.

He owns the Cheyenne that I'm priveleged to have a key for on my car-keys.

Actually the key is for the door only. Once you unlock the access door to the twin-engine turboprop, meander up the air-stair, find your way into the left seat, and if you know the start-up-procedures for turboprop engines, just start'em up. No key required.

Anyway, back to the point of this post. Actual conversation between my buddy and I a long time ago:

Jet: "Greg, how much do you pay the docs that are required at your facilities?"

Greg: "As little as possible."

Dude's exact words.

Tell me medicine isnt a business.

 

[ThinkFast007]

Greg: "As little as possible."

Dude's exact words.

Tell me medicine isnt a business.

Thank you. There you have it..from a REAL world anesthesiologist.

Idio...man. Bottom line, it's just easy economics. If you dont fight for your profession you will be replaced...and quite easily. hat's of to the AANA, they've understood that. Young, budding docs like you Idio, need to realize medicine is a business. THere's a great thread going on in the General Residency Forum about this and how docs arent being compensated enough. As stated earlier, its true 250k income might be 'ok' NOW. but in 10 years factor in inflation,etc it's not much.


what is the ASA doing? Toughlife, bro...just cant wait...you and i ...we gotta get ourselves elected onto the residnet section of the board next year!

 

[nitecap]

idiot-
so you're absolutely right, i'm an MSIV. very true. I didnt know much about managed care, how hosp adminstration works,etc. What did i do? Or shall is say what have I been doing? I'll tell you. For teh last month or so i've been working with the CEO and VP of medical affairs doing an elective with them. True I cant learn everything about the business aspects of medicine...but i do ask them questions and they give me pretty truthful answers. Dude told me straight up....hospitals love foreign medical grads, why? Easy labor. True they have to pay them the same, but hey he said...if a US grad has a problem with our hospital or a doc doesnt want to work...we'll have a PA or FMG take his place anytime for the same rate.

so..goes to show you...medicine IS A BUSINESS. to a lot of administrators it's just about mking revenue, at the cheapest way possible. you'll see maybe next year, but these administrators are usually NON-MD's just trying to mk bank. so you are replacable!

you talk about niche? dude, this isnt friggin internal med. Anesthesiology for the most part has the OR stuff, Pain, CV, peds, and OB. it's not like there's anesthesia for 35,000 feet above sea level or something (despite what Jet wuld like you to think ). specialties or niches are very hard to find outside of those.

So this niche you speak about...interesting stuff...cuz aside from those 5 'specialties' of anesthesia, there's nto much out there. So basically you are telling me that cuz you want to be lazy in residency (ie want to be relieved by some CRNA) you are going to compromise your future job market. So you really think these CRNAs that sit on the bench while you want to have a lunch or take a sh it are just sitting there waiting for you to come back w/o an ambition of your own. You say you dont want unsupervised anesthesia, but let me tell ya, if go on with you lazy ways that's exactly what you're going to get.

What's a present day analogy. Look at the immigration problem that's on current events. Americans got a little too cushy and some woudl argue 'lazy' and now look...they're replaced with cheaper labor. albeit, some would say of dang good quality. Similarly, if you sit back and take it easy, i'd really like to find out what sorta niche your gonna find yourself in.

oh by the way, anytime...wnt advice on getting drunk i'll be your man.

Your only a MSIV. Clears things up for me a bit as far as your lack of understanding of many topics here and your gun slinger attitude, which I would like if it werent so negative toward me.

SO you spent a month with a CEO and are now ready to run your own group i guess. What do you suppose these CEO's do if an American MD doesnt want the pay they are offering and chooses to practice else where. As in any business they are going to find someone that is willing to work just as hard and do just as good a job as you. Whats wrong with a FMG anesthesiologist? Especially when they have done their residency and training here. Whats wrong with them stepping in to fill these voids especially when you claim they are working for the same rate. Sounds like fair and reasonable business to me. Its not like the FMG is being hired for less than was offered to the fat white american guy, yes that would be an issue. So explain to me the point you are trying to prove.

