Wisconsin Hospital Replaces All Anesthesiologists With CRNAs

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coffeebythelake said:
Already another thread about this bro
Sad for patients who unknowingly seek care at this hospital
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thx, did not see that thread....agree with ur sentiment
 
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Members don't see this ad :)
I keep asking this question though. Where is the ASA hiding? Looks all that advocacy bs didn't work for us and we keep losing our ground. It sure worked for them (ASA) by collecting annual membership and conference fees.
 
Tony C anesthesia said:
I keep asking this question though. Where is the ASA hiding? Looks all that advocacy bs didn't work for us and we keep losing our ground. It sure worked for them (ASA) by collecting annual membership and conference fees.
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The appropriate response is that the ASA addresses this head on with physicians in their weekly email, addresses it with envision directly, and if envision still goes through with it they cut ties. Don’t give them a booth at the ASA meeting, stop taking their money. This would be a nice change from what EM has done for years and would send the message that the ASA’s priority is physician led care.

I’m not optimistic that will happen but it’s a nice thought.
 
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ambiturner said:
The appropriate response is that the ASA addresses this head on with physicians in their weekly email, addresses it with envision directly, and if envision still goes through with it they cut ties. Don’t give them a booth at the ASA meeting, stop taking their money. This would be a nice change from what EM has done for years and would send the message that the ASA’s priority is physician led care.

I’m not optimistic that will happen but it’s a nice thought.
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AMCs are very influential at the ASA leadership level.
 
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ambiturner said:
The appropriate response is that the ASA addresses this head on with physicians in their weekly email, addresses it with envision directly, and if envision still goes through with it they cut ties. Don’t give them a booth at the ASA meeting, stop taking their money. This would be a nice change from what EM has done for years and would send the message that the ASA’s priority is physician led care.

I’m not optimistic that will happen but it’s a nice thought.
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This is why I don't donate
 
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Planktonmd said:
AMCs are very influential at the ASA leadership level.
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This is why IDGAF about the ASA. They really do nothing for the anesthesiologists and more about funding their fancy trips, hotel stars and travel for "ASA-related activities". Yeah F that. I am keeping my $$$.
 
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cockblockandrun said:
This is why IDGAF about the ASA. They really do nothing for the anesthesiologists and more about funding their fancy trips, hotel stars and travel for "ASA-related activities". Yeah F that. I am keeping my $$$.
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That's exactly my point. Well-said!
 
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I totally get the frustration with the ASA... but please fund your state component societies. Politics are local, and lobbying costs money. God knows the state crna societies are more effective than the docs...primarily because they donate more. And that’s embarrassing and pathetic.
 
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Lecithin5 said:
I totally get the frustration with the ASA... but please fund your state component societies. Politics are local, and lobbying costs money. God knows the state crna societies are more effective than the docs...primarily because they donate more. And that’s embarrassing and pathetic.
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What's the opt out state gonna do? Become more opt out?
 
ambiturner said:
Don’t give them a booth at the ASA meeting, stop taking their money.
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This 100%. No excuse.

In another region, Envision is to Florida as stink is to ****. That state is smothered.

Were the docs and admin not getting along in Wisconsin?

was Watertown regional medical center spending too much to subsidize envision?

the local news article stated they will still have an anesthesiologist and on staff, why?
I think they don’t want to go all in.
 
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GassYous said:
What's the opt out state gonna do? Become more opt out?
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Well, I’m more specifically referring to the majority (for now) of states that are currently not opt out, or that are in the throes of the battle (ie Michigan). Look, you can’t expect apathy and not contributing any money to any cause to be fruitful. I’m not saying anything controversial here.
 
GassYous said:
What's the opt out state gonna do? Become more opt out?
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The next step is reimbursement parity (Medicare already does this but not private insurance) for CRNA solo care QZ with Anesthesiologist involved care.
Then the next step, if there are CAA's in the state, allow CRNAs to supervise and bill for CAAs.

The AANA is not hiding any of their strategies and goals.
 
dabears505 said:
The end is here
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I've been posting on this topic for 14 years on SDN. The "end" is NOT here but we are inching closer every year. Maybe, just maybe, in 10-15 years the AANA will have achieved enough wins to actually staff hospitals across the USA without anesthesiologists. What? You say they are doing that now? No. They are staffing rural facilities and outpatient centers. The goal is to actually staff medium sized hospitals in suburban USA without any supervision.

