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Wikipedia Vandalism of Anesthesiologist Article: How You Can Help

Discussion in 'Anesthesiology' started by Coastie, Mar 23, 2007.

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  1. Coastie

    Coastie Junior Member 10+ Year Member

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    Oct 17, 2005
    Hey guys...

    Ever use wikipedia?

    It's a free online encyclopedia.

    Well, recently, there have been a few CRNA's who constantly vandalize the Anesthesiologist article, as well as the Anesthesiologist portion under the "Anesthesia" article.

    To top it off, they turned the CRNA portion of the article into a massive soapbox full of distortions.

    To combat them, I've made edits of my own...with references..which they keep deleting.

    Wikipedia is one of the first hits under a google search of our profession, and alot of people use it for their education..

    So, let's define the terms of the battle. Using references and following the wiki rules, we can help educate the public about what we do and the scope of CRNA's.

    Thanks!

    Our article:

    http://en.wikipedia.org/wiki/Anesthesiologist

    Anesthesia Providers section under Anesthesia article:

    http://en.wikipedia.org/wiki/Anesthesia#Anesthesia_providers
     
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  3. flashgordon

    flashgordon 7+ Year Member

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    These CRNAs who think they're equal/better than Anesthesiologists need to be shot. Did you go to medical school? No? Then **** off... Know your place in the team. You are not a doctor.
     
  4. Coastie

    Coastie Junior Member 10+ Year Member

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    We're right in this discussion, but posts like that aren't gonna help..

    Wanna do some damage?

    Make sure wikipedia is kept up to date with solid information and references. Make sure to use good links, and construct the argument within wiki guidelines.

    They can't win that fight if we play it right. If we let emotions get ahold of us, then they will win...

    Setting the terms of the fight...just a small step in the right direction.
     
  5. bookite

    bookite New Member 7+ Year Member

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    IS this true?
    "CRNAs provide 27 million hands-on anesthetics each year, roughly two thirds of the US total." from the wikipedia website.
     
  6. toughlife

    toughlife Resident 5+ Year Member

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    Sep 11, 2004

    you need to add 'while being supervised by anesthesiologists'
     
  7. foxtrot

    foxtrot Member 10+ Year Member

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    Jun 29, 2005
    Southeast
    Nice post. Thanks for making us aware of this. This is the kind of thing that we need to to aware of. Anytime there are any large articles regarding the field of anesthesia that the public can view, we as anesthesiologists need to be aware of what is being said and if the facts are right. This is one way we can continue to educate the public since the ASA does such a ****ty job. I am so tired of the ASA being so P.C. about everything. The AANA sure as hell has no problem not being P.C. .
     
  8. Coastie

    Coastie Junior Member 10+ Year Member

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    I added the biggest fact (with reference) on that page:

    Of the 40 million anesthetics given per year, Anesthesiologists provide or participate in (supervise) 90% of them.

    That is straight from the ASA.

    The 27 million CRNA "fact" is from the AANA site.

    Both links are allowed on the wiki site....But we're higher up on the page.

    Furthermore, the CRNA link doesn't delineate supervised vs independant, and, in fact, implies no supervision.

    I was quick to change this, in addition to noting that they can only "practice" in 14 states without a physician supervisor due to the Medicare CMS opt-out which is a Governor line-item, which can, per CMS rules, be revoked at any time...and that this line-item is only allowed per certain criteria, including extreme needs of the populace.

    ASA, want to hit em where it counts? Convince the Governors to revoke their sig's would be a nice start.....

    Anyway, keep up the good work @ wiki..it's a START.
     
  9. BeatrixKiddo

    BeatrixKiddo Guest

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    The Island
    Lol. This is cute.
     
  10. Coastie

    Coastie Junior Member 10+ Year Member

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    Oct 17, 2005
    By the way, for additional "wiki" credibility...

    Make a username. It takes 5 minutes, and masks your IP.

    Take 5 minutes to make a "profile" which describes your interests and areas of expertise.

    You can do both of the above and remain perfectly anonymous.

    This goes a long way in the "wiki wars" when a CRNA advocate who is either anonymous by wiki standards (IP listed only) or has a name without a profile slashes through one of our articles...

    Remember to keep the wiki rules, use respect (key), and use references. Wiki is big about "neutral POV (point of view)".

    Off to the races!
     
  11. Coastie

    Coastie Junior Member 10+ Year Member

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    Oct 17, 2005

    Considering the majority of your posts have been in either the lounge or MCAT discussions, I imagine you don't understand the importance of our "defining the terms" of battle.

