aa's - page 2

how many states are aa's practicing in currently? how close are they to getting approval in other states? I guess what i'm worried about is the fact that i'll be $140,000 in debt with student loans... Read More

  1. by   Sheri257
    This has been posted on other threads. But I believe there are only 700 AA's nationwide, and only two schools. I believe they just need a bachelor's, which can be in anything (English, for example) and some pre-req science courses. After that, the AA program itself is about seven semesters or less than two and a half years. No nursing degree, no ICU experience, no RN license, etc. required.

    While AA's are currently not much of threat, I think the concern revolves around future trends and things like the above mentioned ad. I now understand why D.C. CRNA's are fighting the AA issue if this ad is any indication, and if D.C. hospitals are looking to hire AA's at comparable salaries.

    :uhoh21:
    Last edit by Sheri257 on Apr 15, '04
  2. by   suzanne4
    Thanks for the info. Had never heard of them before...........
  3. by   Sheri257
    Incidentally, here's a link from ASA that compares AA's versus CRNA's. Some of it is inaccurate since, for example, the Georgia program does not require a BS.

    http://www.asahq.org/asarc/AA-CRNA_Comparison.pdf

    http://www.emory.edu/WHSC/MED/ANESTH...dmissions.html

    But it does mention that eight states license AA's, and D.C. and Texas AA's operate under "delegatory authority."

    Speaking of Texas, $180,000 for an AA position there?

    http://www.gaswork.com/cgi-bin/ipblt...ostIDNum=20813

    I don't know if that's for real but, apparently, the D.C. ad is. From what I understand, the hospital testified that $120,000 is what they pay AA's.

    Last edit by Sheri257 on Apr 15, '04
  4. by   clickhere
    Quote from user69
    I think AAs have been practicing for about 30 years.

    From Emory's Website:
    "Emory[font=WP TypographicSymbols]=s AA/APA program has been at the Masters level since 1969 when it admitted its first class, and has grown from 24 months to 27 months duration. Emory grants a Master of Medical Science (MMSc) in Anesthesiology and Patient Monitoring Systems."

    That would be over 30 years, and according to Emory there are 545 practicing AA's.
  5. by   user69
    Thanks for posting the comparison between AAs and CRNAs. But one thing looked a bit off. It said that one third of all practicing CRNAs do not have an undergraduate degree. Can that be correct?
  6. by   deepz
    Quote from user69
    Thanks for posting the comparison between AAs and CRNAs. But one thing looked a bit off. It said that one third of all practicing CRNAs do not have an undergraduate degree. Can that be correct?

    Many things 'look a bit off' when one professional group tries to define and denigrate their competition. Perhaps the A$A means that one third of CRNAs entered the field before a bachelor's degree was required for entry into anesthesia schools? Perhaps their info is dated ... BTW at last count there are 31,000 CRNAs serving America, not 24,000 as the A$A asserts.

    600 some is the total number of AA graduates in the past 30 years, a couple hundred of whom no longer practice as AAs, according to a past president of their group.