I guess the hospital should just close down b/c american educated MD's dont want to work at their facilty. Please the ego that you guys get for having that degree is off the charts man. "We are better than FMG's that do the same thing as us, we are superior to DO anesthesiologist, screw all CRNA's we are better than them they suck, the CEO's will just hire FMG's and midlevels if we dont work there". If more people outside of the medical field like politians, CEO's, and the general public got a glimpse of these egos, provider bashing from within and aurguments many of them lacking any real data or points besides opinions and here say I believe they would have a different view of the MD. Boy how 4 yrs of school all of a sudden turn a *****, insecure, nerd that lacks assertiveness to a certified bad a$$ and control freak, that is better than everyone in the world.

Think they ought to do a study on brain transformation during med school and what areas are up or down regulated that cause they attitudes and complexes. You place so many judgements as a MSIV and prob maybe seen a CRNA work a hand full of times if that. MAybe never even seen a AA work. Yet you place narrow mined, inexperienced judgments based on things your sister's, pimp's, baby's moma's crackdealer's uncle the anesthesiologist or CEO told them that they told me. You havent a clue man. Yes basic sciences you may be all that but all your other aurguments are invalid until you have spent more than 15-30 shifts in the OR that you may have gotten in med school preferably one that uses midlevel providers in an ACT practice.

Sorry to break it to you thinkfast but if you are training at a programs that also trains SRNA's or employs CRNA's the senior SRNA's and staff CRNA's will be running circles around you for a while.

 

[Idiopathic]

you talk about niche? dude, this isnt friggin internal med. Anesthesiology for the most part has the OR stuff, Pain, CV, peds, and OB. it's not like there's anesthesia for 35,000 feet above sea level or something (despite what Jet wuld like you to think ). specialties or niches are very hard to find outside of those.

So this niche you speak about...interesting stuff...cuz aside from those 5 'specialties' of anesthesia, there's nto much out there. So basically you are telling me that cuz you want to be lazy in residency (ie want to be relieved by some CRNA) you are going to compromise your future job market.

Well, Im interested in pedi hearts, for instance. Thats pretty much a niche, I think you would agree.

As for the lazy, thats not what I said. I did say that I would rather spend my time on complex cases (i.e. transplants, cranis, etc.) than have to do entire optho months or run a lot of mundane cases. You can learn just as well on a simple case, I know, but I know that having CRNA's around my training institution will enable me to: read more, work more complicated cases and have the opportunity to see more. Just personal preference. Learn to read, man. No one said anything about being lazy or not wanting to work.

And its becoming increasingly difficult to make it through one of your posts. I sometimes have to read them two or three times. But thanks for alerting me to that 'immigration problem thats on current events"

 

[Idiopathic]

Thank you. There you have it..from a REAL world anesthesiologist.

Idio...man. Bottom line, it's just easy economics. If you dont fight for your profession you will be replaced...and quite easily. hat's of to the AANA, they've understood that. Young, budding docs like you Idio, need to realize medicine is a business. THere's a great thread going on in the General Residency Forum about this and how docs arent being compensated enough. As stated earlier, its true 250k income might be 'ok' NOW. but in 10 years factor in inflation,etc it's not much.


what is the ASA doing? Toughlife, bro...just cant wait...you and i ...we gotta get ourselves elected onto the residnet section of the board next year!

Is this an epiphany? Do you guys think you are enlightening us that medicine is a business and that employers want to pay their employees "as little as possible?" Why dont you get off JPP's jock for a little while (no offense, Jet...they just yap and yap, eventually you let them up there) and come back down to earth. Would you get rid of all CRNA's? What would that do to medical costs and your reimbursement. Would it go up? I think not. Would you be able to run as many cases as a practicing MD? Not if you work in a combined practice. Is our hold on the complexity of our profession so tenuous that we could be replaced at a moments notice? I personally dont think so. Do I think that CRNA's should have unlimited practice rights? Of course not. Would I fight this? Totally. Do I feel the need to eliminate them from the scope of medical practice? No way. They serve a purpose, just as do NP's and PA's. Doctor supervision should always be a must.