    Good luck with the MCAT. :thumbup:
     
  12. BeatrixKiddo

    BeatrixKiddo Guest

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    The Island
    Thanks! No, no, I can tell this is very important. Godspeed. :thumbup:
     
  13. VolatileAgent

    VolatileAgent Livin' the dream 7+ Year Member

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    i'd suggest keep a word file with the text that should be there. all you have to to is go in and cut-and-paste it back into the wikipedia site. you don't even need to read it. some enterprising person could easily check periodically (every few hours, if so motivated) and just do this. that way it'll stay up to date with what should be said.

    in fact, on nbc news last night they had an expose on the "disinformation" that wikipedia promulgates.

    http://video.msn.com/v/us/msnbc.htm?g=C9F78C26-7C20-4A9B-94F8-2978B33FAD16&f
     
  14. Coastie

    Coastie Junior Member 10+ Year Member

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    Wikipedia actually has an archive of every entry or edit placed.

    You can revert back immediately using this function under "edit this page".



     
  15. mwbeah

    mwbeah Banned Banned

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    That's funny, I didn't have this "supervision" in Iraq.....................

    There are alot of great MDAs and CRNAs, but its funny...... the ones that always bicker are the ones who lack the confidence in their own abilities.

    The two-thirds number is correct and it is not "supervised"... if it was correct, there would be millions of needed anesthetics in underserved areas that would not occur.

    Your not going away and we aren't going away, to many people needing surgery and not enough of us (quit bitc_ing and grow up)

    Remember .............but big brother is always watching.
     
  16. opa beleza?

    opa beleza? Junior Member 5+ Year Member

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    If you come to our towns and work with us --- we will make you rich. If you work against us we will replace you with AAs and destroy any chance of independance in the eyes of the public you may have had -- we will do this anyway -- and you know the public will choose doctor supervision when informed. By the way, thanks for your service.:thumbup:
     
  17. mwbeah

    mwbeah Banned Banned

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    Okay if you say so................. I have worked in 3 of the biggest cities in the United States and was pretty darn independent. But I am sure I wasn't working with you :)

    Like I had said before, the people who bicker and fight are the ones who lack confidence in themselves and their ability.

    More people living longer........... more surgical cases being performed................... not enough providers...................... hmmmmmm I don't think I or my great great great great great great great grandchildren need to worry about job security any time soon.

    Have a nice day.

    (BTW how would the public respond to the fact the "C" equal "MD" while "B" equals "PhD" :) ...... I don't think you will be destroying me anytime soon as I will be responsible for teaching some of your curriculum in the near future)


    FYI (on the job security thing.........)

    http://www.asahq.org/Washington/narules.htm

    "(2) In those cases in which a CRNA administers the anesthesia, the anesthetist must be under the supervision of the operating practitioner except as provided in paragraph (e) of this section. An anesthesiologist's assistant who administers anesthesia must be under the supervision of an anesthesiologist."
    "(e) Standard: State exemption. (1) A CAH may be exempted from the requirement for physician supervision of CRNAs as described in paragraph (c)(2) of this section, if the State in which the CAH is located submits a letter to CMS signed by the Governor, following consultation with the State's Boards of Medicine and Nursing, requesting exemption from physician supervision of CRNAs. The letter from the Governor must attest that he or she has consulted with the State Boards of Medicine and Nursing about issues related to access to and the quality of anesthesia services in the State and has concluded that it is in the best interest of the State's citizens to opt-out of the current physician supervision requirement and that the opt-out is consistent with State law."
    States That Have Opted Out From the Federal Supervision Requirement Since Publication of the November 13, 2001 CMS Rule Permitting Such Opt-Outs
    (14 states as of June 2005)
    • Iowa opted out of the federal supervision requirement in December 2001.
    • Nebraska opted out in February 2002.
    • Idaho opted out in March 2002.
    • Minnesota opted out in April 2002.
    • New Hampshire opted out in June 2002.
    • New Mexico opted out in November 2002.
    • Kansas opted out in March 2003.
    • North Dakota opted out in October 2003.
    • Washington opted out in October 2003.
    • Alaska opted out in October 2003.
    • Oregon opted out in December 2003.
    • Montana opted out in January 2004.
    • South Dakota opted out in March 2005.
    • Wisconsin opted out in June 2005.
     
