At least one good has come from this CRNA mess. It has shown other medical specialties what the natural course is if you let a group of midlevels become dedicated to your specialty. No specialty should allow midlevels to obtain a degree or certificate that legitimizes them in that specialty. It allows them a way to identify with each other and organize. There is a fledging midlevel movement in radiology called RPA (1 school, 300 alumni). The radiologists are trying to squash it before it becomes a problem. The specialized midlevels can become a threat only if they have the support of the specialty.
I'm just sorry to see the sad state of affairs in anesthesiology. The damage is irreversible at this point.
The damage is not "irreversible" at this point. The Mid-Levels can be contained for the next three to five decades by promoting the use of AA's.
In 50 years the MD Anesthesiologist may be extinct anyway as advanced computers take over the specialty (see Star Trek sick bays). Thus, the specialty can be saved for at least thirty more years if not fifty by fighting the AANA, stopping all academic CRNA programs and promoting AA schools.
The window of opportunity for stopping the AANA is still open (for now anyway).
I am 100% convinced this solution will work to stop the AANA advancement on our specialty. Of course, it takes cooperation from the ASA and Academic Chairs to get this done. So, even though I beileve in the solution I do not believe the resolve exists to implement it.
As for Choosing Anesthesiology all over again I would Pass on it. This is not to say I am unhappy with the money, the hours, the job or the specialty.
Anesthesiology has been very, very good to me personally and financially.
My Residency training was Outstanding and the best experience of my life.
However, the AANA Independence Issue combined with the Medicare reimbursement rate (CRNA level pay) would steer me to my second choice:
Cardiology. There are no Mid-Levels doing Interventional Cardiology and the future looks bright for the specialty. This would be my choice today and others may choose something else. Cardiology is not a lifestyle specialty and is very susceptible to Medicare cuts as well. But, there are no Nurses placing Stents or reading Echo's and I doubt there ever will be.
Those of you who are entering the specialty and those considering the field need to realize that we are not doomed yet. We are still in control of the our destiny and can still stem the tide of the AANA/CRNA Solo Practice Issue.
I view Medicare rates and CRNA "solo" practice as the same issue. If we want to be paid as a Physician we need to make sure a Physician is required for the care of the patient. The AANA has no business lobbying Medicare for anything. They are Nurses and less than 20% (I believe 10%) practice Independently. We have the means (Academic Programs) to replace a large number of CRNA's with AA's over the next 5 years. But, do we have the will and the vision to do so? Some fail to see the wisdom of another Mid-Level Provider in the operating room. Too bad, because the AA is the ONLY Mid-Level Provider to official recognize the value of a Board Certified Anesthesiologist. The AA is the ONLY Mid-Level provider to legally need a Board Certified Anesthesiologist to supervise them. In short, the AA is the best option we have for explaining to the Public and the government that we are essential to the care of patients in the operating room.
. If you're good at what you do, the money will come... even with all the predicted cuts, gloom-and-doom crap I've been hearing about.