I hope things even out somewhat in the near future, if you can help that, more power to you.

 

[ThinkFast007]

blah blah blah SO you spent a month with a CEO and are now ready to run your own group i guess. What do you suppose these CEO's do if an American MD doesnt want the pay they are offering and chooses to practice else where. As in any business they are going to find someone that is willing to work just as hard and do just as good a job as you. Whats wrong with a FMG anesthesiologist? Especially when they have done their residency and training here. Whats wrong with them stepping in to fill these voids especially when you claim they are working for the same rate. Sounds like fair and reasonable business to me. Its not like the FMG is being hired for less than was offered to the fat white american guy, yes that would be an issue. So explain to me the point you are trying to prove.
balh blah blah.

Anyways...coming from a CRNA, as long as it's not somethign educational related to anesthesia...nto really going to any attention to it.

I agree, the general public should get to know more about medicine. Doctors, believe it or not save lives and work hard. Yup four years of schooling my friend, that's four years plus residency to be proficient in medicine. See, the public doesnt realize that all that lawyers and midlevels love to do is squeeze the money out of hospitals and doctors. I agree, i wish the public found out about this. dude, nite you have issues my friend. issues that stem from an unconscious desire to be a doctor. dude, i bet 5 yrs ago your pathetic as s wouldnt be caught in a doctors lounge. luckily for you there's a place like this, where you can hide behind that screen and talk to doctors as if you were professionally equal. as a human being, sure we're equals...but as a doctor...or atleast one to be...you're still a nurse.

see unfortunately, the public thinks docs are all very rich. they think we dont need any more money. slowly, but surely heads are turning as they realize that doctors are not getting fairly compensated. but the thing is that everyone, even the lay ppl are concerned about making ends meet and making more money...they can care less whether their doctor is making money or not. Issues like Tort Reform are very important and should be made public. DOCTORs need to step up and ask for reform, rather make it happen.

Anyways....back to the original point i was making. There are young budding ppl in other career paths that have a very vested interest intheir profession's future, i think we ought to have that same mentality. I think we all need to understand that medicine is a business. Yes, i've been real lucky to work along side some great adminstrators and have learned alot. No I never made teh claim that i've learned it all...cuz it's impossible...but mr. CRNA better watch your back brotha, cuz once we learn the business...brother-man you'll finally be put back into your place.

 

[jetproppilot]

Your only a MSIV. Clears things up for me a bit as far as your lack of understanding of many topics here and your gun slinger attitude, which I would like if it werent so negative toward me.

SO you spent a month with a CEO and are now ready to run your own group i guess. What do you suppose these CEO's do if an American MD doesnt want the pay they are offering and chooses to practice else where. As in any business they are going to find someone that is willing to work just as hard and do just as good a job as you. Whats wrong with a FMG anesthesiologist? Especially when they have done their residency and training here. Whats wrong with them stepping in to fill these voids especially when you claim they are working for the same rate. Sounds like fair and reasonable business to me. Its not like the FMG is being hired for less than was offered to the fat white american guy, yes that would be an issue. So explain to me the point you are trying to prove.

I guess the hospital should just close down b/c american educated MD's dont want to work at their facilty. Please the ego that you guys get for having that degree is off the charts man. "We are better than FMG's that do the same thing as us, we are superior to DO anesthesiologist, screw all CRNA's we are better than them they suck, the CEO's will just hire FMG's and midlevels if we dont work there". If more people outside of the medical field like politians, CEO's, and the general public got a glimpse of these egos, provider bashing from within and aurguments many of them lacking any real data or points besides opinions and here say I believe they would have a different view of the MD. Boy how 4 yrs of school all of a sudden turn a *****, insecure, nerd that lacks assertiveness to a certified bad a$$ and control freak, that is better than everyone in the world.