  18. Duckie24

    Duckie24 Totally Quackers! 5+ Year Member

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    Not trying to add fuel to this stupid fire, but just want to point out some of the egregious errors in your post. First of all, at my medical school even though we are Pass/Fail, a Fail would be a 'C' anywhere that I have ever attended a university class (and even all my pre-post-secondary education for that matter), and believe me, I've attended several universities, so this isn't just anecdotal. Secondly, the only time I have been taught by PhD's since starting medical school was during the pre-clinical years. Since then, and for the forseeable future for that matter, it has been, and will only be by MD/DO's.
     
  19. mwbeah

    mwbeah Banned Banned

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    OK, if you say so it must be true.......................;)

    What school was that? (just checking several handbooks from schools and they say "C" is passing)
     
  20. Coastie

    Coastie Junior Member 10+ Year Member

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    CRNA's are feeling the heat, and trying desperately to reverse documented evidence placed on wikipedia.

    This includes massive deletions of material already approved by Wiki admins, and even posting a link to this thread complaining.

    Hilarious! This is exactly what we can expect from the more militant ones when faced with the truth. We gotta take the truth to them and the public if we want to win...
     
  21. Coastie

    Coastie Junior Member 10+ Year Member

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    The numbers just don't play out.

    There are 40 million total anesthestics in this country a year, and of them, 35% are Solo Physician, 55% are ACT, and 10% are CRNA solo.

    You are not able to adminster anesthesia in 50 states without a physician. You are only able to do so in the 14 Medicare opt-out states, which can be revoked by a Governor at any time.

    Not sure about the rest of your stream of consciousness, but last time I checked, MD = MD, DO = DO, and CRNA = advanced nursing degree.

    Good luck, and thanks for your service to our country.


     
  22. mwbeah

    mwbeah Banned Banned

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    I haven't even looked at it and it really doesn't matter...... I am a researcher and a US Army CRNA and currently working on fluid resuscitation interventions following hemorrhagic shock resulting in global ischemia.................. My future is secure, I just hate bickering....... its just not necessary....... (but you all are young :) )

    But as to a previous post, here are some examples of passing grades and I am sure I could go on and on with just an hour or two of research. In fact there is a JAMA article on this very topic (in PUBMED).

    "http://med.stanford.edu/md/curriculum/assessment-grading.html
    All medical school courses are taken pass/fail.



    http://www.osumdphd.org/financial.htm
    overall average for each year of 75%

    http://www.rosalindfranklin.edu/cms/Medicine/clerkship.cfm
    The final; grade for the Clerkship will stand as a "Defer" until the examination is retaken and passed, at which point the grade will become a ‘C'."

    Sounds like grades are very subjective and loose...... in fact I know it is.... I have been around awhile. I have no issue with that as everyone learns what they need to know to provide safe care for patients, just remember men, women, nurses, doctors, medics, soldiers, civilians, PhDs, etc are all the same and eventually you will learn that these "tiffs" are just idiotic. Whatever your argument or evidence for a particular stance, there is (more than likely) equal evidence to the opposite. I have definitely learned that over my years in my pursuit of academic acheivement. As for my clinical expertise, ask the soldiers I provided trauma anesthesia for.................. (nuff said).

    God I love this country.... honestly y'all keep fighting (but try not to fight with each other).

    Just think how much money we could all make (said in jest but not really) if the leadership of both the AANA and ASA could consistently get along (it is only a small percentage of people that make it hard on everyone). But I am telling you that if you want to fight, both sides can endlessly perpetuate the fight (nonsense, just plain nonsense).

    Seriously, I got plenty of "luv" for everyone. Y'all have a wonderful day!
    Mike
     
  23. Johnisit1234

    Johnisit1234 Member 10+ Year Member

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    Feb 24, 2004


    Please remember that there is a reason why we are MDs and you are still nurses. The public puts more faith in doctors than they do nurses. There is a reason why we went to medical school and why only the top students get into medical schools. Not saying that getting into nursing school is easy, but if you compare average GPAs and other measures, medical students are generally the top of the class. Further, getting a "C" as you call it is sorta like getting a B+ in most other programs. Medical school is not easy; anyone going through the process can attest to that.
     
  24. Coastie

    Coastie Junior Member 10+ Year Member

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    Yeah, I'm sure you haven't looked at it.

    If you had, you would notice the only bickering is coming from CRNA's who keep removing links to documents which show the true boundaries of their practice rights, such as interventional pain procedures, Medicare opt-out rules, or statistics on anesthetic delivery.

    If you hate this kind of bickering, I'm sure you will understand where we are coming from in our goal to educate the public with regards to their healthcare needs.

    Thanks!