The DNP CRNA will be "equivalent" and "independent" providers of anesthesia along with their physician "colleagues." Nurse Anesthesiologist or Physician Anesthesiologist will both be independent providers. That's why a fellowship is crucial to your long term survival in the upcoming anesthesia provider war.
 
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BLADEMDA said:
I've been posting on this topic for 14 years on SDN. The "end" is NOT here but we are inching closer every year. Maybe, just maybe, in 10-15 years the AANA will have achieved enough wins to actually staff hospitals across the USA without anesthesiologists. What? You say they are doing that now? No. They are staffing rural facilities and outpatient centers. The goal is to actually staff medium sized hospitals in suburban USA without any supervision.

The DNP CRNA will be "equivalent" and "independent" providers of anesthesia along with their physician "colleagues." Nurse Anesthesiologist or Physician Anesthesiologist will both be independent providers. That's why a fellowship is crucial to your long term survival in the upcoming anesthesia provider war.
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And I'll be living on the cheap saving all my pennies for the next 15 years so that when/if this happens I can bounce.
 
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BLADEMDA said:
I've been posting on this topic for 14 years on SDN. The "end" is NOT here but we are inching closer every year. Maybe, just maybe, in 10-15 years the AANA will have achieved enough wins to actually staff hospitals across the USA without anesthesiologists. What? You say they are doing that now? No. They are staffing rural facilities and outpatient centers. The goal is to actually staff medium sized hospitals in suburban USA without any supervision.

The DNP CRNA will be "equivalent" and "independent" providers of anesthesia along with their physician "colleagues." Nurse Anesthesiologist or Physician Anesthesiologist will both be independent providers. That's why a fellowship is crucial to your long term survival in the upcoming anesthesia provider war.
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Blade, what practices would be more insulated? Would places like Kaiser or academics/VA be at least more likely to keep the existing docs and transition them to a "collaborative" model (while hiring more crnas to replace retirements), or would independent private practices have more say in their own choice of model?
 
dabears505 said:
The end is here
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The end is not here. The future is not at Watertown regional medical center. Looking at its physician roster is a glorified outpt surgery center. Do they even have an ICU? These hospitals are dying. Any remotely complicated case will get shipped to a hospital with anesthesiologists.

Let’s see the nurses take over a real hospital and maintain quality standards and then I’ll worry.

Nurses have and will continue to dominate the land of LMAs and one IV cases. If your diet consists of only these type cases you‘re in trouble otherwise you‘re fine.
 
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ryanjmy said:
The end is not here. The future is not at Watertown regional medical center. Looking at its physician roster is a glorified outpt surgery center. Do they even have an ICU? These hospitals are dying. Any remotely complicated case will get shipped to a hospital with anesthesiologists.

Let’s see the nurses take over a real hospital and maintain quality standards and then I’ll worry.

Nurses have and will continue to dominate the land of LMAs and one IV cases. If your diet consists of only these type cases you‘re in trouble otherwise you‘re fine.
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I agree. That's why you need to look for a group which staffs a real hospital. A facility with enough acuity and volume that CRNAs are highly unlikely to take over completely. While there is no guarantee, I don't see all CRNA groups taking over medium sized hospitals in suburban USA anytime in the next 10 years.
 
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ryanjmy said:
The end is not here. The future is not at Watertown regional medical center. Looking at its physician roster is a glorified outpt surgery center. Do they even have an ICU? These hospitals are dying. Any remotely complicated case will get shipped to a hospital with anesthesiologists.

Let’s see the nurses take over a real hospital and maintain quality standards and then I’ll worry.

Nurses have and will continue to dominate the land of LMAs and one IV cases. If your diet consists of only these type cases you‘re in trouble otherwise you‘re fine.
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That's my favorite kind of diet. 1 iv lma cases.
 
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GassYous said:
This is why I don't donate
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cockblockandrun said:
This is why IDGAF about the ASA. They really do nothing for the anesthesiologists and more about funding their fancy trips, hotel stars and travel for "ASA-related activities". Yeah F that. I am keeping my $$$.
Click to expand...

Tony C anesthesia said:
That's exactly my point. Well-said!
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This is precisely why they have to rely on AMC money... because physicians dont donate.... lobbying doesnt run on thoughts and prayers.
 
