Is the AA profession gaining ground?

The truth hurts!

It took three years to get the Florida legislation passed for AA's. In the end, many of those who initially opposed the legislation voted for it because they finally figured out they'd been lied to.

And you don't think the ASA is guilty of "dirty" politics. Give me a break...I just find it funny that my post at the top of the page didn't get any response from paindoc or jwk. Oh well.

If the truth hurts, that might explain the A$A aversion to it.

Ask your boss if he still goes around claiming to have done 300,000 cases by himself.


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I assume this is the post you're referring to.

AA's and CRNA's working in the same practice (this includes mine) with the same # of years in anesthesia practice have identical base salaries. A new grad AA and new grad CRNA get an identical package. A 10 yr AA and 10 yr CRNA get an identical package.

Does this answer your question?

yep...but according to paindoc in another post, AAs where paid less than CRNAs and therefore a better option to employ AAs rather than CRNAs. Just curious is all.

That's your first mistake. Paindoc has also stated that the average general surgeon, oncologist, pulmonologist, neurologist, etc, makes in the 120's to 130's in a major metropolitan area in the Midwest (Chicago). Paindoc has a handful of agendas. Accuracy aint one of them.

You have to realize that the push for more AA's schools by the ASA has nothing to do with providing more qualified anesthesia providers for the benefit of the patient. With CRNA's having identical safety records as MDA's, and being able to provide the same record for less money, MDA's will do everything they can to limit the practice of CRNA's to protect their pockets. CRNA's are gaining more and more autonomy in every state and MDA's see this as an infringement on THEIR turf. The solution? AA programs, which require MDA supervision, thus keeping the hierarchy intact and protecting their pockets.

On another board the MDA's are routinely furious about CRNA's. They say the ASA is doing nothing to protect them and have said they are starting their own anti-CRNA PR campaign to inform and educate the public. My favorite part about this campaign? One poster said, "If we plan on doing this, we'll need some really good outcome studies..." The response, "We don't need outcome studies. We'll highlight the training differences between the two..." I could NOT stop laughing at that! In other words, "Results don't matter. It's slant and spin." I love it! All this talk about how far superior MDA's are to CRNA's and not a study to back it up! In an industry where everything must have data and evidence, it's being dismissed as unnecessary in this case.

If a med student did their residency but decided to do 8 years in anesthesia instead of the usual 4 (numerous fellowships let's say), that person would be far better trained and have far superior outcomes when it comes to morbidity and mortality rates, correct? Maybe even twice as good as the typical MDA? Of course not. 8 years of residency is not necessary to provide safe anesthesia services. So, the question is, how much is necessary? And how would you measure it? The measuring part is easy and has already been defined: morbidity and mortality rates. How much training is necessary to provide identical morbidity and mortality rates of MDA's? CRNA's have already answered that question as well.

I am a CRNA and work in Wisconsin. I have been reading all of the posts regarding AA’s vs CRNA’s and I have some comments to add. First, the AA’s can defend the fact that knowledge in sciences better prepares a practitioner for the OR. Granted, some biochem is useful during patient care, but not essential. As other people have pointed out, most MD’s/CRNA’s forget a lot of the basic sciences they learn in the beginning of their education. I work with MDA’s and their day to day clinical knowledge is comparable to that of CRNA’s. However, does this mean that I think that because they may have forgotten some of nonessential facts that the education of the MDA is interchangeable with a CRNA. The answer is no. On the other hand, I don’t think academic knowledge equals quality care. I think it can influence it, but quality of care is very individual. Throughout my education, I have worked with many brilliant people(CRNA’s, MDA’s, RN’s) that were book smart but were poor practitioners.

I think that the bigger issue here is the economics of healthcare. Flat out, I believe that wages will not continue to soar as they have. Even though we are facing an enormous anesthesia provider deficit, cuts are coming. Reimbursement is becoming less and less, not only for anesthesia providers, but for surgeons as well. The decrease in reimbursement is going to cause wages to drop and this drop will drive a lot of potential providers from the field.

The problem of not enough anesthesia providers has to be addressed. Studies have proven that educating MDA’s if far more expensive than CRNA’s. I don’t know the cost of educating AA’s. However, as I stated before, if salaries of MDA’s drop from 400,000 to 200,000, there will be a drop in the number of doctors that enter the profession. I am not saying that MDA’s go into anesthesia for the money, but they have to make enough to pay for their education. I believe that the anesthesia care team will be the standard. Who will make up this team will be determined.

I understand that AA’s are proud of their profession and have every right to defend it, but our professions nor are our educations equal. Along the same line, a MDA’s education or profession is not equal to that of a CRNA. MDA’s have much more education and this education is medically focused beyond the basic sciences. I believe that MDA’s are better suited to care for patients postoperatively because of this advanced education. They cared for patient throughout there medical school education. Along the same line, CRNA’s are better equipped to care for patients secondary to both their nursing education and experience compared to AA’s. This is not to say that there isn’t a place for AA’s, nor that some AA’s are not better practitioners than some CRNA’s. I do believe that AA’s cannot and must not use their credentials interchagably with that of a CRNA. AA’s cannot practice independently. In addition, a CRNA must not and should not compare their education with that of an MDA. However, what can be compared is quality of care. With that said, there is not any difference between CRNA’s vs MDA’s in regards to quality of care and I believe the same will be established for AA’s vs. CRNA’s.

I think that the idea that AA’s will replace CRNA’s is just not true. As others have pointed out, there are just a handful of schools with just a few AA’s practicing. AA’s have been around for a long time and if the ASA truly felt that AA’s could replace CRNA’s then that would have happened. If AA’s were interchangeable with CRNA’s, then why haven’t their numbers increased of the last twenty years?

Well... I read THAT and absolutely laughed MY you know what off. Smearing a profession with no outcome studies to back it up?? Why the audacity of it!!! You guys kill me.

How is that any different from what you CRNAs and your beloved AANA are doing to AAs in their smear campaign across the country. Same exact thing.. no studies showing any difference at all, just as you said "slant and spin" highlighting training and experience differences. You guys are such hypocrites.

Please don't lump me into that group. I have two very good friends who are beginning AA programs: one at Case Western, one at Emory. We look forward to one day all coming back to CO and working together when we've all graduated. Maybe I'm in the minority but I actually welcome AA's. There is PLENTY of work for all of us for many, many years to come.

Well said. i can't wait to be a member of the AANA. i'm not even out nursing school yet but i'm still excited to know i'll be a member of the greatest lobbying Associations in any nursing specialty in the very near future, if God permits.