     
  25. dogbone65

    dogbone65 tryin to stay outa troubl 5+ Year Member

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    According to the public, they trust nurses more than anyone else. The gallup polls of the last several years have nurses at the top. Nurses were at 84% while doctors are at 69%. Wonder if it has anything to do with the call room fun, paid "educational" trips on tax payers dollars or anything?
     
  26. mwbeah

    mwbeah Banned Banned

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    Helloooooo, I take the same classes with the medical student in my PhD program (Neuroscience), in fact our graduate biochemistry class in even a higher level class than the medical students. I AM WELL VERSED IN WHAT MEDICAL STUDENTS TAKE :) b/c I take it also...... and in some cases take higher level courses.

    Some of the "medical classes" I have taken - membrane and endocrine physiology, medical pharmacology (my third pharm course in my career), functional neuroanatomy (to include cadaver dissection).... I could continue if you really want me to..... Also, I could forward you the excel spreadsheet for grades and show you that a nurse can consistently be in the top ten percent in performance......

    The main difference in the curriculum is that at the end of the two years the medical students goto clinical rotations (I have been clinical for 5 years) and the PhD students finish their research. In fact, I can forward an invitation for my public defense to everyone after my dissertation committee gives me their blessing.

    Love ya!
    Mike
     
  27. mwbeah

    mwbeah Banned Banned

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    Its funny, I am listening to the news and wondering how this "healthcare reform" issue currently being debated on the campaign trail will affect the profit margin....................


    where is rodney king, I think I hear him........................

    Honestly, Love y'all!!
    Mike
     
  28. Conflicted

    Conflicted Banned Banned 7+ Year Member

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    Funny, i see it differently.

    I went and read the 'discussion' section and looked at the edit history. It appears to me this article was decided and agreed upon by both 2 CRNAs and 2 MDAs quite some time ago (3-4 months?). Nothing has really changed in that time except this post was made on SDN which is correlating with changes made BY MDAs (or more likely residents).

    So it appears that it isnt CRNAs who are removing links and "being vandals". Vandalizing suggests that someone came in a defaced something which already existed. So that being the case, it would be you who is the vandal now wouldn't it?

    Looking at the "links removed" i dont see any injustice either. I do notice that the CRNAs have never edited the MDA section (or any other section of the anesthesia article) but that constantly you have edited the CRNA section. Now what does this tell you?

    come now, everyone loves a good argument, but this one is obvious.

     
  29. mwbeah

    mwbeah Banned Banned

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    Shucks, this is the first free time I have had in awhile so I will have to take a look at it I guess. I will investigate that point and get back to you.

    EDIT: it looks like "conflicted" beat me to it.
     
  30. Coastie

    Coastie Junior Member 10+ Year Member

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    From what I understand, Wikipedia is a "living" encyclopedia.

    Any further discussion of content should probably be taken to the actual wikipedia page, where arguments and discussions about different points of view are welcome.


     
  31. Duckie24

    Duckie24 Totally Quackers! 5+ Year Member

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    You can be as sarcastic as you like, but the fact is the scenario I pointed out above is true. I lived it. So in this case, if I said it, it is true. I am sure there are some schools where a 'C' is passing. I concede that point and it is one that I was not arguing. I also know for a fact that not all PhD programs require a 'B' to continue.
     
  32. mwbeah

    mwbeah Banned Banned

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    I concede I was being slightly sarcastic (isn't it fun!!). Your are most definitely right, most if not programs vary in the rules and regs. Speaking of fun, I am sitting here and my four year old daughter is delighted that I am letting her paint my toenails a nice "Barbie Red". LOLOLOLOL :)

    HAGD,
    Mike
     
  33. morpheus md

    morpheus md Interventional Pain 09-10 2+ Year Member

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    Nope, it has more to do with the fact that nurses spend more time taking care of the personal needs of each patient, while doctors are making medical decisions regarding the patients health. The fact that the average nurse is caring for 1/10 the number of patients than the average doctor has on their list allows the patient to have a more personal connection with them, building a bond. Nurses on average are excellent at what that do, as are doctors. I appreciate that, everyone has their role, it's just that not everyone seems to be equipped to recognize their role.
     
  34. Duckie24

    Duckie24 Totally Quackers! 5+ Year Member

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    I can't follow what you are arguing here. MD/DOs and PhDs are two separate things, obviously...you know that. Of course PhD students are going to take higher level classes in some areas than MD/DO students, PhDs are supposed to be experts in a specific area. For instance, I really hope you are taking many more classes than the typical MD/DO that involve the neurosciences since that is your specialty area, just like I hope a PhD in ethics takes many more classes in that area than me.

