Anesthesia in Dr. Offices

Go to gaswork.com and waalaa.

An anesthesia practice based mostly in office settings usually results after a fairly long history. In other words, you have to do your homework, and pay your dues.

Office anesthesia is only appropriate for providers with experience in more traditional settings. This does two things for you. First, of course, you build the clinical skills and expertise neccessary to function in multiple types of environments, using equipment that (while meeting all safety standards) is not always the most recent model.

But also, you build professional relationships. People who are in office practice don't just look for openings, and fill out an application. It is more of a buisnessman to buisness man negotiation. It is a contractual relationship. It takes strong business skills, as well as anesthesia skills.

So your pay is going to be a direct result of what type of contract you are able to negotiate. CRNAs in these settings sometimes choose to do their own billing. You have to think "independent contractor". You are not usually an employee in these settings. So you have no guaranteed paycheck, no benefits.

It is a different mindset than what most nurses are used to.

I am sure Yoga will explain it better, I don't have the direct experience with that Yoga does!

loisane crna

Loisane,
I could not have said it any better than you did, but I will add some additional observations.

You are very much alone in an office setting with no back-up personnel and even limited equipment back-up. You must be (1) very self-confident, (2) very experienced, (3) possess strong clinical and interpersonal skills, and (4) very flexible.

You get an office practice by marketing yourself, being able to provide the service and knowing the business of anesthesia. Most of us who have practiced in the office setting have set up a private practice business and have negotiated contracts and have a strong understanding about finances, such as reimbursement models and business finances.

I think office surgery is going to be regulated in the near future and probably a CRNA with less than 5 years experience will not be able to get malpractice insurance coverage for office practice.

I just heard yesterday of a patient who arrested at the end of a rhinoplasty procedure in an office setting. She is a coma. The anesthesia provider was an MD (big sigh of relief here), but I have reviewed many legal cases where a CRNA was the provider.

One last thing--no coffee breaks, no lunch breaks, no regular hours--yesterday, I put in 12 hours without a break.

I know I sound negative, but this is one practice setting where you have to pay your dues before you start it. There are a lot of positives--no shifts, no call, no OB, good reimbursement and a wonderful opportunity to be a true professional.

YogaCRNA