Why are AA's good for MD's???

[Milhouse Van Houten]

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everyone on the board is excited about AAs....what's the deal??

 

[COMBAT MEDIC172]

?

 

[yes2drugs]

everyone on the board is excited about AAs....what's the deal??

Try the mid level thread.
I won't say anything to "poison the well" of your mind here.
Make up your own mind and take everything with a grain of salt.

 

[Southpaw]

everyone on the board is excited about AAs....what's the deal??

This will likely get moved, which is probably appropriate.

To answer the question, there aren't enough MDs to cover the needs for the delivery of anesthesia in this country but even if there were there would still be plenty of room for midlevel providers. The current midlevel providers in the US are AAs and CRNAs.

There are AAs on this forum who can give better insight than I, but in general I think they have great respect for our training and knowledge base and there is a collegial working environment.

The large majority of CRNAs fall into the above category. However, a fair number of CRNAs believe themselves to be equivalent to MDs, and have no respect for the years of training we put into medicine with regards to medical school, general medicine/surgery year, and clinical anesthesia years. The representative organization of CRNAs, the AANA, believes CRNAs to be equivalent to MDs and acts politically to blur the lines of difference between the two providers. CRNAs have tried to enter pain management backed by the AANA, but fortunately law has sided with medicine thus far. The AANA believes CRNAs should have no supervision whatsoever, and acts politically with that belief. It stands to reason therefore, that the goals of the AANA are in conflict with that of the ASA, and thus there is constant strife. The history of disagreement between CRNAs and MDs is long and ugly, and it's 100% completely political. Personally, I've enjoyed all of the CRNAs I've worked with, but our conversations have never veered into the politics of anesthesia or elements of my knowledge base which extend beyond the OR.

And so anyway, people around here tend to get excited when more AAs are known to be entering the workforce.

 

[Taurus]

It's simple. I want to have the choice of working with either CRNA's or AA's. Each has their pro's and con's. The CRNA's don't want you to have choice. They want you to only rely on CRNA's. This is anti-competitive behavior. Personally, I view AA's as the anesthesia equivalent of PA's and I prefer PA's over NP's. The AA's and PA's are under the boards of medicine which I think have better oversight than the nursing boards.

See my thread on the California nursing board and how incompetent they are. Governor Schwarzenegger last week replaced most of the members because of how bad the board is.

http://forums.studentdoctor.net/showthread.php?t=645527

 

[thegasman]

i would personally like to work with aa's because of my dislike of the political strategy of the aana. But the laws in my state mandate 1:2 supervision of aa's while crnas can be supervised 1:4, giving aa's a disadvantage and making them not cost effective for my group.

 

[deleted50478]

This will likely get moved, which is probably appropriate.

To answer the question, there aren't enough MDs to cover the needs for the delivery of anesthesia in this country but even if there were there would still be plenty of room for midlevel providers. The current midlevel providers in the US are AAs and CRNAs.

There are AAs on this forum who can give better insight than I, but in general I think they have great respect for our training and knowledge base and there is a collegial working environment.

The large majority of CRNAs fall into the above category. However, a fair number of CRNAs believe themselves to be equivalent to MDs, and have no respect for the years of training we put into medicine with regards to medical school, general medicine/surgery year, and clinical anesthesia years. The representative organization of CRNAs, the AANA, believes CRNAs to be equivalent to MDs and acts politically to blur the lines of difference between the two providers. CRNAs have tried to enter pain management backed by the AANA, but fortunately law has sided with medicine thus far. The AANA believes CRNAs should have no supervision whatsoever, and acts politically with that belief. It stands to reason therefore, that the goals of the AANA are in conflict with that of the ASA, and thus there is constant strife. The history of disagreement between CRNAs and MDs is long and ugly, and it's 100% completely political. Personally, I've enjoyed all of the CRNAs I've worked with, but our conversations have never veered into the politics of anesthesia or elements of my knowledge base which extend beyond the OR.

And so anyway, people around here tend to get excited when more AAs are known to be entering the workforce.

I agree with the above and it represents the main reasons I favor expansion of AA programs. An additional point is that training AAs over CRNAs benefits the medical system as a whole. There are not enough good nurses as it is, and CRNAs were mostly much better than average nurses. Training CRNAs fills a gap in anesthesia but creats/worsens the nursing shortage AND lowers the average quality of nurses. This stuff is not as important to me as avoiding the back stabs of the AANA, but it is important to ICU patients.
AAs and CRNAs are equal in the OR. The difference is political.