    And no one is suggesting that nurses are stupid. You went to school to become a nurse, and are now in a PhD program, so you are probably very intelligent. I could have done my undergraduate work in nursing and then gone on to medical school and would have performed just as well, further proving that nurses can be in the top of the class. The operative word there is "can". Any one of us could have chosen a path that could prove the point we are trying to make. Could every nurse get accepted to medical school? Could every MD/DO have been accepted to nursing school? Who knows. Certain people would obviously have the option of choosing their path, and I'm sure others have their options limited because of academic potential.

    And yes, PhD students continue on in the classroom/lab for a given amount of time. MD/DO students do the same as well. Their education continues in a different setting, similar to how a PhD students continues their education in a different environment. And comparing clinical time is like trying to compare ages. Just because I happen to be older than most of the people I am working with doesn't mean I know more than them. I just happen to be older. So saying that one has more clinical experience than any other random person doesn't mean much. There will always be someone with more clinical experience than me, and there will always be someone with more clincial experience than you.

    Best of luck as you finish your thesis. I have many friends who have completed their PhD and I know the hard work required to reach such an achievment. :thumbup:
     
  35. mwbeah

    mwbeah Banned Banned

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    I agree a PhD and MD are not the same, and isn't the whole "I'm better than you..." argument silly :)

    (RANDOM THOUGHTS)

    But I have to say, if I were an anesthesiologist, I would be instilling my will on the hospital (i.e. the pain clinics, the icu, etc). An MDA can do so much more that "just the OR". Some of my very best friends are MDAs and we know what each can do and cannot do. In the OR, CRNAs are excellent (as are the MDAs of course). But we are usually limited to the perianesthesia arena no doubt. An MDA has endless leadership (and BILLABLE) opportunities within the hospital and within pain/same day clinics.

    MDAs fight with us when they have enourmous potential for gain outside the "direct" OR environment. I mean you can get your hands into just about everything in the hospital.......... CRNAs understand that our role (in many but not all cases) is within perianesthesia services. There are the exceptions that provide pain services, etc to the very underserved areas (which by the way there boundaries seem to be radiating).

    Like it or not, the patient population is exponentially increasing and will force healthcare reforms that directly affect everyone (healthcare and medicine just ain't what it used to be). Just like CRNAs are some of the best nurses, MDAs are some of the best physicians and can have a role in the ER, ICU, clinics, etc. If I were you, I would get my foot in those doors b/c that fight is much less complicated.

    CRNAs are an institution and we aren't going anywhere, it is just not going to happen. Would you like to be the Governor that shuts down hundreds of hospitals and clinics within a state b/c there are no MDAs to "supervise" surgical anesthesia services and other anesthesia services provided to hospitals and clinics? It is just not possible to deliver surgical services to the ever aging and increasing population without both our existences. The rate that anesthesia providers are trained is not (and will not be) equal to the increased rate of surgical/anesthesia services performed per day. Aha, with that being said, what is all the hub bub about, there is plenty (AND I DO MEAN PLENTY) of work for everyone. Have you read the classifieds lately or received the numerous phone calls and snail mail from staffing agencies...........I just don't know why this fight ensues. Unless thousands of training programs pop up overnight, this trend will infinitely continue.

    If you know of an instantaneous "fix" that works, then I will personally submit your name for a nobel prize in physiology/medicine. (In other words, this situation is much more complicated than you or I know)...... so bicker if you must but in the end we will be long dead and gone and still this nonsense will continue.


    H.A.N.D (have a nice day) :)
    Mike
     
  36. ReefTiger

    ReefTiger Junior Member 5+ Year Member

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    Nov 30, 2005
    Quote:
    Originally Posted by mwbeah
    Helloooooo, I take the same classes with the medical student in my PhD program (Neuroscience), in fact our graduate biochemistry class in even a higher level class than the medical students. I AM WELL VERSED IN WHAT MEDICAL STUDENTS TAKE b/c I take it also...... and in some cases take higher level courses.

    Some of the "medical classes" I have taken - membrane and endocrine physiology, medical pharmacology (my third pharm course in my career), functional neuroanatomy (to include cadaver dissection).... I could continue if you really want me to..... Also, I could forward you the excel spreadsheet for grades and show you that a nurse can consistently be in the top ten percent in performance......

    The main difference in the curriculum is that at the end of the two years the medical students goto clinical rotations (I have been clinical for 5 years) and the PhD students finish their research. In fact, I can forward an invitation for my public defense to everyone after my dissertation committee gives me their blessing.