    deepz
  7. by   Athlein1
    Clarification: the Emory AA program requires a bachelor's degree, as it awards a master's degree.
    Also, note that Emory admits that 10% of its AAs go on to med school, and another 2-3% go on to further education. A 12-13% attrition rate from the AA profession is a revealing statistic, don't you think?
    And, for all you worriers and ruminators out there, understand this. CRNAs have been providing anesthesia in this country for decades. We are here to stay. In what capacity we will be able to practice depends on our continuing support of our national organization and political involvement to protect our practice rights at the state and national levels.
    MDAs are here to stay, too. Whether you choose to work with them in a medically-directed anesthesia care team setting or work under your own direction is your decision.
    When you are an AA, you do not have the luxury of that decision. You are always medically-directed, always supervised, always controlled. It is an inherent part of the job description.
    Do not make the mistake of comparing the quality and scope of care that CRNAs provide to that of AAs. The practices are not interchangeable. Period.
    Equal salary? Perhaps - in this isolated instance. Equal scope of practice? Certainly not.
  8. by   mato_tom
    Quote from Athlein1
    Clarification: the Emory AA program requires a bachelor's degree, as it awards a master's degree.
    Also, note that Emory admits that 10% of its AAs go on to med school, and another 2-3% go on to further education. A 12-13% attrition rate from the AA profession is a revealing statistic, don't you think?
    And, for all you worriers and ruminators out there, understand this. CRNAs have been providing anesthesia in this country for decades. We are here to stay. In what capacity we will be able to practice depends on our continuing support of our national organization and political involvement to protect our practice rights at the state and national levels.
    MDAs are here to stay, too. Whether you choose to work with them in a medically-directed anesthesia care team setting or work under your own direction is your decision.
    When you are an AA, you do not have the luxury of that decision. You are always medically-directed, always supervised, always controlled. It is an inherent part of the job description.
    Do not make the mistake of comparing the quality and scope of care that CRNAs provide to that of AAs. The practices are not interchangeable. Period.
    Equal salary? Perhaps - in this isolated instance. Equal scope of practice? Certainly not.

    any data on % of cases for CRNAs that ARE medically directed by an MDA?
  9. by   deepz
    Quote from mato_tom
    any data on % of cases for CRNAs that ARE medically directed by an MDA?

    The A$A will tell you that MDAs 'control' 90% of the anesthetics in America.

    Don't believe it.

    Half the hospitals in America use CRNAs only.

    deepz
  10. by   Sheri257
    Question for the CRNA's here: I've always assumed the reason MDA's were pushing for AA's was to take control away from CRNA's and, essentially, make more money off of AA's by paying them less.

    However, if these ads are any indication, they're paying AA's a lot of money. I'm told the $120,000 salary in D.C. is for real and, apparently, it's what they're offering both CRNA's and AA's for that position. Supposedly, this hospital is the primary proponent of AA's in the D.C. dispute.

    So, the question is, if they're paying such high salaries, what's in it for them? What difference does an AA make in a situation like that, versus a CRNA if they cost the same? And why would they be fighting with the city council to keep AA's if they cost just as much?

    I'm cynical by nature, and don't necessarily believe it's because they're concerned about the current shortage. Although I suppose that could also be a reason.

    I tend to agree with deepz's A$A designation. This has got to be about the money. I'd just like to understand how this works for them.

    Last edit by Sheri257 on Apr 16, '04
  11. by   jbro
    well spoken.

    Quote from Athlein1
    Clarification: the Emory AA program requires a bachelor's degree, as it awards a master's degree.
    Also, note that Emory admits that 10% of its AAs go on to med school, and another 2-3% go on to further education. A 12-13% attrition rate from the AA profession is a revealing statistic, don't you think?
    And, for all you worriers and ruminators out there, understand this. CRNAs have been providing anesthesia in this country for decades. We are here to stay. In what capacity we will be able to practice depends on our continuing support of our national organization and political involvement to protect our practice rights at the state and national levels.
    MDAs are here to stay, too. Whether you choose to work with them in a medically-directed anesthesia care team setting or work under your own direction is your decision.
    When you are an AA, you do not have the luxury of that decision. You are always medically-directed, always supervised, always controlled. It is an inherent part of the job description.
    Do not make the mistake of comparing the quality and scope of care that CRNAs provide to that of AAs. The practices are not interchangeable. Period.
    Equal salary? Perhaps - in this isolated instance. Equal scope of practice? Certainly not.
  12. by   Laser
    Whether anyone likes it or not, the general public sees the MDA world as the preeminent anesthesia authority / leader in this country and this seems reasonable to me. They possess a graduate medical education in anesthesia and are by definition experts. On the other hand, ask any 100 or so people on the street what a CRNA is, or does. I know that the vast majority will not know. Fortunately for the CRNA world, demographics have been good to us throughout the years. (I say us as a wannabe CRNA). Unfortunately, no one knows who we are. This has to be dealt with if we are to equitably differentiate ourselves within the anesthesia community.