 

[jwk]

i would personally like to work with aa's because of my dislike of the political strategy of the aana. But the laws in my state mandate 1:2 supervision of aa's while crnas can be supervised 1:4, giving aa's a disadvantage and making them not cost effective for my group.

PM me if you're in SC. If you're in Florida, the ratio was changed this year to 1:4.

 

[jwk]

This will likely get moved, which is probably appropriate.

To answer the question, there aren't enough MDs to cover the needs for the delivery of anesthesia in this country but even if there were there would still be plenty of room for midlevel providers. The current midlevel providers in the US are AAs and CRNAs.

There are AAs on this forum who can give better insight than I, but in general I think they have great respect for our training and knowledge base and there is a collegial working environment.

The large majority of CRNAs fall into the above category. However, a fair number of CRNAs believe themselves to be equivalent to MDs, and have no respect for the years of training we put into medicine with regards to medical school, general medicine/surgery year, and clinical anesthesia years. The representative organization of CRNAs, the AANA, believes CRNAs to be equivalent to MDs and acts politically to blur the lines of difference between the two providers. CRNAs have tried to enter pain management backed by the AANA, but fortunately law has sided with medicine thus far. The AANA believes CRNAs should have no supervision whatsoever, and acts politically with that belief. It stands to reason therefore, that the goals of the AANA are in conflict with that of the ASA, and thus there is constant strife. The history of disagreement between CRNAs and MDs is long and ugly, and it's 100% completely political. Personally, I've enjoyed all of the CRNAs I've worked with, but our conversations have never veered into the politics of anesthesia or elements of my knowledge base which extend beyond the OR.

And so anyway, people around here tend to get excited when more AAs are known to be entering the workforce.

Excellent summary of the issue. It's really quite simple - AA's believe that a patient is best served by the involvement of an anesthesiologist, at some level, with every anesthetic. Just like every patient deserves to have a surgeon (not a PA or RNFA) do their surgery.

Also important to remember - AA's don't seek to replace CRNA's. There is plenty of business to go around. Unfortunately, the reverse is not true, and CRNA's engage in illegal restraint of trade to keep AA's from working in hospitals in several states where AA practice is legal. Did you know that when a bunch of CRNA's in a practice go to the hospital or the department chairman and threaten to leave en masse if AA's are hired that that is an illegal act?

CRNA's can't stand on their own merits, and with all due respect, most are very talented. However, they feel like they have to tear down everyone else in the process trying to further their absurd arguments that their training and experience is the same or better than anesthesiologists. There's a place for everyone - but CRNA's are scared to death of the competition. Always have been, and always will. Never mind that there is virtually 100% job placement for CRNA's.

 

[dfk]

i would personally like to work with aa's because of my dislike of the political strategy of the aana. But the laws in my state mandate 1:2 supervision of aa's while crnas can be supervised 1:4, giving aa's a disadvantage and making them not cost effective for my group.

yes, clearly patient-driven your thoughts are. rock on.

 

[yes2drugs]

Excellent summary of ths issue. It's really quite simple - AA's believe that a patient is best served by the involvement of an anesthesiologist, at some level, with every anesthetic. Just like every patient deserves to have a surgeon (not a PA or RNFA) do their surgery.

Also important to remember - AA's don't seek to replace CRNA's. There is plenty of business to go around. Unfortunately, the reverse is not true, and CRNA's engage in illegal restraint of trade to keep AA's from working in hospitals in several states where AA practice is legal. Did you know that when a bunch of CRNA's in a practice go to the hospital or the department chairman and threaten to leave en masse if AA's are hired that that is an illegal act?

CRNA's can't stand on their own merits, and with all due respect, most are very talented. However, they feel like they have to tear down everyone else in the process trying to further their absurd arguments that their training and experience is the same or better than anesthesiologists. There's a place for everyone - but CRNA's are scared to death of the competition. Always have been, and always will. Never mind that there is virtually 100% job placement for CRNA's.

The conservative free market side of me wants to agree with you. The anesthesia side of me wants to disagree with you.!!

 

[dfk]

The conservative free market side of me wants to agree with you. The anesthesia side of me wants to disagree with you.!!

IMO, jwk is right on with this assessment.

 

[thegasman]

yes, clearly patient-driven your thoughts are. rock on.

they are. In my opinion, independant crna practice and the demise of the anesthesia care team (the goal of the aana), is not in the patient's best interest. Therefore, the anesthesia care team including the aa (who does not wish to supplant the anesthesiologist) is in the patient's best interest. I have discussed aa's with anesthesiologists who work with both aa and crna and the general consensus was that there was no difference in patient care. (except maybe that the aa's had less of a chip on their shoulders and were more open to direction from the anesthesiologist)