    Love ya!
    Mike


    I always get a kick out of you people. Hey, I took a couple of medical school classes and I passed! That must mean I am good enough to be a doctor. Now I'm getting a PhD so I can introduce myself as Dr. X while omitting the fact I'm only a clinical advanced nurse when it comes to patient care.

    I respect the hell out of PhD's. They are intelligent and hard working. But they are not and will never be MD/DO's unless they first get accepted to medical school. Only when you first get accepted and then take all medical school classes simultaneously will I ever accept your success in a single class. Could you do it? Maybe, maybe not. We will never know.

    I'm curious as to the percentage of nurses, or even graduate level students who further go on to get PhD's that would gain acceptance to medical school. I remember a lot of my friends who didn't get accepted went to grad school. I'm less curious as to the percentage of people admitted to medical school gaining acceptance into the aforementioned programs. I know most anyone with intelligence on this board would agree that the percentages would be lopsided in the MD/DO's favor.

    Congratulations on being clinically sound. Last time I checked, it's pretty difficult to kill a person in your limited OR role. You can thank anesthesiologists for the research and safety standards. Why don't you manage them pre and post op or in the critical care unit? Why don't you make medical decisions? Oh, that's right, it's because that is not your role in health care. A PhD won't change it either.

    But I still have much love for ya and what you've done for our country. I'd let you work under me any day:thumbup:
     
  37. mwbeah

    mwbeah Banned Banned

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    So much for civility :) You obviously didn't understand what I wrote, it has been quite alot more than a couple of classes. But I digress....
    (BTW my MCAT score was 31 so if I had wanted to take that route the door was open. I chose the PhD path instead, b/c it was the more intelligent financial decision for my family (I am a wee bit older)).

    But nonetheless, you are making my point exactly! Why don't y'all get your foot in other doors instead of banging your head against this wall of (CRNAs vs MDAs). Like my previous post stated, we will all be long dead and gone and the situation will still necessitate both our existences.

    Ignorance is bliss isn't it :)

    H.A.N.D.
    Mike
     
  38. Conflicted

    Conflicted Banned Banned 7+ Year Member

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    "allnurses" Is not a representation of th CRNA opinion by any stretch of the imagination.
     
  39. fakin' the funk

    fakin' the funk ASA Member 10+ Year Member

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    NURSE, you have your own forum on a DIFFERENT site. Use it.
     
  40. The_Sensei

    The_Sensei Banned Banned

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    Look at these states..........are you freaking kidding me!?! I wouldn't work in ANY of these for less than $600k. The combined population of all the opt out states doesn't even equal the population of California. Go ahead, nurses......have those states.:laugh:
     
  41. Atropine

    Atropine Junior Member 5+ Year Member

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    :sleep: MCAT of 31? Wow, now that is impressively low. As I suspected, you tried to get into medical school. You know what? You probably could get a valid tropical education in the caribbean medical school of your choice...
    Normally, I don't find any humor in silly nurse vs MD threads but I just pitched a 9 inch tent with the PhD vs MD beatches going at it. Yes, ignorance can be bliss... just like my right hand is at night under the covers.
    Why do you need a PhD if you're just a nurse? You don't need a PhD to clean up feces and put on diapers. Oh wait, you sly dog you.... I forgot the chemical and biological analyses of feces and urine can only be handled at the PhD level.

    By the way, who(well, except apparently you...) chooses the PrettyHungryDoctor route over Physician for financial reasons? I suspect it was, as other posters have already astutely pointed out, actually secondary to your lack of academic acuity. It's kinda like the large d_ck vs small d_ck argument guys have. I'm an MD and I have a large one. You're not, and you're trying to make up for one...
    Oh boy, I'm getting red and hot in my special place. Now, I'm not a psychologist or goddamn...a psychiatrist but I got some skills... The majority of PhDs, in my opinion, were mediocre undergrad students who couldn't get into medical school. To make up for their failure, they subsequently go to graduate school to get a Master's in B_ttf_ck. Then they realize that will only get them a job at the local elementary school distributing OJ and PBJ sandwiches while preventing kids from playing doctor on each other. Ah.. but studying B_ttf_ck at the PhD level--now that's the ticket towards a $60,000/yr salary at the high school of your choice.

    It's impossible to be our equal because the majority of us got our MDs on our first try but if you try again you might be able to add an MD to your other ahem... degrees. Only then will I consider you a real doctor. Hmmm... that sounds impressive - " Mike H.A.N.D who finally got an MD but worked as a nurse and phd until he could get enough clinical acumen to make it into medical school" .
     