    Why are MDA's pushing AA's? It's political. Everything I see and read tells me that it's about controlling the profession of anesthesia, which by the way, they have been largely successful at. There is a part of me that wants to say, ok, cool. After all, they are the MD experts. Unfortunately, the ASA doesn't think like mother Teresa. I personally have no problem working with MDA's in a collaborative relationship. The care team concept is reasonable and provides for a high quality patient care. The vast majority of surgeons and MDA's that I have worked with are great people both personally and professionally and they value the intrinsic worth of nurses. But, let's face it; the ASA political leadership has an agenda and they are very up front about it. If you have any doubts, just look at the article in the April 2004 issue of the AANA Journal, "Standards of Care and the ASA Medical Direction Statement" on page 91. Look at medicare's November 13, 2001 Federal Register: "A final rule concerning the federal Medicare and Medicaid physician supervision requirement for Certified Registered Nurse Anesthetists." This was a major victory for the ASA. Think about how much time is being spent by state CRNA Associations to try and minimize the impact on CRNA practice. Fortunately, some states have successfully opted out.

    Although there are not that many AA's at this time, demographics are now helping the AA cause. I genuinely feel that they will be a force to be dealt with within the mid to distant future by virtue of the ASA pushing for them. Think about how many medical school anesthesia departments are capable of absorbing AA classes. The ASA has power, both real and perceived. The recent push for using more AA's is not happening accidentally.

    From my point of view, AA's coming up in the world isn't the end of the world. It's going to take some time for their numbers to reach significant levels. The real challenge is how CRNA's differentiate themselves from MDA's /AA's in the public's mind. Heck, the general public doesn't even know what a CERTIFIED REGISTERED NURSE ANESTHETIST is. Do you think they might imagine what an ANESTHESIA ASSISTANT is? I think so. I can already hear some, not all, MDA's referring to CRNA's as there assistants.

    We all know that a CRNA's scope of practice encompasses more than AA's scope of practice. AA's can not practice independently anywhere. This along with other issues needs to be differentiated. In the end the CRNA profession really needs to differentiate themselves and it has to be simple so that the public knows who we are and what we do. I believe that the future is bright for CRNA's. CRNA's have over 100 years of providing quality anesthesia care. This is powerful stuff....


    Man, I can't wait to get started.
  13. by   smk1
    Quote from lizz
    Question for the CRNA's here: I've always assumed the reason MDA's were pushing for AA's was to take control away from CRNA's and, essentially, make more money off of AA's by paying them less.

    However, if these ads are any indication, they're paying AA's a lot of money. I'm told the $120,000 salary in D.C. is for real and, apparently, it's what they're offering both CRNA's and AA's for that position. Supposedly, this hospital is the primary proponent of AA's in the D.C. dispute.

    So, the question is, if they're paying such high salaries, what's in it for them? What difference does an AA make in a situation like that, versus a CRNA if they cost the same? And why would they be fighting with the city council to keep AA's if they cost just as much?

    I'm cynical by nature, and don't necessarily believe it's because they're concerned about the current shortage. Although I suppose that could also be a reason.

    I tend to agree with deepz's A$A designation. This has got to be about the money. I'd just like to understand how this works for them.

    Not a crna or srna but have read that some of the concerns are regarding the fact that MDA's can directly decide which cases AA's will or will not take. Because AA's practice is governed by the AMA doctors have control over their expansion. This is not the case with CRNA's because they work under their own license and are governed by the BON. This could be at least part of the problem. If CRNA's can bill for the same amount and have their own practice then that would cut a doctor out of the equation, this couldn't happen with an AA because they require a collaboration of some sort. Someone let me know if I am completely off base here !

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