Think they ought to do a study on brain transformation during med school and what areas are up or down regulated that cause they attitudes and complexes. You place so many judgements as a MSIV and prob maybe seen a CRNA work a hand full of times if that. MAybe never even seen a AA work. Yet you place narrow mined, inexperienced judgments based on things your sister's, pimp's, baby's moma's crackdealer's uncle the anesthesiologist or CEO told them that they told me. You havent a clue man. Yes basic sciences you may be all that but all your other aurguments are invalid until you have spent more than 15-30 shifts in the OR that you may have gotten in med school preferably one that uses midlevel providers in an ACT practice.

Sorry to break it to you thinkfast but if you are training at a programs that also trains SRNA's or employs CRNA's the senior SRNA's and staff CRNA's will be running circles around you for a while.

Uhhhh....

I like you, Think. But alotta times inexperienced people going into anesthesia say things they shouldnt.

You guys lack street credibility. More importantly, concerning administration of anesthetics in this country in non-academic settings, quite frankly, you have no idea what the f u ck you are talking about.

And Nite, you and I have had our battles.

At one point I wanted to rip your head off and s hit down your neck.

But you've made a turnaround lately (not that thats important to you, I realize).

Agree that now you are responding to hecklers.

I respect that.

And I agree with your post.

Too many non-experienced dudes talking trash that they have no business talking trash about.

And it kinda pains me to drop this post, cuz Think/Tough are along my blood lines.

But you guys are way outta line with your propeganda.

MDs are the kings. Agreed.

But CRNAs are well respected, needed professionals in the anesthesia arena.

Your posts show your ignorance/naietivity/inexperience.

I've gotta call a spade a spade, when necessary.

Nice post, Nite.

 

[rn29306]

Uhhhh....

I like you, Think. But alotta times inexperienced people going into anesthesia say things they shouldnt.

You guys lack street credibility. More importantly, concerning administration of anesthetics in this country in non-academic settings, quite frankly, you have no idea what the f u ck you are talking about.

Too many non-experienced dudes talking trash that they have no business talking trash about.

And it kinda pains me to drop this post, cuz Think/Tough are along my blood lines.

But you guys are way outta line with your propeganda.

MDs are the kings. Agreed.

But CRNAs are well respected, needed professionals in the anesthesia arena.

Your posts show your ignorance/naietivity/inexperience.

I've gotta call a spade a spade, when necessary.

Nice post, Nite.

Booya.

Here's to an experienced, established voice of reason.

I've seen private practice run like a smooth, well oiled machine with butta thrown in for good measure in ATC design and gentlemen, it is a far cry from the hellhole academic programs some of you must attend to get such negative opinions right off the bat. I train at a level 1 trauma teaching center so I've seen this side too.
In private practice, everyone does his or her thing and are effecient like you wouldn't believe. Not a wasted move the entire surgery. Lap choles 12-19 minutes skin to skin on average. Surgeon will beat full-dose mivacrap.....excuse me, mivacron sometimes. There is no chest thumping or mental mastrubation going on. Most people on first name basis. Everyone knows who the MDs are so there is no need to show off. Pecking order is clearly established and no one is trying to one-up anyone, much unlike academic settings. CRNAs have wakeups down to seconds. Preop and circulating RNs that don't have to be told how to prep a patient for surgery or set up a room. Minimal turnover times. Happy surgeons out before their tee times. Patients have very good insurance on average so people make bank for work done. So on and so on.

If you've never seen private practice run from an anesthesia standpoint, re-read JPP's post again for good measure because you honestly don't have a clue.

 

[ThinkFast007]

Is this an epiphany? Do you guys think you are enlightening us that medicine is a business and that employers want to pay their employees "as little as possible?" Why dont you get off JPP's jock for a little while (no offense, Jet...they just yap and yap, eventually you let them up there) and come back down to earth. Would you get rid of all CRNA's? What would that do to medical costs and your reimbursement. Would it go up? I think not. Would you be able to run as many cases as a practicing MD? Not if you work in a combined practice. Is our hold on the complexity of our profession so tenuous that we could be replaced at a moments notice? I personally dont think so. Do I think that CRNA's should have unlimited practice rights? Of course not. Would I fight this? Totally. Do I feel the need to eliminate them from the scope of medical practice? No way. They serve a purpose, just as do NP's and PA's. Doctor supervision should always be a must.