  42. chicamedica

    chicamedica 1K Member 7+ Year Member

    1,781
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    Jul 31, 2003
    USA
    Why are you a CRNA if you have a Ph.D in neurosci?
     
  43. swpm

    swpm Now with extra snarkiness 10+ Year Member

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    May 15, 2006
    I just want to comment on one aspect of the CRNA propaganda machine.

    They are universally proud of the years of "clinical experience" they accrue before going on to become CRNAs. Many seem to think these years somehow make up for their inferior academic and clinical training.

    I am unimpressed.

    Clinical experience for a medical student, intern, resident, or attending consists of managing patients. Making decisions that have consequences.

    Nurses don't do that. They carry out a plan formulated by a doctor. They can be quite good at it. But their latitude to make decisions is (rightly) limited to "hold the metoprolol if HR <60" ... there's only so much experience to be gained when you have no autonomy and no responsibility.

    The years you spent delivering medications, changing sheets, recording vital signs, and paging a doctor whenever something unexpected happened are not the asset you think they are.
     
  44. EtherMD

    EtherMD Banned Banned

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    Dec 25, 2006
    Mike,

    Are you a CRNA with a PhD? If so, do you use the title "Doctor" when talking with patients? Do you have your PhD on your name tag or Doctor?

    Unlike some on this Board I understand the value a CRNA with a good educational background brings to the O.R. In addition, I agree with you 100%that CRNA's such as yourself will not lack work in the USA. There is no way the academic programs could ever produce enough graduates to replace 50% of the Anesthesia work force.

    That said, your organization and its constant desire to become "Doctors" while actually being Nurses has created a rift in the Anesthesia community.
    Also, your organization's desire to work Independently as a Mid-Level Provider with just a Masters Degree is inappropriate. The AANA should have at least waited until the DNAP became standard before demanding NO SUPERVISION from any Physician (I would still oppose you but at least it makes more sense).

    You do realize that your income is only as good as it is because Anesthesiology is a PHYSICIAN specialty. If your organization succeeds in its goals it will become a Nursing specialty (primarily) and will be paid as such.
    Thus, your organization is willing to reduce the income of CRNA's in its quest for power and domination. You better hope the ASA leadership and Academic Chairs remain apathetic in this battle because if the sleeping giant awakens you will be severely hurt. Anesthesiologists have an alternative in the Operating Room to the CRNA: AA's. Thus, the MD/DO leadership could force many CRNA's out of work or reduce their salary by creating thousands more AA's. In fact, it is possible to create thousands more AA's every 28 months.
    Too bad the ASA and the AANA couldn't resolve their differences amicably.
    But, the INDEPENDENCE issue will be fought to the end by both sides.
    The irony is that once you win Independence in all 50 states you are likely to earn less money as a result.
     
  45. Conflicted

    Conflicted Banned Banned 7+ Year Member

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    Oct 17, 2006
    ETHER

    Interesting post.

    Just as some info. The AANA and every CRNA i know has little interest in the "DnP" program and all of them feel it is inappropriate for anyone but an MD or DO to be called "Doctor" in any clinical setting. A PhD or DnP is simply an academic title reserved for academic settings ONLY.

    I do not understand the independence argument. There is never a CRNA who isnt working in conjunction with a Physician, Dentist, Podiatrist etc. The Opt Out states are about billing for medicare only not independent practice. The only difference b/t and opt out state and one which isnt is that the other person there (MD/DO, dentist etc) must cosign the billing.

    If this was a large issue then i would also assume that PAs should be "shut down" since they can work in relative independence and have their "supervision" requirement met by having a physician sign off their charts every few months (without any patient contact). This is very common in urgent care centers and rural ERs across the country. They would seemingly have much more "independent practice" than a CRNA who is always working with someone.

    So CRNAs are always supervised to some degree by another person with further medical training. Where is the independence there? If your referring to the rural areas, well, there is always a supervising surgeon there as well and without CRNAs there would be no anesthesia care at all. As fakin the funk so politely phrased his value of these people:
    A sum which these areas could never pay.
     
  46. EtherMD

    EtherMD Banned Banned

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    Dec 25, 2006
    No need to continue the AANA rhetoric with me. If the AANA and CRNA's were content with RURAL AMERICA then a deal could be worked out today.
    In fact, the ASA could even let you have two or three more rural states as a show of good faith provided the AANA recognized the value of MD/DO Anesthesiology supervision in the rest of the country. The ASA and the AANA could issue a joint statement agreeing to a "truce" in the Anesthesia wars if the AANA would back off its desire to fight for Independence in EVERY state.