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GandalfTheWhite said:
This is precisely why they have to rely on AMC money... because physicians dont donate.... lobbying doesnt run on thoughts and prayers.
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I rather keep that money for myself than donating to an organization that is taken over and owned by AMCs.
 
vm26 said:
Wisconsin Hospital Replaces All Anesthesiologists With CRNAs (medscape.com)

scary
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This has made all sorts of new through a bunch of medical newsletters and websites, including the ASA Today email blurb, Medscape, and several others. I think this is a real WTF moment for some. I think it's one thing for a national company to come in and uproot an established group, which has happened all over the country. It's quite another to replace all the anesthesiologists with a CRNA-only group, thus significantly lowering the standard of care for that part of Wisconsin.
 
Is this new? Fairly uncommon, sure, but didn't most of the "CRNA only" rural hospitals have anesthesiologists at one time. Also, do we know how many were displaced?
 
nimbus said:
Seems like they could easily find new jobs in the current environment.
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Yup. But people hate to move. Especially people with children. Something about not wanting to disrupt their kids lives which makes no sense to me. Kids are resilient and people gotta eat. I have moved and somehow I adjusted. Moving continents, now that will screw up a kid for some time. Or maybe I am absolutely crazy and clueless to the fact. Maybe I never adjusted like I think I did?
 
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GandalfTheWhite said:
This is precisely why they have to rely on AMC money... because physicians dont donate.... lobbying doesnt run on thoughts and prayers.
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Nah- I was heavily involved with the ASA and my state society as a resident. I have first hand experience what goes on behind the scenes. While I agree regarding CRNA encroachment, a bigger issue is anesthesiologists throwing each other and selling out the specialty to AMCs. CRNAs are not the only boogeymen around.
 
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cockblockandrun said:
Nah- I was heavily involved with the ASA and my state society as a resident. I have first hand experience what goes on behind the scenes. While I agree regarding CRNA encroachment, a bigger issue is anesthesiologists throwing each other and selling out the specialty to AMCs. CRNAs are not the only boogeymen around.
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Are you still doing locums?
 
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linkin06 said:
www.opensecrets.org

PAC Profile: American Society of Anesthesiologists

American Society of Anesthesiologists raised $4,528,927 in the 2017-2018 election cycle. See the details.
www.opensecrets.org www.opensecrets.org


www.opensecrets.org

PAC Profile: American Assn of Nurse Anesthetists

American Assn of Nurse Anesthetists raised $1,925,840 in the 2019-2020 election cycle. See the details.
www.opensecrets.org www.opensecrets.org


why does AANA get so much more bang for their buck?
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The PACs donate to legislators. This corporate/hospital decision had nothing to do with that.
 
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D P356 said:
that’s not new. Don’t know about ASA response, but I believe SRNA schools lost some training sites due to this.
@AdmiralChz can chime in.
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Correct. Same repackaged garbage they've been spouting for years. SSDD.

Finally some folks are waking up about "why are we training someone who says we're unnecessary?"
 
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AANA: We don't need anesthesiologists! CRNAs are the answer!

Also AANA: The anesthesiologists won't train our students! Protectionism!
 
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linkin06 said:
www.opensecrets.org

PAC Profile: American Society of Anesthesiologists

American Society of Anesthesiologists raised $4,528,927 in the 2017-2018 election cycle. See the details.
www.opensecrets.org www.opensecrets.org


www.opensecrets.org

PAC Profile: American Assn of Nurse Anesthetists

American Assn of Nurse Anesthetists raised $1,925,840 in the 2019-2020 election cycle. See the details.
www.opensecrets.org www.opensecrets.org


why does AANA get so much more bang for their buck?
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because it is politically incorrect to stay anything bad about any form of nursing. It is perfectly acceptable, however, to complain about greedy doctors. If you so much as point out that some random NP somewhere is not as well trained as an internist or family medicine doc, you are all of a sudden surrounded on all sides by nurses from every random area talking about how much they care for patients and put patients first and on and on and on.
 
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AAs need to be supported and we need to open up at least 100 AA schools in the next 10 years. That should be the goal.... Why would you continue to train CRNA students whose membership's central theme and rhetoric is Anesthesiologist are 1) useless 2) not as good 3) un necessary 4) too expensive ) etc etc etc . It is completely idiotic. And the fact that ASA has not gotten on that talking point should give you pause about writing out a check to them...... Makes you wonder who is running and supporting the ASA mission. ? hmmmm.. Perhaps private equity?
ASA is not beyond that..