I hope things even out somewhat in the near future, if you can help that, more power to you.

man sometimes i really wonder who's side you on?

never said that midlevels should be completely eliminated. They do indeed serve a purpose. I believe in using AA's. They arent as politically motivated to take your job away and they do indeed serve the purpose of what you desribe CRNAs as doing. True, you may have never worked with a AA, so that's why your ignorance is makign you look stupid. AAs can serve the SAME purpose as a CRNA. many 'team' models out there use them instead of the CRNA.

Next, you talk about your residency and the time to read. so curious, so how did anesthesiologists about say 10 years ago do residency when there werent CRNAs? Guess they just knew how to speed read right? Or did they just osmotically absorb all the information by placing the textbooks over there head? bottom line there's time to read in residency, especially anesthesiology residency. Last time i chcked...i couldnt find a residency that worked a resident more than 60 hours (and that's even in programs that did NOT have CRNAS/AAs).

So dont understand you. I know you are still bitter over the unfair DO/IMG advantage when it comes to matching...but clear out your eyes. It's punks liek you that give CRNAs their leverage. if you really thnk that CRNAs are just going to sit around and be your faithful apprentice til you die, you are as naive as the gal that goes to prom with the football team's quarterback, thinking he just wants to hold hands after the dance.

wake up.

give them fuel they need to flare the flame. it's what you are doing rather stupidly.

check this article out


Cottrell cited a University of Pennsylvania study that found, "for every 10,000 patients there were 25 to 40 more needless deaths when an anesthesiologist was not involved in care" ("Anesthesia Direction and Patient Outcomes. Anesthesiology 2000;1(93):152-63).

 

[jetproppilot]

Uhhhh....

I like you, Think. But alotta times inexperienced people going into anesthesia say things they shouldnt.

You guys lack street credibility. More importantly, concerning administration of anesthetics in this country in non-academic settings, quite frankly, you have no idea what the f u ck you are talking about.

And Nite, you and I have had our battles.

At one point I wanted to rip your head off and s hit down your neck.

But you've made a turnaround lately (not that thats important to you, I realize).

Agree that now you are responding to hecklers.

I respect that.

And I agree with your post.

Too many non-experienced dudes talking trash that they have no business talking trash about.

And it kinda pains me to drop this post, cuz Think/Tough are along my blood lines.

But you guys are way outta line with your propeganda.

MDs are the kings. Agreed.

But CRNAs are well respected, needed professionals in the anesthesia arena.

Your posts show your ignorance/naietivity/inexperience.

I've gotta call a spade a spade, when necessary.

Nice post, Nite.

With all due respect to you, Think,

we are a clinical site for LSU's nurse-anesthetist program.

Most of the SRNAs I see are good.

Occasionally I see franchise-player-SRNAs.

Usually, I hire the franchise players.

But there was this one SRNA.

Yvette. Nice, nice personality chick. Gets along with everyone.

Wanted to work at another hospital because it was five minutes from her house. And she had worked there as an RN for years, so it was kinda her home.

She was at my hospital for a cuppla months.

Know The Force that UT & Mil refer to? Well, Yvette had the force.

TWICE during her time at our hospital I had pts labelled difficult airway, meaning anesthesiologists at other facilities had difficulty intubating these people and resultantly labeled them difficult-airways.

Read my previous posts for my philosophy on handling difficult airways that are labeled that by clinicians I dont know personally.

Knowing Yvette wielded The Force , I gave her first-try at both these "difficult airway" patients.

She snorkeled both of them. With a Miller 3.

Sadly, she is not coming to my group. She wouldda obviously been an asset to me/my partners/our surgeons/our patients.

Point being,

Nite is right in this regard.

You may wield the force. But then again you may not.

Only your training will elucidate that.

Yvette yields the force. Its proven.

And she's an SRNA.