    In today's world surgeons have NO BUSINESS supervising a Nurse giving Anesthesia. Most know NOTHING about the field and are unable to help if a crisis occurs. Our patients deserve an MD/DO Board Certified Anesthesiologist in charge of their care. The ASA and the AAAA agree on this issue completely.

    The BATTLE continues because the AANA and some of its more militant membership want PRACTICE rights without the proper level of education.
    We are talking about large cities in the biggest States of the USA. These patients can afford and deserve an MD/DO Board Certified Anesthesiologist in charge of their care. Plain and simple. Nothing to do with Medicare in underserved areas at all. Everything to do with knowledge, education and training in Anesthesia. Surgeons lack the knowledge and training to supervise an anesthetic. The richest Country in the world should get the BEST Anesthesia care available. This means a Board Certified Anesthesiologist in charge of the anesthetic. A Nurse "playing" Doctor does not cut the mustard.

    As for the B.S. about most CRNA's not wanting the DNAP title it is irrelevant.
    The AANA which represents 95% of CRNA's is going along with the idea because it suites the agenda of total EQUALITY for Nurse Anesthesia.
    Nurses may be clinically sound but they are not Physicians and can not be EQUAL to one.

    I stand by my previous post that Anesthesia is a Physician specialty and this has helped the income of CRNA's. The AANA is riding the coat-tails of the ASA to boost the income of its membership. If Anesthesia is Nursing then you can expect a significant decrease in your income because Medicare is paying SOLO CRNA's Physician level reimbursement. So, which is it?
    Is Anesthesia Nursing? If so, solo CRNA's should get a 50% paycut today.
    Is Anesthesia the Practice of Medicine? If so, MD/DO's need a pay raise from Medicare (a big one). Right now, Medicare is splitting the difference and paying a very high Nursing level or a very low Physician level.

    The AANA needs to be careful for what it wishes for; it may just get it.
     
  47. mwbeah

    mwbeah Banned Banned

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    Nov 7, 2004
    I am a CRNA and will soon finish the PhD, my research area concerns neuroprotective maneuvers during fluid resuscitation following hemorrhagic shock (resulting in cerebral hypoperfusion and global ischemia). If anyone is interested I can definitely chat about that area for hours upon hours.

    Thanks,
    Mike

    PS
    I leave the area for a few hours and look at all the violent comments, sheesh..... :)
     
  48. mwbeah

    mwbeah Banned Banned

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    Nov 7, 2004
    My nametag will be CRNA, PhD but I will present myself to patients as "Mike" in the hospital and (soon) to students as "Dr." in the research and academic setting. But I don't think that having a Neuroscience PhD will be detrimental in the OR.

    But, all in all the bottom line however is that we (CRNAs) aren't going anywhere. As technology continues to advance medicine, this will create more and more procedures requiring anesthesia services. In addition as the population continues to increase in life expectancy, more and more procedures will require anesthesia services. Like I said, would you want to be the Representative or Senator that caused the shut down of healthcare services to hundreds of thousands of their constituents? :) Unless there is the instantaneous creation of hundreds if not thousands of anesthesia training programs, the need for anesthesia services will continue to overwhelm the availability of providers (both CRNAs and MDAs). Again we will be far dead and gone but this fight will continue and whoever can argue the best will have the upperhand. MDAs will attack us and we will respond, the AANA will attack other organizations and they will respond. Right or wrong its just that way it is........... as each organization protects their "herd".

    From a business standpoint, I know how productive a group of 8 CRNAs and 2 MDAs can be [I mean a good cohesive team that has mutual respect for each other]...... that is a gold mine right there (not to mention a great quality of life). When you trust each other, everyone has more money, more time off, and more fun!

    Think about that.........hmmmmmmm (all this fighting and no one stops to look at the business aspect....)
     
  49. mwbeah

    mwbeah Banned Banned

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    Nov 7, 2004
    My view on the "DNP": I think it is a bad idea and just "clouds the waters" (if you ever see my posts on other forums you will see that my view on that has been quite consistent).
     
  50. Conflicted

    Conflicted Banned Banned 7+ Year Member

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    Oct 17, 2006
    EtherMD

    These are tired arguments what is the point of re-arguing them?

    You dont have to believe what I said about the DnP but its simply the truth.

    Your definition of independence is No anesthesiologist. However, the legal definition of independence is not. CRNAs can currently practice in all US states "independently" based on your definition.

    I wont bother entertaining the other cyclic arguments as they serve no purpose and are 100% based on association (AANA/ASA) politics.
     

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