DEfund the ASA if they do not champion this issue.
 
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Aheadbyacentury said:
AAs need to be supported and we need to open up at least 100 AA schools in the next 10 years. That should be the goal.... Why would you continue to train CRNA students whose membership's central theme and rhetoric is Anesthesiologist are 1) useless 2) not as good 3) un necessary 4) too expensive ) etc etc etc . It is completely idiotic. And the fact that ASA has not gotten on that talking point should give you pause about writing out a check to them...... Makes you wonder who is running and supporting the ASA mission. ? hmmmm.. Perhaps private equity?
ASA is not beyond that..

DEfund the ASA if they do not champion this issue.
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Thanks for your support of CAAs.

The ASA is quite supportive of the CAA movement. They work quite closely with us (the AAAA) on expanding CAA education and practice. CAAs are on a number of ASA committees and on the board of ASA-PAC, and the ASA has representation on a number of CAA organizations.

We work closely with the state component societies on expansion of AA practice. Getting enabling legislation passed is expensive, and as you might imagine, there is immediate and fierce opposition from the nurses. There are a number of states in play this year.

The number of AA schools and graduates is increasing every year (two new programs in FL, a couple others in the planning stages). As we continue to expand, it becomes easier to recruit folks interested in the academic side of the profession.
 
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jwk said:
Thanks for your support of CAAs.

The ASA is quite supportive of the CAA movement. They work quite closely with us (the AAAA) on expanding CAA education and practice. CAAs are on a number of ASA committees and on the board of ASA-PAC, and the ASA has representation on a number of CAA organizations.

We work closely with the state component societies on expansion of AA practice. Getting enabling legislation passed is expensive, and as you might imagine, there is immediate and fierce opposition from the nurses. There are a number of states in play this year.

The number of AA schools and graduates is increasing every year (two new programs in FL, a couple others in the planning stages). As we continue to expand, it becomes easier to recruit folks interested in the academic side of the profession.
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The CRNA rhetoric against physicians is divisive, inaccurate, unfounded and dangerous to patient care. THe ASA needs to STOP spending any money fighting them and just full steam ahead start spending money on supporting legislation to replace them. Start spending money wisely with active campaign in support of AAS who support the team concept. IF CRNAS want to be independent, which is what they teach their students... let them be independent.. Meanwhile AAs will be taking the jobs going forward. And as the baby boomers start to retire.... things will change
 
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Aheadbyacentury said:
The CRNA rhetoric against physicians is divisive, inaccurate, unfounded and dangerous to patient care. THe ASA needs to STOP spending any money fighting them and just full steam ahead start spending money on supporting legislation to replace them. Start spending money wisely with active campaign in support of AAS who support the team concept. IF CRNAS want to be independent, which is what they teach their students... let them be independent.. Meanwhile AAs will be taking the jobs going forward. And as the baby boomers start to retire.... things will change
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I think this is the way forward.
 
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Aheadbyacentury said:
The CRNA rhetoric against physicians is divisive, inaccurate, unfounded and dangerous to patient care. THe ASA needs to STOP spending any money fighting them and just full steam ahead start spending money on supporting legislation to replace them. Start spending money wisely with active campaign in support of AAS who support the team concept. IF CRNAS want to be independent, which is what they teach their students... let them be independent.. Meanwhile AAs will be taking the jobs going forward. And as the baby boomers start to retire.... things will change
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Sadly in most states, the opposite is the strategy. Typically CAA legislation is used as a pawn or threat in order to stave off a CRNA independent practice bill. It kind of reaches a point of trench warfare stalemate where the state Anesthesiologists don't aggressively push for an AA bill and the NAs don't aggressively push for an independent practice bill. In the end, physicians will be the suckers left holding the bag because the NAs aren't going to just sit back and not push for independent practice. It'll happen eventually, and if it happens in your state, wouldn't you want to be able to have the option to hire AAs instead? Unfortunately, in my experience, many states are going to be caught off guard when CRNA independent practice passes in their state and they didn't preemptively try to get AAs in--now there's no threat for the CRNAs and they can fully mobilize against a reactionary AA bill.
 
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